Precautions
A number of precautions may be suggested when practising acupuncture:
- Patients should lie down during treatment.
- Disposable sterile needles should be used.
- Needles should be counted before and after treatment so that all may
be accounted for. - Patients should be carefully observed for excessive bleeding.
Western acupuncture^68
Some general practitioners (GPs) and physiotherapists with orthodox back-
grounds find it difficult to accept the intangible nature of traditional
acupuncture, which relates to the flow of qi. Many dispute the existence of
meridians or acupuncture points,^69 preferring to link their practice to trigger
points instead.70,71Trigger points are small areas in muscle that have been
strained or injured and have not healed. They may remain sensitive for
many years, causing pain that may be experienced some distance away from
the trigger point. Interestingly, the trigger points and pain referral sites
appear to be similar in all people and, furthermore, many of the trigger
points are identical to acupuncture points.
It is suggested that acupuncture works by stimulating the nervous
system, leading to the release of opioid peptides (endorphins),
compounds that are closely involved with the mechanisms by which the
body controls its perception of pain. Thus, acupuncture is used in the
treatment of intractable pain without the attendant traditional Chinese
theory. This variant, which involves very brief needling lasting no more
than a few seconds at trigger points, has been termed ‘minimal acupunc-
ture’.^72 Exponents of minimal acupuncture commonly treat musculo-
skeletal pain, arthritis and symptoms of stress, including tension
headaches, gastrointestinal problems and nausea.
Applications of acupuncture
Therapeutic areas in which acupuncture has been used include the
following.
Pain
Back pain
Many systematic reviews for back pain include trials that use different tech-
niques and control procedures.^73 However, the balance of evidence appears
to suggest that acupuncture can be useful in the treatment of back pain
142 | Traditional medicine