Medical College Practitioner Eases Pain with Acupuncture

Acupuncture has gained wide acceptance in recent years as skeptics - including patients, the medical community, and even some insurance companies - have become convinced of its value.

According to the 2002 National Health Interview Survey conducted by the National Center for Alternative and Complementary Medicine - the largest and most comprehensive survey of complementary and alternative medicine use by American adults to date - an estimated 8.2 million US adults have used acupuncture; an estimated 2.1 million had used it in the previous year.

The US Food and Drug Administration (FDA) approved acupuncture needles for use by licensed practitioners in 1996. The FDA requires that sterile, nontoxic needles be used and that they be labeled for single use by qualified practitioners only. The needles are extremely thin.

Lynn M. Rusy, MD, FAAMA, Medical College of Wisconsin Associate Professor of Anesthesiology, serves as Associate Director of the Jane B. Pettit Comprehensive Pain Management Center at Children's Hospital of Wisconsin, where she is conducting a study comparing outcomes from different ways of using acupuncture in children.

The study focuses on the use of acupuncture in the treatment of myofascial (connective tissue) pain and fibromyalgia, a chronic pain condition affecting muscles and connective tissues. Steven Weisman, MD, Medical College Professor of Anesthesiology and Director of the Center, challenged Dr. Rusy to compare various needle placements to demonstrate that certain patterns were more beneficial than others. The success of specific placements would indicate that their effectiveness was not a random occurrence.

"Our study is designed so that patients receive four weeks of acupuncture treatment, either the treatment that I believe works or a treatment with the same number of needles in different places in the body," explains Dr. Rusy. It didn't take long for Dr. Rusy's treatment results to become obvious.

"It was clear to me that one acupuncture protocol was much better than the other in relieving pain," she notes. "So far, we've seen vast improvements in the pain scores after the patients get what I felt was 'good' acupuncture versus acupuncture that was not directed at myofascial pain."

Case File: A Boy Relieved of Pain
"A patient I've had great success with using acupuncture was two and a half years old when I first started treating him," said Dr. Rusy. "He's a boy who just didn't eat right. Physicians and gastroenterologists did workups for all his problems. I don't think they ever found anything specific significantly wrong with him, but he ended up getting a gastrointestinal tube because he vomited all the time. The g-tube was placed for nutrition supplementation and the parents were essentially tube-feeding him. He wasn't taking anything at all by mouth.

"His pediatrician e-mailed me because she knew I did acupuncture, and nausea is one of the major reasons for using acupuncture as a treatment. I'd never treated a patient that young. The parents were nearly at their wits' end and were ready to try anything. I started with 'P-6', one of the most studied acupuncture points (at the underside of the arm just above the wrist), a great point for nausea.

"There have been numerous articles published, one of which I wrote about six years ago, on how the P-6 point is related to nausea in tonsil patient anesthesiology. That's a well-known point; in fact people who have seasickness or air travel sickness can buy pressure bands to stimulate it."

Dr. Rusy consulted with the boy's mother about doing acupressure or other non-needling techniques, but the mother chose to start immediately with the needles. "They're very tiny needles. Other than a little pierce of the skin, there's not a lot of pain associated with it. So we put his needles in; I recall doing the P-6 point and others in his legs.

"Of course he cried when they went in," said Dr. Rusy. "But he stopped vomiting, completely, after the first thirty-minute treatment."

Success
"The parents were just amazed. I started treating him weekly and we developed a plan using ear tacks. Those are very tiny needles, a few millimeters long, that can stay in the ear for weeks.

"I also worked on the P-6 point and points in his leg, belly, and around his g-tube, also for nausea. They'd bring him here to the pain management center and I'd put those in. He'd still cry when they went in, but then he'd play happily in the clinic for 45 minutes; I'd take them out and he'd go. He started eating again and the vomiting was under control. Acupuncture really turned things around for him."

The parents and Dr. Rusy worked with other doctors to deal with the psychological component of the young patient's eating/vomiting problem. "We were using acupuncture along with the emotional and psychological treatment. Now he's treated about every month. His remaining problem is largely behavioral, and we're doing less of the acupuncture."

In many cases, acupuncture is considered when other approaches have not solved problems such as pain and nausea. Because of its essential nature - drug-free, very minimally invasive, and relatively pain-free - it can be an extremely valuable tool for young patients.

Dan Ullrich
HealthLink Contributing Writer

This article includes information the American Academy of Medical Acupuncture.

For more information on this topic, see the first part of Dr. Rusy's article, Acupuncture Can Be an Effective Option for Children.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.