Hi folks, I’d say that around 50% of patients come see me for pain, either acute or chronic (generally defined as pain that’s lasted longer than 3 months). Most people have heard or experienced themselves that acupuncture is effective for treating pain – which is great in its own right, as no one wants to be in pain, but also because it can often negate or avoid the need for pain medications, all of which come with their own problems. Tylenol, for example, is hard on the liver, while NSAIDS such as naproxen come with risks such as stomach bleeds, heart attacks and strokes. Opiods, of course, come with the risk of addiction and death.
Opiod use and deaths are at epidemic levels and many people experience inadequately managed pain. Addiction to opiods often starts when a patient has been prescribed them to deal with acute pain. 50% of addictions begin after opiod use for post-operative pain. The human toll through loss of productivity and life is unimaginable.
As the report linked below says, “medical pain management is in crisis”, so medical science has been looking to understand how effective acupuncture is in fighting pain through well-designed scientific studies. This paper, which is a meta-analysis (a paper that studies other studies on a subject), concludes that “the majority of studies showed that acupuncture is an efficacious strategy for acute pain, with potential to avoid or reduce opiod addiction”.
This meta-analysis looked at 27 studies on pain and acupuncture and included studies on post-operative pain including major surgeries, which showed a reduced need for analgesics, including opiods. Given the risk of even short-term use of opiods for addiction, this is a robust and important finding. Opiods have their place in medical treatment but should be used as a last resort when other, safer interventions such as acupuncture have failed to produce adequate results. The safety profile of acupuncture is far superior to opiods, and studies show that it often outperforms opiods for pain relief.
Two of the studies reviewed the effects of acupuncture in intubated patients. They showed a reduced need for the sedative drug midazolam to manage the discomfort of intubation when acupuncture was performed.
Four reviews looked at the use of acupuncture for lower back pain and concluded that it significantly reduced both lower back pain as well as the need for pain medication. Seven reviews looked at acupuncture for migraines and showed a larger pain-reducing effect than either sham acupuncture or pain medications.
One of the great things about acupuncture is its safety profile. Acupuncture has a low risk of negative effects and usually its secondary effects are positive, such as improved sleep and mood, increased energy and relaxation. The NIH Consensus Statement on Acupuncture concluded that “… the incidence of adverse effects is substantially lower than that of many drugs or other accepted procedures for the same conditions”. Rare serious events such as pneumothorax or infections were directly related to inadequate training. To give one example, of 300 patients who received either morphine or acupuncture to treat their pain, 56% of the morphine group suffered from negative side effects, while only 2.6% of the acupuncture group had negative effects.
I’ve been practicing acupuncture for about 15 years, during which time its only become more and more popular. The biggest problem with it now is that because its not covered by OHIP, patients need to either have extra cash or insurance coverage to access Chinese medicine care. Even when they have benefits under extended health plans, the amounts covered are often inadequate.
Given how clear the evidence is for its effectiveness in treating pain (and other conditions such as infertility), we really need to take a close look at including acupuncture in OHIP so that everyone, regardless of income level or life circumstances, has the opportunity to use it as a safe, effective alternative to more dangerous interventions such as opioids.
Link to article – https://academic.oup.com/painmedicine/advance-article/doi/10.1093/pm/pnac056/6563599?login=false#362057810
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