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Slide 1 - Acupuncture Introduction and Overview
Slide 2 - Definition U.S. History Evidence of Efficacy Mechanism of Action Types of Acupuncture Practical Tips Coding
Slide 3 - 3.1 million have used in U.S Literally means 'needle piercing’ Traditional acupuncture regulates the flow of Qi (vital energy) There are many types of Qi Qi is considered one of the human body's fundamental substances and helps to maintain normal activities Qi permeates all parts of the body, and flows along organized pathways known as acupuncture channels, or meridians. Traditional Chinese Medicine practitioners believe that a balanced flow of Qi throughout the system is required for good health, and imbalances can be corrected by acupuncture stimulation Thus, a state of good health is determined by the dynamic balance between opposing yin-yang forces
Slide 4 - Acupuncture in the U.S. Documented evidence of use in 1826-Franklin Bache, a Philadelphia physician and grandson to Benjamin Franklin, published an article of its use Sir William Osler also endorsed acupuncture as an effective treatment for lumbago and sciatica in The Principles and Practice of Medicine Referenced in an Civil War surgeon's manual
Slide 5 - Modern U.S. History 1971 James Reston wrote a front-page article for the New York Times describing how his postoperative pain from an emergency appendectomy was relieved by acupuncture while traveling in Beijing Prompted a group of US physicians to observe practice in China and publish an article in Journal of the American Medical Association During Historic visit to China in 1972, President Nixon and his personal physician witnessed several surgeries using acupuncture-assisted anesthesia
Slide 6 - Most well designed studies show mixed results Placebo response high- If positive expectation then greater pain relief Fair Evidence for: Back pain Joint pain Neck pain Headache Cancer Pain N/V from Pregnancy and Cancer
Slide 7 - Acupuncture Point *71% correlation between trigger points and acupuncture points* Nerve fibers woven among blood and lymph vessels leading to superficial levels on the dermis Epidermis thins at the acupuncture point and has a corresponding modification of collagen fibers
Slide 8 - Mechanism of Action Mechanism of action is through conduction of bioelectromagnetic signals Activates opioid systems, and autonomic and central nervous systems, causing the release of various neurotransmitters and neurohormones Note: Acupuncture analgesia can be completely blocked by Naloxone
Slide 9 - Needling an acupuncture point stimulates a bioelectric response Changes the electrical charge 2 Hz releases diencephalons act on anxiolytic μ receptors 2 to 15 Hz releases β-endorphin and met-enkephalin in the brain and dynorphin in the spinal cord -more effective in relieving deep and chronic pain 100 Hz causes release of dynorphin alone Something else is actually going on as analgesic effect is much longer than the half-life of endorphins Mechanism of Action
Slide 10 - Evidence of Efficacy fMRI Evidence Technetium-99m injected at acupuncture point shows diffusion along different pathways and rates than vascular and lymphatic channels-credence to meridian theory
Slide 11 - Morphogenetic Singularity Theory States that meridian system is related to the bioelectric field in morphogenesis and growth control
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Slide 15 - PRINCIPAL MERIDIANS
Slide 16 - MERIDIANS PRINCIPAL
Slide 17 - Needle Type Combination Depth Direction Location What is done to the needle Left alone- dispersion Manipulated and/or Stimulated Manually- rate and duration Electrically Frequency Duration Heated – (Moxa Cigar/Heat lamp/etc)
Slide 18 - De Qi Sensation felt when an acupuncture point is properly piqued Warm or Heavy primarily a peripheral phenomenon, because it can be blocked by chilling, local anesthetic, and mechanical pressure
Slide 19 - Functional Point Acupuncture Energy Moving Acupuncture Principal Meridian Curious Meridian Tendon Muscular Meridian Distinct Meridian Scalp Acupuncture Auricular Acupuncture Cupping Qua Sha (Scraping)
Slide 20 - Two Needle Technique Great for trigger points or musculotendinous pain Point of Maximal Tenderness- place 2 needles about 5-10 mm apart Connect to Electrical Stimulator for 10-15 min at >10 Hz Repeat as needed - +
Slide 21 - Scalp Acupuncture -Good for general pain states -Used alone or as adjunct
Slide 22 - Ear Acupuncture – same as scalp BFA-all purpose pain tx Semi-Permanent Needle
Slide 23 - Coding(CPT) and Reimbursement 97810: one or more needles, without electrical stimulation, initial 15 minutes -0.60 RVU 97811: Each additional 15 minutes, with re-insertion of needles -0.50 RVU 97813: one or more needles, with electrical stimulation, initial 15 minutes -0.65 RVU 97814: Each additional 15 minutes with re-insertion of needles – 0.55 RVU
Slide 24 - Complications Few complications have been reported Serious adverse are infections and punctured organs There are fewer adverse effects associated with acupuncture than with many standard drug treatments At least 2 reports of Pneumothorax
Slide 25 - QUESTIONS???? www.lhasaoms.com Acupuncture Supplies