Acupuncture

Question 1

How long do you leave needles in for normally? [1]

Answer 1

20-30mins

Question 2

Which levels can acupuncture work at? [4]

Answer 2

LOCAL
SEGMENTAL
CENTRAL
MYOFASCIAL TRIGGER POINTS (MTrP)

Question 3

How does local acupuncture work? [4]

Answer 3

Stimulates nerve fibres in skin and muscle
Vasodilation / Blood vessel proliferation
Nerve growth

Acupuncture promotes local healing

Question 4

State 4 clincial applications of local acupuncture [4]

Answer 4

Skin lesions
Ulcers
Scars
Warts

Question 5

Describe mechanism of segmental effect of acupuncture

Answer 5

Action potentials travel up to spinal segment
Depress the activity of the dorsal horn
↓ response to painful stimuli

Acupuncture reduces pain in the segment where the needles are inserted

Question 6

Give an example of a clinical use of segmental effect of acupuncture [1]

Answer 6

knee OA.

Question 7

Describe central effect of acupuncture [4]

Answer 7

Action potentials reaches brain structures
* Cortex
* Hypothalamus
* Limbic system

Serotonin, Oxytocin, Beta-Endorphins
Not point specific

Acupuncture has a calming, anxiolytic effect and improves wellbeing

Question 8

Which substances are released during central effect of acupuncture? [4]

Answer 8

General
* Limbic system deactivation (fMRI)
* Endorphin release
* ACTH release
* Oxytocin release

Question 9

What is a myofascial trigger point? [1]

Answer 9

hyperirritable spot, usually within a taut band of skeletal muscle, which is painful on compression and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena.

Question 10

Name 4 clincial applications of acupuncture? [4]

Answer 10

Primary myofascial pain
Nociceptive musculoskeletal pain
Functional disorders
Allergies
Skin conditions
Depression / Anxiety / Other psychiatric disorders
Fibromyalgia
Neuropathic pain

Question 11

How can you implement sham acupuncture to try and elicit acupuncture research [2]

Answer 11

NON-PENETRATING SHAM CONTROLS
PENETRATING SHAM CONTROLS

Several attempts to provide a device (e.g. ‘’Stage dagger’’ needle) Difficult to conceal from pt. Can be used in limited situations. Prevents proper acupuncture (i.e. Depth of insertion)

Can be: A.in the wrong site (but often not credible to patient), B. Right site but superficial and without stimulation (still have an effect –segmental and extrasegmental and central-), C. Both

Question 12

NICE suggests acupuncture for which pathologies [2]

Answer 12

Headache
Chronic primary pain
Fecal incontinence
Overactive bladder