Tyler Wadsworth, M.D.

Acupuncture for Pain Relief

The ancient practice of acupuncture has spread rapidly during the last few years in the United States. Acupuncture in the modern era was introduced to America during President Richard Nixon’s historic 1971 trip to the People’s Republic of China. Acupuncture is now practiced in all parts of the United States and all over the world. Tyler Wadsworth, M.D. is a board-certified Sports Medicine physician at Sports Medicine Consultants, PC in St. Louis, Missouri with over 15 years of experience in the treatment of pain with acupuncture. Traditionally, medical physicians are skeptical of non-traditional therapies. However, over the past few years, many St. Louis physicians have referred their patients to Dr. Wadsworth for acupuncture to relieve their pain.

What Does Acupuncture Do?

There is growing scientific evidence that acupuncture is a safe and effective treatment for pain. Numerous studies in the medical literature show that the effects of acupuncture are at least partially due to the release of endorphins and related compounds. Endorphins are part of the natural pain-control mechanisms in the nervous system.

Newer research has also shown insight into the effects of acupuncture on the brain. Positron Emission Tomography (PET) scans and functional MRI scans can measure metabolic activity in the brain. Several studies (Neurosci Lett. 2001 Jul 13;307(2):105-8; Neuroimage. 2002 Aug;16(4):1028-37; Chin Med J 2003;116(12):1836-1839) have shown that acupuncture points used to treat pain, gastrointestinal, or vision problems cause an increase in metabolism in the specific parts of the brain associated with these functions. That such modern and objective research tools confirm the effects of acupuncture is exciting and helps to further legitimize the use of acupuncture in modern medicine.

Some of the most interesting acupuncture studies have looked at the treatment of degenerative arthritis (osteoarthritis). In one study (Christensen, et al, Acta Anesth Scand 36 (6), 1992), twenty-nine patients with arthritis of the knee who were on a waiting list for knee-replacement surgery underwent acupuncture treatment. The effectiveness of the treatment was assessed by patient questionnaires, physical examination and improvements in walking speed. Eighty percent of the patients had significant, measurable improvement in their pain, and 25% of them had such good relief that they decided against having the surgery. A more recent study of patients with knee arthritis (Tillu, et al, Acupuncture in Medicine, 20(1) 2002) demonstrated a significant improvement in pain measures and walking and stairclimbing speed in who were treated with acupuncture compared to controls, who worsened in all measured outcomes. Three of 30 acupuncture subjects in this study elected to withdraw from the joint replacement list. The only reported complication was bruising reported in 3 subjects. Joint replacement technology is wonderful for people who need it, but if adequate relief can be obtained without surgery, most physicians would recommend against it.

Expectations

It is important to point out that acupuncture has a subtle and gradual onset of action for most people. Relief often does not begin to occur until the second or third treatment. If you decide to try acupuncture, it is important to realize that it may take a series of three or four treatments to realize much improvement, especially if the pain has been present for a while. It works well for acute pain also, and occasionally is used after trauma or surgery.

Ask your physician to place a needle or two to see what it feels like. You will see that it is not painful. The needles are very fine, and rarely perceived as sharp. There may be a gentle numbness, heaviness or ache, which the Chinese call “de qi”. It may be accompanied by a feeling of drowsiness, relaxation or energy, depending on which points are selected by your acupuncturist.

You will likely be treated with ten to twenty of these small needles during your first treatment. The needles are left in place for approximately twenty minutes. On subsequent treatments, there may be a change in needle placement. The acupuncturist may stimulate the needles by gently manipulating them. Occasionally, the needles are stimulated by application of a mild, safe electrical current.

Adverse Reactions

As with any medical procedure, some risk is involved with the insertion of needles. Infection is typically not a problem in people with normal skin and immune systems. Dr. Wadsworth uses sterile, disposable needles and these are never re-used; it is not possible to catch AIDS or hepatitis from the acupuncture needles. If you decide to have acupuncture elsewhere, insist that only sterile, disposable needles are used.

There is a slight risk of bruising at the needle sites. If you have any problem with blood clotting or are on blood thinners, it is important to tell your acupuncturist. If there is bruising, there may be some soreness at the needle site for a few days, as with any other bruise.

Between two and five percent of people feel as if they may faint during an acupuncture treatment. This is a feeling of lightheadedness, dizziness, sweating or clamminess that comes on after the treatment is initiated. This feeling usually passes as we lie the patient down, and goes away quickly when the needles are removed. It may be avoided by eating before a treatment. Lying down during the treatment will nearly always prevent this phenomenon.

There is a remote risk of damage to underlying organs during needle insertion. The most significant example of this would be lung puncture. Although this is extremely rare, it has been reported with acupuncture. While this is a treatable complication, it may require hospitalization and placement of a chest tube. If you feel short of breath or experience chest pain after acupuncture involving needles over the chest (front or back), you should discuss this with your acupuncturist.

Although it is important to be aware of the possible adverse effects of any medical treatment, it should be emphasized that acupuncture is among the safest forms of medical therapy, even compared to modern medications.

Acupuncture Treatment

Acupuncture is usually done once weekly for a trial period of four treatments. During this time, it is important to note any changes in the level of pain. Although it may take two or three treatments to note much difference, after this period of time there is usually a clear pattern of improvement. Approximately seventy-five percent of people who undergo acupuncture treatment note significant improvement.

When improvement occurs, the acupuncture is continued and the treatments are administered less frequently as pain relief lasts longer. People who have a chronic condition such as arthritis sometimes need to come in every one to three months as needed to maintain the improvement.

Insurance Coverage

Most insurance carriers do not consider acupuncture a covered medical benefit. Ironically, although acupuncture has been around for at least three thousand years, many insurers consider it “experimental”. Sometimes, a letter of medical necessity from your physician may sway your carrier to cover acupuncture. If this is the case, Dr. Wadsworth can write to your insurance company. More and more health insurers are covering acupuncture for treatment of pain.

The cost of acupuncture is $70-75 per treatment. However, a discount is given for payment at time of treatment, so the cost to most patients is $60. This includes the cost of the needles and professional fees. If a longer visit is required for re-examination, this will be billed as an office visit. The usual course of treatment for a problem such as back pain or headache involves between six and ten treatments.

About Dr. Wadsworth

Tyler Wadsworth, M.D. is a Sports Medicine physician at Sports Medicine Consultants, PC in St. Louis, Missouri. Dr. Wadsworth has had an interest in acupuncture since early in his medical training, and has lectured at local and national medical education meetings about acupuncture. He began learning about and treating patients with acupuncture in 1987, and has treated hundreds of patients with acupuncture. Dr. Wadsworth's clinical activities include treatment and rehabilitation of musculoskeletal problems, including sports- and work-related injuries, such as spine, knee, shoulder, and other injuries. He has special interest in sports-related medical issues, such as sports nutrition and exercise for treatment of high blood pressure, heart disease, fibromyalgia, and other medical conditions. Additionally, he provides fitness assessments and exercise prescription for patients interested in improving their health through exercise. Dr. Wadsworth also prescribes individualized nutrition and exercise programs as a component of a comprehensive plan to treat back pain, diabetes, obesity, high cholesterol, arthritis, and other exercise-responsive medical conditions.

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