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March 2, 2014

Acupuncture for back and knee pain - Alternatives to surgery

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Back and knee pain can be hard to live with.  It can keep you from being active, or from enjoying simple pleasures, like a walk outside.  It can even keep you up at night.  Worst of all, over time, chronic pain can make you feel down, depressed, and tired.  Where conventional medicine may allow you to lead a longer and more productive life, it doesn't always offer solutions to those aches and pains that come from actually living longer and playing harder.  In these situations, acupuncture may be a more effective, less invasive, and less expensive alternative.

While there are situations where back and knee surgery is absolutely called far, there are others which aren’t as clear.  There are several realities that make this such a gray area; 1) doctors are overworked and can’t spend much time with a patient, even if they want to.  This can lead to the over prescribing of drugs and surgery, as opposed to alternative therapies, such as acupuncture, physical therapy, or massage; 2) Chronic pain tends to eventually be down-played or ignored, because it is frustrating for healthcare workers to deal with.  Feeling like you can’t help someone is hard, especially when it’s your job.  3) There usually aren’t many good treatment options for chronic conditions, like arthritis, bursitis, tendinitis, or fibromyalgia, etc.  This is, in fact, why these conditions are chronic.

As stated, while surgery may most certainly be indicated for a given condition, it’s wise to consider the risks vs reward.  What are the rates of success for the particular surgery?  On the one hand, back surgery has lower rates of success, and even has a specific billing code for failed procedures; “Failed Back Surgery Syndrome”.  A recent study review of records on the outcomes of spinal fusions has found spinal fusion surgery to have a 76% failure rate, with the lead author stating, ““The study provides clear evidence that for many patients, fusion surgeries designed to alleviate pain from degenerating discs don’t work” (Nguyen TH, Randolph DC, Talmage J, Succop P, Travis R).  On the other hand, according to the American Academy of Orthopedic Surgeons, the success rate of knee replacement is 90%, but may increase the risk of pulmonary embolism (Alma B. Pedersen, Frank Mehnert, Soren P. Johnsen, Steen Husted, Henrik T. Sorensen).  So, as we can see, the rate of success really depends on the type of surgery.  However, surgery aside, one also has to consider other potentially prohibitive factors, such as physical therapy recovery time and costs, as well as increased risk of infectious disease from hospital stays.

In my clinical experience, chronic muscle tension and tightness can create the same symptoms as arthritis, bursitis, neuropathy and disc-related disorders.  For example, arthritis, or bursitis-type hip pain may, in fact, be caused by a chronically tight IT (ileotibial) band or hip muscle, such as the tensor facia latae.  Tightness in the Quadratus Lumborum can create sacral pain.  Tightness in the IT band, (once again), can pull the patella and create knee pain.  Finally, tightness in the Psoas muscle can create groin pain.  These types of pain are potentially muscular, and as such, would not likely respond to surgery.  In fact, scar tissue in the area may further aggravate the problem.Acupuncture treats all of these types of pain very well.

Health is complicated, and everyone’s condition is unique.  There is no one-size-fits all treatment.  If you suffer from chronic pain, you should absolutely see your doctor.  In fact, you should get as many different opinions as you can.  However, healthcare is also extremely expensive, and the effectiveness of some major surgeries is often called into question.  Before you decide on major, invasive surgery, consider that other, less expensive, options like acupuncture may give you the best, most immediate relief.  

Nguyen TH, Randolph DC, Talmage J, Succop P, Travis R. Long-term Outcomes of Lumbar Fusion Among Workers' Compensation Subjects: An Historical Cohort Study. SPINE (Phila Pa 1976) 2011 (Feb 15);   36 (4):   320–331

Alma B. Pedersen, Frank Mehnert, Soren P. Johnsen, Steen Husted, Henrik T. Sorensen. Venous Thromboembolism in Patients Having Knee Replacement and Receiving Thromboprophylaxis: A Danish Population-Based Follow-up Study.Journal of Bone and Joint Surgery, 2011; 93 (14): 1281-1287 DOI: 10.2106/JBJS.J.00676