Under the spotlight: acupuncture

 Popular around the globe, acupuncture is becoming increasingly mainstream in the UK discovers Iona Walton

Millions of people across the globe use acupuncture – often for chronic pain – but controversy surrounding its value as a therapy still exists. Many people who have considered acupuncture as a tool in their battle with arthritis are put off by the lack of clear, up-to-date and unbiased information. This review is designed for you.

What is acupuncture?

Acupuncture involves inserting very thin needles through the skin at specific points on the body at various depths. It sounds painful but it isn’t. Practiced in China for thousands of years, its popularity has spread rapidly in Europe, the US and Canada.

There are two types of acupuncture: traditional acupuncture and medical acupuncture.

In traditional acupuncture, the body’s acupuncture points are reported to be a way of accessing energy flows, which when imbalanced, result in illness. When needles are inserted into these points with appropriate combinations, the energy flow can be brought back into correct balance.
Medical acupuncture is based on the idea that acupuncture needles stimulate nerve endings and alter the way your brain functions and how the body responds to pain. Medical acupuncturists use acupuncture techniques as part of their practice alongside conventional treatment. Acupuncture points are said to be areas where nerves, muscles and connective tissue can be stimulated to increase bloodflow and trigger the activity of natural painkillers.

Maureen Cromey is a highly respected London-based acupuncturist with over 20 years’ experience and is on the editorial board of the European Journal of Oriental Medicine.

“Acupuncture stimulates the nerves, improves circulation and reduces inflammation,” she says. “It has a homeostatic mechanism that normalises the system. It is extremely effective for many health issues but in the specific area of arthritis it has good results on lower back pain, osteoarthritis of the knee and fibromyalgia.”

Side effects

Acupuncture is generally considered safe when performed by an experienced practitioner using sterile needles. Relatively few complications have been reported and there are fewer adverse effects than with many standard drug treatments (such as anti-inflammatory medication and steroid injections) used to manage painful musculoskeletal conditions such as osteoarthritis, fibromyalgia, myofascial pain and tennis elbow.

How to choose an acupuncturist

One of the reasons why acupuncture is not considered a mainstream treatment is that it is not a tightly regulated profession; at the moment anyone can call themselves an acupuncturist.

“Acupuncturists have different levels of training so some achieve better results than others and this introduces bias in the research,” Maureen explains. “So choose someone who is a member of the British Acupuncture Council (BAcC), which aims to guarantee excellence in training, safe practice and professional conduct.”

Members of the BAcC have to complete at least three years training in traditional acupuncture and traditional Chinese medicine at an accredited training college or university. The practitioner will carry the letters MBAcC after his or her name.

Alternatively, the British Medical Acupuncture Society (BMAS) is the professional body for doctors, dentists and nurses, who use acupuncture. Medical acupuncturists usually have fewer training hours in the acupuncture technique and use it as part of their practice. All members are UK registered health professionals who hold a Certificate of Accreditation and a Diploma of Medical Acupuncture.

The third safe option is a chartered physiotherapist who has trained and become a member of the Acupuncture Association of Chartered Physiotherapists (AACP). A physiotherapist must have completed an 80-hour foundation course or a university degree in acupuncture before registering with the AACP. Members of the AACP are thus trained in acupuncture but do not have the depth of knowledge and experience as a member of the BAcC.

The acupuncturist should consider the full picture – not just the knee, for example – and tackle overall health in addition to the current issue.

“Best effects are realised when acupuncture is used in conjunction with emotional support and lifestyle changes when necessary, such as losing weight, reducing calorie intake and lowering sugar as this causes inflammation,” Maureen says.

What happens in my first appointment?

Acupuncture usually involves several weekly or fortnightly treatments of 60 minutes. The initial session will be longer so that the patient’s medical history and the process itself can be discussed.

The patient lies down face-up, face-down or on their side depending on where the needless are to be inserted. (Single-use disposable sterile needles are used.) The patient can feel the needles being inserted but initially without pain. When the needle reaches the right depth there is a deep aching sensation. Sometimes the needles are heated or stimulated with electricity after insertion. Once inserted, the needles remain in place for about 20 minutes.

The cost

Acupuncture for lower back pain is available on the NHS and some GP practices and hospitals offer integrated healthcare with complementary therapies including acupuncture. Ask your GP if it’s available in your local area.

If you aren’t lucky enough to go down this route prices vary considerably but expect to pay about £45for a 60 minute session. Booking a series of sessions in one go usually results in a discount.

Other benefits

New scientific evidence highlights that insomnia and other sleep problems can be treated extremely effectively with acupuncture.

“With acupuncture’s increasing popularity and the growing body of research demonstrating its efficacy, it is a safe and effective option for anyone suffering chronic pain,” Maureen says. “But traditional acupuncture is also known to be enormously beneficial for helping to correct sleep problems. Most people find treatment wonderfully relaxing, as acupuncture is known to calm the nervous system and also increase endorphin production.”

Further information

• The British Acupuncture Council: www.acupuncture.org.uk
• The British Medical Acupuncture Society: www.medical-acupuncture.co.uk
• Acupuncture Association of Chartered Physiotherapists: www.aacp.org.uk

Recent support for acupuncture:

• The World Health Organisation produced a report in 2003 that says that evidence points to acupuncture being effective for treating 28 conditions including knee pain, lower back pain, neck pain, periarthritis of the shoulder and tennis elbow.
•  The National Institute for Clinical Excellence published guidance in 2009 for the NHS to provide acupuncture for lower back pain and now also recommends it for migraines and tension type headaches.
•  The latest study (published in the Archives of Internal Medicine in September 2012) analysed data from 17,922 people who used acupuncture for back and neck pain, osteoarthritis, shoulder pain or chronic headache. The effects of acupuncture were found to be clinically relevant.