Friday, 21 September 2012

3 great tips on how to maintain posture

Posture is extremely important and the cause of many problems seen in my clinic. This video explains why posture is so important and how to maintain it.These simple techniques are easy to follow and learn, helping you prevent further problems arising.

Acupuncture for tension headaches

The National Institute of Health and Clinical Excellence (NICE) is a special health authority of the NHS that sets guidelines on the use of medicines, treatments, procedures and clinical practice for doctors and other healthcare practitioners. In 2009 NICE recommended that acupuncture should be made available on the NHS as a cost-effective short-term management treatment for the management of early, non-specific lower back pain. Today, NICE further extended their endorsement of acupuncture by recommending that acupuncture should be prescribed to patients in the prophylactic treatment of chronic tension-type headache. The guidelines stipulate a course of 10 sessions over the course of 5-8 weeks.
Not insignificantly, NICE conclude that acupuncture is the only proven method to prevent tension-type headaches and migraine and that doctors should prescribe it.
In a month in which a meta-analysis of nearly 18,000 patients demonstrated acupuncture’s capacity to help those in chronic pain from arthritis, there are now many reasons to consider acupuncture as a treatment for a number of health conditions.

You can read details of the new NICE announcement on The British Acupuncture Council’s website here: or read the guidelines directly on the NICE website here

Acupuncture for osteoarthritis of the knee

2 papers in Acupuncture in Medicine look at the acceptability to patients, and cost implications, of a group acupuncture clinic for osteoarthritis of the knee held each week in Parkbury House Surgery in St Albans. For more information on how acupuncture can help with osteoarthritis please contact me or visit my website for more information.

Watch the video on how acupuncture can help for migraines

Migraine sufferers Tina and Chris tell us how acupuncture helped alleviate migraine, whilst David Millard MBAcC offers some insight into the treatment. For more information on how acupuncture can help you please visit my website.

Tuesday, 18 September 2012

Acupuncture for chronic pain

An international collaboration, involving some of the UK’s top acupuncture researchers, has provided definitive evidence that acupuncture is effective for chronic pain. The Acupuncture Trialists' Collaboration analysed raw individual patient data, which was available for 17,922 participants enrolled in 29 high-quality, randomised trials of acupuncture for four chronic pain conditions; back and neck pain, osteoarthritis, shoulder pain and headache. It is the first systematic review of acupuncture to use individual patient data to conduct its meta-analysis. This method is superior to the usual method of using summary data, as it enables different outcomes to be combined and allows use of statistical methods that generate more precise results.

 The study, published in the prestigious Archives of Internal Medicine on September 10th, showed that for each of the four chronic pain conditions, the analgesic effect of true acupuncture was slightly better than that of placebo acupuncture. However, the difference between true acupuncture and usual care alone was found to be much larger and of clear clinical significance. Acupuncture was found to be statistically superior to control in all comparisons. Patients who received true acupuncture had less pain, showing scores that were 0.23, 0.16, and 0.15 SDs (standard deviations) lower than sham controls for back and neck pain, osteoarthritis, and chronic headache, respectively. The effect sizes for true acupuncture in comparison to no-acupuncture controls were lower by 0.55, 0.57, and 0.42 SDs, respectively. The authors give an example of what these effect sizes might mean in real terms. For an RCT where pain is scored on a 0-100 scale, a baseline pain score might be 60. Given a standard deviation of 25, post-treatment scores might be 43 in a no-acupuncture group, 35 in a sham acupuncture group and 30 in a true acupuncture group. In comparing true acupuncture with no acupuncture, the effect size for individual RCTs showed that it had a smaller benefit in patients who received a programme of ancillary care (for example physiotherapist-led exercises), than in those patients who continued to receive usual care (for example rescue analgesics). The average effect size of true acupuncture (approximately 0.5 SD, judged as ‘medium’), compared with no treatment, was judged to be of clear clinical relevance. The authors point out that while the difference between acupuncture and sham was of lesser magnitude (approximately 0.2 SD, judged as ‘small’), this is still a robust difference that could be clearly distinguished from bias. Theirs is the first study to unequivocally demonstrate this.  

Although the data indicate that acupuncture is more than a placebo, the relatively small difference between true and sham acupuncture suggests that factors in addition to the specific effects of needling contribute to its therapeutic effects. However, the authors also emphasise that the clinical choice made by doctors and patients is not between acupuncture and sham, but between acupuncture and no acupuncture, and, for this comparison, there is a clear and clinically relevant difference. The collaborators conclude that this landmark study provides the most robust evidence to date that acupuncture is a reasonable referral option for patients with chronic pain. They hope their findings will encourage clinicians to recommend acupuncture as a safe and effective treatment and inform future clinical and policy decisions. (Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012 Sep 10:1-10. doi: 10.1001/archinternmed.2012.