Acupuncture Treatment for Musculoskeletal Pain: A Textbook for Orthopaedics, Anesthesia, and Rehabilitation PDF
Preview Acupuncture Treatment for Musculoskeletal Pain: A Textbook for Orthopaedics, Anesthesia, and Rehabilitation
ACUPUNCTURE TREATMENT FOR MUSCULOSKELETAL PAIN ACUPUNCTURE TREATMENT FOR MUSCULOSKELETAL PAIN A TEXTBOOK FOR ORTHOPAEDICS, ANESTHESIA, AND REHABILITATION Harris Gellman, MD University of Miami Florida, USA v ~ CRC Press Taylor & Francis Group Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2002 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material repro- duced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copy- right.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identifica- tion and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com I thank my wife for her support and patience without which I could not have completed this book; To my children, I thank them for their unconditional love; To my mentors and teachers, I thank them for their friendship and the stimulation to seek knowledge; and to the contributors, I thank them for the willingness to share their knowledge and give of their time to make this an outstanding work. CONTENTS Preface ix List of Contributors xi PART I BASICS OF ACUPUNCTURE 1 1 Introduction to Acupuncture and Chinese Medicine 3 2 The Neurophysiologic Basis of Acupuncture 8 May C. M. Pian-Smith, Lang Ha T. Pham, and Francis W. K. Smith, Jr. 3 Acupuncture Basics 28 4 Acupuncture Points and Indications 42 PART II ACUPUNCTURE TREATMENT OF THE MUSCULOSKELETAL SYSTEM 119 5 Evaluation and Treatment of the Pain Patient: Author's Preferred Technique 121 6 Acupuncture Treatment Protocols by Anatomic Location 129 7 Arthritis and Chronic Joint Pain 134 8 Neck, Cervical Spine, and Back: Acute and Chronic 136 9 Special Pain Problems 139 PART Ill SPECIAL TECHNIQUES 141 10 Intramuscular Stimulation (IMS)-A Neuroanatomic Dryneedling Technique for Myofascial Pain Syndromes Affecting the Musculoskeletal System 143 C. Chan Gunn 11 Acupuncture Physical Medicine 162 Mark D. Seem 12 Craig-PENS: Basic Theory and Clinical Application 181 Stephen M. Taylor References 190 Index 199 PREFACE In today's changing medical environment, physicians are being called upon to provide more comprehensive care-by patients as well as their insurance carriers. Patients expect more from us as physicians in our ability to manage both acute and chronic pain. Many of our patients are becoming aware of such treatment alternatives as acupuncture, homeopathy, and Chinese herbal medicine, and expect that we, as physicians, should also have an understanding of these techniques. Until recently, many physicians have ignored the techniques used in China for thousands of years to treat pain and other maladies, however, many United States medical schools now include courses in acupuncture and alternative medicine in their curricula. I personally have been interested for many years in the use of alternative methods to treat patients who have been treatment failures, in an attempt to achieve at least some measure of improvement. Many of these patients have valid complaints of pain. The inability to cure or even improve these complaints has led to a search for a way to help. We, as western trained physicians, tend to focus on specific complaints that we can rapidly identify and treat, ignoring the ones we feel are unrelated. Eastern philosophy is much different. The relationships between the organ systems are well recognized, allowing seemingly unrelated sets of complaints to be identified as a weakness or overactivity of energy within a single organ system or group of organ systems. Western physicians are traditionally taught that the body's physiologic functions are mediated by hormones, polypeptides, and neurotransmitters that are released and transported through the blood. The Chinese, or eastern, philosophy of medicine and healing is based on the body's energy or Chi. This system or paradigm of medicine is different than ours, but in many ways, just as valid. To understand and use acupuncture for the treatment of disease and pain, one must accept some of the basic philosophies of Chinese medicine. Traditionally, western trained physicians initially have trouble understanding the concept of chi or energy flow. Interestingly, these same physicians have no trouble understanding the ability to measure the electrical energy of the heart using EKG monitoring, or the brain with an EEG. The use of electricity to augment fracture healing when a non-union or delayed-union is present has become an accepted technique. A natural extension of this is the understanding that all of the body's organs are surrounded by an electric field, which we are capable of measuring, should we so choose. Extending these concepts to include the concept of chi, we realize that, not only is there an electric field that surrounds the body, but also one that flows within the body. These energy fields flowing within the
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