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I first started using acupuncture as a treatment back in 2012. I was working in general practice at the time and found that for some people, standard medical treatments (such as drugs, physical treatments, injection, surgery), were of limited effectiveness and on occasions, led to worse outcomes. After completing the year long Graduate Certificate in Medical Acupuncture (Monash University), I started incorporating acupuncture with my GP patients. Results were most encouraging with most people experiencing improvement in their symptoms, general functioning and wellbeing. Some were even able to cancel planned surgical procedures and cease medications. I dedicated more of my practice to acupuncture and successfully completed another year of study, and examinations, to attain the Fellowship of the Australian Medical Acupuncture College in 2016. I now dedicate my work at HT Health Group to medical acupuncture, utilising both needle and LASER techniques.
The most common problems I treat are chronic pain conditions. Most people have already tried many forms of treatment and continue to struggle with persistent pain and the associated effects on their functioning, mobility, mood, sleep and wellbeing. Understanding the causes of ongoing pain is complicated. As a generalisation, most people and some health professionals are focused on a discrete tissue injury/ disease as a cause of their pain with the resulting frustration when this cannot be found and fixed. Rather, chronic pain involves complex changes of the pain system involving the tissues, nerve endings, nerves, myofascia (muscles and supporting structures), central nervous system (spine and brain centres), psychological factors and stressors. It is very different to acute pain where the pain serves as an important protective mechanism. For reasons not fully understood, pain from an initial injury or disease can persist long after the original condition has resolved.
My approach is first to fully evaluate the patient's symptoms through history, examination and review of investigations and treatments to date. Occasionally a specific condition or a localised cause can be found that requires medical or surgical treatment. From this assessment, I consider the relative contribution of the various components to the pain experience. The other reason for a thorough assessment is to ensure that there is no major structural problem and to reassure the individual that they are safe to move and that there is no need to guard the area. I then spend time explaining the complexities of chronic pain and the treatment approach.
The most common conditions I treat with acupuncture include :
Acupuncture broadly works on 3 levels:
Acupuncture, as with other physical therapies, needs to be tailored to the individual particularly taking into account the level of sensitisation. Higher levels of sensitisation are evidenced by high pain levels, longer duration, psychological distress, sleep disturbance, reduced mobility and function, wider area of pain, guarding with tight tender muscle bands and excessive sensitivity to touch/ pressure. It is as if the pain system settings have been dialled up so that the pain becomes persistent and even non painful stimuli, such as pressure, stretch, temperature change, are processed as pain – as real as pain from damaged tissue. In these settings the priority is to dial the system down using more distant points and other calming strategies.
Most acupuncture treatment schedules involve weekly sessions over approximately 6 weeks. More chronic conditions with high levels of sensitisation can take 2-3 months for a significant response. Responses vary – some people notice immediate benefits others take up to 4-6 sessions. Whilst most people experience significant benefit, I find approximately 20% attain no benefit of note. Adverse effects are uncommon and usually mild, the most common being transient flaring of pain. There can be general side effects - light headedness, sedation and side effects from needling – bruising, damage to structures. Most people find the process calming. Needling is mildly and transiently painful – I can and often use low level LASER in certain situations. This is an effective alternative to needling which I utilise for certain conditions, points where needling could be hazardous and for patient preference.
Either concurrently, or following reduction in the pain, a tailored exercise programme can be organised. This can enable a more complete return to function and help attain the important goal of people being able to self manage their health conditions.
There is good evidence now for the effectiveness of acupuncture. Studies have always been problematic in that there is no good comparable placebo. A meta analysis of acupuncture in chronic pain conditions was published in the May 2018 edition of the Journal of Pain. Representing over 20 000 patients acupuncture showed statistically significant improvement in pain scores, over sham, which persisted over time. Several professional guidelines now support acupuncture treatment including the American College of Physician. Their guidelines for managing chronic back pain advises four first line treatments – exercise, rehabilitation programmes, acupuncture and mindfulness based stress reduction.
Acupuncture appointments can be made by phoning HT Health Group on 6221 1675 or booking online through this website. Medicare rebates are available with an approximate gap fee of $45.
Medical Acupuncture with Dr Andrew Elkerton