Acupuncture in the treatment of Musculoskeletal Conditions

The National Institute for Health and Care Excellence (NICE) recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraine.

They have also acknowledged that acupuncture can bring relief for osteo-arthritis of the knee and dental pain.

 

 

 

To highlight the potential benefits of acupuncture for pain related conditions, I would like to share with you some information based on a piece of research I did whilst working with the NHS in a GP surgery, over an 18 month period. This is particularly relevant as the majority of patients I treated were referred for musculoskeletal conditions (72%).

I had worked in this practice several years previously, till the funding structure changed. I was later invited back to work when the surgery identified some funding to continue the acupuncture service. This practice has a patient population of 14,700 in a diverse multi-cultural area. Patients were referred by their GPs but could also self refer, requesting acupuncture from their GP.

The aim of the evaluation was to gather data & provide feedback to the practice GPs regarding patient’s reported outcomes & experience of acupuncture treatment.
A further aim was to provide evidence regarding the benefits of acupuncture available on the NHS to GPs and commissioners with the hope of securing further funding & the continuation of the service.

 

Types of conditions

The International Classification of Primary Care process codes were used for categorization of conditions.

From the chart, it can be seen that the majority of conditions treated (72%) were musculoskeletal in nature (including musculoskeletal with a neurological component). There was an even spread of conditions treated within this.

 

ICPC heading               ICPC codeNo of conditions
DigestiveD2
EarH2
MusculoskeletalL37
NeurologicalN5
Musculoskeletal/neurologicalL/N5
PsychologicalP3
RespiratoryR1
Respiratory/neurologicalR/N1
UrologicalU2
TOTAL58 conditions

 

DURATION OF THE CONDITIONS

From this table, it can be seen that 74% of patients had conditions of one year or more duration, ie chronic conditions. Some patients had had their conditions for over 10 years!

Duration of the conditionNumber of patients% of patients
More than 5 years26 patients45%
1-5 years17 patients29%
3-12 months12 patients21%
1-3 months3 patients5%

 

Most of the patients I treated (74%), had had their conditions for one year of more meaning they had chronic conditions. Some patients had had their conditions for over 10 years! I was given the opportunity to treat patients for up to 6 sessions and the evaluation was carried out at the beginning of the sixth session ie after having had only 5 treatments, which is not very long for a chronic condition.

 

Outcomes were evaluated using MYMOPS (Measure your Medical Outcome Profile) a quantitative validated research tool, which asks patients to evaluate their symptoms and how their condition is affecting their quality of life on a six point scale. This was carried out at the first and sixth treatment session and data was analysed by a student at the University of Westminster (where I used to teach) as part of a collaborative project.

 

MYMOP OUTCOMES

• 78% of all patients had clinically significant improvements to their symptoms.

• 41.6% of total patients reduced or stopped their medication. This was not only analgesic (pain relief) medication, but also included reduction to anti-depressants, diazepam & salbutamol.

 

Patients were also asked to complete a questionnaire in which their response to acupuncture treatment was analysed. The areas where patients felt the most improvement and that was mentioned the most was regarding pain, stress and quality of life.

I feel more pro-active – better equipped to deal with life generally. I feel physically & emotionally stronger. I have been exercising regularly, lost some weight & emotionally/ mentally highs and lows are not so severe.

Here are some additional quotes from patients about their experience of having acupuncture:

“I had a bad shoulder for months and had been going to physio, but the pain would not go. Since I had the acupuncture, the pain seems to be gone.”

“Acupuncture helped me to relax my body and loosen my muscles – that are very tight. Felt much lighter. Pain in neck & shoulders much relieved. Treatment helped me quite well. In the last few days – all came back as I think I’ve had a viral infection and feel achy all over.”

 

“Before I came I could not sit or sleep without pain and after four sessions I saw a big difference.”

 

“Felt a lot less pain than I started off with. Marian gave me some useful advice about exercise and a supplement, which has given me a lot more energy and she also gave me some dietary advice.”

 

“For me it was a new experience dealing with my pain and stay away from taking painkillers. I felt free from painkiller during the treatment.”

 

“A joy to look forward to knowing my pain in my legs and hands would be reduced.”

 

“The experience itself was very beneficial to me. It was the best feeling I had for ages when the needles are placed into my body. I was surprised by how much warmth was generated into my body.”

 

Summary:

Patients reported almost consistently positive treatment outcomes with positive feedback supported by significant changes in MYMOP scores. This was in spite of the chronic nature of most conditions and the limited number of appointments available. Patients also perceived numerous benefits from treatment – above and beyond improvements in their primary symptoms for which they had been referred. Patients also appreciated the holistic nature of acupuncture treatment.

 

By Marian Fixler

Resident Acupuncturist at Shine Holistic, Church Street.

 

For more information on research in the field of acupuncture,
please visit the British Acupuncture Council website:
http://www.acupuncture.org.uk

 

The above article is a summary of a paper I had published:
M.Fixler, C.Ogden, F.Moir & M.Polley, Patient Experience of Acupuncture in a GP Practice, Complementary Therapies in Clinical Practice. Vol 18, Issue 3, August 2011