MSc, BSc Hons, DipMedAc, MISCP

Simon holds a Master of Science Degree in Physiotherapy and is a member of the Irish Society of Chartered Physiotherapists. A post graduate Diploma in Medical Acupuncture entitles him to accredited membership of the British Medical Acupuncture Society. Simon specialises in the integration of medical acupuncture techniques with manual therapy and therapeutic exercise for the treatment of musculo-skeletal pain and dysfunction.

Acupuncture changes our Sympathetic Drive

An interesting study by Paulson & Shay (2013) confirms that Acupuncture activates the sympathetic nervous system during and after treatment. 

Their single blinded randomised descriptive study showed that those who received acupuncture to the forearm muscles (on one side) after a bout of fatiguing wrist extension exercises measured a bilateral decrease in skin resistance and distal skin temperature. There was a significant difference in outcome measures when compared to sham acupuncture or no treatment. The fact that the changes were measured bilaterally suggests central control changes, probably at the level of the hypothalamus.

The acupuncture group also measured an increase in perfusion (blood flow) but on the side of treatment only, which the authors suggest is likely to be due to a local circulatory versus central/systemic control change.

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Medical Acupuncture for Pelvic Pain?

Many would support the idea that the pelvis is crucially important as a platform to support the spine and lower limbs. It has also been suggested that in the same way a pelvic dysfunction can affect the function of the extremities, so too can extremity function or dysfunction, such as an ankle sprain, affect the normal function of the pelvis.

The pelvic girdle as a whole, including the sacro-iliac joints (SIJ) can also be a source of pain. Mark Laslett describes a series of pain provocation tests which have been validated as a means of diagnosing
pain arising from the SIJ (Laslett et al, 2003).

However true SIJ (that is joint interface) related pain is rare. If present we don't want to take the approach of compress further with support belts and 'core' exercises according to physiotherapist,
author and educator Diane Lee who is an expert when it comes to matters of the pelvis.

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Dose and Relationships, What Matters?

In the latest issue of British Medical Acupuncture Society's newsletter 'The Point' Adrian White provides a very interesting review of a presentation given at the Society's Autumn Scientific meeting.
The presentation was given by Petra Bauemler who works in Dominic Irnich's pain unit in Munich, Germany and discussed the findings of a mixed methods study she had recently completed look at the different approaches taken when treating neck pain.
In the presentation she describes how 14 patients with neck pain were treated in Argentina, China and Germany and the findings where as follows:
  • In Argentina patients received up to 10 needles in individualised points over 10 visits, one or twice per week. 
  • In China patients received up to 52 needles, mostly in fixed standard points and have to go for daily treatment for up to 30 visits.
  • In Germany patients receive treatment which falls somewhere in between.
What was interesting is that the outcome on neck pain and range of movement was the same in all three treatment settings!
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Undiagnosed Foot Pain - Relief at Last!

A 54 year old male hill walker develops medial forefoot pain while walking downhill and decides to tighten the boot laces to give extra support to the foot. Afterwards, the pain persists and continues over the next 12 months resulting in gait disturbances and reduced walking distances.

Multiple examinations and investigations by orthopods ruled out the usual suspects such as stress fracture of the first or second metatarsal, plantar fasciitis, metatarsalgia, hallux valgus and neuropathies. He was told to go and stretch his calf muscles and all would be well.

Well, not quite...

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Bilateral Tension Pneumothorax - A Reminder To Play It Safe

A recent case report published in Acupuncture in Medicine by Tagami et al (2012) reminds us to be vigilant in our practice when it comes to the potential risk of pneumothorax.

It describes the case of a 69 year old large bodied man who was diagnosed with a rare case of bilateral pneumothorax at a Tokyo hospital's emergency department. He presented with chest pressure, cold sweats and shortness of breath. Immediately after the pneumothorax was confirmed on X Ray, his cardiopulmonary status deteriorated and bilateral tension pneumothorax was diagnosed - an emergency. He was treated successfully with the insertion of drainage chest tubes and he made a full recovery.

It was only after treatment that is was discovered he had received acupuncture 8 hours previously and with no risk factors for spontaneous pneumothorax it was determined that the acupuncture must have been the cause (Remember that pneumothorax can develop up to 48 hours post treatment).

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