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Acupuncture refers to the insertion of fine, solid needles into any part of the body for pain relief, healing and general well being. It has been used by the Chinese people for over 3000 years.
In New Zealand the term “Acupuncture” is generally considered to be a broad umbrella term which encompasses different philosophies of needling. You may hear Acupuncture being referred to as Traditional Chinese Acupuncture, Western or Medical Acupuncture or Dry Needling. Physiotherapists in New Zealand may practice one or a mixture of these practices.
You may also find different methods of using acupuncture that may not even involve the insertion of a needle such as acupressure, laser, moxibustion and cupping. Sometimes electro acupuncture may be used where electrodes are connected to the acupuncture needles and an electrical impulse used.
When physiotherapists in New Zealand use Acupuncture the needles they use are disposable, single use, pre-sterilised needles of varying widths and lengths. A number of needles may be used at each treatment and these are typically left in position for up to 30 minutes before being removed depending on the response required. A needle is manipulated until a QI sensation is felt (a tingling or often warm heavy sensation that can spread away from the area of the needle).
Utilisation within the context of physiotherapy will include a diagnosis based on clinical reasoning as part of an overall management approach.
Traditional Chinese Acupuncture: Utilisation of meridian or extra points based on a Traditional Chinese Medicine (TCM) approach which includes diagnosis and clinical reasoning using various Chinese medicine assessment methods and/or paradigms. TCM is based on the Chinese concept of energy balancing where there are two forces within the body that require balance in order to achieve health and fitness; these forces are commonly referred to as YIN (negative) and YANG (positive). Treatment with Acupuncture is undertaken with the aim or restoring all the body systems to a state of balance (homeostasis). The aim of inserting an acupuncture needle is to influence the flow of QI (pronounced 'chee'), which circulates in channels or meridians within the body. The QI circulates within the deeper organs of the body, but connects to the superficial skin via acupuncture points. In the state of a normal healthy body, a balance exists between these organs. Both the superficial energy in the meridians and the deeper energy in the organs can be influenced by the stimulation of specific acupuncture points. If injury, disease, emotional trauma or infection occurs, the natural flow of QI within the meridians and organs may well be affected and the result is an altered flow, either a slowing or stagnation of QI causing pain and inflammation, or a deficit of QI, which may cause weakness, exhaustion and longer debilitating disease. The stimulation of relevant acupuncture points may free stagnation, reduce excess QI or increase QI to the specific area or organ therefore helping to restore normal QI flow and balance.
Western or Medical Acupuncture: Western acupuncture utlises meridian points but applies it to Western scientific reasoning with particular consideration to neurophysiology and anatomy. It does not utilise any traditional Chinese assessment methods or paradigms. Western Acupuncture is used by physiotherapists to achieve pain relief via the stimulation of the nervous system, such as the brain and spinal cord to produce the body’s own pain relieving neuro-chemicals, such as endorphins for pain relief; melatonin to promote sleep and serotonin to promote well being. These neuro-chemicals assist the body's healing process and offer pain relief as a precursor for other manual or manipulative therapy or home exercise programme. The practitioner uses their anatomical knowledge of the body to select acupuncture points that stimulate nerve endings which will help to relieve pain and promote healing. Sometimes a small electrical impulse may be applied to the needles (electro-acupuncture).
Dry Needling or Trigger Point Acupuncture: Rapid short term needling to altered or dysfunctional tissues in order to improve or restore function. This may include (but is not limited to) needling of myofascial trigger points, periosteum and connective tissues. It may be performed with an acupuncture needle or any other injection needle without the injection of fluid. This is a practice utilised by both traditional and Western acupuncturists.
When physiotherapists in New Zealand use Dry Needling or Trigger Point Acupuncture, a single use, sterilised, disposable acupuncture needle is placed into the trigger point in the affected muscle until a twitch is felt in the muscle, aiming to reproduce the patient’s symptoms. More than one trigger point may be needled in a session and the needles are generally not left in place. The muscle may then be stretched to improve the length of the muscle. Heat or ice packs may also be applied after treatment to help relieve post-treatment soreness. As this is a very strong stimulation of the nerve endings, the patient will usually feel a very strong aching sensation and may also feel the twitch response as the trigger point is needled during the treatment. There will sometimes cause post-treatment aching which can continue up to 48 hours after treatment.”