Acupuncture in Physiotherapy

Background

Acupuncture may be offered to you as part of your rehabilitation and pain management programme. Acupuncture is one of a number of different types of treatment that the physiotherapist can offer and there is good evidence for its effectiveness. Often a physiotherapist will use acupuncture alongside treatments such as exercise, joint manipulation/mobilisation and general rehabilitation.
Acupuncture is viewed by physiotherapists as a complementary rather than an alternative therapy

What is Acupuncture?

Traditional Chinese Medicine (TCM) acupuncture (which can be traced back as far as 1000BC) developed out of a concept of using needles inserted into the body as a means of balancing the movement and level of 'Qi' (energy life force) within the body – an imbalance of Qi leading to disease, pain or disability.
Recent research is now supporting the effectiveness of acupuncture, particularly in the management of pain, suggesting that it is effective in the treatment of low back pain, neck pain, and knee/hip osteoarthritis.
Acupuncture combined with physiotherapy is now widely accepted within the NHS and private practice.

When Should it Not Be Used?

There are certain circumstances where acupuncture should not be used.

•  If you have a known metal allergy, specifically stainless steel

•  If you have a needle phobia

•  If you have a known infection in the area to be needled

When Should it Be Used With Caution?

You should also inform your physiotherapist if you:

•  Have haemophilia

•  You are pregnant or trying to conceive

•  Suffer from epilepsy

•  Have a deficient/weakened immune system

•  Have a heart pace maker

•  Are taking anticoagulation (blood thinning medication)

•  Are Diabetic

These conditions do not exclude you from having acupuncture but they will influence its application. Your Physiotherapists needs to know.

Does Acupuncture Work?

Yes, but it does not work for all. Success can depend on a number of factors, which include:

•  General health

•  The severity and duration of the condition

•  How the condition has been managed in the past

No two people are the same and it is one of the strengths of acupuncture that we treat people individually to get better results. If you know someone who has experienced acupuncture you may find it helpful to discuss the process before deciding on treatment.

What does Acupuncture Treatment Involve?

Your Physiotherapist will use sterile, single use needles. The needles are fine (a lot finer than an injection needle) and they are inserted quickly through the skin and into the tissues. Acupuncture needling should not be painful although some people do report experience a pinprick or scratch like sensation.
Once the needles are in place you may feel a mild ache, numbness, warm or heavy sensation at and around the needle. This should not be unpleasant. This is referred to as 'De Qi' and is a sign that the body’s inbuilt pain relieving mechanisms are being stimulated.

How Many Needles Will Be Used?

Most commonly a treatment will involve the insertion of between 2-16 needles.

Needle Stimulation?

Once the needles are in place your physiotherapist may gently stimulate the needle until you experience the De Qi. This may be repeated again throughout the treatment.
Needles can also be stimulated using electrical impulses. This is called electro- acupuncture. Here needles are coupled to a battery-operated machine. This causes a tingling sensation to be felt at the site of the needle. Low Frequency impulses can help reduce longstanding chronic pain whilst higher frequency impulses can be more helpful in managing acute pain and muscle spasm.

How Long are The Needles In For?

Needles can be in place for as little as a few seconds or 1-2 minutes. More commonly needles will be in place for between 10-30 minutes.

Where Will The Needles Be Placed?

Needles may be inserted:

•  Around the painful area

•  Away from it (hands or feet)

•  On the opposite side of the body

Recent research suggests that needling away from an area of pain is effective. This can be particularly useful if you feel the painful area is too sensitive.

How Many Treatments Are Needed?

Research suggests that for a longstanding condition such as low back pain, a course of 6 – 10 treatments is required to achieve the best results. If after further assessment/ treatments your symptoms remain the same, it is unlikely that acupuncture will help you. If you do respond positively to acupuncture the period of symptom ease is varied and uncertain. Some people experience lasting relief of symptoms especially when used to manage a recent acute problem. Your physiotherapist will discuss your individual management plan. Acupuncture treatments may vary dependent on the condition being treated and how you respond to treatment. Each treatment should be tailor-made to you and your condition.

Is It Safe?

Members of the Acupuncture Association of Chartered Physiotherapists (AACP) are required to train to a minimum standard and are bound by professional codes of conduct through the Chartered Society of Physiotherapy (CSP) and Health Professions Council (HPC). 
Acupuncture is safer than many of the drug treatments used. However, any procedure that involves inserting needles into the body has some potential problems, but these remain minimal. Acupuncture has been known to produce some ‘side effects’ in certain people.

Minor Side Effects:

•  Some discomfort at needle site

•  Drowsiness and sleepiness following treatment

•  Bruising at the needle site

•  Temporary pain increase

•  Fainting

•  Feeling faint