A few weeks ago I had a new patient who had severely rolled her ankle the week prior. When it happened she had pretty significant bruising and swelling, but she was able to suck it up and get through the week. I treated her ankle with electro-acupuncture, using just a handful of points for 15 minutes. The result was a significant improvement in ankle strength, range of motion, and comfort when walking. She came back in a few days later with reduced swelling and had maintained the gains from the previous session. Following her second treatment, she decided to go skiing on the weekend and restarted her walking regime on a treadmill. Despite the increase in activity, she came back pain-free except with certain loaded and pivoting movements. Needless to say she was very pleased and surprised with the results, but the powerful effects of Contemporary Acupuncture are something that I have come to expect.
When I suggest acupuncture to my patients I usually get one of three responses.
- Some people are enthusiastic – maybe they knew someone who has raved about it, or they are open to alternative treatments.
- Others are tentative – they don’t know much about it and have lots of questions.
- The third group is simply terrified of needles…
Once the dust settles, most people ask the responsible questions: What does it do? Where will it be done? What does it feel like? What are the risks? By the time I’ve answered these questions they are usually pretty confident that it is both safe and comfortable, and that I’ve put a lot of thought into how and why it will benefit them specifically. It is this thought process and rationale based on a modern understanding of physiology that distinguishes my contemporary approach from others.
Acupuncture has been around for thousands of years, originating in China and East Asia. Through centuries of trial and error, practitioners developed their own techniques to address pain and bodily dysfunction, culminating in various meridian systems on the body, including hands, feet, ears, and scalp. This traditional approach attempted to balance the flow of vital energy, known as Chi, as it travels through the meridians. The points used in treatment were based on experience and intuition, with a limited understanding of the true nature of the dysfunctions. Over the last 50 years the western world has become increasingly exposed to acupuncture. Currently 30% of physiotherapists in Ontario are registered to perform some form of acupuncture, not to mention chiropractors, massage therapists, doctors, and many others.
Many practitioners have adopted variations on the traditional Chinese medicine (TCM) approach to acupuncture. Fewer have taken it a step further by combining this traditional modality with our knowledge of pain physiology and movement dysfunction. These practitioners have the ability to achieve superior results by restoring nerve activity that impairs function. It was this Contemporary Acupuncture approach that I used with my patient with the sprained ankle and I use with many of my patients each week.
When assessing my patients I put an emphasis on identifying functional movements that are altered, limited, or painful. I deconstruct these movements by challenging the neuromuscular system using resistance testing and combined movements, making note of weakness and use of compensatory patterns. Through careful palpation I assess for tissue restrictions and peripheral nerve sensitization. This process allows me to select specific, relevant acupuncture targets and provides me with valuable outcome measures to assess the effects of treatment. I can then use electro-acupuncture to normalize the nerve activity related to these areas, often resulting in lasting changes in strength, mobility, and symptoms.
The keys to success with this approach are advanced functional assessment skills to identify areas of dysfunction, and an understanding of the physiological impact of the acupuncture points used. Contemporary Acupuncture is a very valuable aspect of my practice, not because of the needles themselves, but because of the rationale and the integrated process of selecting targets.
At the end of the day, effective treatment comes from a strong understanding of what is being treated and the mechanisms through which the treatment works. We’re just scratching the surface in terms of understanding most of the complexities of the human body. But acupuncture, when applied using our current knowledge of physiology, is helping to redefine what an effective treatment can be.