Acupuncture is an effective medical technique when used as a part of an integrative medicine approach for pain management. Acupuncture using both traditional and non-traditional contemporary techniques such as photobiomodulation therapy using medical therapeutic lasers; electroacupuncture and dry needling often result in pain improvement. Multiple controlled trials have been published using acupuncture for acute and chronic low back pain; knee osteoarthritis; migraine headaches; tension headaches; fibromyalgia; neck pain; and soft tissue injury.
Mechanism of Action
Acupuncture is thought to restore the normal flow of energy in the body. Acupuncture has multiple effects on the central and peripheral nervous system. The release of endogenous opioids, serotonin and norepinephrine with effects on decreasing inflammation and altering pain perception. The mechanism of action of acupuncture is not completely known. Investigation continues to better understand the pathophysiology associated with improvements demonstrated with acupuncture therapy.
Low back pain is a common reason for patients to seek acupuncture treatment. Over the past 20 years there have been more than 600 journal articles describing effects of acupuncture for acute and chronic low back pain. Clinical systematic reviews of acupuncture for acute and chronic low back pain demonstrate significant improvement in pain perception. Acupuncture is recommended to be included as one treatment modality for acute and chronic low back pain.
Acupuncture for Pain
Results of multiple clinical reviews and Meta-Analysis have demonstrated clinically significant improvement in multiple additional conditions. Conditions include the following:
- Peripheral arthritis
- Tension headaches
- Migraine headaches
- Knee Osteoarthritis
- Myofascial Pain
Acupuncture for knee osteoarthritis is a cost effective medical management technique for the use of knee osteoarthritis. Results of multi systematic reviews and Meta-Analysis have demonstrated clinically significant improvements in knee osteoarthritis pain.
Acupuncture is an effective topical technique for the care and treatment of patients experiencing tension headaches and migraine headaches. Additionally, acupuncture can be utilized as an effective prophylactic treatment to reduce and/or prevent recurrences of migraine and tension headaches.
Dry Needling for Myofascial Pain
Myofascial pain is characterized by the areas of abnormal muscle tension on palpation that is accompanied by tender points. Characteristic finding is trigger points. There are many treatment options including manipulation massage, stretching, trigger point injections and photobiomodulation (PBM) therapy.
Dry needling is distinguished from trigger point injections (wet needling) because it uses solid acupuncture needles rather than hollow hypodermic needles. Acupuncture dry needling is effective in treatment of many types of nerve and muscle injuries. There are a variety of dry needling approaches, rationale and styles. Many physical therapists are now approved and credentialed to perform dry needling.
Dry needling is an effective technique for cervical neck pain and tension headaches. Additionally, dry needling is an effective technique for the care and treatment of fibromyalgia.
Additional uses of acupuncture include the treatment of postoperative pain in conjunction with opioid analgesics which appears to reduce the need and dose of opioid usage.
Acupuncture is generally well tolerated with few adverse effects and in general is quite safe. Adverse effects typically involve local pain and/or headache which occurs in about 10% of patients. Side effects usually are minor and resolve without any intervention. Serious events such as hospital admissions, permanent disability or death rarely occur.
The use of laser light (photobiomodulation therapy) as an alternative to needles to stimulate acupuncture points has been promoted for almost three decades. Evidence supports the use of laser acupuncture in the treatment of acute and chronic myofascial pain, postoperative nausea and vomiting and for the relief of acute and chronic tension headaches.
Cold Laser (photobiomodulation therapy) Treatment Methods
Cold Laser (photobiomodulation therapy) treatment methods is an effective innovative technology in pain management. Cold lasers are sometimes called low level lasers (LLL) or soft lasers which cause cellular stimulation resulting in the biomodulation of the cell and the cellular processes. The laser transmits light energy to the surface of the cell where it is received and transferred to the mitochondria for cellular healing and restoration of normal cell function.
In conclusion, traditional needle and non-traditional laser acupuncture are effective tools in the treatment of acute and chronic pain syndrome. All patient experiencing acute and chronic pain should consider acupuncture therapy as a part of their pain management and recovery program.
Photobiomodulation Therapy (PBM) is an effective treatment modality for many types of acute and chronic pain including dental pain, wounds, sports injuries, post-operative pain, musculoskeletal pain, neuropathy, fibromyalgia and shingles. PBM protocols have assisted patients dependent on opioids to become opioid free.