Acupuncture and Alternative Medicine - Can They Help You?
Date:
8/12/2009 | 12:00 pm
Acupuncture is one of the oldest healing practices in the world. Originating in traditional Chinese medicine, acupuncture aims to restore and maintain health through the stimulation of specific points on the body by a variety of techniques. In the United States, where practitioners incorporate healing traditions from China, Japan, Korea, and other countries, acupuncture is considered part of complementary and alternative medicine which can be used together with or in place of conventional medicine. Acupuncture can be helpful by itself for some conditions, but it's also increasingly being used in conjunction with more conventional Western medical treatments. For example, doctors may combine acupuncture and drugs to control pain and nausea after surgery.
Can it help you? For patients with osteoarthritis, muscle or nerve issues can sometimes be helped with a combination of conventional and complementary medicine treatments.
Jerrold A. Friedman, M.D., in Cooper’s Department of Physical Medicine and Rehabilitation, uses manual medicine and acupuncture, along with other methods, in his treatment of patients with many musculoskeletal issues. He is board certified in Physical Medicine & Rehabilitation and Medical Acupuncture and has been a diplomat of the American Board of Medical Acupuncture since 2001. He received his medical degree from SUNY Syracuse, N.Y., completed his internship at Staten Island University Hospital, New York, N.Y., and his residency at Thomas Jefferson University Hospital in Philadelphia, Pa.
He sees patients in Camden. Learn more about acupuncture and integrative medicine at Cooper.
Jerrold A. Friedman, M.D.: Welcome to this week’s Health eTalk. I have found great success in utilizing a variety of treatments for my patients. Educated in both Western and Chinese medicine, I often discuss these options with my patients. Many of my patients have not tried these alternative therapies in the past and are very pleased with the results. Acupuncture and manual medicine are not for everyone. Are these therapies ones that can help you?
Send me your questions and I’ll attempt to give you guidance for your particular issue.
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Do you have an opinion on prolotherapy and do you use it with any success? Mona from Turnersville |
8/12/2009 12:02:53 PM |
Jerrold A. Friedman, M.D.:
I often use prolotherapy. Prolotherapy is an excellent way to address injured tendons and ligaments. The idea behind prolotherapy is to stimulate the wound repair process by injecting solutions usually sugar into the damaged ligaments or tendons.
Instead of injecting a cortisone agent to decrease inflammation, a sugar substance is injected to stimulate inflammation which is part of the natural healing process. After injection the pain usually diminishes and the structure feels stronger.
Prolotherapy causes new collagen fibers to be laid down. The tendons and ligaments are stronger than prior to injection.
As part of the rehabilitation process exercises to teach proprioception (where the joint is in space) can then be added to retrain the movement pattern which is usually altered as part of the injury.
Acute and chronic ligament sprains and strains usually respond great to this type of treatment. Why the ligament/tendon was injured, to what degree there is a partial or complete tear, and what other structures are involved such as joint capsule, nerve or muscle will affect the success of the treatment.
Instead of injecting a cortisone agent to decrease inflammation, a sugar substance is injected to stimulate inflammation which is part of the natural healing process. After injection the pain usually diminishes and the structure feels stronger.
Prolotherapy causes new collagen fibers to be laid down. The tendons and ligaments are stronger than prior to injection.
As part of the rehabilitation process exercises to teach proprioception (where the joint is in space) can then be added to retrain the movement pattern which is usually altered as part of the injury.
Acute and chronic ligament sprains and strains usually respond great to this type of treatment. Why the ligament/tendon was injured, to what degree there is a partial or complete tear, and what other structures are involved such as joint capsule, nerve or muscle will affect the success of the treatment.
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I have 'knots' in my shoulders/neck area. Would acupuncture help with this? Thanks. Adrianne from Cherry Hill |
8/12/2009 12:06:03 PM |
Jerrold A. Friedman, M.D.:
Knots" are often muscle spasms or trigger points. Why are the trigger points there? Is there subtle imbalance in the muscloskeletal or neuromotor system, between muscle flexors and extensors, increased nerve tension, or injured tendons. Muscle will tighten and spasm to protect nerve and tendon. Finding and treating the underlying injury and not just the symptom, the "knot," will provide longer lasting relief.
Manual medicine, massage, Osteopathy, Chiropractic, dry needling, injecting medication into the trigger point and Acupuncture can decrease the "knots," muscle spasm and trigger points.
The next step may be a muscle balance retraining program or a posture spine stabilization program to maintain the improved movement after the restricted area is released. Without a home exercise program, the reason why the knots developed may not be addressed.
Manual medicine, massage, Osteopathy, Chiropractic, dry needling, injecting medication into the trigger point and Acupuncture can decrease the "knots," muscle spasm and trigger points.
The next step may be a muscle balance retraining program or a posture spine stabilization program to maintain the improved movement after the restricted area is released. Without a home exercise program, the reason why the knots developed may not be addressed.
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I have lower back pain on the left side right above the buttocks. Frankie from Willingboro |
8/12/2009 12:08:44 PM |
Jerrold A. Friedman, M.D.:
Low back pain is a huge topic with many potential reasons for the pain.
The pain may be due to a muscle spasm or "knot" or it can be as complicated as an invasive spinal tumor. The treatment would depend on the cause and duration of the pain.
Of importance as to the back pain would be: is the pain localized to one spot ( perhaps muscle or tendon) or does it radiate down the legs or across the back in a belt like manner? (Radiation may be associated with nerve involvement.) Are there difficulties with bowel or bladder control? (The spinal cord may be involved.) Does the pain change when you change position, for example is the pain worse with sit to stand transitions? (this may be related to the SI joint.) Disc pain may be increased with sitting or by doing a classic sit-up exercise.
In general, low back pain often does improve with acupuncture. Electroacupuncture can be helpful when the condition has been present for a long time.
A physical examination and a little more history would be necessary to give a better answer as to whether acupuncture would help with your specific condition.
There are many ligament attachment sites in the general region you mention such as the iliolumbar ligament. If the ligaments are involved prolotherapy is often helpful.
If the fascial system is involved or if there is a muscle imbalance or chronic overuse issue, changing your exercise program or daily activities may be of benefit. An Occupational therapy work site evaluation and review of proper body mechanics may also be valuable.
See comments on questions by Adrienne on "knots" and Mona on prolotherapy.
The pain may be due to a muscle spasm or "knot" or it can be as complicated as an invasive spinal tumor. The treatment would depend on the cause and duration of the pain.
Of importance as to the back pain would be: is the pain localized to one spot ( perhaps muscle or tendon) or does it radiate down the legs or across the back in a belt like manner? (Radiation may be associated with nerve involvement.) Are there difficulties with bowel or bladder control? (The spinal cord may be involved.) Does the pain change when you change position, for example is the pain worse with sit to stand transitions? (this may be related to the SI joint.) Disc pain may be increased with sitting or by doing a classic sit-up exercise.
In general, low back pain often does improve with acupuncture. Electroacupuncture can be helpful when the condition has been present for a long time.
A physical examination and a little more history would be necessary to give a better answer as to whether acupuncture would help with your specific condition.
There are many ligament attachment sites in the general region you mention such as the iliolumbar ligament. If the ligaments are involved prolotherapy is often helpful.
If the fascial system is involved or if there is a muscle imbalance or chronic overuse issue, changing your exercise program or daily activities may be of benefit. An Occupational therapy work site evaluation and review of proper body mechanics may also be valuable.
See comments on questions by Adrienne on "knots" and Mona on prolotherapy.
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Would Acupuncture work on nerve pain from shingles? How about sciatica pain? Barb from Mount Ephraim |
8/12/2009 12:11:00 PM |
Jerrold A. Friedman, M.D.:
Acupuncture can help with both. Pain from sciatica and shingles is very different and the acupuncture treatment for the two conditions is very different. You will want to consult with your practitioner about specific treatment options for each of these.
Shingles may benefit from herbal medication. There are topical compounded prescription medications which may also be of benefit.
Shingles may benefit from herbal medication. There are topical compounded prescription medications which may also be of benefit.
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Can acupuncture relieve sciatic nerve pain / discomfort; and, if so, what is the relief period? Can treatments be repeated safely & at what frequency, assuming there is no severe damage? Robert from Cherry Hill |
8/12/2009 12:13:09 PM |
Jerrold A. Friedman, M.D.:
Sciatica is a general term which refers to irritation of the large nerve which travels from the lower back down the back of the leg into the foot.
Depending on the cause of the nerve irritation acupuncture can be of benefit. If needed treatments can be done safely several times a week. As the condition improves the acupuncture frequency can be tapered.
The relief period varies person to person and depends on the specific etiology of the sciatica. Some people respond immediately and are practically all better after one treatment. Others may need several treatments before they notice an effect. About 10% of people do not seem to respond to acupuncture. There is approximately a 10% non-response rate in animal studies as well. It is believed that this is related to a genetic variant in the opioid receptors.
If there is limited response to treatment, a trial with electroacupuncture and or adding a microsystem such as the ear, scalp, or hand may be of benefit.
The addition of physical therapy (improve core strength and stability, proper posture and mechanics), aquatic physical therapy (the body weight is offloaded in the water), TENS trial, biofeedback, meditation, weight loss, antiinflammatory diet, moist heat, manual medicine, trigger point injections, prolotherapy, and epidural injections may all be of benefit. The key is to start with a good evaluation and diagnosis by your physician to identify the cause of the nerve pain.
Depending on the cause of the nerve irritation acupuncture can be of benefit. If needed treatments can be done safely several times a week. As the condition improves the acupuncture frequency can be tapered.
The relief period varies person to person and depends on the specific etiology of the sciatica. Some people respond immediately and are practically all better after one treatment. Others may need several treatments before they notice an effect. About 10% of people do not seem to respond to acupuncture. There is approximately a 10% non-response rate in animal studies as well. It is believed that this is related to a genetic variant in the opioid receptors.
If there is limited response to treatment, a trial with electroacupuncture and or adding a microsystem such as the ear, scalp, or hand may be of benefit.
The addition of physical therapy (improve core strength and stability, proper posture and mechanics), aquatic physical therapy (the body weight is offloaded in the water), TENS trial, biofeedback, meditation, weight loss, antiinflammatory diet, moist heat, manual medicine, trigger point injections, prolotherapy, and epidural injections may all be of benefit. The key is to start with a good evaluation and diagnosis by your physician to identify the cause of the nerve pain.
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Would acupuncture help with quitting smoking? How does it work? John from Camden |
8/12/2009 12:16:13 PM |
Jerrold A. Friedman, M.D.:
Acupuncture has been shown to be helpful as an adjunct treatment for many forms of addiction. Smoking cessation is a complex issue. It involves psychological, social, physical and behavioral components.
Acupuncture can be helpful in reducing the restlessness, irritability and anxiety associated with smoking cessation. There are many different protocols for treating smoking with acupuncture. Some treatments may involve body point with acupuncture needles while others involve ear points and tacks which may remain in place for several days up to a week. My personal belief is that acupuncture should be combined with other methods to achieve lasting results from a smoking cessation program. It is unlikely that acupuncture alone will prevent you from putting a cigarette in your mouth.
As far as how acupuncture works, there are many theories. We can prove many different biological responses to acupuncture treatment in both the central nervous system and the endocrine system. We are not sure if this is how acupuncture works but these are some of the best studied responses. Acupuncture releases your body's natural opioids (narcotics) at many different levels of the central nervous system including the brain and spine. These endogenous opioids play a role in analgesia. Many neurotransmitters and neurohormones are also released. These can influence blood flow.
As a Physical Medicine and Rehabilitation-trained physician, I am more comfortable treating the musculoskeletal system and tend not to treat smoking addiction. There are many organizations and web sites where you can find a qualified Acupuncture practitioner including the American Academy of Medical Acupuncture and National Certification Committee of Acupuncture and Oriental Medicine.
Acupuncture can be helpful in reducing the restlessness, irritability and anxiety associated with smoking cessation. There are many different protocols for treating smoking with acupuncture. Some treatments may involve body point with acupuncture needles while others involve ear points and tacks which may remain in place for several days up to a week. My personal belief is that acupuncture should be combined with other methods to achieve lasting results from a smoking cessation program. It is unlikely that acupuncture alone will prevent you from putting a cigarette in your mouth.
As far as how acupuncture works, there are many theories. We can prove many different biological responses to acupuncture treatment in both the central nervous system and the endocrine system. We are not sure if this is how acupuncture works but these are some of the best studied responses. Acupuncture releases your body's natural opioids (narcotics) at many different levels of the central nervous system including the brain and spine. These endogenous opioids play a role in analgesia. Many neurotransmitters and neurohormones are also released. These can influence blood flow.
As a Physical Medicine and Rehabilitation-trained physician, I am more comfortable treating the musculoskeletal system and tend not to treat smoking addiction. There are many organizations and web sites where you can find a qualified Acupuncture practitioner including the American Academy of Medical Acupuncture and National Certification Committee of Acupuncture and Oriental Medicine.
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I have been recently diagnosed with rheumatoid arthritis and have flare ups of hands and feet, will acupuncture help alleviate my symptoms? Jeannette from Camden |
8/12/2009 12:18:41 PM |
Jerrold A. Friedman, M.D.:
Acupuncture may help. Rheumatoid arthritis (RA) involves the immune system and herbal medication may prove to be more effective than acupuncture. It is important to ask about possible interactions between herbal medication and other medications. Acupuncture has the advantage of no medication interactions and potentially no side effects aside from the usual risks of infection, bleeding and local trauma associated with any needle stick.
A course of occupational therapy or hand therapy may be beneficial in teaching joint preservation techniques, energy conservation techniques and the use of adaptive utensils to protect the quality and function of the hands which can be severely involved in RA. Simple things like built up handles on utensils, using rocker knives, turning items counter clockwise instead of clockwise, using a triangular wedge to open and close door knobs can all help protect the hands and maintain function.
Many foods have anti-inflammatory properties which can be helpful in reducing pain and inflammation. These include: turmeric, fish oil (pharmaceutical grade to avoid metal toxins), ginger, black walnuts, and flax seeds. Dr. Andrew Weil has written many articles on this topic. These foods may thin the blood and affect liver function when taken in large quantities or when mixed with certain medication. You will need to check with your physician or pharmacist.
A course of occupational therapy or hand therapy may be beneficial in teaching joint preservation techniques, energy conservation techniques and the use of adaptive utensils to protect the quality and function of the hands which can be severely involved in RA. Simple things like built up handles on utensils, using rocker knives, turning items counter clockwise instead of clockwise, using a triangular wedge to open and close door knobs can all help protect the hands and maintain function.
Many foods have anti-inflammatory properties which can be helpful in reducing pain and inflammation. These include: turmeric, fish oil (pharmaceutical grade to avoid metal toxins), ginger, black walnuts, and flax seeds. Dr. Andrew Weil has written many articles on this topic. These foods may thin the blood and affect liver function when taken in large quantities or when mixed with certain medication. You will need to check with your physician or pharmacist.
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Might acupuncture benefit an individual diagnosed with very severe spinal stenosis, spondyliosis, arthritis, dropped foot (much nerve damage)? Any info you can provide will be very much appreciated as Robert is age 79 and surgery is his only option. Thank you. Mrs. L from Toms River |
8/12/2009 12:20:14 PM |
Jerrold A. Friedman, M.D.:
Acupuncture may help to improve blood flow and mobility to the affected area. Acupuncture may help to alleviate pain by modifying our bodies natural opioids. Acupuncture will not reverse spinal stenosis or compression.
In my experience pain as a result of severe spinal stenosis may respond to electroacupuncture combined with a microsystem treatment. If there is bowel or bladder involvement as evident by incontinence, urinary retention or chronic constipation you should meet with a surgeon. As to "much nerve damage" , the longer a condition has been present the harder it is to treat. More treatments may be needed to see a response. Acupuncture will not reverse the stenosis. Surgery will help to alleviate the pressure on the spinal cord and nerve roots.
There are minimal downsides to a trial with acupuncture. The risks of acupuncture are like any other needle: infection, bleeding, bruising and placement into a structure which was not intended.
In my experience pain as a result of severe spinal stenosis may respond to electroacupuncture combined with a microsystem treatment. If there is bowel or bladder involvement as evident by incontinence, urinary retention or chronic constipation you should meet with a surgeon. As to "much nerve damage" , the longer a condition has been present the harder it is to treat. More treatments may be needed to see a response. Acupuncture will not reverse the stenosis. Surgery will help to alleviate the pressure on the spinal cord and nerve roots.
There are minimal downsides to a trial with acupuncture. The risks of acupuncture are like any other needle: infection, bleeding, bruising and placement into a structure which was not intended.
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What exactly is meant by "alternative medicine" and does that mean a patient chooses that kind of medical care over conventional medical care? Also, what credentials should I look for in someone practicing "alternative medicine" ? Thanks! Sandy from Salem |
8/12/2009 12:23:42 PM |
Jerrold A. Friedman, M.D.:
Alternative medicine sounds like there is something wrong with medicine that is not allopathic (M.D. medicine). Complementary medicine sounds like this form of medicine may help the treatment that is considered conventional by allopathic medicine. It implies that the complementary treatment may not be effective on its own. Integrative medicine sounds best to me. It is not an either/or situation or "better than thou" situation. I think there are many aspects of integrative medicine that can be incorporated into the treatment of almost every condition to enhance the individual's health and well being.
There is no specialty test or examination board that I can direct you to for "alternative medicine".
For physicians, there is the American Academy of Medical Acupuncture which offers a competency examination in Medical Acupuncture which is optional. There is a competency examination offered by The Cranial Academy which is also optional.
There is no specialty test or examination board that I can direct you to for "alternative medicine".
For physicians, there is the American Academy of Medical Acupuncture which offers a competency examination in Medical Acupuncture which is optional. There is a competency examination offered by The Cranial Academy which is also optional.
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I am curious to know about the cost of acupuncture, and also if health insurance covers the cost. Also is acupuncture used to manage an illness or does it provide a cure? Valerie from Blackwood |
8/12/2009 12:25:14 PM |
Jerrold A. Friedman, M.D.:
The cost varies from area to area and depending upon what is done for example acupuncture needles with moxa/electricity the addition of herbs. Costs are often between $50-200/ session.
Most insurance companies do not cover acupuncture. Some companies do offer health and wellness plans which offer a discount on the cost of the treatment. Some plans offer acupuncture only for pain management. Each company is different and you need to check with your individual insurance plan.
Until recently California did have a government sponsored plan Medi-Cal (California Medicaid) which paid for acupuncture. This was changed with the current economic crisis.
Worker's Compensation and personal injury often pay for acupuncture.
Acupuncture just like medication can be used to manage an illness or provide a cure. The answer depends on the specific illness and how long the condition has been present.
Most insurance companies do not cover acupuncture. Some companies do offer health and wellness plans which offer a discount on the cost of the treatment. Some plans offer acupuncture only for pain management. Each company is different and you need to check with your individual insurance plan.
Until recently California did have a government sponsored plan Medi-Cal (California Medicaid) which paid for acupuncture. This was changed with the current economic crisis.
Worker's Compensation and personal injury often pay for acupuncture.
Acupuncture just like medication can be used to manage an illness or provide a cure. The answer depends on the specific illness and how long the condition has been present.
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I have spinal stenosis and in February of 2002 I had a spinal fusion at L4 and L5 levels. Can acupuncture help me with my stenosis which is being caused by compression of the L4 & L5 nerves on both sides? W. Wallace from New Castle |
8/12/2009 12:27:14 PM |
Jerrold A. Friedman, M.D.:
Thank you for your question. please see the response to Mrs. L.
It is unlikely that acupuncture will change the spinal stenosis. Acupuncture may help improve mobility of the spine and decrease pain. If you have not already tried: weight loss (hard to do if you are in pain), an aquatic therapy program, tai chi, yoga, and meditation can all help to modify pain. If there are injured ligaments contributing to a decompensated posture (which can further aggravate back pain), then prolotherapy may be of benefit.
People can get pain an a result of a surgical scar. Since you have already had surgery, treating the scar may offer some relief.
More history would be helpful. Did the symptoms improve after surgery? Was there a new event which triggered the pain? The surgery was over 7 years ago, imaging the area to check on the fusion or to look for new pathology may be beneficial. A reevaluation by the operating surgeon may be valuable.
It is unlikely that acupuncture will change the spinal stenosis. Acupuncture may help improve mobility of the spine and decrease pain. If you have not already tried: weight loss (hard to do if you are in pain), an aquatic therapy program, tai chi, yoga, and meditation can all help to modify pain. If there are injured ligaments contributing to a decompensated posture (which can further aggravate back pain), then prolotherapy may be of benefit.
People can get pain an a result of a surgical scar. Since you have already had surgery, treating the scar may offer some relief.
More history would be helpful. Did the symptoms improve after surgery? Was there a new event which triggered the pain? The surgery was over 7 years ago, imaging the area to check on the fusion or to look for new pathology may be beneficial. A reevaluation by the operating surgeon may be valuable.
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I once had acupuncture to quit smoking. The practitioner used very small pins that remained in my outer ear between treatments that I would stimulate by pulling on my ear whenever I had a craving for a cigarette. Are there any other applications where the needles remain in place for longer than the scheduled acupuncture session? Brian from Woolwich |
8/12/2009 12:29:08 PM |
Jerrold A. Friedman, M.D.:
Please see the response to John.
There is a whole map of the body on the ear, scalp and hand. There are several different maps of the ear including French energetic and Chinese. Ideally any condition can be treated from any of these maps. The ear tacks or seeds can be used for an extended period of time to treat many different conditions.
There is a whole map of the body on the ear, scalp and hand. There are several different maps of the ear including French energetic and Chinese. Ideally any condition can be treated from any of these maps. The ear tacks or seeds can be used for an extended period of time to treat many different conditions.
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Does this help with "old age arthritis" I am 50 years old and I have almost constant pain in my hands and wrists from arthritis. I have already seen a hand doctor at Temple,where I used to work, and he told me there isn't much I can do, could try periodic injections to help with the pain he said. Karen from Cherry Hill |
8/12/2009 12:31:38 PM |
Jerrold A. Friedman, M.D.:
I''m not sure what is ment by "old age arthritis" at the age of 50.
Degenerative joint disease is a lousy term. It does not mean that the body is falling apart. From a rehab point of view and preventative medicine vantage please see the response to Jeanette.
Electroacupuncture can be very helpful in treating pain as the result of hand "arthritis". Learning to improve mobility of the shoulder and scapula can also shift the stress from the hand intrinsic muscles and joints to the larger and stronger muscles in the upper arm. This may also decrease pain.
Degenerative joint disease is a lousy term. It does not mean that the body is falling apart. From a rehab point of view and preventative medicine vantage please see the response to Jeanette.
Electroacupuncture can be very helpful in treating pain as the result of hand "arthritis". Learning to improve mobility of the shoulder and scapula can also shift the stress from the hand intrinsic muscles and joints to the larger and stronger muscles in the upper arm. This may also decrease pain.
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Can Acupuncture help sciatica pain and will Medicare pay for the treatment? Lois from Medford |
8/12/2009 12:33:02 PM |
Jerrold A. Friedman, M.D.:
Acupuncture can help sciatic pain. At this time, medicare considers acupuncture to be experimental and it is not a covered service.
Please see the response to Robert and Valerie.
Please see the response to Robert and Valerie.
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I have heard that acupuncture is helpful for asthma. As a matter of fact, I know someone who says that she had acupuncture treatment and it "cured" her asthma. She is no longer on meds. As a person with severe asthma and allergies requiring hospitalization once a year a least, I will try anything to breathe easier. Can acupuncture help me? Elizabeth from Pine Hill |
8/12/2009 12:35:41 PM |
Jerrold A. Friedman, M.D.:
Yes, Acupuncture can help treat asthma. At times acupuncture can not only help to manage symptoms but can provide a cure. The treatment may be combined with herbal medication. I myself tend to treat more musculoskelatal issues as I am trained as a Physical Medicine and Rehabilitation physician.
Asthma can be an exaggerated response from the immune system. Acupuncture can improve immune responses. There are other therapies which can improve the immune system and modify the acupuncture response such as NAET. http://www.naet.com/ TCM acupuncture may be a style you would like to consider. Cranial Osteopathy has also been shown to decrease symptoms of asthma.
Asthma can be an exaggerated response from the immune system. Acupuncture can improve immune responses. There are other therapies which can improve the immune system and modify the acupuncture response such as NAET. http://www.naet.com/ TCM acupuncture may be a style you would like to consider. Cranial Osteopathy has also been shown to decrease symptoms of asthma.
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I'm receiving shots every two weeks for pain due to pinched nerves in neck due to arthritis. Neck never hurt, pain is behind and below left shoulder blade, travels under arm and through left breast. I question diagnosis and treatment, been going on too long. Had x-rays, Mri, CAT scan and emg. What do I do next? Thanks. Barbara from Mount Laurel |
8/12/2009 12:37:12 PM |
Jerrold A. Friedman, M.D.:
Barbara,
Thank you for your question. What type of injections are you receiving? Are they epidural injections, trigger points, prolotherapy or other?
The results of the imaging studies and EMG would be helpful. How long have you been receiving the injections?
A thorough examination and reevaluation by another practitioner may be helpful to determine why you are requiring injections every 2 weeks.
Acupucture could probably help with pain and improve mobility of the shoulder blade and cervical and thoracic spine.
Thank you for your question. What type of injections are you receiving? Are they epidural injections, trigger points, prolotherapy or other?
The results of the imaging studies and EMG would be helpful. How long have you been receiving the injections?
A thorough examination and reevaluation by another practitioner may be helpful to determine why you are requiring injections every 2 weeks.
Acupucture could probably help with pain and improve mobility of the shoulder blade and cervical and thoracic spine.
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I have a nerve on my face (just below my right eye) that hurts intensely and is currently being treated with Lyrica which does keep it under control. Is accupuncture a possible treatment that might eliminate the need for Lyrica? Pam from Haddonfield |
8/12/2009 12:42:14 PM |
Jerrold A. Friedman, M.D.:
Sounds like trigeminal neuralgia. Acupuncture locally on the face or with the use of a microsystem (the ear, scalp, or hand if the face is to painful) may be able to help with the sysmptoms. As to whether or not acupuncture could replace lyrica, I do not know. It would be an acupuncture trial. If you do well the lyrica could be tapered.
Here at Cooper University Hospital, Gamma Knife Radiosurgery is often used to treat trigeminal neuralgia with great success. After many years of pain and many medication trials, patients are often able to completely get off of all of their medication after a single Gamma Knife treatment.
Here at Cooper University Hospital, Gamma Knife Radiosurgery is often used to treat trigeminal neuralgia with great success. After many years of pain and many medication trials, patients are often able to completely get off of all of their medication after a single Gamma Knife treatment.
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Good day, have you ever used acupuncture to treat patients experiencing Distal Peripheral Neuropathy acquired as a result of chemotherapy? Also, can acupuncture be used to stimulate the immune system? Thanks for taking the time to read this. Glenn from Cherry Hill |
8/12/2009 12:44:15 PM |
Jerrold A. Friedman, M.D.:
Good day Glenn and thank you for your question.
Unfortunately, the same chemotherapy treatment to treat cancer can damage other tissues including peripheral nerves. Chemotherapy can deplete the body's nutrients and vitality.
Acupuncture may help as part of a detox program to limit some of the injury which may be caused by chemotherapy. Acupuncture can improve energy and activity levels. Acupuncture may also help to decrease "brain fog" which some people report with certain chemotherapeutic agents.
I personally have had mixed success treating peripheral neuropathy. I have not had a lot of experience with peripheral neuropathy due to chemotherapy. I do believe acupuncture can be helpful for peripheral neuropathy. Often there are associated internal organ issues which benefit from herbal supplementation as well. The herbals may or may not be appropriate depending on the chemotherapy. You should discuss this issue with your Oncologist.
Acupuncture has clearly been shown to modify the immune system. People often get treatment prior to change of seasons to prevent illness. It is sort of an acupuncture "tune up" if you will.
Unfortunately, the same chemotherapy treatment to treat cancer can damage other tissues including peripheral nerves. Chemotherapy can deplete the body's nutrients and vitality.
Acupuncture may help as part of a detox program to limit some of the injury which may be caused by chemotherapy. Acupuncture can improve energy and activity levels. Acupuncture may also help to decrease "brain fog" which some people report with certain chemotherapeutic agents.
I personally have had mixed success treating peripheral neuropathy. I have not had a lot of experience with peripheral neuropathy due to chemotherapy. I do believe acupuncture can be helpful for peripheral neuropathy. Often there are associated internal organ issues which benefit from herbal supplementation as well. The herbals may or may not be appropriate depending on the chemotherapy. You should discuss this issue with your Oncologist.
Acupuncture has clearly been shown to modify the immune system. People often get treatment prior to change of seasons to prevent illness. It is sort of an acupuncture "tune up" if you will.
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I have Blackberry thumb - joint pain which radiates into my hand. Can acupuncture help or what would you recommend? Thank you. Chrissy from Philadelphia |
8/12/2009 12:46:39 PM |
Jerrold A. Friedman, M.D.:
Acupuncture can be helpful in reducing inflammation and improving blood flow. Acupuncture can be helpful in decreasing pain as a result of osteoarthritis, tendonitis, and bursitis. The longer a condition has been present the harder it is to cure the injury as opposed to manage the symptoms.
Changing your physical activities (habits), an anti-inflammatory diet, topical medications and a good exercise program can also decrease pain. If the thumb continues to be painful, a hands free voice activated system may be useful. There are many types of dictation software which will follow simple commands and tasks. This may protect the joint from abnormal wear and pain. If the tendons are involved prolotherapy may be useful.
Changing your physical activities (habits), an anti-inflammatory diet, topical medications and a good exercise program can also decrease pain. If the thumb continues to be painful, a hands free voice activated system may be useful. There are many types of dictation software which will follow simple commands and tasks. This may protect the joint from abnormal wear and pain. If the tendons are involved prolotherapy may be useful.
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I have ostheoarthritis and also tendonitis in my shoulders and bursitis in my left hip. It is a lot of pain. It is possible to use acupuncture for helping me with pain? Nelly from Glassboro |
8/12/2009 12:47:52 PM |
Jerrold A. Friedman, M.D.:
Acupuncture can be helpful in reducing inflammation and improving blood flow. Acupuncture can be helpful in decreasing pain as a result of osteoarthritis, tendonitis, and bursitis. The longer a condition has been present the harder it is to cure the injury as opposed to manage the symptoms. This does not mean something that has been present for a long time can not get better. The course of treatment may be much longer and may require more frequent treatments.
An anti-inflammatory diet, biofeedback, mindfulness meditation, topical medications and a good exercise program can also decrease pain.
An anti-inflammatory diet, biofeedback, mindfulness meditation, topical medications and a good exercise program can also decrease pain.
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What are the differences between alternative medicine, complementary medicine and integrative medicine? Are these different specialties? Why, when and how are they used? Thank you. Faye from Franklinville |
8/12/2009 12:49:47 PM |
Jerrold A. Friedman, M.D.:
In my opinion they are different names for the same thing. Alternative medicine sounds like there is something wrong with medicine that is not allopathic (M.D. medicine).
Complementary medicine sounds like this form of medicine may help the treatment that is considered conventional by allopathic medicine. It implies that the complementary treatment may not be effective on its own. Integrative medicine sounds best to me. It is not an either/or situation or "better than thou" situation. I think there are many aspects of integrative medicine that can be incorporated into the treatment of almost every condition to enhance the individual's health and well being.
Complementary medicine sounds like this form of medicine may help the treatment that is considered conventional by allopathic medicine. It implies that the complementary treatment may not be effective on its own. Integrative medicine sounds best to me. It is not an either/or situation or "better than thou" situation. I think there are many aspects of integrative medicine that can be incorporated into the treatment of almost every condition to enhance the individual's health and well being.
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I was wondering if you thought that either Acupuncture or other types of "Alternative Medicine" could offer much relief to someone who has chronic daily headaches as a result of a traumatic brain injury (TBI)? Etzel from Philadelphia |
8/12/2009 12:51:26 PM |
Jerrold A. Friedman, M.D.:
Acupuncture may be helpful. Better defining the injury components: brain, skull, ligament and muscle attachment, would help in the treatment process. Acupuncture may help with pain. Acupuncture spirit points, internal and external dragons and windows of the sky points may help with adjustment issues and symptoms of brain fog common with TBI.
Cranial Osteopathy may be very helpful to address pain and other symptoms related to TBI. Cranial Osteopathy is the study of anatomy and physiology of the cranium and its inter-relationship with the body as a whole. It may be applied for the prevention and treatment of disease and enhancement of health, within the practice of the science of osteopathy. cranialacademy.com
Mindfulness meditation or guided imagery may also be beneficial at treating and managing symptoms.
Biofeedback may also be of benefit.
Cranial Osteopathy may be very helpful to address pain and other symptoms related to TBI. Cranial Osteopathy is the study of anatomy and physiology of the cranium and its inter-relationship with the body as a whole. It may be applied for the prevention and treatment of disease and enhancement of health, within the practice of the science of osteopathy. cranialacademy.com
Mindfulness meditation or guided imagery may also be beneficial at treating and managing symptoms.
Biofeedback may also be of benefit.
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I'm battling depression and weight gain. I've been out of work and have no health insurance. I'm stuck in a vicious circle and see no way out. I've had acupuncture before and am a believer. Can this help my current problems? Thanks. Arlene from Bellmawr |
8/12/2009 12:53:59 PM |
Jerrold A. Friedman, M.D.:
There are community psychology, psychiatry and acupuncture treatment programs that often offer sliding scale fees for treatment. They can be as little as $15 for a treatment but the compromise is that you are not in a private environment.
Many large hospital settings do have charity care, but you need to apply.
Sounds like addressing the depression may be the best starting point.
There are many styles of acupuncture. I think a traditional Chinese Medicine style of acupuncture may be helpful for anxiety and depression. Other useful changes you can make would be to increase your activity level and supplemental fish oil. Both have been shown to alleviate some aspects of depression.
Many large hospital settings do have charity care, but you need to apply.
Sounds like addressing the depression may be the best starting point.
There are many styles of acupuncture. I think a traditional Chinese Medicine style of acupuncture may be helpful for anxiety and depression. Other useful changes you can make would be to increase your activity level and supplemental fish oil. Both have been shown to alleviate some aspects of depression.
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I am not able to log on my computer for the acupuncture discussion on 8/12 at noon. Is there any way I can listen at a later time? Thanks. Elena from Glassboro |
8/12/2009 12:55:46 PM |
Jerrold A. Friedman, M.D.:
Thank you for your question. The beauty of our eTalks is that you can “tune in” whenever you like. All the questions and answers are posted on our web site (cooperhealth.org) long after the chat is over. So if you have a question and you can't join the chat live, you can send it ahead of time and then check back on our web site anytime after our eTalks to read the answer.
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What conditions can acupuncture be used for and how successful is it? Also, is there a specific condition (or conditions) that acupuncture has proven to be particularly effective? Thank you. Chip from Cherry Hill |
8/12/2009 12:57:44 PM |
Jerrold A. Friedman, M.D.:
According to the National Institute of Health Concensus Statement on Acupuncture 1997, acupuncture has had promising results with adult postoperative and chemotherapy induced nausea/vomiting, and postoperative dental pain. The NIH also stated that acupuncture may be useful as an adjunctive treatment or an acceptable alternative or be included in a comprehensive management program for addiction, stroke rehabilitation, headache, menstrual cramps, headache,low back pain tennis elbow, fibromyalgia, myofascial pain, carpal tunnel syndrome and asthma.
The World Health Organization has listed more than 40 conditions for which acupuncture is indicated.
I personally have seen great responses to muscular conditions especially sprain/strain, myofascial pain and muscle imbalances. I have also seen rash and sinus symptoms improve dramatically and faster than otherwise expected. Many of my colleagues have had impressive success with improving fertility issues and complimenting invitro fertilization. In general the more acute the symptoms or injury the better the chance of success at treating that symptom or injury. The longer something has been present the less likely it can improve. Many conditions can still improve. I have treated many patients with symptoms of many years duration. Typically these people need more frequent treatment and over a longer time frame than someone with acute symptoms or injuries.
As far as proving efficiency, there are many intrinsic factors which make acupuncture a challenge. There are many styles of acupuncture. An acupuncture point to treat a condition may be used in one style but not in another style. The diagnosis is based on the patient's pulses, energy levels, symptoms, and biopsychosocial make up. In an acupuncture setting 2 patients with a herniated disc at L5 are probably not going to have the same treatment. Whereas in allopathic medicine they may be given the same class of medication.
It is hard to do a blind study to determine efficacy. Was the acupuncture needle placed, not placed or was the point a real acupuncture point or a sham point? These factors make acupuncture much harder to replicate in a blind study compared to a drug study.
The World Health Organization has listed more than 40 conditions for which acupuncture is indicated.
I personally have seen great responses to muscular conditions especially sprain/strain, myofascial pain and muscle imbalances. I have also seen rash and sinus symptoms improve dramatically and faster than otherwise expected. Many of my colleagues have had impressive success with improving fertility issues and complimenting invitro fertilization. In general the more acute the symptoms or injury the better the chance of success at treating that symptom or injury. The longer something has been present the less likely it can improve. Many conditions can still improve. I have treated many patients with symptoms of many years duration. Typically these people need more frequent treatment and over a longer time frame than someone with acute symptoms or injuries.
As far as proving efficiency, there are many intrinsic factors which make acupuncture a challenge. There are many styles of acupuncture. An acupuncture point to treat a condition may be used in one style but not in another style. The diagnosis is based on the patient's pulses, energy levels, symptoms, and biopsychosocial make up. In an acupuncture setting 2 patients with a herniated disc at L5 are probably not going to have the same treatment. Whereas in allopathic medicine they may be given the same class of medication.
It is hard to do a blind study to determine efficacy. Was the acupuncture needle placed, not placed or was the point a real acupuncture point or a sham point? These factors make acupuncture much harder to replicate in a blind study compared to a drug study.
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Are you also familiar with the Emotional Freedom Techniques, (see emofree.com) which uses the same meridian theory base as acupuncture, but uses light touch on face and hand acupoints? It is easily taught and can be self-applied when needed. As a psychotherapist, I am always amazed how it frequently can melt physical pain. Robin from (CUH EAP Counselor) |
8/12/2009 1:01:02 PM |
Jerrold A. Friedman, M.D.:
I am not familiar with Emotional Freedom Technique. However I have been very impressed with toyohari acupuncture which was developed in Japan by blind practitioners. The needles are placed either just above or barely touching the skin. It is a very energetic system of acupuncture. This may be a great approach for individuals who are uncomfortable around needles. http://www.toyohari.org/ Other practitioners have been working with cold lasers which can be applied briefly to the acupuncture points. The advantage of the lasers is for people who are anxious around needles. Acupressure also works along the meridians without the insertion of needles.
The technique you describe sounds like a great method for the individual to be able to control their own symptoms. As you know, being actively involved in one's treatment as opposed to being a passive participant will greatly improve the rate of success. Shared decision making between physician and patient is a prominent topic in health care today. Cooper is at the forefront of promoting patient centered care incorporating the PLANE TREE MODEL.
The technique you describe sounds like a great method for the individual to be able to control their own symptoms. As you know, being actively involved in one's treatment as opposed to being a passive participant will greatly improve the rate of success. Shared decision making between physician and patient is a prominent topic in health care today. Cooper is at the forefront of promoting patient centered care incorporating the PLANE TREE MODEL.
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Can accupuncture treat Gentital HSV? Laura from Cherry Hill |
8/12/2009 1:13:39 PM |
Jerrold A. Friedman, M.D.:
Acupuncture is useful for many types of viral syndromes. Viral symptoms can be activated by any excessive stress on the body. The stress may be physical, emotional, or environmental. Poor sleep and poor nutrition, and lack of exercise can contribute. If these conditions are present you may want to consult a sleep disorder specialist, nutritionist. or psychologist/psychiatrist.
An Acupuncture tune up especially around the change of seasons when we are more susceptible to illness may be invaluable. Acupuncture has been demonstrated to improve the body's natural defenses ( immunoglobulins), improve wound healing and speed recovery time from trauma.
An Acupuncture tune up especially around the change of seasons when we are more susceptible to illness may be invaluable. Acupuncture has been demonstrated to improve the body's natural defenses ( immunoglobulins), improve wound healing and speed recovery time from trauma.
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My husband has been diagnosed with a possible ULNA nerve damage in his right hand/arm. He has seen Dr. Gealt and Dr. Campelleone and has had several tests. So far no one has recommended a fix or a cure other than maybe surgery. Do you think acupuncture could help? Fran from West Berlin |
8/12/2009 1:24:47 PM |
Jerrold A. Friedman, M.D.:
Thank you for the question. It is always easier to treat an injury when it first occurs. Sounds like this has been present for a prolonged period of time. The likelihood that acupuncture will be of benefit depends on how extensive the nerve damage. How was the nerve injured? An entrapment vs compression vs overuse injury would be treated very differently.
Initially the hand may be numb and painful and as more of the nerve is damaged the pain may lessen. An acupuncture trial is the best way to answer your question. Within a few visits your husband would know if the treatment will be of any benefit.
Initially the hand may be numb and painful and as more of the nerve is damaged the pain may lessen. An acupuncture trial is the best way to answer your question. Within a few visits your husband would know if the treatment will be of any benefit.
Jerrold A. Friedman, M.D.
: Thank you for your great questions today. I hope that I’ve provided information about complementary medicines that will help you maintain good health throughout your life. There is much we can learn from the Eastern cultures about less stressful living, healthy eating habits and living in the moment.
These are important lessons for a long and healthy life – which I wish to all of you.
The Cooper Neurological Institute has many complimentary medicine programs. To learn more click here.
These are important lessons for a long and healthy life – which I wish to all of you.
The Cooper Neurological Institute has many complimentary medicine programs. To learn more click here.
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