Stuck Up
Stuck, prodded, poked, and goaded! Is there no limit to the invasion perpetrated by modern medicine in the name of good health, clinical, and preventive medicine? And now it’s the turn of alternative and new-age remedies, with an old, but not so old, friend bringing up the rear. You know his name, and growing numbers are feeling the pinch of his bite, as acupuncture holds sway on a field of both unabated enthusiasm and spined skepticism. The poster child of more than a decade ago has again come to the fore in informed enclaves of the United States, in the wake of dissatisfaction with the pills, potions, procedures, and pronouncements from on-high of allopathic medicine. Perhaps the Chinese got it right the first time. After all, there is strength in numbers, and 1.3 billion of them can’t be wrong. With an estimated 70 percent of people in Western industrialized countries having low back pain, the descendants of Chairman Mao have had their work cut out for them up to now, and are finally starting to receive the credit and a handsome profit, to boot, for technologies developed eons ago.
In 1997, 6.8 million U.S. adults either lamented or demonstrated physical disability associated with back pain, which was nonspecific low back pain in most cases. The financial shortfall resulting, and bringing smiles to the pusses of those affectionately called “orthopods,” in the jargon of the trade, was more than $90 billion annually in health care expenses. Of that amount, $26 billion was directly attributable to the treatment of back pain. Enter, from stage left, the new protagonist and darling of the grimace-in-pain set, namely, acupuncture, which had been heretofore mysterious in its ramifications, therapeutic results obtained, and modality of use. Might the reader, at this point, provide some elucidation on the subject? Probably not, unless, of course, belonging to the growing legion of converts.
Actually, a licensed practitioner will advise a patient to relax and leave the probing to him or her, with the acupuncture needles left in place after insertion for 15 to 30 minutes. During that brief period of time, which may seem like ages for some, the practitioner may stimulate the needles manually, with electrical current, by burning an herb on the ends of the needles, or with heat. All of these methodologies elicit a dull, localized, aching sensation in the patient, and a tugging sensation perceived by the acupuncturist, as mechanical interaction occurs between the needles and connective tissue of the “pin-cushioned” guinea pig, hapless victim, or satisfied customer, whichever term is preferred. One treatment is considered inadequate by most practitioners, and a series of 12 sessions of acupuncture, starting with 2 sessions a week and tapering off after 4 weeks to once weekly, is just what the doctor ordered. Booster treatments, monthly or every other month may follow.
Silver linings are never 100 percent, and the cost of acupuncture is not negligible, ranging from $65 to $125 per session. To make matters worse, Medicare and Medicaid do not cover acupuncture. On the positive side of the ledger, however, the proportion of third-party health insurance plans providing coverage for the procedure has increased from 32 percent in 2002 to 47 percent in 2004. Major adverse effects of acupuncture are close to nil also, and significant minor adverse events occur in less than 0.1 percent of cases. The latter include needle-site pain, nausea and vomiting, and dizziness or fainting. So, the end may, indeed, justify the means, when impalement on small needles terminates that nagging, sinking feeling, lumbar stiffness, or aching that heralds the new morn or accompanies the setting sun of a day lived badly.
The American College of Physicians and the American Pain Society have also put in their two cents, recommending acupuncture for refractory low back pain not responding to self-care and conventional treatment modalities. The U.K. National Health Service has even taken the matter one step further, providing a maximum of 10 acupuncture sessions over a period of 12 weeks for people with low back pain that has persisted for more than 6 weeks.
When chronic back pain does not respond to reassurance on the part of the health care provider, physical activity, and a number of conventional medical treatments, then being “stuck up” takes on an all together entirely different connotation from that immortalized by yesteryear’s prom queen. A course of 10 to 12 acupuncture treatments over a period of 8 weeks from a licensed medical professional can take the sting out of being “on one’s back,” and make it pleasurable again.
© 2010, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
9/05/2010 09:01:00 AM
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