By Adrian White PhD MA BM BCh, Mike Cummings MB ChB Dip Med Ac, Jacqueline Filshie MBBS FRCA
This publication is a transparent and sensible introductory advisor to the perform of clinical acupuncture. It describes the Western scientific method of using acupuncture as a remedy following orthodox prognosis. The textual content covers questions of safety, diversified techniques to acupuncture, easy aspect info, scientific matters and the appliance of acupuncture in scientific stipulations, specifically within the remedy of pain.A functional advisor to the rules and scientific perform of clinical acupunctureA transparent advisor to the neurophysiological rules which underlie clinical methods to acupunctureA simple clarification of the several forms of clinical acupuncture treatmentAllows the reader to accrue the sensible wisdom precious sooner than commencing to paintings with scientific acupuncture.
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Extra resources for An Introduction to Western Medical Acupuncture
The intermediate cells release the neuromodulator enkephalin, which blocks the transmission of pain in the substantia gelatinosa cells, part of the nociceptive pathway (from the unmyelinated C fibres). The effect of enkephalin can be detected as a generalized depression of activity of the dorsal horn (Sandkuhler 2000). The effect is known as ‘segmental analgesia’, and takes some minutes to develop, but then outlasts the duration of the acupuncture stimulation, possibly even lasting several days.
The PAG also receives input from the limbic system, which explains how psychological states can alter the perception of pain. There are two known descending pathways from the PAG, and probably more that are yet to be discovered: One system descending from the PAG releases serotonin at the intermediate cells of the dorsal horn – the same cells that are already activated by the segmental effect of acupuncture. 2 Diagram to show neuronal circuits involved in acupuncture and TENS analgesia. The afferent pathways involved in transmitting nociceptive information from a painful scar to the higher centres via the dorsal horn, the ascending tracts and the thalamus are shown.
Natural opioid antagonist cholecystokinin: anxiety Cholecystokinin (CCK) is a naturally occurring antagonist of opioid peptides. It was named after being first found to cause contraction of the gall bladder. Raised levels of CCK in the CNS are associated with an increased perception of pain; in addition, anxious patients have raised levels of CCK and, therefore, are likely to experience more pain. Therefore, to achieve the maximal benefit from opioid release, it is important to prepare patients for acupuncture in ways that reduce anxiety, such as avoiding rush, providing adequate explanation, leaving opportunities for questions and discussion, as well as using touch, if appropriate.