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Ask an expert - muscles and bones - osteoporosis

3 questions

Q: My  mum has osteoporosis, her pain is now not just in her back but now on her ribcage area, despite having tests at the hospital, they cannot help her and she lives in terrible pain, my questions is would acupuncture help her?

A: Not surprisingly for a problem which besets a greater proportion of the world population as life expectancy increases, there is a growing body of research directed at the use of acupuncture for the reduction of pain from osteoporosis. No-one has suggested that treatment can increase one density, although there are a few small studies which suggest that the rate of deterioration may decrease. However, there is an increasing number of studies such as this one

http://www.ncbi.nlm.nih.gov/pubmed/24673048

which offer encouraging results, although the sample sizes are too small to be able to make generalisable claims.

In general terms acupuncture treatment has been used for pain relief in pain management centres for the last forty years. Nixon's visit to China in the 1970s with picture of people having operations without anaesthetic and pain relief kicked off a huge amount of research as well as use of acupuncture. A treatment with no side effects was infinitely preferable to drugs like NSAIDs which have killed thousands of patients over the years. The clinical findings were very clear in the effect of treatment on the body's own painkillers, endorphins and enkephalins, and so its use as a treatment for pain has been consistent throughout that time.

The main question with using acupuncture is how much relief and how sustainable. If the equation is favourable, where a modest investment in regular treatment offers a reasonably long period of pain reduction then people often have regular maintenance treatment, occasionally stepping up the frequency for events and occasions where pain might increase. If the relief is short-lived, however, then the equation may not be so well balanced.

The one great advantage of traditional acupuncture is that it treats the person as much as the problem in the simple belief that a system in balance will maximise the pain relief from local treatment. Pains rarely have a single cause from a Chinese medicine perspective; a weakness here and a weakness there may create the condition for a pain to develop yet somewhere else. Just picking off the symptom will be nowhere near as effective as putting as much of the system in balance as possible alongside more straightforward pain relieving treatment.

Every patient is different, however, and the only way to get a really well informed view of whether acupuncture treatment may be beneficial would be to take her to a local BAcC member for a brief face to face assessment. Most are happy to give up time without charge to help people to decide whether this is the treatment for them, and to get a chance to meet them and see their surroundings, both of which can make a difference to how comfortable feel with taking on something which for many people is quite unusual. I have to tell you that we aren't; we're just normal looking people using a system which has been around for over 2000 years.

We hope that you manage to find something or someone to help with your mum's pains.

As you have no doubt seen from the factsheet on our website http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/chronic-pain.html

chronic pain is often treated with acupuncture. There are good historical reasons for this. When the popularity of acupuncture rose sharply after Nixon's visit to China in 1976 one of the more eye-catching uses was of a man having heart surgery using acupuncture for pain relief and anaesthesia. Many researchers invested a great deal of effort in this area because the neurotransmitters associated with pain are easily measures, and the patient outcome assessment methods are quite sophisticated. Although there is nothing conclusive enough for us to give an unqualified 'yes' in answer to your question, the issue for us is not whether the treatment will work but the extent
to which it will work and how sustainable the effect is.

From a Chinese medicine perspective, pain arises when the flow of energy ('qi' as we call it) in the channels is either blocked, in excess or deficient. Changes in the proper flow always generate symptoms, and the skill of the practitioner lies not simply in reinstating proper flow in the affected area but determining whether it is a local problem or whether the symptom is an indicator that the overall balance has been affected. This can often mean treating the system as a whole and inserting needles a long way from
the site of the pain, which many find a little baffling.

The judgement call which the practitioner has to make with the patient is whether the extent of relief and the time that it lasts justifies the expense of the treatment. It can, unfortunately, come down to finances, and it may well be that if the relief is shortlived (less than a week), and there is no progressive improvement a practitioner might start to look for other options instead of, or as well as, treatment. With osteoporosis proper, this might be a more critical discussion. Once bone density has gone it's gone, and unless it is demonstrable that acupuncture is helping the patient to get worse slower, then it is probably sensible to explore other options. Transient osteoporosis usually spontaneously resolves within 18 months, however, and there may well be some value in looking at combined treatments to help someone through the problem.

The key thing is to review progress at all stages. Treating chronic problems can often lead to a pattern of treatment developing which can often run to several hundred pounds in cost, and it is vital that the patient gets to review whether the continued expense is worth it.

The best advice we can give is that you visit a BAcC member local to you for advice. This will probably give you a better assessment of what may be possible, and means that the practitioner can advise you based on your unique presentation.

There is not a great deal of evidence from research trials for the treatment of osteoporosis with acupuncture. There are some very positive laboratory-based studies of the treatment of rats, but nothing of substance on human subjects.

 

 

However, it sounds from your question as though the pains may be coming from sciatica induced by the erosion and collapse of the lower vertebrae, and there is certainly more evidence suggesting that acupuncture may be of use with this, as can be seen from our factsheet here

 

As far as the underlying problem is concerned, however, while Chinese medicine works from an entirely different theoretical basis, the problems which people now face are no different from ones have faced for thousands of years. There are a number of ways in which what we term 'osteoporosis' was recognised and treated. In some systems of Chinese medicine the treatment offered is aimed directly at the problem; in others, the treatment is much more a matter of balancing up the energies of the body in the simple belief that where balance exists, symptoms disappear.

 

The important thing to remember, though, is that direct physical loss or damage is the same in any system of medicine, and in the words of the sales slogan, 'once it's gone, it's gone'. For chronic degererative conditions the best hope is that things get worse slower or stay at the stage they have reached, so this is very important to bear in mind if you choose to seek treatment from a BAcC member.

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