BOOK
E-Book An Introduction to Western Medical Acupuncture
Adrian White | Mike Cummings | Jacqueline Filshie
(2008)
Additional Information
Book Details
Abstract
This book is a clear and practical introductory guide to the practice of medical acupuncture. It describes the Western medical approach to the use of acupuncture as a therapy following orthodox diagnosis. The text covers issues of safety, different approaches to acupuncture, basic point information, clinical issues and the application of acupuncture in clinical conditions, especially in the treatment of pain.
- A practical guide to the principles and clinical practice of medical acupuncture
- A clear guide to the neurophysiological principles which underlie medical approaches to acupuncture
- A basic explanation of the different styles of medical acupuncture treatment
- Allows the reader to accrue the practical knowledge necessary before beginning to work with medical acupuncture.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| An Introduction to Western Medical Acupuncture | iii | ||
| Copyright | iv | ||
| Foreword | v | ||
| Preface | vii | ||
| Acknowledgements | ix | ||
| Contents | xi | ||
| Glossary | xv | ||
| Chapter 1: Introduction | 1 | ||
| How can we be sure acupuncture is a valid therapy? | 2 | ||
| Why not simply accept the traditional explanations for acupuncture? | 4 | ||
| Reassessing the phenomena of acupuncture | 5 | ||
| Section 1: Principles | 7 | ||
| Chapter 2: An overview of Western medical acupuncture | 7 | ||
| Acupuncture in the West | 8 | ||
| Five mechanisms for understanding Western medical acupuncture | 8 | ||
| The use of Western medical acupuncture | 13 | ||
| Other interpretations of Western medical acupuncture | 13 | ||
| Milestones in Western medical acupuncture | 14 | ||
| Further reading | 16 | ||
| Chapter 3:Neurological mechanisms I:local effects | 17 | ||
| Introduction | 17 | ||
| Sensory nerves | 18 | ||
| Physiology of local acupuncture | 18 | ||
| Needle sensation: de qi | 18 | ||
| Local neuropeptide release | 19 | ||
| Other possible local mechanisms | 20 | ||
| Clinical application | 20 | ||
| Where to place the needle? | 21 | ||
| Acupuncture points | 21 | ||
| Numbering system of acupuncture points | 22 | ||
| Needle stimulation: the acupuncture ‘dose’ | 23 | ||
| Number of needles | 23 | ||
| Thickness of needles | 23 | ||
| Depth of insertion | 24 | ||
| Needle manipulation to elicit de qi | 24 | ||
| Needle retention time | 25 | ||
| Standard treatment dose | 25 | ||
| Summary | 25 | ||
| Chapter 4: Neurological mechanisms II: segmental analgesia | 27 | ||
| Introduction | 27 | ||
| Somatic afferents: anatomy and physiology | 28 | ||
| Afferent nerve pathways: small unmyelinated and myelinatednerves | 28 | ||
| The perception of pain | 29 | ||
| Physiology of segmental acupuncture | 30 | ||
| Clinical application of segmental analgesia | 31 | ||
| Electroacupuncture | 32 | ||
| Segmental acupuncture for visceral conditions | 32 | ||
| Visceral afferents: anatomy and physiology | 33 | ||
| Convergence | 34 | ||
| Segmental development of the foetus | 35 | ||
| Autonomic effects of acupuncture | 35 | ||
| Clinical application to visceral conditions | 36 | ||
| Superficial needling option | 37 | ||
| Summary | 37 | ||
| Further reading | 38 | ||
| Chapter 5: Neurological mechanisms III: extrasegmental analgesia | 39 | ||
| Introduction | 39 | ||
| Neuromodulators: opioid peptides | 40 | ||
| Electroacupuncture and opioid peptides | 42 | ||
| Non-opioid mechanisms in acupuncture analgesia | 43 | ||
| Descending inhibitory pain control | 43 | ||
| Clinical application | 45 | ||
| Individual response to acupuncture | 46 | ||
| Cumulative response to acupuncture: gene expression | 46 | ||
| Natural opioid antagonist cholecystokinin: anxiety | 47 | ||
| Acupuncture analgesia for surgery | 47 | ||
| Aspects of pain | 47 | ||
| Classification of pain | 47 | ||
| Sensitization: peripheral and central | 48 | ||
| Strong stimulation: diffuse noxious inhibitory control | 49 | ||
| Summary | 50 | ||
| Further reading | 50 | ||
| Chapter 6: Neurological mechanisms IV: central regulatory effects | 51 | ||
| Introduction | 51 | ||
| Pain: the affective component | 52 | ||
| The limbic system | 52 | ||
| Psychological changes | 54 | ||
| Autonomic effects | 54 | ||
| Hypothalamo-pituitary-adrenal axis | 55 | ||
| Hypothalamo-pituitary-ovarian axis | 55 | ||
| Other endocrine effects | 55 | ||
| The immune system | 56 | ||
| Drug dependency | 56 | ||
| Nausea and vomiting | 56 | ||
| Clinical application | 56 | ||
| Summary | 57 | ||
| Chapter 7: Myofascial trigger points | 59 | ||
| Introduction | 59 | ||
| Definition | 61 | ||
| Incidence | 62 | ||
| Aetiology | 62 | ||
| Myofascial trigger points from acute or chronic muscle strain | 62 | ||
| Other causes of myofascial trigger points | 64 | ||
| Precipitating and perpetuating factors | 64 | ||
| Mechanism | 65 | ||
| Clinical features | 65 | ||
| Presenting symptoms | 65 | ||
| History: direct questioning | 68 | ||
| History: other symptoms | 68 | ||
| Trigger points and spinal pain | 68 | ||
| Diagnosis | 70 | ||
| Palpation | 70 | ||
| Twitch response | 71 | ||
| Difficulties in myofascial trigger point examination | 72 | ||
| Differential diagnosis | 72 | ||
| Investigations | 72 | ||
| Treatment techniques | 73 | ||
| Prognosis | 75 | ||
| Summary | 75 | ||
| Further reading | 76 | ||
| Chapter 8: Traditional Chinese acupuncture reinterpreted | 77 | ||
| Introduction | 77 | ||
| Chinese origins of acupuncture | 78 | ||
| European origins of acupuncture | 79 | ||
| The evolution of acupuncture in China | 79 | ||
| The worldwide spread of acupuncture | 80 | ||
| The 20th century | 81 | ||
| Traditional Chinese acupuncture theories | 81 | ||
| The context of traditional Chinese acupuncture | 81 | ||
| Chinese anatomy and physiology | 82 | ||
| Qi | 83 | ||
| Yin/Yang ‘balance’ | 83 | ||
| Five phases (elements) | 84 | ||
| Meridians | 85 | ||
| Acupuncture points | 85 | ||
| Associated effect points | 85 | ||
| Diagnosis in traditional Chinese medicine | 85 | ||
| Tongue diagnosis | 85 | ||
| Pulse diagnosis | 86 | ||
| The nature of traditional Chinese medicine diagnosis | 86 | ||
| Section 2: The Evidence Base | 93 | ||
| Chapter 9: Clinical research into the effectiveness of acupuncture | 93 | ||
| Introduction | 94 | ||
| Blinding participants in acupuncture trials | 94 | ||
| Problems with ‘placebo’ acupuncture | 94 | ||
| ‘Sham’ acupuncture | 95 | ||
| Non-penetrating sham controls | 96 | ||
| Penetrating sham controls | 96 | ||
| Testing the success of patient blinding | 97 | ||
| Practitioner blinding | 98 | ||
| Other problems in acupuncture research | 98 | ||
| Conditions suitable for clinical trials | 98 | ||
| Lack of research resources: suboptimalacupuncture treatment | 99 | ||
| Acupuncture as a complex intervention | 100 | ||
| Results of acupuncture trials at odds with clinical observation | 100 | ||
| Choice of the control group | 101 | ||
| The German insurance company studies | 102 | ||
| Assessing the evidence | 103 | ||
| Acupuncture for musculoskeletal conditions | 104 | ||
| Neck pain | 104 | ||
| Upper limb pain | 105 | ||
| Low back pain | 105 | ||
| Low back and pelvic pain in pregnancy | 106 | ||
| Chronic knee pain | 106 | ||
| Myofascial pain | 108 | ||
| Fibromyalgia | 108 | ||
| Other musculoskeletal conditions | 109 | ||
| Acupuncture for headache | 109 | ||
| Migraine | 109 | ||
| Tension-type headache | 110 | ||
| Acupuncture for other painful conditions | 110 | ||
| Chronic pain | 110 | ||
| Dental pain | 111 | ||
| Postoperative pain | 111 | ||
| Miscellaneous | 111 | ||
| Acupuncture for respiratory conditions | 111 | ||
| Asthma | 111 | ||
| Acupuncture for addictions | 112 | ||
| Smoking cessation | 112 | ||
| Alcohol, heroin and cocaine dependence | 112 | ||
| Acupuncture for central-nervous-system conditions | 113 | ||
| Stroke | 113 | ||
| Acupuncture for nausea and vomiting | 113 | ||
| Nausea of pregnancy | 113 | ||
| Acupuncture for genitourinary and reproductive medicine | 114 | ||
| Gynaecological conditions | 114 | ||
| Infertility | 115 | ||
| Acupuncture in pregnancy | 115 | ||
| Urological conditions | 115 | ||
| Miscellaneous | 116 | ||
| Skin conditions | 116 | ||
| Tinnitus | 116 | ||
| The cost effectiveness of acupuncture | 116 | ||
| Summary | 118 | ||
| Chapter 10: Evidence on the safety of acupuncture | 119 | ||
| Introduction: acupuncture is safe in skilled hands | 119 | ||
| A modern approach to safety | 120 | ||
| The potential risks of acupuncture | 121 | ||
| Mild events | 122 | ||
| Significant events | 123 | ||
| Serious events | 124 | ||
| Unavoidable events | 125 | ||
| Indirect risk | 126 | ||
| Summary | 126 | ||
| Section 3: Practical Aspects | 127 | ||
| Chapter 11: Preparation for treatment | 127 | ||
| Introduction | 127 | ||
| Patients suitable for acupuncture | 128 | ||
| Contraindications | 128 | ||
| Absolute contraindications to particular techniques | 129 | ||
| Relative contraindications: balancing risk and benefit | 129 | ||
| Special precautions | 130 | ||
| Pregnancy | 131 | ||
| Strong reactors | 131 | ||
| Patients with cancer | 132 | ||
| Information and informed consent | 132 | ||
| Conditions suitable for acupuncture | 134 | ||
| Acupuncture equipment | 136 | ||
| Standard needles | 136 | ||
| Guide tubes | 137 | ||
| Other types of needle | 137 | ||
| Electroacupuncture equipment | 138 | ||
| Ancillary equipment | 139 | ||
| Re-sterilizing needles | 139 | ||
| The setting for acupuncture | 140 | ||
| Preparation of the practitioner | 140 | ||
| Summary | 140 | ||
| Chapter 12: Effective needling techniques | 142 | ||
| Introduction | 142 | ||
| Dose of acupuncture | 143 | ||
| Acupuncture: basic technique | 143 | ||
| Insertion | 144 | ||
| Advance | 145 | ||
| Manipulation | 145 | ||
| Retention | 146 | ||
| Removal | 146 | ||
| Acupuncture: variations on the basic technique | 147 | ||
| Needling myofascial trigger points | 147 | ||
| Superficial needling | 147 | ||
| Periosteal pecking | 148 | ||
| Electroacupuncture | 148 | ||
| Origins | 148 | ||
| Application | 148 | ||
| Safety of electroacupuncture | 150 | ||
| Individual patient sensitivity | 151 | ||
| Managing the course of treatment | 151 | ||
| Summary | 152 | ||
| Chapter 13: Safe needling | 153 | ||
| Introduction | 153 | ||
| Treat patients lying down | 153 | ||
| Equipment and administration | 154 | ||
| Handling needles | 154 | ||
| Forgotten patients | 154 | ||
| Reducing the risk of infection | 158 | ||
| Hygiene and skin preparation | 158 | ||
| Vulnerable sites and vulnerable patients | 159 | ||
| Bacterial endocarditis | 160 | ||
| Reducing blood-borne infection | 160 | ||
| Professional development | 160 | ||
| Summary | 161 | ||
| Chapter 14: Other acupuncture techniques | 162 | ||
| Introduction | 162 | ||
| Continuous stimulation by indwelling needles | 163 | ||
| Safety of indwelling needles | 163 | ||
| Auricular acupuncture | 164 | ||
| Background and concepts | 164 | ||
| Western medical auricular acupuncture | 165 | ||
| Treatment | 165 | ||
| Safe needling of the ear | 166 | ||
| Approaches to continuous auricular stimulation | 166 | ||
| NADA technique | 167 | ||
| Smoking cessation | 168 | ||
| Other stimulation techniques | 168 | ||
| Acupressure | 168 | ||
| Moxibustion | 169 | ||
| Plum-blossom needle | 169 | ||
| Laser ‘acupuncture’ | 169 | ||
| Transcutaneous electrical nerve stimulation | 170 | ||
| Gold and silver needles | 170 | ||
| Other acupuncture microsystems | 171 | ||
| New scalp acupuncture of Yamamoto | 171 | ||
| Korean hand acupuncture | 171 | ||
| Interpretation | 171 | ||
| Electrodiagnostic techniques | 171 | ||
| Electroacupuncture after Voll | 172 | ||
| Ryodoraku | 172 | ||
| Summary | 172 | ||
| Section 4: Treatment Manual | 175 | ||
| Chapter 15: Treatment guidelines | 175 | ||
| Introduction | 175 | ||
| Summary of general treatment principles | 176 | ||
| Selecting the point | 176 | ||
| Stimulating the point | 177 | ||
| Increasing the dose of treatment | 177 | ||
| Guidelines: musculoskeletal conditions | 178 | ||
| Myofascial trigger point pain | 178 | ||
| Osteoarthritis (OA) | 178 | ||
| Spinal or paraspinal pain (neck, thorax, low back) | 179 | ||
| Soft-tissue conditions | 179 | ||
| Lateral epicondylitis | 179 | ||
| Medial epicondylitis | 179 | ||
| Shoulder pain | 179 | ||
| Tenosynovitis, e.g. de Quervain’s | 179 | ||
| Plantar fasciitis | 179 | ||
| Ligaments and tendons | 180 | ||
| Non-cardiac chest pain | 180 | ||
| Guidelines: other painful conditions | 180 | ||
| Tension type headache | 180 | ||
| Migraine | 180 | ||
| Atypical facial pain | 181 | ||
| Fibromyalgia | 181 | ||
| Intermittent claudication | 181 | ||
| Phantom limb pain | 181 | ||
| Trigeminal or post-herpetic neuralgia | 182 | ||
| Complex regional pain syndrome and Raynaud’s syndrome | 182 | ||
| Guidelines: abdominal symptoms | 182 | ||
| Gastrointestinal symptoms | 182 | ||
| Bladder symptoms | 182 | ||
| Guidelines: conditions without pain | 182 | ||
| Nausea | 182 | ||
| Hayfever, allergic rhinitis | 183 | ||
| Menopausal hot flushes | 183 | ||
| Tinnitus | 183 | ||
| Itch | 183 | ||
| Safety first | 183 | ||
| Recording treatment | 183 | ||
| Chapter 16: Reference charts: points and innervation | 185 | ||
| How to locate acupuncture points | 185 | ||
| Myofascial trigger point pain referral patterns | 185 | ||
| Traditional acupuncture points | 185 | ||
| Bony landmarks | 186 | ||
| Body measurements | 186 | ||
| Acupuncture points by region | 186 | ||
| Other reference tables | 189 | ||
| Further reading | 189 | ||
| References | 219 | ||
| Index | 229 |