The holistic approach to medicine often uses acupuncture to treat a variety of symptoms and conditions. However, patients who have never experienced acupuncture are sometimes skeptical about whether it really works – or if it would work for them. The following case study describes how one very skeptical patient became a believer in the value of acupuncture for back pain.
The patient was a male in his 70's with severe back pain. As a retired radiologist, he had considerable knowledge of Western medicine as well as extensive experience examining and reviewing images of various body regions including the spine. Being trained in this way he had considerable knowledge as to the cause of his back pain. He was experiencing severe back pain – sciatic nerve pain – to the point where he was confined to a wheelchair.Many years prior to this recent back pain episode he underwent surgury for his back, two disc replpacements in the lumbar region. This seemed to help for a while but gradually his back begain to ache again whith period of more severe pain too but not as bad as this recent episode. As he explained it he had severe spinal stenosis with degenerative disc disease and his options for further Western medicine treatment were limited.
A few weeks prior to coming for acupuncture he was given a few epidurals (corticosteroid spinal injection) with very little relief. He was also offered pain medications to which he took very sparingly as he did not want to become addicted or dependant on opiate pain medication. With his limited options and severe pain, he was looking for an alternative, hoping for a better outcome, and a friend recommended he try acupuncture.
The consultation and treatment
During his first visit at Southwest Integrative Medicine, the patient reported that even small stints of walking or standing further aggravated his painful back and leg. The type of pain he had is called radicular pain, meaning the pain was radiating. The pain started in his back and would radiate down his left leg to the outer knee area. This is often referred to as sciatic pain and in Western medicine is thought to be caused by an irritated nerve in the Lumbosacral region of the spine. Dr. Robin Terranella explained that Chinese Medicine and acupuncture treatments base their treatments on addressing the underlying energy dysfunction causing the patient’s extreme pain.
After a history and exam, he diagnosed urinary bladder and gall bladder channel stagnation due to qi blockage. To remedy this, he used acupuncture points along the urinary and gall bladder meridian to open up and improve energy flow. He also diagnosed kidney qi deficiency. Kidney qi deficiency often occurs in older adults, and often creates symptoms such as cold hands and/or feet and lower back pain. This is a “constitutional” long standing issue involving an underlying energetic deficiency, whereas qi stagnation is usually more of an acute issue.
Dr. Terranella supported the patient’s kidney qi by usgin moxa in addition to the acupuncture treatment on the patient’s back. Moxa, or moxabustion, is a technique in which a small amount of dried Chinese herb is burned at or near specific acupuncture points to stimulate qi. The herbs can be applied directly to the skin or put on an acupuncture needle. The goal is to build energy at that point to help increase energy within the patient.
The results
The patient returned to Southwest Integrative Medicine one week later, walking without his wheelchair. He reported his pain was about 75% better. As a non-believer, he was both surprised and very happy that acupuncture had helped him where other traditional treatment methods had failed. Before being sidelined by his pain, the patient had been an avid outdoorsman, enjoying hiking and trekking and he was afraid he would not be able to get back to this.
Dr. Terranella recommended two to three treatments for this patient, because he was going out of town for a while. Although, he says most patients typically need three to five treatments overall to get things under control.
As a comparison, in China, acupuncture is typically delivered in a series of 10 treatments for all types of conditions. When things are more chronic and degenerative like his was, it indicates the need for ongoing treatments. The initial 3-5 treatmetns typically reduce the pain significantly and as time goes on they may need follow up treatments. This main conintued to improve with each treatment and as far as we know his back pain is no longer a major issue for him.
Dr. Terranella says it is not unusual for conventional doctors to seek alternative treatment, due to curiousity or no other alternatives. As he says, "the good thing is you don’t have to believe for it to work.”
