JENNY MILLER, DC GETTING TO THE POINT: A DISCUSSION ON ACUPUNCTURE.

J E N N Y M I L L E R , D C

GETTING TO THE POINT: A DISCUSSION ON ACUPUNCTURE

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• 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)• 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), 102-108.

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

• 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