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GETTING TO THE POINT:
A DISCUSSION ON ACUPUNCTURE
JENNY MILLER, DC
DISCLAIMER
• The views and opinions expressed in my
presentation today, including any examples or
assumptions, are mine personally, and do not
necessarily reflect the official policy or position of
the Department of Veterans Affairs or any agency
of the U.S. Government.”
INTRODUCTION
• Education/Background/Experience
• How did you get into acupuncture?
HOW DOES IT WORK?
• Eastern vs. Western Perspective
• Eastern
• Meridians
• Balance
• Western
• Muscular Tension
• Blood Flow
• Endorphins
TYPICAL VISIT
• Initial Visit
• 60 minutes
• Exam and History
• Initial treatment
• Follow-up Visit
• 30 minutes
• Continued treatment
• Self-care instructions
TYPICAL VISIT
• The “tools”
• Needles
• Vary in length and thickness
• Vary in material
• Electro-stimulation
TYPICAL VISIT
• Common Complaints
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•
•
•
•
•
Low back pain
Neck pain
Headaches
Stress/Anxiety
Sleep concerns
Sinus pain/congestion
TYPICAL VISIT
• Cautions/Contraindications
• Often relative rather than absolute
•
•
•
•
•
•
•
Unexplained or undiagnosed medical conditions
Sepsis or overwhelming infection
Unexplained/unstable syncope or seizure
Pacemaker patient should avoid electro-stimulation
Pregnancy
Needle phobia
Epilepsy or uncontrolled movements
TYPICAL VISIT
• Cautions/Contraindications (continued)
•
•
•
•
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Diabetes
Allergy to stainless steel
Non-cooperative/Confused patients
Steroids
Local contraindications
• Active infection
• Skin lesion
• Malignancy at the insertion site
TYPICAL VISIT
• Bleeding disorders & use of anti-coagulants
• These are not absolute contraindications as acupuncture
needles are nearly always thinner or finer than phlebotomy
needles and intravenous catheters which are routinely
administered in hospitals; however, the acupuncture
provider should always be notified of bleeding risks.
TYPICAL VISIT
• Considerations
• ADHD or inability to sit calmly
• Significantly low pain tolerance
• Needles should not be placed in the orbit or umbilicus
EFFECTIVENESS & LITERATURE
• Cherkin, D.C., Sherman, K.J., et al. (2009). A Randomized Trial
Comparing Acupuncture, Simulated Acupuncture, and Usual
Care for Low Back Pain. Archives of Internal Medicine, 169(9),
858-866.
• Hollifield, M., Sinclair-Lian, N., Warner, T.D., & Hammerschlag, R.
(2007). Acupuncture for Posttraumatic Stress Disorder: A
Randomized Controlled Pilot Trial. Journal of Nervous &
Mental Disease, 195 (6), 504-513.
EFFECTIVENESS & LITERATURE
• King, H., et al. (2015). Auricular Acupuncture for Sleep
Disturbance in Veterans with Post-Traumatic Stress Disorder: A
Feasibility Study. Military Medicine, 180 (5), 582-590.
• Li, J., et al. (2014). Acupuncture Treatment of Chronic Low
Back Pain Reverses an Abnormal Default Mode Network in
Correlation with Clinical Pain Relief. Acupuncture In Medicine:
Journal of the British Medical Acupuncture Society, 32 (2), 102108.
INTEGRATIVE HEALTH
• Acupuncture is one piece of the puzzle
• Integrative Health Program offers
• Group Orientation
• Health Coach
• Massage Therapy
• “Bridge to Self-Care”
INTEGRATIVE HEALTH
• IH also works closely with these programs & groups:
•
•
•
•
Nutrition and MOVE programs
Yoga/Tai Chi
Mind Body Medicine Group
Smoking Cessation Group
ACUPRESSURE
•
•
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•
Digit Pressure
Bracelets
Ear Seeds
Press Tacks
ACUPRESSURE
ACUPRESSURE
SELF-CARE
• Acupressure
• Breath work & breathing exercises
• Mantram/Affirmations/Visualization/Meditation
• Stretches/Exercises/Tennis ball/Foam roller
• Posture/Work station recommendations
• Essential Oils
CASE STUDIES
• 44 year old female
• CC: Bilateral knee pain 8-9/10 at worst; also
cervical, thoracic, and headache pain
• Goal: increase walking which is limited to six blocks
due to pain
• Participating in MOVE program & lost 20 pounds in
2-3 months
CASE STUDIES
• Treatment
• Twice per week for three weeks with follow up visit three
weeks after
• Outcome
• Knee, headache, neck, upper back pain symptoms mild at
most. No pain at time of visit
• Walking 3-5 miles 3-5 times per week
• Lost nearly 30 pounds total
• Self care: acupressure points, tennis ball massage
• Rated benefit of acupuncture 9 on scale of 10
CASE STUDIES
• 78 year old male
• CC: Headache, also knee pain, & right wrist pain
• Average HA pain 3-4/10 with severe HA once/week.
• Knee pain present 20 years. Intermittent, 8/10 with
stairs
• Right wrist pain limits bowling activities
• Tai Chi and Yoga classes several times per week aid
in sleep
CASE STUDIES
• Treatment
• Twice per week for three weeks
• Outcome
• Headaches “manageable”
• Knee pain improved, noted mainly with kneeling.
• Improved flexibility right wrist and decreased pain
• Planning to begin bowling that week
• Benefit rated 10 on scale of 10
• Self-care: acupressure
• Continue tai chi and yoga classes
CASE STUDIES
• 46 year old male
• Mid and lower back pain 20 years
• Increased with prolonged activity
• Avoids going fishing due to low back pain
• Nightmares
• Consistently making sleep difficult
• Currently taking medications for nightmares
CASE STUDIES
• Treatment
• Twice per week for three weeks with follow up three to four
weeks later
• Outcome
•
•
•
•
Fishing on a weekly basis
Started a new job spending more time on his feet
No nightmares
Benefit rated 9-10 on scale of 10