Balham physiotherapist uses acupuncture to resolve back pain, neck pain and tennis elbow. Many other physiotherapists use acupuncture for pain relief and to reduce muscle spasm as an adjunct to other physiotherapy modalities such as joint manipulation and exercises. Acupuncture is the insertion of fine needles into certain points in the body, be it Traditional Chinese Medicine (TCM) acupuncture points or other points such as trigger points, which are sore spots in the muscles.
It is believed that about 70-80% of patients respond to acupuncture favourably with a reduction in pain and symptoms, clinically I would suggest this is a little higher at around 80-90%, however it doesn’t “work” for everyone.
Contra-indications to acupuncture
Before you receive acupuncture your physiotherapist will ask certain questions to make sure you are suitable for treatments. These include:
• Metal allergy
• Needle phobia
• Pregnancy (during the first trimester)
If any of these apply to you, you should not receive acupuncture. Your physiotherapist will also look out for:
• Infection at or near the needle site
• Open sores
Care must also be taken using acupuncture during the second and third trimester of pregnancy, and I typically do not use at all on pregnant women.
Is acupuncture painful?
The needle may be slightly painful on insertion as many of the body’s pain receptors are located in the skin. This is why something as innocuous as a paper cut can be quite sore. Your physiotherapist will firmly tap the needle into the skin to get it quickly passed these pain receptors. Sometimes the needle does pass through one of these receptors and it can feel quite sharp in the skin. If this is the case the needle can be taken out and a fresh needle can be applied close by.
When the needle is inserted and pushed into a muscle or connective tissue the physiotherapist may rotate the needle or piston it up and down. What they are trying to do is elicit what is known in TCM as the sensation of “De Qi”. This is a sensation of dull ache, soreness, heaviness or pressure that denotes that the acupuncture is having an effect. Sometimes the physiotherapist can piston the needle into the muscle to elicit what feels like sharp twitches or jolts in the muscle, this again can be a little uncomfortable and oftentimes the little jolt can catch you of guard, but it isn’t excruciatingly painful and denotes a treatment effect.
How does acupuncture work?
There are many theories about how acupuncture works – both Western and Eastern philosophy. The Eastern philosophy doesn’t always seem to fit with how we think and view the body in the 21st century, however there is now some good “Western” scientific research to suggest how it might work.
In TCM pain or disease is caused by a blockage of the flow of energy through channels in the body called meridians. Using acupuncture in certain places along these meridians can stimulate the flow of energy again and begin to resolve the symptoms.
In Western medicine we know from research that acupuncture causes our brain to release natural pain killing chemicals out into the nervous system. These natural chemicals bind on to pain receptors in the brain and can block some of the pain messages, much like how a painkiller would work. We also know that the insertion of needles into the body will cause an increase in blood flow to that area, bringing in oxygen and nutrients and removing waste, which can stimulate healing. We also know that when the acupuncture needles and manipulated they can create a whorl of tissue around the needle / tissue interface that stretches the connective tissues radiating out from the needle site, creating a subtle mechanical stretch that can decrease tension in muscles and connective tissue.
What conditions respond to acupuncture?
A TCM practitioner may use acupuncture and herbs to treat conditions such as PCOS, insomnia or arthritis, however physiotherapists, unless trained in TCM, will only really use acupuncture for pain relief and muscle spasm.
The following conditions respond well to acupuncture:
• Low back pain
• Neck pain
• Tennis elbow
• ITB syndrome
How many treatment sessions are required?
Everyone will have a unique experience with acupuncture, however most people will feel a difference with 2 or 3 treatments. If this is the case acupuncture use should be continued along with other types of physiotherapy until you feeling better or have a management strategy to complete your rehabilitation at home.
Acupuncture can make you feel drowsy so driving more than a few miles home might not be wise. Also acupuncture can make you feel a little sore for 24 hours. So if you get home or wake up the next day after a treatment and you feel a bit sore – don’t worry. The chances are that the physiotherapist has not made your symptoms worse; you are just having a natural response to the acupuncture. That pain will wear off in a day or so and you should also feel slightly better, especially if you are also following the advice and exercises that your Balham physiotherapist gave you.