Miles Belgrade.ppt - ASPMN · 2014-09-26 · Miles Belgrade, M.D. Medical Director, Fairview Pain...
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9/8/2010 1 Miles Belgrade, M.D. Miles Belgrade, M.D. Medical Director, Fairview Pain Center Medical Director, Fairview Pain Center University of Minnesota Medical Center University of Minnesota Medical Center Adjunct Professor, University of Minnesota Adjunct Professor, University of Minnesota Medical School Medical School My Teachers My Teachers ¾ Felix Mann, MB Felix Mann, MB ¾ Prof Anton Prof Anton Jayasuriya Jayasuriya, MD , MD Alternative and Alternative and Complementary Therapies Complementary Therapies World Medicine Systems Alternative H lth Health Systems Individual Practices
Transcript of Miles Belgrade.ppt - ASPMN · 2014-09-26 · Miles Belgrade, M.D. Medical Director, Fairview Pain...
9/8/2010
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Miles Belgrade, M.D.Miles Belgrade, M.D.Medical Director, Fairview Pain CenterMedical Director, Fairview Pain CenterUniversity of Minnesota Medical CenterUniversity of Minnesota Medical Center
Adjunct Professor, University of Minnesota Adjunct Professor, University of Minnesota Medical SchoolMedical School
My TeachersMy Teachers
Felix Mann, MBFelix Mann, MBProf Anton Prof Anton JayasuriyaJayasuriya, MD, MD
Alternative and Alternative and Complementary TherapiesComplementary Therapies
World Medicine Systems
Alternative H lthHealth
Systems
IndividualPractices
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Acupuncture in Multiple Acupuncture in Multiple Civilizations Civilizations
600 BC Written
documents on
618 ADAcupuncture
officially recognized
as an independent
4th to 10th centuries
Acupuncture introd ced to
1822Acupuncture banned from the Imperial
court as
Mid-20th CenturyMao Tse
Tung revives the stat s of
1969Endorphins
1971President Nixon opens diplomacy with China and acupuncture is rediscovered
1977Acupuncture analgesia in
h mans
1997The NIH holds a
consensus conference
Acupuncture HistoryAcupuncture History
on acupuncture theory and technique
depe de tspecialty by the Imperial
Medical Academy of
the Tang Government
introduced to other
countries like Japan
Western medicine is
introduced to China
the status of acupuncture in China and nurtures its
development
do p sare
discovered
rediscovered by the West
humans shown to be reversed by Naloxone
co e e ceon
acupuncture supporting its use in certain
conditions
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History of Acupuncture in the History of Acupuncture in the USAUSA---- RiseRise
1940s: Mao Tse Tung 1940s: Mao Tse Tung July 26July 26thth, 1971: , 1971: James Reston and James Reston and PingPing--Pong DiplomacyPong Diplomacygg g p yg p y1970s: Acupuncture 1970s: Acupuncture fever in the USAfever in the USA1980s: Research1980s: Research1997: NIH Consensus 1997: NIH Consensus ConferenceConference
NIH Consensus Conference NIH Consensus Conference November 1997November 1997
Acupuncture is Widely practiced in the USAcupuncture is Widely practiced in the USSufficient evidence as primary therapy:Sufficient evidence as primary therapy:
Nausea/vomiting due to postNausea/vomiting due to post--op and chemoop and chemoP tP t d t l id t l iPostPost--op dental painop dental pain
NIH Consensus Conference NIH Consensus Conference November 1997November 1997
Sufficient evidence as adjunctive therapy:Sufficient evidence as adjunctive therapy:AddictionAddictionStroke rehabStroke rehabHeadacheHeadacheMenstrual crampsMenstrual crampsMenstrual crampsMenstrual crampsTennis elbowTennis elbowFibromyalgia and myofascial painFibromyalgia and myofascial painOsteoarthritisOsteoarthritisLow back painLow back painCarpal Tunnel syndromeCarpal Tunnel syndromeAsthmaAsthma
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What is Acupuncture?What is Acupuncture?
A system of medicine that is part of traditional A system of medicine that is part of traditional Chinese medicineChinese medicineStimulation of tissue at wellStimulation of tissue at well--defined points to defined points to achieve a therapeutic effectachieve a therapeutic effectppAcupuncture points lie on channels or Acupuncture points lie on channels or meridiansmeridiansPoint selection based on traditional principles of Point selection based on traditional principles of Chinese medicine or by formulaChinese medicine or by formula
Acupuncture MeridiansAcupuncture Meridians
Traditional Chinese MedicineTraditional Chinese MedicineBased on Taoist Based on Taoist principlesprinciplesYin and YangYin and YangChiChi12 organs12 organs12 organs12 organsMeridians and pointsMeridians and pointsTonification and sedationTonification and sedationTongue and pulse Tongue and pulse diagnosisdiagnosisHerbal medicine and Herbal medicine and acupuncture acupuncture
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Acupuncture TechniqueAcupuncture Technique
NeedlesNeedlesInsertionInsertionPoint locationPoint locationStimulationStimulationStimulationStimulationPoint selectionPoint selectionDuration & frequencyDuration & frequency
Point LocationPoint Location
Acupuncture Point SelectionAcupuncture Point Selection
Local points treat local disordersLocal points treat local disordersTender points (Ashi points)Tender points (Ashi points)Points on a meridian traversing the problem Points on a meridian traversing the problem regionregionregionregionSix important distal points treat the head, neck, Six important distal points treat the head, neck, and trunkand trunkCertain points have general effects: e.g. Certain points have general effects: e.g. sedation, tonification, homeostasissedation, tonification, homeostasisEar regions correspond with the body via a Ear regions correspond with the body via a homunculushomunculus--like projectionlike projection
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Local Points Treat Regional DisordersLocal Points Treat Regional Disorders
The Six Important Distal PointsThe Six Important Distal Points
The Six Important Distal PointsThe Six Important Distal Points
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Dangerous PointsDangerous Points
Risks of AcupunctureRisks of AcupunctureCommonCommon
Discomfort 40%Discomfort 40%Bruising 2%Bruising 2%BleedingBleeding–– minimal but commonminimal but commonFainting 1%Fainting 1%gg
UncommonUncommonInfectionInfectionPneumothoraxPneumothoraxRetained needle fragmentRetained needle fragmentPeripheral nerve injuryPeripheral nerve injurySpinal cord injurySpinal cord injuryMiscarriageMiscarriage
Epidural Hematoma After Epidural Hematoma After AcupunctureAcupuncture
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Acupuncture ContraindicationsAcupuncture Contraindications
Cancer treatment (other than symptom Cancer treatment (other than symptom control)control)Acute bacterial infectionsAcute bacterial infectionsOth t di l diti i iOth t di l diti i iOther acute medical conditions requiring Other acute medical conditions requiring specific treatmentspecific treatmentSeverely debilitated patientsSeverely debilitated patientsPregnancy (relative contraindication)Pregnancy (relative contraindication)
Acupuncture IndicationsAcupuncture Indications
Musculoskeletal pain acute or chronicMusculoskeletal pain acute or chronicNauseaNauseaBenign headacheBenign headacheAddiction adjunctive therapyAddiction adjunctive therapyFibromyalgiaFibromyalgia
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Early Research Into Early Research Into Acupuncture MechanismsAcupuncture Mechanisms
J.S. Han AAPM Honolulu 2008J.S. Han AAPM Honolulu 2008
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Anesth & Analgesia 2008
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Mayo Clinic Proc June 2006
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Problems in Acupuncture Problems in Acupuncture Research DesignResearch Design
Variation in techniquesVariation in techniquesTreatment based on Western diagnostic Treatment based on Western diagnostic categoriescategoriesN i di id l i ti f t t tN i di id l i ti f t t tNo individual variation of treatmentNo individual variation of treatmentSham problemsSham problems
StimulationStimulationSham pointsSham pointsDouble blindingDouble blinding
