Traditional Acupuncturists Research Articles

Acupuncture & electrotherapy: An alternative and complementary treatment method

Acupuncture involves activating specific points on the skin, usually by inserting needles. Acupuncture was based on the principles of traditional Chinese Medicine. Traditional acupuncturists understood health in terms of a vital force or energy called "Qi" that circulates between the organs along channels called meridians. The flow of 'Qi' energy must be of the right strength and quality in each of these meridians and organs so that health is maintained. Acupoints are located along the meridians and can alter the flow of energy and appear to correspond to nerve endings. There is a distinct difference between traditional and Western acupuncture, but the two approaches overlap significantly. In terms of Western theories, acupuncture induces signals in central nerves that modify the transmission through the spinal cord, as well as the perception of pain in the brain. Electrotherapy leads to stimulation of the sensory and motor nerves, and is especially used in the treatment of pain. Different set of parameters may lead to different physiological effects and treatment may be more specific. Electroacupuncture can be performed with or without needles, activating traditional acupuncture points or choosing points that have a neural background, such as trigger points or tender points. The purpose of this study is to verify that acupuncture works as an effective alternative and complementary treatment method. It is a safe, effective and natural approach, which helps to regain and maintain health and mental well-being.

Lifestyle and health behaviour change support in traditional acupuncture: a mixed method survey study of reported practice (UK)

AimsComplementary medicine therapists such as traditional acupuncturists are a large resource for supporting public health targets to improve health behaviours. Our objectives were to determine the prevalence and patterns of UK acupuncturists’ provision of lifestyle change support, test theory-based hypotheses about facilitators and barriers to supporting lifestyle changes and to explore associated characteristics and attitudes.MethodsA mixed methods design in which British Acupuncture Council members (Sept 2019-April 2020) completed an online questionnaire assessing prevalence of lifestyle change support, typical patterns across patients and behaviours, Theory of Planned Behaviour constructs, practitioner characteristics and open-text responses regarding additional behaviours and clinical decisions to introduce lifestyle change.ResultsThree hundred fifty-two traditional acupuncturists participated (Mean age = 51.5 years, SD 9.9; 81.8% (n = 288) female). 57.7% (n = 203) reported offering support for lifestyle change during their most recent consultation. 91.7% (n = 323) reported supporting lifestyle change ‘always or most of the time’ for patients with chronic conditions and 67.9% (n = 239) reported this for patients with acute conditions. The pattern of typical support for different health behaviours ranged from 44.6% (n = 157) for smoking reduction (acute conditions) to 95.2% (n = 335) for diet support (chronic conditions). A linear regression model found that frequency of support for lifestyle change in acute patients was predicted by acupuncturists’ attitudes to both clinical role and importance of health behaviours, confidence in their ability to provide lifestyle change support and use of fewer behaviour change techniques. The decision to first offer lifestyle change support was guided by perceived patient receptiveness, whether presenting condition/diagnosis were likely to improve with lifestyle change and whether a strong therapeutic relationship was established.ConclusionsTraditional acupuncturists’ reports suggest their work supports key public health targets for promoting healthy behaviours. Less frequent support for alcohol/smoking may reflect user characteristics but may suggest training needs for acupuncturists. Increase could be made for support in acute presentations, however the importance of patient receptiveness, linking advice to condition, and therapeutic alliance should be explored further. There may be important differences between acupuncture practice and mainstream healthcare (e.g. high level of contact, longer visits, holistic approach) which impact mechanisms of action of behaviour change.

Midwives’ experiences of caring for women with antenatal anxiety and depression: A qualitative study with midwifery acupuncturists

Background: Pregnant women seek help for a range of physical and emotional pregnancy symptoms from traditional acupuncturists. Whether midwifery acupuncturists in Aotearoa New Zealand (Aotearoa NZ) provide acupuncture for antenatal anxiety and depression (AAD) in practice is currently unknown. Aim: This qualitative arm of a mixed-methods study aimed to explore midwifery acupuncturist experiences of caring for pregnant women with AAD in Aotearoa NZ. The aim of the research was to examine the factors that influence midwifery acupuncturists' perceptions of acupuncture use for AAD. Method: This was a mixed-methods study involving an online survey and in-depth interviews from a convenience sample of Aotearoa NZ midwifery acupuncturists who had completed a Certificate of Midwifery Acupuncture. This paper describes the thematic analysis of the semi-structured interviews. Findings: The eight interviewees were mostly NZ European (n=6) and Lead Maternity Carers (LMCs; n=6) caring for pregnant women in rural and urban locations throughout Aotearoa NZ. The interviews revealed an overarching theme, “helping midwives to navigate the ocean of AAD”, which identified the lack of support participants experienced from current maternity health services for AAD in Aotearoa NZ. Subthemes “Missing the boat during pregnancy” expressed how participants felt no options were available for AAD prevention, while “keeping women afloat with no ship in sight” represented how interviewees tried to keep women in their care stable even though access to maternal mental health services was difficult. Participants felt acupuncture was a useful non-pharmaceutical tool that works; however, they had reservations about “adding acupuncture to the midwifery toolbox”. Conclusion: Aotearoa NZ midwifery acupuncturists were concerned about AAD and the limited conventional options available for women in their care. Acupuncture was viewed as a promising adjunct to usual treatment for AAD. Reservations included adding acupuncture to an already heavy midwifery workload, the cost of acupuncture, and the appropriateness of the treatment.

The 'disenchantment' of traditional acupuncturists in higher education.

Efforts of traditional acupuncturists in the UK to regulate their practice and standardise their training, led, from the mid-1990s, to the launch of acupuncture undergraduate programmes within, or validated by, universities. It appeared as if by so doing acupuncturists were on course to align themselves with 'scientifically plausible', state-regulated, allied health professionals, a remarkable development considering the marginality of acupuncture practice outside East Asia, and its paradigmatic tensions with biomedicine. But was it really to be? Based on in-depth interviews with higher education acupuncture educators and an analysis of educational documents published by the leading professional body, we explore the way in which this paradigmatic tension is negotiated within a framework that is dominated by biomedicine. By critically revisiting sociology of professions and anti-colonial analysis, we examine an over two decades long journey of acupuncture educators in academic institutions in the UK. Based on this analysis, we point at some of the challenges that acupuncturists faced in higher education that may have restricted the academic legitimisation of acupuncture and that left them in a position of academic marginality and greater exposure to scrutiny, leading to their academic and mainstreaming 'disillusionment'. At the same time, by positioning themselves as 'professional academics' within higher education institutions and demonstrating professionalism, acupuncture educators were able to demonstrate academic and professional 'credibility' and therefore distance themselves from the continuous scrutiny over their 'biomedical fragility'.

Acupuncture for stroke: perceptions and possibilities

To investigate perceptions and acceptability of, and attitudes towards, acupuncture for post-acute stroke and rehabilitation care by exploring the views of different stakeholders. Three electronic surveys were conducted to gauge the breadth of knowledge and acceptance of acupuncture in post-acute stroke and rehabilitation care among three stakeholder groups: (1) traditional acupuncturists registered with the British Acupuncture Council (BAcC); (2) National Health Service (NHS) professionals attending the 2017 UK Stroke Forum conference; and (3) the UK network of Stroke Club co-ordinators. Of 278 NHS respondents, 31% were doctors. Over half (52%) of all NHS respondents reported they had insufficient knowledge about acupuncture, its effectiveness (23%) or how to refer (21%). Only 12% had previously referred stroke patients for acupuncture but 46% thought that there was role for acupuncture in post-acute stroke care (50% were unsure). Two thirds of BAcC acupuncturist respondents had treated at least one stroke patient, with 70.1% having treated 1-5 stroke patients and 71% having provided treatment in the last year, most commonly for motor impairment (88.2%). Of 99 Stroke Club coordinators who responded, only seven had ever been asked about acupuncture by patients, but most felt there would be interest. Interest in the provision of acupuncture for post-acute stroke care was expressed by both NHS practitioners and acupuncturists. Further research is required on the acceptability of acupuncture to patients as well as evidence of its clinical and cost effectiveness.

Distinct Neuroanatomical Structures of Acupoints Kidney 1 to Kidney 8: A Cadaveric Study.

Objective: The Systematic Classic/Zhen Jiu Jia Yi Jing (ZJJYJ, ) is considered to be the first complete acupuncture manual to detail the location and meridian assignations of 349 acupuncture points. Despite numerous transcriptions and editing changes, many traditional acupuncturists adhere to the classics and rarely question their validity. However, ushering the use of acupuncture into the modern era requires examining acupuncture point locations objectively by comparing contemporary anatomical knowledge with classical texts. The aim of this research was to examine distinct neuroanatomical targets associated with acupuncture points to: (1) standardize the precise neuroanatomical target of each acupuncture point; and (2) crossreference neuroanatomical targets with classical point locations. This was done to demonstrate ancient authors' intentions when describing acupuncture points as coordinates used to stimulate the peripheral nervous system. Materials and Methods: The unique neuroanatomical targets associated with acupuncture points on the Foot Shao Yin Kidney meridian were defined. Specifically, KI 1 through KI 8 were examined by comparing classical point locations from the ZJJYJ with modern standardized textbook locations from Chinese Acupuncture and Moxibustion, current anatomical literature, the current authors' cadaver dissection research, and electrostimulation of acupuncture points in healthy volunteers. Results: KI 1-KI 8 correlated with motor entry points as well as with nerve branches and vessels derived from the posterior tibial neurovascular bundle. Conclusions: This research demonstrated a procedure to verify and standardize the distinct neuroanatomical structures of acupuncture points. Standardization of neuroanatomical targets of acupuncture points will enable researchers and clinicians to obtain reproducible results in clinical treatments and research protocols.

Medical Pluralism and the State: Regulatory Language Requirements for Traditional Acupuncturists in English-Dominant Diaspora Jurisdictions

Regulation of traditional acupuncturists has proven controversial in several jurisdictions. In this work, we detail and analyze the range of English-language registration, practice, and record-keeping requirements for regulated traditional acupuncturists across Canada, the United States, and Australia. Drawing on the results of an extensive documentary review and 28 qualitative interviews, we identify five primary themes underpinning policy-related discourses and debate: patient safety; standardized, integrated health care systems; economic considerations; traditional knowledge protection; and culturally inclusive care delivery. We critically examine these policy discourses, positioning them within a broader literature related to language policies in multiculturalist states and considering their relevance to the question of traditional medicine professional regulation in diaspora. With reference to the principle of regulatory equity, and to the concept of a pluralistic public, we present a set of recommendations for traditional medicine regulators contending simultaneously with clinical and cultural considerations.

Complementary and alternative medicine's occupational closure in Portuguese healthcare: Contradictions and challenges.

This article analyses strategies of closure recently enacted by complementary and alternative medicine practitioners in order to achieve occupational control over work domains in healthcare, taking Portugal as an example. A combination of the neo-Weberian occupational closure theory of the professions and Abbott's jurisdictional vacancy theory is proposed as the framework for analysis. Acupuncture and homeopathy will be presented as case studies. Data are derived from in-depth interviews with 10 traditional acupuncturists and 10 traditional homeopaths. Data analysis suggests that (1) professionalisation, (2) alignment with biomedical science and (3) expressing 'legitimating values' of a countervailing nature have been three significant strategies complementary and alternative medicine practitioners have used in an attempt to achieve market closure. It is argued that these strategies are contradictory: some involve allegiances, while others involve demarcation from biomedical science. A further outcome of these strategies is the promotion of complementary and alternative medicine treatments and solutions in everyday life. The success of these strategies therefore, although helping to reinforce the biomedical model, may simultaneously help complementary and alternative medicine to demarcate from it, posing thus challenges to mainstream healthcare.

Overlapping marginalities: statutory regulation of traditional acupuncturists in North America and the English-language controversy

Overlapping marginalities: statutory regulation of traditional acupuncturists in North America and the English-language controversy

Traditional acupuncturists and higher education in Britain: The dual, paradoxical impact of biomedical alignment on the holistic view

Traditional acupuncturists' quest for external legitimacy in Britain involves the standardization of their knowledge bases through the development of training schools and syllabi, formal educational structures, and, since the 1990s, the teaching of undergraduate courses within (or validated by) Higher Education Institutions (HEIs), a process which entails biomedical alignment of the curriculum. However, as holistic discourses were commonly used as a rhetorical strategy by CAM practitioners to distance themselves from biomedicine and as a source of public appeal, this ‘mainstreaming’ process evoked practitioners' concerns that their holistic claims are being compromised. An additional challenge is being posed by a group of academics and scientists in Britain who launched an attack on CAM courses taught in HEIs, accusing them of being ‘unscientific’ and ‘non-academic’ in nature. This paper explores the negotiation of all these challenges during the formalization of traditional acupuncture education in Britain, with a particular focus on the role of HEIs. The in-depth qualitative investigation draws on several data sets: participant observation in a university validated acupuncture course; in-depth interviews; and documentary analysis. The findings show how, as part of the formalization process, acupuncturists in Britain (re)negotiate their holistic, anti-reductionist discourses and claims in relation to contemporary societal, political and cultural forces. Moreover, the teaching and validation of acupuncture courses by HEIs may contribute to broadening acupuncturists' ‘holistic awareness’ of societal and cultural influences on individuals' and communities' ill-health. This investigation emphasises the dynamic and context-specific (rather than fixed and essentialized) nature of acupuncture practice and knowledge.

Lifestyle and Self-Care Advice Within Traditional Acupuncture Consultations: A Qualitative Observational Study Nested in a Co-Operative Inquiry

The study objective was to develop methodology for observational research within traditional acupuncture consultations in community-based practice, and to explore how traditional acupuncturists communicate with patients about lifestyle and self-care. This was a mixed-method qualitative study, using audio-recording of consultations followed by telephone interviews of patients. The study was nested within a cooperative inquiry. As co-researchers, group members participated in framing the research questions, deciding methods to be used, and discussing the emergent findings. Four (4) experienced traditional acupuncture practitioners, registered with the British Acupuncture Council, contributed to the co-operative enquiry and recorded consultations in three clinics in Somerset. Subjects comprised a convenience sample of patients attending 21 consultations. A purposive subsample of patients was selected for interview. Audio-recording was challenging to some practitioners who felt that it might result in infrequent, but nevertheless worrying, withholding of personal information by patients. Patients, however, reported that they were generally positive about the audio-recording. Each consultation was analyzed as a trajectory in which eight categories of talk interwove with each other and with periods of physical examination, needling, and silence. Trajectories showed where talk about self-care ("self-care talk") appeared in the consultations, the content of such talk, and who initiated it. The data confirmed that self-care advice arises from, and is explained in terms of, each person's individual Chinese Medicine diagnosis. The identification of different types of talk and the way that "self-care talk" is interwoven throughout the consultation emphasized the integral nature of self-care support and advice in the practice of traditional acupuncture. Some patients had difficulty putting self-care advice into practice, even when they were intellectually committed to it, suggesting that practitioners may need to follow up more carefully on the advice they have given. Self-care in traditional acupuncture consultations is integral, interactive, and individualized. This study has mapped out a potential agenda for research into self-care in traditional acupuncture consultations and illustrates the exciting opportunities that open up when observational and interview data are combined.

Tactics of acupuncture for migraine prophylaxis

In order to provide some more scientific and practical advice and tactics for acupuncture in prevention of migraine in clinic, a computer-based information search was conducted in MEDLINE database, and the current reports of clinical trials were summarized and a comparison of Western and Chinese research designs was made. The significant role of acupuncture for prevention of migraine has not been applied in wide range in China until the present day. However, it has been paid great attention in Western countries. This situation might be related to the differences of efficacy assessment of acupuncture between China and Western countries; meanwhile, in the past traditional acupuncturists put much stress on the therapeutic approaches for acute attacks of headache but less on prevention. It is necessary for Chinese doctors to learn from research method in the West and emphasize more on acupuncture for preventing migraine and conduct high-level clinical trials as well. The author recommends that Chinese doctors should select acupuncture points mainly according to meridian syndrome differentiation and apply long term intermittent interventions.

A 54-Year-Old Woman with Degenerative Back Pain

Back pain is a common symptom: up to 70% of UK adults experience this symptom by the age of 60 and most have moderate to severe pain. Back pain accounted for 12% of consultations to traditional acupuncturists in 2001 and is one of the most common reasons for consultation with an acupuncturist. This case report concerns a 54-year-old woman with metastatic breast cancer and degenerative lower back pain, which remained painful despite intensive pharmaceutical management and facet joint injection and was ultimately successfully managed with two 30 min acupuncture treatments 2 weeks apart, using eight points on the BL meridians. Acupuncture treatment using tender points was later trialled for neuropathic pain secondary to local recurrence in her mastectomy scar, however this was unsuccessful and inpatient hospice admission for further intensive pharmaceutical management was required.

Segment-Anatomie: Der SchlüSsel Zu Akupunktur, Neuraltherapie Und Manualtherapie

Ingrid Wancura-Kampik. Published by Urban & Fischer (Elsevier), Munich (2008) 421 pages, €79.95 (hardback) 978-3-437-57970-7 This is a book of fundamental importance for the acupuncture profession. Most medical acupuncturists will be aware of the concepts of “segmental acupuncture” outlined by Bekkering and van Bussel.1 However, physiotherapists who practise acupuncture may be more familiar with trigger point therapy, and the majority of traditional acupuncturists will have little knowledge of either approach. All will benefit from reading this textbook which, as the subtitle claims, may well be a key to understanding many aspects of acupuncture, neural therapy (a method of treatment using local anaesthetic injections) and indeed manual therapy, in terms of Western anatomy. It will also be useful to other health professionals as an aid to diagnosis. Dr Wancura is a highly experienced acupuncture practitioner, the co-author of several works on acupuncture since 1974, and involved in the study of the “forgotten knowledge” of segmental anatomy since 1965. The present book is the summation of her own knowledge on the subject, a comprehensive if not all-inclusive review of the extensive literature published in German (around 240 references), in comparison to which that available in English looks very minimal indeed! In fact, only 10 English language publications are listed here, although much of the author’s base material derives from works by Henry Head and James Mackenzie translated into German. (In all, nearly 7% of the references are translations from English. The proportion of papers translated from German in a comparable English textbook would be far less.) The book is richly illustrated (116 illustrations, many in two or more parts) and divided into 10 chapters: (1) an introduction to the segments and metamerism; (2 and 3) on the role of the peripheral spinal and autonomic nervous systems in the segments; (4–7) on the dermatomes, myotomes, sclerotomes and enterotomes (viscerotomes); (8) on the connections within and between the …

Perceptions of evidence‐based medicine: traditional acupuncturists in the UK and resistance to biomedical modes of evaluation

Acupuncture and other types of 'complementary and alternative medicine' (CAM) are proving increasingly popular in the UK. As attempts to incorporate acupuncture into allopathic medicine have grown in number, the issue of assessing its effectiveness in ways consistent with the concept of evidence-based medicine has become more urgent. The nature, relevance and applicability of such assessments remain controversial however. This paper reports a qualitative study of acupuncturists' own perceptions of evidence and evidence-based medicine in relation to their therapeutic interventions. The material is presented in two main sections: explaining how acupuncture works, and resisting evidence-based medicine. The interviews reveal a great deal of scepticism and ambivalence and a deep questioning of the salience of conventional (biomedical) modes of evaluation of interventions.

Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain

Objective To determine whether a short course of traditional acupuncture improves longer term outcomes for patients with persistent non-specific low back pain in primary care.Design Pragmatic, open, randomised controlled trial.Setting...

The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists

Recent reports have highlighted the importance of having good evidence on the safety of acupuncture. 1 2 Sound evidence on the risks associated with acupuncture is, however, scarce.3 Our primary...

Acupuncture for low back pain: results of a pilot study for a randomized controlled trial

To pilot procedures to be used in a randomized controlled trial of acupuncture for low back pain. Uncontrolled clinical trial. Primary care and acupuncture clinics in York, England. 20 patients with low back pain lasting 1 month or more. 10 sessions of individualized acupuncture from a traditional acupuncturist. Change in Oswestry low back pain disability questionnaire; present pain intensity scale; effect on daily living scale, and SF-36 general health questionnaire at post-treatment and 6 months after the end of treatment. 14 patients completed follow-up. Patients had similar severity scores at baseline to those referred to an NHS outpatient clinic. Post-treatment, there were statistically significant improvements in Oswestry, present pain intensity, effect on daily living and the physical functioning, social functioning, bodily pain, vitality and mental health sub-scales of the SF36. Similar results were found at the six month follow-up. Oswestry scores showed reduced levels of pain at 6 months compared to than at post-treatment, falling approximately 40% from baseline. Though the improvements in pain and quality in life may be due to the natural course of back pain, the promising responses justify further research. The procedures used in the study are appropriate for a randomized controlled trial. Drop-out could be reduced by more careful patient monitoring.

The significance of needle placement site in acupuncture

Traditional acupuncturists claim that correct needling of classical acupuncture loci is associated with a characteristic set of sensations usually referred to as ‘Teh Chi’. The studies reported here examine this claim. In the first a multiple adjective sensation rating scale was developed and administered to 125 patients receiving acupuncture treatment. The results were subjected to principal components analysis and the first factor to emerge provide some support for the constellation of sensations corresponding to Teh Chi. In the second study the scale was used in a randomised controlled mixed single/double blind experiment in which 65 volunteers were stimulated at three classical and three non-classical (sham) needling sites by either a trained acupuncturist (single blind) or an anaesthetist (double blind). The results of the second study did not support the contention that the sensations of Teh Chi occur more frequently at classical acupuncture needling sites. The implications of the results for the practice of acupuncture are discussed.