Did you know a physiotherapist can provide acupuncture?

AACP Chairman, Jonathan Hobbs explains the benefits of this traditional Chinese medicine.

Most people have heard of acupuncture, many know it involves needles and that its origins come from traditional Chinese medicine, but how does acupuncture actually work and did you know that physiotherapists can provide it? Acupuncture is one of many techniques used within physiotherapy as part of the treatment of pain and inflammation. The evidence available suggests that acupuncture is beneficial to people with multiple sclerosis (MS).

How it works

Acupuncture involves the insertion of very fine stainless steel needles into the skin. It has been used in China for over 2,000 years and increasingly in Western medicine with a growing body of scientific evidence and clinical research supporting its effectiveness.

Acupuncture is able to safely reduce pain by stimulating the brain and spinal cord to produce natural pain-relieving chemicals such as endorphins, melatonin (which promotes sleep) and serotonin (to promote wellbeing), to name just a few.

Acupuncture points are chosen to induce a strong segmental inhibitory effect. Chemicals produced locally, and by mechanisms at the spinal and supraspinal levels (above the spine, the brain) assist in healing and offer pain relief. By managing a patient’s pain, acupuncture can enhance physiotherapy treatments, such as exercise, therefore aiding recovery. Functional magnetic resonance imaging (fMRI) studies have demonstrated the effect that acupuncture has on the ‘pain pathways’ of the brain.

MS related research

For MS, acupuncture is used to help relieve pain and tension as well as to improve movement, sensation and spasticity. It may also help to reduce fatigue, increase energy levels and give a boost to the immune system.

One study (Grieve et al.) demonstrates that acupuncture treatment for pain in patients with MS has clear benefits. The sustained benefit of acupuncture as a treatment for pain was further confirmed by the fact that most patients managed to reduce their analgesia requirements, with some being able to stop taking painkillers completely. There was also some subjective improvement in mood, mobility and energy levels, and more than half of the participants felt that their sleep patterns improved. Despite a brief increase in pain in some, the overall perceived benefit was favourable.

One uncontrolled open study (Tjon Eng Soe 2009) looked at whether electro-acupuncture diminishes voiding symptoms and improves the quality of life in MS patients with overactive bladder and urge incontinence. Researchers found it may have a useful role in MS patients with mild bladder dysfunction, who do not wish to take medication or are unable to because of side effects. It must be noted that this study looked at a very small population, so the results can be seen only as preliminary.

Further research has shown that acupuncture treatment may specifically help to relieve symptoms of MS by:

• Acting on areas of the brain known to reduce sensitivity to pain and stress as well as promoting relaxation and deactivating the ‘analytical’ brain which is responsible for anxiety and worry
• Improving muscle stiffness and joint mobility by increasing local microcirculation which aids dispersal of swelling
• Reducing inflammation by promoting the release of vascular and immunomodulatory factors

Another review, which summarised and evaluated the available evidence of acupuncture for neurological diseases concluded that more rigorous trials are warranted to establish acupuncture’s role in MS.

Research investigating acupuncture’s safety has consistently found acupuncture to be safe when performed by a competent practitioner. Side effects are rare and tend to be mild and short-lived, they may include; bruising, mild pain or bleeding and drowsiness. If you are concerned about any possible side effects, please speak to your physiotherapist.

Find your local practitioner

With over 6,000 members, the Acupuncture Association of Chartered Physiotherapists (AACP) is the largest acupuncture organisation in the UK. All AACP members are chartered physiotherapists who have successfully completed acupuncture training at a postgraduate level. Acupuncture combined with physiotherapy is widely accepted within both the NHS and private practice.