What is Medical Acpuncture?
WHAT IS ACUPUNCTURE AND WHAT DOES IT DO?
Before I speak about acupuncture, I wanted to address my training and background with acupuncture. I am a graduate of McMaster University’s Medical Acupuncture program. This program has been around for decades and is taught by a Medical Doctor who has a PhD related to clinical TCM based acupuncture. This program uses the Traditional Chinese Medicine (TCM) approach in tandem with the most recent clinical literature.
Acupuncture is rooted in Chinese philosophy and is based on a system of meridians or you can think of them as pathways of energy through the body. Each meridian has a name like Gallbladder or Small Intestine. When we are injured, part of the belief is that our energy (or our Qi) is not flowing. When you insert an acupuncture needle sometimes you can feel that Qi flowing. This sensation is often described as warmth, fullness, or pins and needles.
HOW DOES ACUPUNCTURE HELP?
If we look at how acupuncture helps, we can look at it from a more Eastern point of view or a more Western. The Eastern side is that you are improving the flow of your Qi through that meridian. The Western side of things is that you are decreasing pain using the gate control theory of pain control, you are decreasing pain by utilizing an endorphin-release mechanism, you are decreasing pain using the hypothalamic-pituitary axis, and you are decreasing pain by using local and systemic hormone release.
HOW DO YOU DECIDE WHERE TO PUT NEEDLES?
As mentioned, I use a TCM approach so every single needle is placed in one of the 100 most-researched TCM points. This means I am using points like Gall Bladder 21 instead of comparatively, the trigger point of trapezius. When considering where to put needles, I like to utilize three different types.
First, I try to put at least one needle in local anatomy based off of a TCM point related to their pain and diagnosis. For example, for a tear in the belly of the hamstring, I may include Urinary Bladder 37 because it’s the closest to the site of injury.
Next, I also include distal points (points further away from the site of injury) along the meridian in which local points are used. Certain points along each meridian are called Shu points. These points can unblock Qi anywhere along that meridian. For example, a Shu point relating to the above UB37 would be UB40. Each meridian has a few Shu points.
Finally, I try to include at least one influential point. There are three influential points I use with patients; Gall Bladder 34 for soft tissue injury, Gall Baldder 39 for nervous tissue injury, and Urinary Bladder 11 for bone and joint pain.
WHO CAN PROVIDE ACUPUNCTURE?
A Traditional Chinese Medicine Doctor or an Acupuncturist can provide acupuncture. Chiropractors, Doctors, Physiotherapists, Nurses, Nurse Practitioners, Registered Massage Therapists can also practice acupuncture once they complete their individual required education and testing. Not all acupuncture providers can use all the TCM points, however.. Chiropractors must do extra education as they are allowed to use all TCM locations (an RMT for example can use 50 TCM locations).
The education behind an Acupuncture program should cover each spot taught, risks and contraindications, physiology and science behind acupuncture, as well as a practical component where technique is practiced and mastered.
WHEN SHOULD ACUPUNCTURE BE AVOIDED?
Certain contraindications exist when acupuncture should be avoided. For some contraindications, it may just be certain locations, others maybe acupuncture as a modality should be avoided. There is research to show benefits of laser over acupuncture points as well.
Contraindications for certain points or acupuncture altogether include:
Pregnancy
Open wounds
Bleeding disorders
Autoimmune disorders
Joint replacements
Pacemakers
Infected tissue
Patients with a mechanical heart valve
TELL ME ABOUT THE NEEDLE AND THE PROCESS?
The needles are all single-use, sterilized stainless steel. Both the length and the width vary. Length can be from half of an inch to three inches! To compare for size, the average medical syringe is 2.9 mm, the average sewing needle is 1.0 mm, and the average acupuncture needle is 0.25 mm.
HOW LONG DO THE NEEDLES STAY IN?
Typically, acupuncture needles remain in place for 5-15 minutes. Although somewhere around 10 minutes is often the goal, if a needle feels uncomfortabl, it can be removed at any time.
WHAT IS ELECTROACUPUNCUTRE OR ACUPUNCTURE WITH E-STIM?
Electroacupuncture is where a current of electricity is applied to the needles, often with clips and wires, for therapeutic benefit. This process is essentially a TENS unit similar to ones with sticky pads applied to the skin. TENS stands for Transcutaneous Electrical Nerve Stimulation. E-stim decreases pain by using the gate control theory, the endorphin-release mechanism, and the pain-spasm-pain cycle. For each of these a different number of Hertz is applied. Duration for e-stim can be anywhere from 10-40 minutes. TENS or Electroacupuncture should be avoided near a pacemaker, the low back or abdomen during pregnancy, open wounds, areas of impaired sensation, epileptic patients, or on the head or anterior neck.
WHAT IS THE GATE CONTROL THEORY?
The TENS unit attached to your acupuncture needle initiates an actionable potential (electrical signal) in peripheral nerves thereby causing the brain to focus on this stimulation instead of the nociceptive input from your injured tissue. For gate control 100-150 Hz is typically used.
WHAT IS ENDORPHIN-RELEASE THEORY?
The TENS unit attached to your acupuncture needles repeatedly stimulates motor and nociceptive A-delta fibres that signal damage causing contractions and brief moments of sharp pain. This triggers our internal opioid releasing system (painkillers our body makes internally). For endorphin-release 2-10 Hz is typically used.
WHAT IS PAIN-SPASM-PAIN CYCLE?
The TENS unit attached to your acupuncture needles causes sustained contraction followed by periods of relaxation thereby reducing the overall tone of muscular tissue. Fatiguing the muscle reduces spasming, which reduces the patient’s pain. For pain-spasm-pain 30-80 Hz is typically used.
For more information about medical acupuncture or Electroacupuncture please reach out via email at hello@madetomove.ca or better yet, book an in-person appointment!
