University of Virginia Health System

Modern Medicine Finds Useful Tool in Ancient Practice

  Yes, but it is not a contradiction to say that it helps free a patient of pain rather than causing pain. Originating in China, the procedure has been around for a long time - some 2,500 years, in fact. Practitioners of acupuncture use needles, which are inserted at predetermined points around the body. Often used as a way of promoting health as well as fighting disease, acupuncture’s goal is to bring about a change in the medical condition or a change in the body itself.

In Western countries, acupuncture has long been considered a "non-traditional" or "Eastern" practice, but it has now come into its own - increasingly recognized as a useful and effective treatment for pain. Some UVa Medical Center staffers might be surprised to learn that UVa has been offering patients acupuncture since May of this year.

Go up to the third floor of the Musculoskeletal Center, the location of the Department of Physical Medicine and Rehabilitation, and you will find UVa’s acupuncture practice. Here,  Dr. Alan P. Alfano, the department’s licensed medical acupuncturist, as well as being a board-certified physiatrist, regularly treats patients with acupuncture for a variety of painful conditions. Moderate to severe, they include low back pain, neck pain, sports injuries, headaches, nerve pain, arthritic pain, and other painful conditions.

Still concerned about needles? Actually, the patient hardly feels anything. Acupuncture needles are about two to three inches long. When inserted by the acupuncturist, most patients feel no more than a slight pinch. The procedure itself is almost without any sensation, although some patients report a "heaviness," "numbness," or a "tingling sensation." Many patients, in fact, fall asleep during the treatment.

The needles are sterile and disposable - used only once to avoid any chance of infection. Occasionally, the acupuncturist may manipulate the needle by hand or with a small electronic device, depending on the condition being treated.

Treatments take approximately 20 minutes, but they can vary, again depending upon the patient’s condition. "We usually know if the acupuncture is effective within the first three to six treatments," says Dr. Alfano. "Occasionally, we see a marked difference in only one treatment."

How acupuncture actually works has been hard to pin down. In recent years, however, it has been the subject of an increasing amount of research. Medical scientists already know that the body releases a number of chemicals, called endorphins, into the bloodstream. these chemicals act much like morphine. The application of acupuncture appears to stimulate the release of these chemicals, which, in turn, are beneficial in relieving pain.

Acupuncture can be used in conjunction with individualized exercise and conditioning programs - which is the way it is usually being used at the UVa Medical Center. Acupuncture is particularly useful in decreasing pain levels to the point where the patient can participate in the activities of daily living, including sports activities.

"The use of acupuncture for difficult pain problems is often accompanied by an exercise program that complements acupuncture treatment," says Alfano. "This is our typical approach in the Physical Medicine Department at UVa."

Alfano, who obtained his M.D. degree from Jefferson Medical College in Philadelphia, formerly had a private practice in Fredericksburg, Va., before joining UVa. He received his acupuncture training through the University of California at Los Angeles, which has a course tailored to physicians.

Why would a patient choose to have acupuncture? Alfano says it’s often a matter of personal preference. "Some people don’t like to use pain medication," he explains, "and acupuncture is a reasonable alternative to pain medication, especially for those who can’t tolerate the medications most commonly used."

Acupuncture, he says, is a very versatile procedure and can be used with, say, psychotherapy, biofeedback and more traditional pharmacological interventions.

Those with arthritis, for example, often encounter the problem of using medications that can be relatively toxic and which can cause problems with the liver, kidney and stomach. In many of these situations, acupuncture may be a good choice.

"Look at it this way," says Alfano. "It’s a fact that many pain management medications are mind-altering in some respect. Many, for example, make you sleepy, irritable or confused. Acupuncture, on the other hand, introduces no chemicals into the body, yet produces relaxation and analgesia."

Again, Alfano stresses, the procedure is a sensible alternative to more western approaches to managing pain, which usually emphasizes the use of medication.

"Acupuncture," says Alfano, in describing the procedure’s advantages, "is a useful complementary technique along with something else that can be tried simultaneously. But it should not be a we’ve-tried-everything-else-so-let’s-try-acupuncture approach." Acupuncture, in other words, should be used as part of the patient’s overall treatment program, not as a final resort.

Medical center staff members and others who might be thinking about acupuncture for their pain and are concerned about payment should follow their insurance guidelines, Alfano advises. Current guidelines in the acupuncture practice suggest physician referral, but this is not a requirement for making an appointment, he says.

Today, the use of acupuncture for a variety of pain situations is gaining momentum across the country. The increased interest in acupuncture’s value and efficacy points to the need for further research into determining outcomes measurements. The National Institutes of Health, through its Office of Alternative Medicine, for example, is funding acupuncture research around the nation.

Sums up Dr. Alfano, "In my practice, it is an important weapon in the battle against pain."

Now that didn’t hurt a bit, did it?

Reprinted from Link, News & Information for the UVa Health System, November 18, 1996. Volume 8, Number 18.