Acupuncture and Chiropractic

Synergistic choices for osteoarthritic joint pain

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Joint pain is a common and persistent reality in the lives of many suffering people. It is estimated that approximately 50% of adults over the age of 55 experience some type of mild to severe pain in various joints of the body. The most prevalent form of these pains is classified as osteoarthritic in nature. This can occur in any and all joints of one’s musculoskeletal system. Osteoarthritis consists of pain, stiffness, swelling, crepitus, and limited range of motion within the joint. In my 32 years of active practice, I have found the synergistic application of chiropractic adjustments and acupuncture to be effective in alleviating acute and chronic pain in many of my patients. When a person asks for help in addressing their pain syndrome, I utilize both therapies within each appointment to create the best results possible for my client. Each session is time intensive with consideration given to providing a patient with the necessary experience to change their painful condition. Discussions of lifestyle, diet, exercise, and emotional support are necessary components of making acupuncture and chiropractic work as a synergistic experience.

There are several medical research facilities striving to better understand various techniques to aid the osteoarthritic patient. A leading spinal surgeon, Dr. Vert Mooney of Del Mar, California, was a leading proponent of using acupuncture and chiropractic manipulation to decrease painful joint symptoms. It is not uncommon for physicians of all specialties to inquire about conservative modalities that can assist in the alleviation of joint pain. Acupuncture and chiropractic can be used in conjunction with traditional allopathic procedures to enable the body to recuperate from persistent painful conditions.

How do the individual and combined acupuncture and chiropractic methods work?

Acupuncture is a form of Chinese medical therapy that traces its roots as far back as 2500 years ago. It is being carefully studied in randomized laboratory settings to determine its efficacy. Western-based research regarding complementary therapies is rooted in discovering evidence-based outcomes. Most current acupuncture research is involved with discovering its consistency with named disease processes within the Western model. Acupuncture is thought to stimulate the central nervous system in three basic manners. These three postulates include the following: 1) The release of opioid peptides. 2) The alteration in the secretion of neurotransmitters and neurohormones. 3) The stimulation of electromagnetic points in the body. Opioids have an analgesic effect on painful joints. The hypothalamus and pituitary gland secrete neurotransmitters and neurohormones that alter the manner in which the body experiences pain. There is focus being given to the possible immune effect of these transmitters also. There are over 2000 acupuncture points as cataloged by Chinese texts. These are thought to be conductors of electromagnetic signals that cause a release of endorphins at painful sites. The increased flow of “Qi” or energy is central to the Chinese mode of treatment. These descriptive notions are well covered in several acupuncture and medical journals, the previous being reported by Paolo Zanardi AP at spine-health.com.

Chiropractic adjustments work on the theory that joint dysfunction is related to and composed of fixation and lack of mobility within the musculoskeletal system. Mobilizing the spinal facets and articulations of the extremities results in increased range of motion and healthy joint function with stronger elasticity. The same principles related to endorphin release, opioid effect, neurotransmitter/neurohormone presence and electromagnetic conduction are thought to be part of the positive outcome from chiropractic adjustments. In the Journal of Manipulative and Physiological Therapeutics Vol. 27, results of a study by Cramer and Fournier concluded that “findings indicate that fixation (hypomobility) results in time-dependent degenerative changes of the facets joints.” In other words, musculoskeletal manipulation is thought to increase joint mobility and decrease surface degeneration of articular surfaces.

A landmark study reported in the Annals of Internal Medicine Vol. 141 on 12-21-2004 revealed the positive effect acupuncture treatment has in the improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee. This was a study funded by the National Institute of Health (NIH). Direct encouragement and advice was provided from the National Institute of Arthritis and Musculoskeletal/ Skin Diseases. Another study of 3553 patients by Claudia Witt of the University Medical Center in Berlin, Germany, from 2001–2004 reported that “the present results show that in patients with chronic pain due to osteoarthritis of the knee or hip, addition of acupuncture to the treatment regime resulted in clinically relevant and persistent benefit.” It was further noted that an acupuncturist’s experience was the most important factor in treatment outcome. Physicians and their patients frequently express the importance of sincere dialogue that comes from the depth of the therapist’s experience. This seems to be especially relevant in the practice of complementary acupuncture and chiropractic.

A recommendation by the University of Maryland Medical Center presented within a collection of treatment suggestions for osteoarthritic pain by the American Accreditation Healthcare Commission (www.urac.org) suggests that acupuncture and chiropractic should be included as viable modalities in the relief of joint pain. Thirty-two sources of research data were included in this article of multidisciplinary treatments.

As a practical and descriptive note, I would like to share an interesting example of how acupuncture and chiropractic adjustments can act as synergistic agents. The spinal segments are frequently involved in facet dysfunction related to joint pain. Along the spinal column there exist two acupuncture meridians or channels that accompany the osseous anatomy. These two channels are the Bladder (UB) Meridian and the Governing Vessel. They are physically proximal to the spinal joints themselves. Prior to adjusting the painful articulations, I insert thin acupuncture needles to enhance endorphin release along the central nervous system. The Bladder Meridian is a unique channel in that it has “associated points” for every other organ of the body including itself. An acupuncture treatment of the Bladder Meridian brings a positive influence and relaxing effect to the entire body in this manner. After a few minutes of mild electro-stimulation to the inserted thin needles, the spine is much more able to respond positively to an adjustment that removes joint fixation. Increased mobility occurs within the joint and pain starts to subside. The two techniques work cooperatively to enhance a patient’s health.

Acupuncture is thought to stimulate the central nervous system in three basic manners.

Dr. Charles Metzker is a licensed/certified chiropractor and acupuncturist. He can be reached at his Lexington practice, (859) 268-4111.