Last weekend on Saturday the 7th of November 2015 I had the pleasure of delivering the third in a regional series focussing on the integration of medical acupuncture in the treatment of low back pain. I suppose I should not have been surprised how quickly the course filled given how challenging low back pain can be to treat. We are all looking for those added skills which might make the difference between a successful or unsuccessful course of treatment.
We began with a clinical overview in which I tried to tie together emerging approaches in the management of this very prevalent and challenging condition. I proposed a ‘functional mechanisms based model’ which could be used as the basis for assessment, clinical reasoning and treatment. Given the medical acupuncture approach is very neurophysiological mechanisms based, if we can asses and reason in this manner and apply our understanding of acupuncture mechanisms when planning and applying treatment, we may be more effective. I was inspired and influenced by the work of Prof. Peter O’Sullivan, David Butler, Gray Cook, Mike Cummings, Paul Hodges and others when compiling this presentation.
Following an overview of the current evidence for medical acupuncture in the treatment of low back pain we went on to a discussion and demonstration of how one could assess the low back in a manner which is time efficient, functional and provides an understanding of to what extent the problem may be specific or non-specific, mechanical or non-mechanical, peripherally or centrally driven as well as key functional issues, movement impairments, and the role of psychosocial factors.
Based on the assessment findings, the day became very practical as attendees learnt to use medical acupuncture techniques tailored to the individual presentation. There was plenty of emphasis on identifying and treating myofascial trigger points should they be present. Attendees also learnt how to use local, segmental, extra segmental and central regulatory points to influence the physiological status of the patient with an aim to facilitate exercise, cognitive re framing and lifestyle changes as may be required. How to use manual therapy alongside these techniques when appropriate was also discussed and demonstrated.
We needled nine points/muscles in all including some more challenging ones such as quadratus lumborum, psoas major, and the multifidi. The use of electroacupuncture and the Pointer Excell 11 for trigger point deactivation was demonstrated and all attendees were able to experiment with these devices.
The day flew by and after another coffee break and some tasty carrot cake, we finished up the points practicals and then an end of day review rounded up what we all agreed was a very successful day of learning. I plan to run the course again in the new year such was the demand for places, so keep an eye on the website for dates.
Feedback from course attendees can be viewed here...