Acupuncture is an under-appreciated minimally invasive technique for quickly reducing pain when applied correctly. I always first opt for what is known as distal acupuncture needling as it is most effective for quickly removing pain. Treating the lower part of the body to heal the upper and treating the upper to heal the lower (’上病下取，下病 上取’, ‘shang bing xia qu, xia bing shang qu’ – literally, ‘upper disease, below treat, lower disease, upper treat’) has been a widely applied treatment principle in acupuncture since ancient times.
Although this concept was written over 2000 years ago the acupuncture “mirroring method” was expanded and popularized by the late Richard Tan. A simple example of this type of treatment is if there is pain in the left knee then treat the right elbow. If there is pain in the right ankle treat the left wrist etc. Of course, it is not always so simple and often may requires a deeper understanding of the body’s six divisions, but in many cases the simple acupuncture treatments work wonders for pain.
This study suggests that acupuncture should be used in emergency departments and no doubt if the insurance companies did further research into the cost/benefits of offering acupuncture there would be significant cost savings. MRIs are expensive and most of the time unnecessary. The results of the study comparing acupuncture to standard of care (morphine):
Success rate was significantly different between the 2 groups (92% in the acupuncture group vs 78% in the morphine group). Resolution time was 16 minutes in the acupuncture group vs 28 minutes in the morphine group. Overall 57% in morphine group had an adverse reaction vs 3% the in acupuncture group. In patients with acute pain presenting to the emergency department, acupuncture was associated with more effective and faster analgesia with better tolerance.
If there was a drug that could match the acupuncture arm of this study it would make front page headlines. Acupuncture for pain management should be a part of healthcare if administered by properly trained and proven effective practitioners. There is a bill stalled in the Massachusetts public health committee to make acupuncture coverage mandatory for pain conditions, please support it by calling committee heads.
Here is the study’s abstract:
Acupuncture is one of the oldest techniques to treat pain and is commonly used for a large number of indications. However, there is no sufficient evidence to support its application in acute medical settings.
This was a prospective, randomized trial of acupuncture vs morphine to treat ED patients with acute onset moderate to severe pain. Primary outcome consists of the degree of pain relief with significant pain reduction defined as a pain score reduction ≥50% of its initial value. We also analyzed the pain reduction time and the occurrence of short-term adverse effects. We included in the protocol 300 patients with acute pain: 150 in each group.
Success rate was significantly different between the 2 groups (92% in the acupuncture group vs 78% in the morphine group P<.001). Resolution time was 16±8 minutes in the acupuncture group vs 28±14 minutes in the morphine group (P<.005). Overall, 89 patients (29.6%) experienced minor adverse effects: 85 (56.6%) in morphine group and 4 (2.6%) in acupuncture group (P<.001). No major adverse effects were recorded during the study protocol. In patients with acute pain presenting to the ED, acupuncture was associated with more effective and faster analgesia with better tolerance.
This article provides an update on one of the oldest pain relief techniques (acupuncture) that could find a central place in the management of acute care settings. This should be considered especially in today’s increasingly complicated and polymedicated patients to avoid adverse drug reactions.
Grissa MH1, Baccouche H1, Boubaker H1, Beltaief K1, Bzeouich N1, Fredj N1, Msolli MA1, Boukef R2, Bouida W1, Nouira S3. Acupuncture vs intravenous morphine in the management of acute pain in the ED. Am J Emerg Med. 2016 Jul 20. PMID: 27475042. [PubMed] [Read by QxMD]