
Acupuncture
Guest Blogger: Bronia Michejenko, RN, MSN, GNP, BC
I have a small cabin on Toledo Bend in East Texas. Australian Pete, a gnarly 88 year old, lives two cabins down from me with three old dogs. Australian Pete has lived in the US for over 60 years but still has his Australian accent. He works as a helper for home construction projects. I stopped by over Thanksgiving and he told me that there are times when he is “all stoved up.” He has seen his health care provider and has not found much relief for his chronic aches and pains. He is looking at alternative therapies.
Millions of older Americans suffer from pain that is chronic, severe, and not easily managed. Pain from arthritis, back problems, other musculoskeletal conditions. Many are turning to complimentary or alternative medicine (CAM) therapies. A recent survey showed that 40 percent of Americans age 18 or older reported using some form of complementary health practice and people age 50 or older were among the most likely to report use. Rigorous, well-designed clinical trials for many CAM therapies are often lacking; and the safety and effectiveness are uncertain. The National Center for Complimentary and alternative Medicine (NCCAM) is sponsoring research designed to fill this knowledge gap by building a scientific evidence base about CAM therapies – whether they are safe and whether they work for the conditions for which people use them.
Safety should be considered by patients before using complementary health products and practices. Our elderly patients should be encouraged to discuss the use of CAM with their health care provider to determine safety and effectiveness and to choose carefully when selecting a CAM provider
The National Center for Complementary and Alternative Medicine published a guide using scientific evidence to help clarify what may be effective and what has been shown to have no effect on chronic pain. I have included two common conditions from the chart in the table below.
In general, there is not enough scientific evidence to prove that any complementary health practices are effective for rheumatoid arthritis, and there are safety concerns about some practices.
Scientific Evidence on Complementary Health |
Some Evidence of Potential Benefit |
Limited, |
Acupuncture |
√ |
|
Massage |
√ |
|
Spinal Manipulation |
√ |
|
Progressive Relaxation |
√ |
|
Yoga |
√ |
|
Acupuncture |
√ |
|
Glucosamine/Chondroitin |
|
√ |
Gamma Linolenic Acid (GLA) |
|
√ |
Herbal Remedies |
|
√ |
Tai Chi |
|
√ |
For further information visit the NCCAM Web site at http://nccam.nih.gov/health/providers/digest/chronicpain.htm
For the complete chart from above see http://nccam.nih.gov/health/providers/digest/pain/science/chart
References:
- Lee M., Shin B, Ernst. E. Acupuncture for rheumatoid arthritis: a systematic review. Rheumatology. 2008, Dec, 47, 12, 1747-53.
- White P, Bishop F, Prescott P, Scott C, Little P, Lewith G. Practice practitioner or placebo? A multifactorial mixed methods randomized controlled trial of acupuncture. Pain. 2012, Feb, 153, 2, 455-62.
- Morone N, Greco C, Rollman B, Moore C, Lane B, Morrow L, Glynn N, Delaney J, Albert S, Weiner D. The design and methods of the aging successfully with pain study. Contemp Clin Trials. 2012, Mar, 33, 2, 417-25.
Join us for a real-time discussion about questions raised by this essay on any Wednesday morning at 8:15 to 8:45 a.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.
December 5, 2012 at 10:19 am
Transcript from the Weekly Discussion on Aging
[06:16] Rodger Markova: Hello Nepherses.
[06:16] Nepherses Amat: you may call me Neph : )
[06:16] Rodger Markova: kk. How are you today Neph?
[06:16] Nepherses Amat: I am fine ty
[06:17] Rodger Markova: Excellent. Drinks and muffins are inside
[06:18] Coffee Mug whispers: Ahh! Fresh Hot Coffee
[06:19] Nepherses Amat: So tell me, what is this today?
[06:19] Rodger Markova: The blog for this week is shown above the fireplace
[06:19] Nepherses Amat: … and is it only UTMB?
[06:20] Rodger Markova: No, it’s open to anyone.
[Futzing with the media player]
[06:23] Nepherses Amat: I have the blog in the media browser now
[06:24] Rodger Markova: This week we have a guest blogger and the topic is alternative therapies and their effectiveness for older adults
[06:24] Nepherses Amat: I see, I am reading about it
[Off topic for a bit here]
[06:31] Nepherses Amat: I believe that experiential psychotherapies can facilitate physical healing.
[06:33] Rodger Markova: I agree. The mind has great control over the body but we are not very adept at using it.
[06:33] Nepherses Amat: yes, well I do not think it is about “control,” perhaps even the opposite
[06:33] Rodger Markova: Oh? What then?
[06:34] Nepherses Amat: more like finding the psychological wounds… beneath the physical dis-ease and then experientially allowing the follow thru that could not happen or preventing, rewriting the trauma.
[06:34] Rodger Markova: More like an enabling force?
[06:35] Nepherses Amat: I did a 6 month group for survivors of childhood sexual abuse. One person was either diagnosed with something, or had a trauma, and came to see me each February. In a drama we ended up tracking that to what must have been one of the original Feb. traumas. This person did throw up a lot that night.
[06:36] Rodger Markova: Interesting.
[06:36] Nepherses Amat: and reported being able to move easier and eat more afterwards over time.
[06:37] Rodger Markova: Do you think then it’s a stress related thing and when the psychological stress is relieved the body relaxes and heals?
[06:37] Nepherses Amat: Yes I do. I think we finally die of stress! Perhaps “stress” is defined to narrowly?
[06:38] Rodger Markova: I agree. Stress is a killer
[06:38] Nepherses Amat: I mean when you think of trauma as stress, grief as stress, and physical exertion. Things beyond worry. That is all stress too.
[06:39] Rodger Markova: But do you think the mind can directly influence the body functions or is it just a passive thing by relieving the stress
[06:39] Nepherses Amat: Oh, I think it has to be deeper than just the conscious mind that is why I said experiential therapies. The body must also be involved to get under the conscious mind.
[06:40] Rodger Markova: Yes, I agree. The unconscious is a big part of us
[06:40] Nepherses Amat: I believe we can make meaning of what we find that way and that in itself is healing for the body.
[06:40] Rodger Markova: Yes
[06:40] Nepherses Amat: So no one else came?
[06:41] Rodger Markova: No, some days it’s quiet
[06:42] Nepherses Amat: ty for having this forum! OK, so I will try to come next week too.
[06:42] Rodger Markova: Thanks. Have a good day.
[06:43] Rodger Markova: Bye
[06:43] Nepherses Amat: Ciao
April 24, 2013 at 3:48 am
Well it is interesting to find my own dialog online! I have meant to get back to this forum, but I seem to have an ongoing engagement on Wednesday mornings now. However, it was nice talking with you!