Modernizing acupuncture

In my last post about acupuncture research I argued that any ambiguity in study design will obscure output data.  While an inadequate control group or a sub-optimal acupuncture group are the most obvious culprits, the ultimate nemesis is our lack of consensus about the physiological framework of acupuncture, and hence of appropriate clinical techniques.  Fortunately, there is active ongoing research at the level of basic science and at the pragmatic clinical level to assist us in developing such consensus. Understandably, it will take time. We are lucky to have this time—that is if we keep delivering value to our patients.  But let’s not take it for granted: we can still be fired if we slack in our efforts to grow, to improve, and to adjust to changes.

Changes are happening everywhere in our field. Clinical tools for carrying out acupuncture procedures changed considerably in the last several decades. Above all, the disposable acupuncture needles today are much smaller than they used to be. Just look at the most popular needle gauges sold by medical suppliers — #34, #36, and higher. Shouldn’t we adapt our centuries-old clinical techniques to the current needle sizes?

For example, think about the Needle Moxa technique– a traditional Chinese form of heat therapy that involves the burning of mugwort, a spongy herb, on top of an acupuncture needle. The needle is supposed to serve as a conduit for heat transmission from the handle of the needle, where moxa punk is attached, toward its tip and into the treated area. Unfortunately, contrary to the commonly held belief, the heat does not reach the tip, at least not through the body of the needle. The diameter of the #34 gauge needle is too small to conduct heat effectively. As an experiment, take a standard 1.5inch needle and make the handle red-hot using a lighter—the tip will be barely warm.  It’s not a great return for all the efforts involved in securing moxa on the handle of the needle and shielding the skin underneath from the accidental falls of the hot moxa flakes!

On the other hand, the small diameter of the needle gives it a relatively high electrical resistance. This makes it possible to use an acupuncture needle as an electrical heating device for point stimulation (Think about the filament in an incandescent light bulb). All it takes are two small electrical alligator clips, a basic portable power supply, and a #34 gauge, 1.5inch needle. One of two clips has to be attached to the shaft of the needle close to the tip. When a small electrical current passes through the body of the needle, there is a sufficient amount of heat being generated across the needle making it very hot. Caution: do not use it on your patients without proper training and do not burn yourself please!

The field of acupuncture in the US is still evolving. It will take it some time to catch up with the modern-day demands. We can facilitate the process by keeping our minds open and by embracing change.

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