Musculo-skeletal pain and restricted movement
Acupuncture is very good at treating disorders of the
musculo-skeletal system and approximately 50% of our work as acupuncturists
falls into this category.
Many people visit their G.P. for muscle-related problems.
Usually painkillers and anti-inflammatory pills are prescribed, and
sometimes the muscular pain will clear up spontaneously with the help of
these medications. On other occasions the medication will give temporary
relief, but the pain returns as the effects of the medication wears off. In
particularly bad cases the medication may not have any effect in reducing
pain.
No one knows for sure exactly how acupuncture works in
the treatment of muscular pain. Many theoretical models have been proposed
and I am sure that all of them hold part of the story. One of the problems
in discussing the theoretical basis of acupuncture is that there are many
different acupuncture techniques and they are all capable of achieving the
desired affect.
Fairly recently, two senior consultant anaesthetists from
the States (Travell &Simons), coined the phase 'trigger points'
to particular points in taut muscle bands which, when needled could cause an
immediate release in the muscle… and instant pain relief. These points are
found by feeling for taut muscle bands in the problematic muscle and then
needling the most tender point. These trigger points can often be felt as
nodules in the muscle fibres, as the diagram illustrates.
The work of Travell and Simons was pioneering, although
when these points were mapped out, they often corresponded to Traditional
Acupuncture points. This work showed a clear overlap between modern research
& clinical findings, and the ancient Traditional Chinese Acupuncture points
& channels.
'Trigger points' certainly account for some muscular
pain, but not all. Recently I treated a patient who had damaged his back
lifting some rocks and had to return to work in two days time. This was an
acute injury and when I palpate his lower back I found a deep muscle that
felt ropey and had very tender points. When the muscle was treated, it
‘twitched’ and his pain disappeared immediately and he returned to work.
Unfortunately not all backs respond in this way. In this case he was a
young, fit man with a very recent injury and the problem was isolated to one
deep gluteal muscle.
As a rule, rather than the exception, most people come to
have acupuncture treatment several weeks or months after their problem
began. Often people wait and hope that their pain will go away before
seeking treatment. When the injury becomes chronic then many more muscles
are affected. There is often a gradual stiffening and reduction in movement.
Often this isn't problematic until it affects everyday activities or when
the person can no longer adapt to the injury. In these cases, treatment is
going to be gradual and may take weeks or even months. I do however aim for
an improvement after every session and as long as the patient can feel this,
then I find that the number of treatments needed for recovery is not so much
a concern.
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