Clinical Physio
Does Acupuncture Work in Physiotherapy?! | Expert Physio Reviews the Evidence
In this tutorial, we review the latest evidence on the use acupuncture in physiotherapy and give our personal insights and top tips on using acupuncture!
References:
*Anjos et al., 2021: https://doi.org/10.2174/0250688202999210225143604
*Trinh et al., 2016: https://doi.org/10.1002/14651858.CD004870.pub4
*Almutairi et al., 2022: https://doi.org/10.3390/healthcare10071176
*Kannan, Bello and Winser, 2022: https://doi.org/10.1177/20406223221078672
*NICE Guideline: Low back pain and sciatica (2016): https://www.nice.org.uk/guidance/ng59/chapter/recommendations
* NICE Guideline: Osteoarthritis (2014): https://www.nice.org.uk/guidance/cg177/chapter/Recommendations#non-pharmacological-management-2
* NICE Guideline: Chronic pain (2021): https://www.nice.org.uk/guidance/ng193/chapter/Rationale-and-impact
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acupuncture one of the most controversial topics in the world of physiotherapy if you want to find out how effective it is including even more controversy then keep watching [Music] hey everyone khalid here welcome back to clinical physio acupuncture is one of the most talked about treatments in physiotherapy and it divides so much opinion now i actually trained myself to do acupuncture in physio about eight years ago so in this video i'm going to summarize what some of the key pieces of evidence are as well as my own personal opinions on how it could be used in practice but first of all what is acupuncture well it's a form of traditional chinese medicine which was thought to have been created over 2000 years ago the traditional chinese approach identifies very specific points around the body that link up to form pathways or what they call meridians where chi or energy was said to flow through the body it was believed that pain could present itself when she was not flowing through the meridians correctly this is where acupuncture would come in and aim to re-establish the flow of qi so that pain was reduced so this has been adapted in the new form western medicine acupuncture so you know when you're a child and you bang your elbow and someone tells you to rub it and by rubbing it oh my goodness it seems to feel better well the idea there is that the brain now has to think of a different sensation a pain inhibition stimulus which means that it stops thinking about the pain and instead has to think about the rubbing so the idea in western medicine acupuncture is that the needles aim to create a different sensation like a warm feeling or a deep ache or even a feeling of general relaxation in order to inhibit pain signals we should be still using the same specific points that they used in traditional chinese medicine but more on that later right so let's go through some evidence and sorry to start with the bad news but for general musculoskeletal conditions the evidence is really mixed so to start with i've picked out this systematic review from anya sertal 2021 which is titled exploring the effectiveness of acupuncture as an adjunct to physiotherapy in the treatment of musculoskeletal conditions a systematic review sounds like just what we need and i really like this review because they compared acupuncture to sham acupuncture so you know that we said with acupuncture in the traditional chinese medicine approach you're using very specific points along very specific pathways well with sham acupuncture you're still inserting needles into the body but instead of those very specific points they use random points throughout the body so what were the results well the authors concluded that for the majority of musculoskeletal conditions they found very little evidence that acupuncture when combined with physiotherapy adds an additional pain relieving effect but they did find some evidence to suggest that it can be useful to add to treatment for neck disability improving muscular strength and for shoulder dysfunction so as a result i thought i'd do some more digging around neck pain and i found this cochrane review from trinital 2016 titled acupuncture for neck disorders now a cochrane review is said to be one of the top pieces of evidence in the world of medicine and this particular cochrane review involved 27 studies including more than 10 000 patients so that is huge so this review looked at things like whiplash associated neck pain chronic neck pain subacute neck pain a real range and they concluded that there is moderate quality evidence to suggest that acupuncture was better than sham acupuncture when pain was measured at the completion of treatment and at short-term follow-ups so in between sessions and they also concluded that acupuncture also had moderate evidence to be better than patients just sitting on a waiting list i.e not receiving any treatment at all so that's really good when it comes to neck pain okay so we have some good evidence for the use of acupuncture with neck pain but as an acetal 2021 highlighted not for a lot of other musculoskeletal conditions so i dive further into the other musculoskeletal conditions now in the uk we have the nice guidelines nice stands for national institute of health and care excellence this organization look at lots of different pieces of research around a specific condition and use that research to create best practice guidelines and they've created guidelines for low back pain and sciatica and osteoarthritis and i have to tell you that the nice guidelines for both of those conditions do not support acupuncture for low back pain it says that they do not recommend the use of acupuncture for low back pain with or without sciatica and also do not include the use of acupuncture for osteoarthritis that's pretty clear and pretty convincing okay so what's the next level well a really important consideration is for those who have chronic pain or persistent pain we know these individuals have very complex pain pathways that can be affected by mood stress anxiety memory family circumstances living circumstances so much at play and because acupuncture is a very pain focused intervention maybe there's some substance to it when it comes to persistent pain management so i found this systematic review and meta-analysis from al mutteriatal in 2022 looking at acupuncture versus sham acupuncture and also comparing it to intravenous lidocaine which is a local anaesthetic and change in diet for patients with fibromyalgia so they included 23 randomized control trials involving over 1 400 patients and their main conclusion was that whilst intravenous lidocaine and diet did not have a significant improvement compared to placebo or sham true acupuncture did have a significant improvement on these patients reducing pain reducing depression and enhancing quality of life so that's really cool and actually the nice institute also released their guidelines on chronic primary pain management and they concluded that practitioners should consider a single course of acupuncture whether that be a traditional chinese or a western medicine approach as long as it's delivered in a community setting is delivered by a senior healthcare professional with adequate training and that the total acupuncture treatment time doesn't exceed more than five hours over the total sessions and that's basically so that patients don't have months and months and months of acupuncture so also a shout out for acupuncture for tension headaches the nice institute released their guidelines on this highlighting that it can be useful and also a shout out to canon bellow and windsor who released their systematic review in 2022 and highlighted that acupuncture can be really useful for patients who have ongoing pain post-stroke so those are a couple of other conditions to throw into the mix too so that's the evidence what about a summary of my thoughts into the use of acupuncture in practice well i know that lots of clinicians don't like acupuncture and from listening to them i suppose there's two key things that stand out for me number one is that acupuncture is considered to be an inactive treatment lots of healthcare professionals either don't give exercises alongside the acupuncture or perhaps give patients the opinion that they don't need exercises and that the acupuncture is the key part of their treatment that kind of feeds into the second point which is that acupuncture can be a very dependent treatment you hear really sad stories of patients having gone back for 20 25 30 40 sessions of acupuncture because they feel like they really need it to manage their condition that can make these patients very vulnerable and you can really understand as a result why clinicians want it phased out of physiotherapy then you add that to the evidence we've seen with the evidence that there's lots that acupuncture doesn't seem to have much benefit with there's also lots of conditions that acupuncture does seem to have a benefit with and i can wholeheartedly say that that's probably the summary of my experience with acupuncture in practice patients that i can remember definitely didn't get better with acupuncture but i can also remember patients who had real differences with acupuncture real differences that really enhance their quality of life so as a result my four tips for using acupuncture in practice number one make sure it's used for the right patient perhaps from this review we'd consider patients with neck pain or patients with persistent pain number two make sure that acupuncture is a part or an adjunct within their physiotherapy treatment the patients still need to be active doing exercises understanding activity modification and therapists should be educating on other self-management strategies so that acupuncture isn't the only part of their treatment number three don't be that clinician that says that patients need 30 sessions of acupuncture if you wish try three or four to see if it has an effect if those three or four sessions don't have an effect i doubt that 20 more are going to have an effect and my fourth and final tip which is an interesting one and is a consideration for you to think about so let's say that your patient walks into your clinic room and they're really stressed they're really anxious and they've got persistent pain and lying down or sitting down for them with some acupuncture needles in for 20 minutes or so allows them to leave the clinic feeling very relaxed feeling distressed perhaps with that warm glow that acupuncture can sometimes give isn't that a good thing perhaps it's that de-stressing feeling that relaxation effect that can have that positive effect with those patients with persistent pain or fibromyalgia that could be a really good use case for acupuncture as long as we act with honesty and integrity as clinicians by not promoting over dependence that could be one of the key things that you use your acupuncture for in practice so guys that's it from me i really hope you've enjoyed this video if you have please support us by smashing that like button and subscribing to the channel for all our best updates also follow us on social media at clinical physio on instagram and check out our website clinicalphysio.com we've got loads for you my name is khalid thank you so much for watching see you really soon here on clinical physio
#Acupuncture #Work #Physiotherapy #Expert #Physio #Reviews #Evidence
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I've also had a really good experience with acupuncture… Amazing actually.
So what do I do to the arthritis because I am planning to go do it on Monday?
I had just 1 acupuncture session yesterday and already I feel around 80% better within 24 hours. Amazing.
Acupuncture is amazing. I have gotten it for so many things and has helped me so much. Its always my go to now when i have something wrong with me
I have actual damage to lower vertebrae, and need manipulation.
Acupuncture is not real medicine.
it works. don't know why, but it's better than any massage
great
I'm 24 , having loss of lumbar lordosis with disc degeneration my physio suggests me acupuncture treatment total 10 session it is fine or will it be worsen the condition ??
Please reply
Great video subbed….chronic neck pain for last 6 years after spearing a guy with my head in a tackle playing american football….just did my first session along with physio(doctor does both) think i am finally onto something.
Does acupuncture also work for motor neuron disease?
this is just silly, see a profession acupuncturist. stop being ignorant….
This has been the most informative and unbiased insight into acupuncture that i've seen so far, Thank you!
Does it work?? Stupid or just practicing?? It’s been around for over 3,000 years for a reason!
Hi Doc, this treatment is okay if you have Rheumatoid Atritis?? Because I wa a diagnose Rheumatoid Atritis last year until now I have treatment too. And I’m stress . Of my situation.
Great video n informative. 👍🏼😊
I have fibromyalgia so I’m going to try it out ❤ thank you 🙏
I've had two sessions- it works. The day after I feel about 70% better and happy again. The second day I can feel my body deteriorating again. Way better than a bunch of pills and forced physical land or water therapy.
Fantastic video, thank you. We must certainly contrast this with Western medicine, which loves to hand people a pill that solves symptoms but not a problem. Yet that is encouraged as it passed some tests for pain relief. I also find that acupuncture is semi reliable and absolutely significant when it works well. Even placebos have enough of a positive effect that all drugs must be tested against them.
Not good for low back pain?? Or sciatica?? 😂 that’s like one of our bread and butters and I have treated many of that.
I don’t know about acupuncture. But acupressure does. https://youtu.be/jY1s4LP33io?si=lbB3fA-_tQ_EseN1
My back hurts so bad after my second treatment
I am one of those people that have been damaged so many times it almost unbelievable. Huge hole in the hwy just under some overhanging trees. Hit it doing 86 mph on the Harley. A couple weeks later could barely walk. After two years of chiropractor went to an acupuncturist.
What finally worked was acupuncture, cupping, and tens.
https://www.youtube.com/@dildacademy1557
For me is the best treatment
I am an acupuncturist. I have a masters degree in Chinese medicine. Patients need to see a qualified professional only. If you don’t get dramatic results in 2-3 visits, you need to find another acupuncturist. Very often people see chiropractors for acupuncture, and they usually have very insufficient training. I had 3000 hours of training before I graduated. Chiropractors and physical therapists get 50 hours.
Hi and thank you for this video. I am having acupuncture for cancer pain. What are your thoughts?
Here is the thing. You can get the attorneys I get. Or you can get the ones that OJ Simpson gets. Here is an example of acupuncture without needles. It’s faster then with needles.https://youtu.be/jY1s4LP33io?si=BTsYQ-Y6NOUhyNrk
Spend a day with the British Medical Acupuncture Association. They are in London. The director is a General Practitioner, and incredibly research and data driven.
For the past month i've been having very sharp pain on my neck. A few hours after i wake up, it always develops into an incredibly strong migraine … i did 3 sessions of traditional Chinese acupuncture – walked out worse than i went in, every time.. after the third session i couldn't stand the pain any more and started taking pills.
Booked a session with a chiropractor and voila!!! No more neck pain, neck grinding, i gained full range of motion and the best of it all, NO MIGRAINES!!
acupuncture – 0; Chiropractor – 1
Most of these "reviews" shown say "May or might improve.."… chiropractic say "it Will improve", and it did.
PS: During my 1st acupuncture session, i felt nausea and eventually puked on the clinics floor… not a good feeling.
Sure doesn't
I used to be an insurance adjuster who dealt with automobile accidents resulting in injury, and while I understand this is anecdotal, the claimants who combined acupuncture with physical therapy (strengthening exercises) resolved their soft tissue injuries faster than with any other course of treatment. This was primarily acute neck and back injuries, which it sounds like there is clinical evidence to support my anecdotal.
I didn’t get any benefits unfortunately.
Hi Khalid, thank you for this video!
A question in regards to your tip nr 4, effect of relaxing in the room for 20 minutes. For that purpose – why use acupuncture? Why not just use a really relaxing room, maybe some warm blanket or other relaxing music. Or recommend going for a spa or massage or a walk in a nice park. Why use relaxation as motivation for acupuncture specifically?
.Placebo trials is what you need to research!!….Straight forward video on youtube "Junk Science Episode 11: Acupuncture."……Or perhaps you just want to make $$ off the same placebo groupies.
Can you do a video on if cupping works?
Scalp acupuncture is amazing for my daughter’s traumatic brain injury
Does acupuncture work if you have sciatic nerve pain?
I would say it may work for some people but not all. I didn't feel any difference when my friend applied it on me for my lower back problem (herniated disc), but I also met a patient who said she tried so many different type of therapy(can't remember what her problem was) and modalities, nothing worked but acupuncture. When you talked about the relaxing environment, i very other therapies were also in relaxing environment, but they just didn't work. Also, I think how experienced the therapists are, how they applied it can also make some difference. In my own case, i only tried it once, i don't know if several sessions will make some difference. So it think it is case to case
It has come from ancient India, Marmalade yoga
Acupuncture will save you ,and your life will be alot better ,i get it done every second week ,i cant believe the effect on my body and energy level if you can ,get it every week first 3 -4 weeks after maybe ones a month ,you will love it
As a licensed Acupuncturist for 20 years, I truly enjoyed your video 🥰 the only thing that I would add is, unfortunately acupuncture studies don’t reflect clinic reality.
The reason is Chinese medicine treats the root cause and each patient individually. So studies with same points protocols for 100 people would not work as each person requires different approaches & treatment plan 🌷😎
i love how this guys says "musculoskehleeetle"😂 great video.
I am not doctor. I am thinking as logically.. Acupuncture just.. 1. Tranfer overload pain contraction into others which done bt brain. 2 clogged blood steam reduction cause needle metal will react with chloride on blood stream. Conclussion: seem like therapy for neourecology.. And totally not as medicine
the answer is simple if a needle stick to your body will cure you from disorders like anxiety depresion panick atacks then why going to a place and paing to somebody to do it just do it yourself and cure your self but its not going to happen cuse is just a placebo effect alsow theres an study that wast conducted where a patiente wast stick with a lot of needles in al different parts of hes body and he did not recive any negative effect from it so how come ? if something is powerfull enough to cure you its alsow powerfull enough to harm you using it the wrong way
Hi. I’ve heard electric acupuncture pen is a lot more effective then the needles. Is this true? maybe you could do a video on that. Thanks
Thank you doc
My name is Monoranjan Debnath, I am 23 years old, I have left eye ptosis since birth, can it be fixed by acupressure?
I just got Acupuncture done today. Now I can shoot kamehamehas
Very informative and well elaborated. Thanks 👍 😊