Acupuncture provides effective relief
Ancient therapy may reduce need for surgery
American clinicians still have a great deal to learn about the use of non-drug interventions for pain management, say two experienced pain consultants. However, one non-drug therapy, acupuncture, is gaining ground with physicians as a viable alternative or adjunct therapy to drug intervention.
"I have had patients who have achieved excellent results with acupuncture, especially for the pain, nausea, and vomiting associated with cancer treatment," says Carol P. Curtiss, RN, MSN, OCN, clinical nurse specialist consultant in Green field, MA, and past president of the Oncology Nursing Society in Pittsburgh.
"Acupuncture can help amplify, or enhance, a patient’s response to pain relieving drugs by using meridian patterns in the body which cause a release of endorphins, the body’s natural pain reliever," explains Mark A. Young, MD, FACP, associate chairman of physical medicine and rehabilitation at New Children’s Hospital, associate chairman of rehabilitation at the Bennett Institute for Sport’s Medicine and Rehabilitation, and associate co-director of rehabilitation at Maryland Rehabilitation Center, all of Baltimore. "Case managers should be interested to know that many patients respond dramatically well with acupuncture, and thousands of dollars can be saved by avoiding the need for further surgery."
Young, a licensed acupuncturist, recommends acupuncture be introduced after week two or three in patients who are responding to their pain management plan with limited or moderate success. "Acupuncture is a harmless technique with dramatic pain relief potential when started fairly early in a patient’s pain management treatment. Chronic pain patients should receive weekly sessions for a minimum of five weeks to afford an adequate period of time to establish release," he says. "Clinicians generally know early on whether a patient is experiencing a positive response to acupuncture. The patient reports an almost immediate improvement in well-being." (For more on pain management, see p. 63. For sources of information on the use of acupuncture for pain management, see reading list insert.)
Releasing natural pain killers
Acupuncture often arrests the pain-spasm cycle that characterizes the pain in patient’s life, Young says. "Acupuncture sessions performed in a series promote a release of the body’s natural pain killers and levels the playing field. It allows the body to rest and heal. I must add that we don’t yet understand the mechanism of action in acupuncture, yet those of us who use acupuncture in our practices often see dramatic results."
Patients who generally respond well to acupuncture include those with:
• low back pain;
• migraine headaches;
• shoulder and neck pain.
He cautions that patients will experience changes in appetite and energy levels during acupuncture therapy. "Patients become tired during their sessions. They also may experience migration of their pain."
Case managers should approve acupuncture and pain management strategies early on, he says. "If case managers approve the use of pain management strategies, such as acu puncture, at the onset of a case they may avoid subjecting patients to a surgical approach that’s not absolutely necessary. There are clearly times when surgery is the only option. However, in many cases, I have been able to save insurance companies thousands by affecting a spontaneous im prove ment in pain intensity with acupuncture."
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