Alternative Medicine
Acupuncture
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The History of Acupuncture in the United States
Acupuncture has been part of Eastern medicine for centuries while in the West, it has been looked upon with great skepticism. However in 1970 interest in the practice was sparked when James Reston, a New York Times reporter traveling with President Richard Nixon's entourage to China , required an emergency appendectomy. Given acupuncture for post-operative pain and nausea, Reston wrote about his experience upon returning to the United States . This brought acupuncture to the attent i on of the Western world and challenged lay persons as well as physicians to look more closely at the benefits of this ancient practice.
A few traditional Western medical centers then began exploring acupuncture's claims. In 1975 the Mayo clinic brought over a medical team from China and experimented with acupuncture for anesthesia. This event opened the doors for the serious study of acupuncture as a viable alternative to mainstream medicine. Today some university and hospital centers teach the practice. The Helms Institute at the University of California at Los Angeles , for example, offers a certification in acupuncture for physicians. Craig Hospital in Denver , Colorado now has a department of Oriental Medicine.
Who Should Consider Acupuncture?
Acupuncture is worth considering as a pain control option for:
- Those who need surgery but are at a risk for anesthesia
- Those in chronic pain for whom medication is ineffective
- Persons for whom use of narcotics is ill advised
Concern over triggering seizure activity or suppressing respiration are two reasons physicians may be reluctant to give anesthesia to someone with brain injury.
Chronic pain can be an issue for persons with brain injury because of painful conditions that often occur with the trauma. Physical injuries to the musculo-skeletal system (such as fractures) as well as changes in the brain's wiring that can cause involuntary muscle contractions (spasticity) are the most common. Muscle tears, nerve pain, pain from heel cord lengthening, backache, headache, and discomfort resulting from asymmetrical growth can also be sources of pain. Because of the complexity and multiple types of pain, medications may not be always be effective, especially when the pain is chronic.
Narcotics, which in Western medicine are the treatment of choice for pain, cannot be a long-term solution for pain in persons with brain injury. Narcotics have a sedating effect on both respiration and cognition—the opposite of what is needed when the goal is to awaken the body and mind. Also, physicians and family must keep in mind that brain injury is for life and the potential for substance abuse of narcotics, if prescribed, is high. Even when traditional remedies are used, acupuncture may offer an individual a break from medications that may be harmful if overused.
Acupuncture is still not well known or widely accepted by physicians in the United States . Yet many persons who are limited in their options for pain management are understandably interested in trying this course of treatment. It may be helpful and in skilled hands, it should do no harm.
How Does It Work?
The Chinese call the ultimate release of energy in the body, Qi (chee) and assert that illness and pain are the result of blocked Qi. The practitioner seeks to release the Qi by inserting very fine needles at the places where major energy points connected to the problem area, intersect. A procedure called electro-acupuncture is the type of acupuncture generally used for pain relief and prevention. It involves using small amounts of electrical stimulus in conjunction with the needles. The strength of the stimulus (which can range from 50 to 2,000 Hz) depends on the purpose of the procedure. Surgery requires higher frequencies; general pain relief uses lower frequencies. It is thought this process triggers the brain to release pain reducing substances like endorphins, enkephelins, and peptides, into the body.
Are There Any Dangers?
Acupuncture is relatively safe but should only be performed by a trained practitioner. Depending on the number of hertz used and the length of time the needles are inserted, the process can induce anesthesia and must be carefully monitored.
There can be a small risk of infection whenever needles are involved, but simple precautions minimize that possibility. When checking out qualified practitioners, ask if they reuse needles. Some practitioners do reuse a patient's own needles, but this is not advisable. As a preventative measure against any contamination or infection, it is best to use new, sterile needles for each treatment.
Who Can Practice Acupuncture?
To practice acupuncture under the auspices of the American Academy of Medicine (AMA), the acupuncturist must be a Medical Doctor (MD). There is an Oriental Medicine degree ( OM ) that provides certification to non-physicians; however OMs are not allowed to practice in Georgia and many other states.
A list of MDs certified to practice acupuncture may be found by checking check with the county medical society. For instance, in Georgia , the Georgia Board of Medical Examiners will have a list of physicians qualified to practice that specialty.
Does Insurance Cover Acupuncture?
As a rule, insurance does not cover acupuncture. The labeling of the needles as “investigational” devices by the Federal Drug Administration (FDA) was one major block. But recently the FDA reclassified acupuncture needles removing this barrier to the wider acceptance of this practice. As increasing support from the medical and lay communities calls for the consideration of acupuncture as a valid form of treatment along side traditional medicine, insurance coverage will likely follow.
Dr. Donald Leslie is Associate Medical Director of Shepherd Center and an elected member of the Center's Board of Directors. He is Medical Director of brain injury services at Shepherd, which includes inpatient and post-acute brain injury rehabilitation programs and recently became head of their new geriatric brain injury unit. He is Co-Medical Director of the Georgia Model Brain Injury System. Dr. Leslie has spoken nationally and internationally on spasticity management, and has been involved in intrathecal baclofen research and therapy for the past ten years. Most recently, Dr. Leslie received certification in acupuncture at UCLA in Santa Monica , California.
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