The Acupuncture Treatment Principles
Diseases of Nervous system are one of the largest groups of disorders seen in general practice. Their symptomatology is very complex and may range from pain, paralysis and paraesthesia to involuntary movements of various kinds, specific sensory loss, and symptoms of autonomic imbalance.
No specific treatment is available in Western Medicine in the majority of these diseases and the management consists largely of supportive measures like physiotherapy, administration of vitamins, together with narcotic drugs and analeptic, where necessary. Acupuncture, however, is an extremely helpful modality in the treatment of these diseases.
Owing to the powerful analgesic effects of acupuncture it is particularly helpful in allaying pain- a problem which causes much distress in the majority of these patients. In addition, it is possible to obtain a recovery of motor function to a degree which is not attainable with any other form of treatment. Subsidiary complaints like speech disorders, sensory loss and autonomic disturbances are also found to respond very favourably to treatment with acupuncture. The analysis of a neurological disorder entails the elucidation of the anatomical localization and the consequent physio-pathological disturbances which result.
||This group of disorders is characterized by fits or seizures which are often sudden, usually resulting in loss of consciousness. There are 4 types of epilepsy:
The only symptom here is a fleeting loss of consciousness, where the patient (usually a child) may be seen to stare straight a head into space. The acupuncture treatment consists of needling specific points used in the interim periods for the routine therapy (DU 20; DU26; P6; H7 and UB62).
This is the more common type of fit. It is characterized by an aura, loss of consciousness with generalized convulsion and post epileptic phenomenon. Prodromal symptoms are sometimes present and loss of consciousness is often preceded by a sharp scream. Acute fits can be brought under control by acupressure at acupuncture point (Du 26) and if necessary, needling at Kidney meridian (K1).
Where the patient develops repeated seizures and does not regain consciousness between attacks, the condition is known as “status epilepticus
”. In such cases certain acupuncture points are selected for treatment.
3.JACKSONIAN FITS (FOCAL EPILEPSY)
Here the seizure begins in one part of the body and may spread to the other muscle groups (sometimes culminating in a grand mal attack). The symptoms sometimes are restricted to an abnormal feeling in part of the body which may spread to other parts (the so called sensory epilepsy).
If the patient is seen during a fit, it may be necessary in addition to needling (Du 20) and (K1), to add suitable acupuncture points lying in the direction of the spread and then stimulating them strongly, in order to stop the fit.
In sensory epilepsy, local points on the scalp, corresponding to the site of the suspected lesion may be used. Local body acupuncture points corresponding to the region of the sensory disturbance could be added.
4.PSYCHOMOTOR (TEMPORAL LOBE) EPILEPSY
Here the fits are not as severe as in grand mal. Fits may be preceded by an aura of unreality and hallucination. In addition to body acupuncture, ear acupuncture may be Useful for maintaining continuous stimulation between treatment sessions.
Results obtained with acupuncture in epileptic patients are very promising. In most cases of petit mal the symptoms may be expected to disappear with 10 to 15 treatments. The results are almost equally good in sensory epilepsy and temporal lobe epilepsy. For grand mal, however, 30 or more treatments may be required with weekly reinforcement for 3 or 4 months or longer. We have treated many cases of traumatic epilepsy (which is post-traumatic syndrome responds very well to acupuncture) with good results. The important constraint in treating epilepsies is to take care to eliminate the possibility of a space occupying lesion.
The acupuncturist should consider the following points in treating epilepsy
Electrical needle stimulation is contraindicated, as it might precipitate attacks.
All drugs may be completely withdrawn at the commencement of the acupuncture therapy. The vast majority of patients manage so well without medication that even the tailing off of the dosage is usually unnecessary. However, where fits of a greater intensity occur within the first few weeks of acupuncture, minimal doses of the earlier drugs may re-introduced and then withdrawn, The strategy must be explained to the patient before commencing therapy so that his/her co-operation is fully enlisted.
Ear acupuncture helps to prevent attacks.
SPASTIC PARALYSIS, CHOREA AND TICS
||The commonest form of Parkinsonism is Parkinson’s disease. There are however, many forms of this disease, which generally affects elderly people. It is mainly a disturbance of voluntary movement caused by the degeneration of the inhibitory nerve fibres in the basal ganglia of the brain. Mental faculties are affected. The disease may be identified by a weakness and spasticity of the face muscles (causing the characteristic mask-like expression), a coarse tremor when rest (particularly in the hand), a tendency for the mouth to stay open with excessive salivation, rigidity of limbs and the characteristic shuffling gait.
Usually improvement is slow, and 60 or more treatment may be necessary for improvement to commence. A success rate of about 75% may be expected with combined body and ear acupuncture. Some patients may need a minimal dose of medication, in combination with acupuncture.
||Spastic paralysis is caused by damage to certain brain areas and centres, resulting in the impairment of voluntary movements and presence of muscle spasm, or lack of co-ordination, or uncontrolled purposeless movements (athetosis), depending on the site of the brain damage. The disorder is often confined to the legs. A rather painful form of recurrent nervous muscular spasm, however, is spasmodic torticollis where, the neck is usually deviated to one side.
Chorea is characterized by uncontrolled jerky movements, involving any part of the body. Sydenham’s chores (rheumatic chorea, St. Vitus’ dance) is a childhood disorder associated with rheumatic fever. Adults exhibit chorea in a rare hereditary condition known as Huntington’s chorea where, in addition to uncontrolled movement, there is progressive mental degeneration.
Tic is an involuntary purposeless movement e.g., shrugging of shoulders, which may earlier have been purposive.
||There are many types of headaches –tension headaches, vascular headaches, post-concussion headaches, headaches due to frontal sinusitis, eye strain and other similar causes.
In all cases of headaches it is advisable to attempt to arrive at a diagnosis, before acupuncture is commenced.
The possibility that the headache is due to cerebral tumour or other space-occupying lesion must be thought of. Conditions like hypertension, constipation, or anxiety, if present, should receive concurrent therapy.
The principle of treatment is to use local acupuncture points and distal points, along the course of the relevant acupuncture meridians (channels). It should be noted that in all types of headaches certain acupuncture points are used.
The acupuncturist should consider the followings in treatment of headaches:
Strong stimulation of acupuncture points in the head area should be avoided. This may aggravate the headache.
Where the headache is acute, manual stimulation of a point in the hand (called Hegu or Li4 would invariably give almost immediate symptomatic relief.
Ear acupuncture may be useful in combination with body acupuncture.
This is very common disorder and the causes include any kind of physical discomfort or pain. In most cases the disturbed sleep pattern may be corrected after few treatments. In all cases the cause should be investigated and the patient advised accordingly. Again, ear acupuncture is very helpful when it is combined with body acupuncture.
FACIAL PARALYSIS (BELL’S PALSY)
The trigeminal nerve (5th cranial nerve) contains mainly sensory fibres which are in three groups (hence “trigeminal”):
||In Bell ’s palsy one side of the face is paralyzed. The cause of facial nerve paresis in these disorders is unknown. It may be due to inflammation in the region of the middle ear, probably as a result of exposure to cold or virus infection.
Natural recovery occurs rapidly in many cases. In early cases of Bell’s palsy recovery may be expected within 6 to 10 sessions of treatment. In long standing paralysis, the “puncture-through” technique may be tried with the use of long needles.
Low frequency electrical stimulation, about 3-10 Hertz, is applied to certain acupuncture points. High frequency stimulation at 100-2000 Hertz is always usually in intractable cases.
The ophthalmic nerve (supplying the upper part of the face)
The maxillary nerve (supplying the upper jaw area) and
The mandibular nerve (supplying the lower jaw area).
In trigeminal neuralgia the patient suffers severe pain in the distribution of one or more branches of the trigeminal nerve. When it is spasmodic, it is associated with a twitching of the facial muscles. The acupuncture treatment of trigeminal neuralgia is based on the principle of combining different body acupuncture points, including distal and local points.
It is desirable to use a large number of acupuncture points on the face and to carry out the treatment twice weekly. When acute pain is present, strong manual stimulation of a point in the hand called Hegu or Li 4 should be carried out. The needles on the face may also be gently manipulated every 5 to 10 minutes.
In resistant cases the duration of the sittings may be increased from the usual half an hour to 45 minutes. Additional body points may also be introduced for reinforcement. Where the patients does not permit the affected side of the face to be needled on account of the severity of the pain, the opposite side of the face may be needled (on the principle that the side of the therapy does not matter).
Acupuncture therapy has been found to be extremely satisfactory. The relief of pain occurs within a few treatments, in most cases. A little paraesthesia may be found as a residual disability. In order to obtain complete recovery the patient may have to be treated for a few months, including self-treatment by the patient with electro-stimulation without needles (TENS machine).
DISORDERS OF THE AUTONOMIC NERVOUS SYSTEM
The autonomic nervous system comprises of two components, the sympathetic and the parasympathetic, which reflexively regulate involuntary functions such as heart beat, blood pressure, and digestive activity.
Disorders affecting these systems are characterized by symptoms of autonomic imbalance, i.e., over-reaction of sympathetic or parasympathetic components. They are very difficult to cure with drugs and are often labelled a being “functional in origin”. The symptomatology is complicated by the fact that sometimes more than one of different systems such as cardiovascular, gastro-intestinal, urinary, and reproductive are involved. These disorders often respond well to acupuncture therapy.
If you want to know further about the treatment of Neurological disorders by Traditional and Western Acupuncture and its effectiveness, please contact UK ACUMEDICA CLINICS