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And the Point Is … ?

Acupuncture therapies vary, and that's OK, says study

THURSDAY, May 17, 2001 (HealthDayNews) -- If you want an acupuncturist to treat that pain in your back, don't expect one standard way to balance your "chi." There may be as many ways to treat the pain as there are acupuncturists, a new study shows.

But the variety is OK, say mainstream doctors. The nature of acupuncture is for treatments to vary.

The idea behind acupuncture is to improve the flow energy, called chi, through the body. Practioners insert slender needles at certain points in the body to release stopped-up energy.

"We are not criticizing acupuncture therapy by any means," says lead study author Dr. Donna Kalauokalani, assistant professor of anesthesiology, internal medicine and psychiatry at Washington University in St. Louis, Mo. "Our aim in this paper was to inform medical doctors of what is really involved in acupuncture treatment in order that physicians can advise their patients on whether alternative low back pain treatments should be considered."

Kalauokalani and her colleagues asked seven acupuncturists practicing traditional Chinese medicine to evaluate and treat a single patient with chronic low back pain. "There was high diagnostic agreement among five of the seven acupuncturists, but treatment recommendations varied between five and 14 acupuncture points requiring seven to 28 needles," Kalauokalani says. Of the 28 acupuncture points selected, only four were prescribed by two or more acupuncturists. Most of the acupuncturists, however, recommended various forms of heat treatment.

The research was published in the May Southern Medical Journal.

Differences in treatment are normal in acupuncture, says Dr. Marc Micozzi, the editor of the textbook, Fundamentals of Complementary and Alternative Medicine.

"In the classical practice of Chinese medicine, therapies for patients may differ from one practitioner to another," says Micozzi, who also is executive director of the College of Physicians of Philadelphia. "It's one of the things we find so challenging to western biomedical concepts regarding alternative therapies."

Acupuncturists "detect what's going on and will tell you that the same disorder is different in different people, and furthermore that disorders and diseases are different in the same person on different days. Disorders are dynamic, and people are dynamic, and therapists are dynamic," Micozzi says. Fixed ideas and therapies for disorders and disease "is exactly contrary to Chinese and alternative medicines," he says.

Because each acupuncturist has his own technique, Micozzi says people in Chinatown will only go to a acupuncturist whose family members have been practicing for six or seven generations. "Practitioners learn different techniques and some of them are family secrets."

Alternative therapies have health policy implications, Micozzi says. Chiropractors and massage therapists also can help low back pain and do it relatively cheaply, he says.

"So now we know of three techniques that are relatively low-cost which can effectively treat what is the most common complaint of working Americans," Micozzi says.

What To Do

For more information on acupuncture, see Acupuncture.com or the American Academy of Medical Acupuncture.

And read these other HealthDay stories on acupuncture.

SOURCES: Interviews with Donna Kalauokalani, M.D., MPH, assistant professor of anesthesiology, internal medicine and psychiatry. Washington University, St. Louis, Mo.; Marc Micozzi, M.D., executive director, College of Physicians of Philadelphia; May, 2001 Southern Medical Journal
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