Acupuncture

Acupuncture

Acupuncture is a medical procedure using insertion and manipulation of thin metallic needles in specific sites, or points of the body, with the objective of treating several medical conditions as well as preserving health. This therapeutic technique is originated from China and is part of a group of medical knowledge developed along the last 2500 years, called Traditional Chinese Medicine (TCM).

The word "acupuncture" is a western adaptation of the Chinese concept and derives from the Latin "acus" (needle) and "puntura" (perforation). In Chinese, this technique is called "Jin Huo", which means metal and fire - the latter referring to the use of moxi, lightened-up cones of Artemisia herb which stimulate acupuncture points.

TCM is a medical system based on concepts differing from those developed by Western Medicine, within a distinct philosophical, social and cultural referential that has some particularities in relation to Western way of life. Ancient Chinese physicians synthesised the clinical and therapeutic phenomena they had observed along thousands of years, collecting precious information about health and disease, and developed a therapeutic approach specific to their context.


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Medical Acupuncture

The concept of Medical Acupuncture is used to designate the practice of acupuncture performed by physicians with a specialization in Acupuncture. The specialist in Medical Acupuncture encompasses, therefore, the medical concepts developed by Western and Eastern Medicine in an integrative approach.  Therefore, we do not refer to Medical Acupuncture as an "alternative" therapy, fundamented on ancestral concepts, but rather as a "complementary" therapy, based on the integration of classic Chinese techniques and the most recent developments of Western medical science.

For this purpose, in addition to specific methods of TCM for diagnosis and treatment, we take into consideration all Western medical resources needed for the diagnosis, analysis and treatment of each case. The proposal of Medical Acupuncture is to offer an efficient and up-to-date treatment, contributing to the extensive medical armoury possessed by Western Medicine.

In Brazil, acupuncture is a medical speciality regulated by the Federal Council of Medicine since 1996. Physicians specialized in this area fulfill an extensive program of Medical Education in Acupuncture and must be certified as Specialists in Acupuncture by Brazilian Medical Association (AMB) and by Brazilian Medical College of Acupuncture (CMA).

The same trend has been followed nowadays by European countries, such as England, Germany, France and Italy, as well as by the USA, Australia and Canada. Among the larger and most active Associations of Medical Acupuncture outside Brazil, we can mention the American Academy of Medical Acupuncture (AAMA), British Medical Acupuncture Society (BMAS), International Council of Medical Acupuncture and Related Techniques (ICMART), and the Australian Medical Acupuncture College (AMAC).

The integrative tide has affected even the Chinese government itself, who has invested in building new Western Medical Colleges and has followed guidelines aiming to increase the demographic distribution of physicians educated in Western Medicine. These actions aim to disseminate more and more the integration of Eastern and Western approaches in clinical practice in this country.


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Western View

There are distinct approaches that seek to explain the mechanisms of action of acupuncture and the current trend - also in China - is the integration of Western scientific knowledge and theories of Traditional Chinese Medicine. Several aspects of these complex mechanisms have not yet been clarified, and a great amount of studies will be necessary for the complete elucidation of these inquiries. It is known nowadays that acupuncture produces multiple biologic responses and that a great part of this effect is caused by stimulation of endocrine system (ES) and of central nervous system (CNS). This results in a wide range of systemic effects, reproduced and observed in clinical responses scientifically documented through evidences (Evidence-Based Medicine). Thin needles are inserted through the skin to specific points of the body, enabling the access to the extensive network that forms the peripheral nervous system, connecting the entire body.  The 365 acupuncture points all over the body correspond to nerve terminations, and their stimulation reflects on central nervous system. Stimulation by acupuncture temporarily changes the bioelectric state of neural network and elicits a neurohumoral response (ES and CNS). There is an adjustment of internal organic balance (homeostasis) and an activation of resources from the body itself for healing and symptomatic relief. Thus, systemic effects such as reduction of pain and inflammation, adjustment of functional pattern of musculoskeletal system, normalization of the activity of autonomic nervous system, as well as the immune and endocrine systems.


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Eastern View

Traditional Chinese Medicine (TCM) was developed from the unique perspective through which Chinese people understood the existential expression of life and the interaction between man and environment. According to this perspective, Humans are a miniaturized reflex of the Universe and are subject to the same universal principles that govern the world around them. Their thorough observation and analysis of the cycles and phenomena taking place in nature were, by analogy, the models used for the understanding of the patterns of functioning of human organism. The models of health and disease on TCM are presented in terms of harmony or disharmony in relation to the flow of vital energy that animates living beings.  The primeval message of these concepts is that all things and events are contextualized in a chain of relations, and that nothing exists in isolation. Humans depend on their environment to survive, and they evolved upon the earth under the same universal laws and intrinsic forces that rule the universe.

      The language of TCM on the classic texts reflects metaphors common to the agricultural, provincial life of ancient China, and describes a way of life in which humans are harmoniously integrated, within a synchronized universe, where all the multidimensional aspects of their existence are inter-related. TCM conceives Human Being as a whole and postulates that all symptoms, whether physical, mental or emotional, are undissociable manifestations of the same organic entity. Within this context all the variety of complaints, signs and symptoms present in each case is valued, since data is interpreted within a context that emphasizes the patient as a whole instead of the isolated disease. According to TCM, disharmonies or disbalances can be verified through physical or psychological signs, since both aspects belong to the same unit. These signs serve as a basis for diagnosis of the initial cause of disbalances. The signs and symptoms are classified and grouped, and guide the diagnostic hypothesis towards conclusions about what, in TCM, is called disharmony pattern. The principle of Yin and Yang is present in all aspects of Chinese theory and is utilized to explain the organic structure of human body, its physiological functions, and the laws concerning the causes and evolutions of diseases.  Human body is a organized whole, consisting of two structurally-connected opposites, though complementary, parts. Chinese Medicine is based on the equilibrium between these two forces in human body and disease is seen as a rupture of this equilibrium. Yin and Yang refer to these two universal aspects, negative and positive respectively, which are permanently flowing, one turning into the other, dynamically, in an unceasing movement. The harmony of Universe, according to this view, comes from the interaction between these opposite and complementary aspects, between one force that promotes action and other that promotes conservation, in a dynamic balance, with one prevailing upon the other in a given period and, then, being superseded by its complementary counterpart . Health, from this perspective, refers to a dynamic equilibrium between the complementary aspects of universal nature, present in our biological constitution. On these conditions, the vital "matter-energy" or Qi, flows harmoniously through our organism. Disease, on the other hand, is the expression of a disbalance between Yin and Yang aspects within us, causing the flow of Qi to be blocked.

Qi flows through the meridians that form a complex network of pathways interconnecting the various areas of human body, from its surface to the inner organs. These meridians are abstract lines, without a concrete structure, where acupuncture points are located. The functional inter-relation of the organism is provided by the circulation of Qi along the various meridians. According to TCM, there are 12 main meridians, six with Yin characteristics and six with Yang characteristics, which are related respectively to the Zang (organs) and Fu (viscera). The Yin meridians are Liver, Heart, Spleen, Lung, Kidney and Pericardium. The Yang meridians are Small Intestine, Large Intestine, Stomach, Gall Bladder and Triple Burner. Stimulus through acupuncture, in this context, works as harmonizer of vital forces of human being, regularizing the flow of Qi and promoting the reestablishment of health and preventing the onset of diseases.


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Therapeutic Indications  

There are precise indications for the cases to which Acupuncture is efficient, as well as a series of situations to which its application is inefficient or even contraindicated.   The main indications of Acupuncture - as complementary therapy, and always based on a correct Western medical diagnosis - are the following situations:  

  • General wellness: eliciting a response of relaxation, in cases of chronic stress and physical and mental fatigue.
  • Musculoskeletal: Back (upper back, dorsal, lower back) pain, vertebral disc herniation, tendinitis, tenosynovitis, myofascial pain, fibromyalgia, muscle pain and injury, ligament pain and injury, joint pain, sports injuries; as an adjuvant therapy on post-surgical rehabilitation process of orthopaedic and rheumatologicinjuries, and others.
  • Cardiovascular: high blood pressure of psychosomatic origin and angina.
  • Pulmonary: coughing, asthma, bronchitis, emphysema.
  • Gastrointestinal: gastritis, diarrhoea, chronic constipation.
  • Neurological: headaches caused by emotional or muscular tension, migraine, insomnia and pain of neuropathic origin; as an adjuvant therapy to post-stroke and facial paralysis rehabilitation process.
  • Psychiatric: dependence on smoking, alcohol and other drugs, food compulsion, insomnia, anxiety, panic syndrome, depression.
  • Genitourinary: chronic cystitis, benign prostatic hypertrophy, urinary incontinence.
  • Gynaecological: premenstrual tension, symptoms of menopause, menstrual cramps, back pain in pregnancy, functional polycystic ovary, mammary dysplasia.
  • Otorhinolaryngologic: rhinitis, sinusitis, pharyngitis.
  • Inflammation and pain (acute and chronic) in general.

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