The Power of Acupuncture: Part 3 of 3

By Capt. Elwood W. Hopkins, Neurologist, Naval Hospital Bremerton, Wash.

This blog is part three of a three part series. Part one was posted on Dec. 22 and part two posted on Dec. 29.

Upon return to my neurology practice at Naval Hospital Bremerton, Wash. in December 2009 I immediately began treating several of my own patients with acupuncture.  And, as the other more experienced acupuncturist at our hospital, Dr. Son told me, once you learn how to use acupuncture, it will transform the way you practice medicine.  Indeed, he was correct. 

I now have provided more than 1,000 acupuncture treatments and have treated a variety of conditions:  headaches, TMJ Syndrome, plantar fasciitis, prostatitis, IBS, acute and chronic joint problems, vertigo, post-operative pains, nerve root, chronic and acute back and neck problems, myofascial pain syndromes, fibromyalgia, athletes with focal maladaptive musculoskeletal problems, chronic fatigue, depression, painful peripheral neuropathies, and as an aid for smoking cessation, weight control, and detoxing opioid-dependent patients.

 About 90% of patients get a good result and many a spectacular benefit. One 70-year old man with 30 years of painful diabetic neuropathy returned after the first treatment describing his benefits as “a miracle,” enabling him to do a full day of yard work with repeated lifting, bending and stooping; things he had not been able to do for decades.  Another patient with spinal stenosis and chronic sciatica has, after four treatments, remained asymptomatic and able to pursue his classic car restoration projects, which require stooping and bending over fenders in engine bays, etc., for the last three months.  Some patients don’t respond, and it is never clear why, at least not to me.  Although a single treatment can provide lasting relief, we were trained to expect that for chronic problems, an initial course of about six treatments, ideally once or twice a week, would be best, after which the condition might need “tune up” treatments at various intervals, or not at all.  Acute problems typically respond to just one treatment.

Although there are many different acupuncture courses, I was especially pleased with the scientific principles that formed the basis for the “Contemporary Medical Acupuncture” course provided by the team from Macmaster University in Toronto that guided our patient evaluations, enhanced our understanding of the musculoskeletal and neuromuscular pathophysiology, and assisted us in designing effective acupuncture treatment plans.  The three other neurologist in my class concurred and we all graduated with an expanded appreciation and enthusiasm for putting this fabulous tool to work.

Our class of 27 students also included psychiatrists, a gastroenterologist, chiropractor, rheumatologist, podiatrist, gynecologist, endocrinologist, sports medicine physician, a few residents and several family medicine physicians.  Clearly, anyone caring for patients  should consider adding this tool to their kit.

The acupuncture needles are actually rounded at the ends, unlike bevelled  “cutting needles” and insert between tissues rather than cutting through and damaging fibers.  Non-nociceptive pressure is applied by one hand of the acupuncturist as the needles are advanced to the desired depth with the other hand. The pressure is a more robust and faster-conducted sensation, thus blocking any pain that might be felt as the needle is inserted.  Needles are of stainless steel, individually wrapped, sterile and disposed of after each use.  Although the adverse effect rate of acupuncture is 1/50,000 treatments, all of these (infection, pneumothorax) are preventable with proper technique. 

There are no contraindications to acupuncture including treating patients on anticoagulants. Some patients may have punctate areas of bleeding when needles are removed and these are readily stemmed with a cue tip.  I have treated adolescents and nonagenerians but would not recommend treating children who might find the experience intimidating and frightening, especially if unable to understand what is being done and why. The only other patient I would not treat would be one who did not want acupuncture. I have treated two patients who felt the acupuncture made them worse, so like everything else in medicine, you can’t always have a successful outcome.

Treatments take about 30-45 minutes, including patient assessment, explanation of the process and placement of needles, application of electrical stimulator and completion of the treatment. Some patients may become light-headed from treatment, especially if they arrive dehydrated. This is caused by both vagal reactions for first time treatments and the vasodilatory effects of the treatment (it is a good treatment for hypertension, especially a hypertensive emergency).  Treatments are performed with patients recumbent or in a massage chair.  Many patients I have treated have been able to reduce or eliminate the use of analgesics, including opioids, as well as antihypertensive medications and several of the patients who have diabetes have found it easier to control their blood sugars, often with fewer medications.  Fewer antidepressant, tranquilizing and sleep medication needs are other benefits about which patients have commented. I have one patient who was about to undergo surgery as a last resort for cervical radiculopathy, but cancelled his surgery after a few acupuncture treatments and has remained asymptomatic for several months. 

It is now evident to me that there truly is a great benefit to acupuncture. If you have ever received acupuncture, share you stories in our comments section.

  • Dr.Heidi Fu, RN, LAc., DAOM

    I like this article very much! I have shared this with all my social network contacts (facebook, g+, twitter). I am glad your military uses acupuncture for pain management, I am 100% supportive :-) Dr. Heidi Fu

  • Megan Kingsley Gale, EAMP/L.Ac. (MSAOM)

    This is a wonderful series of articles. You do a great job explaining how acupuncture works from a anatomical/neurological perspective. I love your enthusiasm. Regarding pediatric acupuncture, consider referring out to an East Asian Medical Practitioner (title of a Acupuncturist with a masters or doctorate degree in Acupuncture and Oriental Medicine in Washington state). My daughter, age 2.5, and diagnosed with Crohn’s disease at 18 months, has had good success with this medicine as an adjunct to her pharmaceuticals and special diet. I hope all physicians who take a course in acupuncture have at least two East Asian Medical Practitioners to refer to. When your treatment is not working for the patient, consider your diagnostics. EAMPs have several more years of training in the diagnositics of this particular medicine and may be able to shed some light for the “difficult” cases. In the future, I hope the Navy (and TriCare) considers acupuncture as a viable modality and hires EAMPs at their medical facilities. I have seen great success with this medicine in many cases that did not respond to standard treatment and many cases where healing rate was greatly increased where this medicine was an adjunct to conventional care.

    Acupuncture is a great way to treat pain and anxiety without the use of opiates.
    -Navy wife

  • Carlo St. Juste Jr., L.Ac, MAOM

    Thanks for the great article. I know in the news recently there has been much attention towards integrating acupuncture into different branches of the military. I did share this with a few friends of mine who enjoyed it.

  • R. L. Vernon RN, MS

    As a retired naval officer, I both deeply concerned and, quite frankly, profoundly saddened by the influx of pseudoscientific CAM into military medicine. Precious health care dollars wasted on CAM can be much better spent!

    The author states: “There is nothing like personal experience to convince one of an effect.” Anecdotal evidence alone cannot support the efficacy and continued use of this modality. Anecdotal evidence is a heavy component of these articles and uncontrolled observations are subject to confirmation bias. A concerted effort to fully survey medical and scientific research archives on the subject will reveal the ever growing body of evidence that acupuncture offers no more than a classical placebo effect. The attentions and even the very mannerisms of the acupuncturist have much more to do with any effect on a patient’s condition than the mystical placement of tiny needles. I’ll admit that the placebo effect can be powerful in many psycho-socialogical aspects, to be sure! But in the spirit of appropriate risk/benefit informed consent of the patient, it has been considered ethically suspect to represent acupuncture, or for that matter, most CAM practices, as any sort of proven medical treatment. And applying acupuncture as a veiled placebo is a form of deception that has no place in medical care.

    What’s next for Navy Medicine? Commissioned naturopathic “doctors” or perhaps native shamans in the Medical Corps? Therapeutic Touch as a recognized Nurse Corps subspecialty? Naval hospital pharmacies stocking healing crystals? Corpsmen with acupuncture needles, baggies of herbs and bottles of homeopathic remedies displacing field dressings in their B1 bag on the battlefield?

  • Johnson NeilderJ

    hello. you have a pretty good post there mate.

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