From lower back pain to cutting-edge cancer care: The possibilities of medical acupuncture
In 1998, Dr Ian Relf was a young doctor working in rural general practice and on-call emergency when he first felt a calling towards medical acupuncture.
Fast forward 28 years and he is now Federal President of the Australian Medical Acupuncture College (AMAC) and pioneering a cutting-edge breast cancer treatment at the Olivia Newton-John Cancer Wellness and Research Centre in Melbourne.
“After seeing a lot of clinical medicine in country general practice and on call emergency, it gradually became apparent that there were large gaps in our ability to effectively treat acute and chronic pain,” said Dr Relf, who is also a lecturer in the Department of Surgery, Melbourne Medical School, at the University of Melbourne.
“As a young doctor, one is simply not aware of the consequences of using opiates and benzodiazepines for chronic pain and the long-term damage it can cause.
“My own practice in medical acupuncture has gone from treating lower back pain and simple musculoskeletal pain to complex cancer pain in the cancer unit at the Austin Hospital.”
A growing evidence base
As Dr Relf’s knowledge has grown, so too has evidence on the effectiveness of medical acupuncture.
He said the treatment modality now had a substantial Level 1 evidence base in common conditions such as musculoskeletal pain, as well as strong outcomes in neuropathic pain, chronic pelvic pain, including endometriosis, and post-prostatectomy incontinence.
“Medical acupuncture effects are significantly due to restoring physiology and nerve function,” said Dr Relf.
“When one starts using medical acupuncture, it is very surprising how effective this medical treatment can be when it starts addressing the real causes of chronic pain, such as muscle spasm and ligaments and soft tissue sensitisation – all the physiological processes not very well addressed by medication.
“Medical acupuncture actually starts to reduce muscle spasm and pain within five minutes of commencing treatment.”
Acupuncture in general practice
Dr Relf said acupuncture also had Level 1 evidence for migraines and other non-space occupying headaches, as well as most types of musculoskeletal pain.
“For example, lower back pain has a strong evidence base, even in older patients,” he said. “It has long-term effects, which are not appreciated and are frequently discounted.
“Surprisingly, based on evidence, medical acupuncture is a first-line treatment for 20 per cent of general practice and particularly in long-term chronic pain and injury.
“Medical acupuncture attracts many doctors who like stepping in and fixing things, particularly in acute medicine.
“Also try to think of doing that in chronic pain, where you can improve long-term chronic pain and injury by 50 per cent within a few treatments and many within the first consultation.”
Practical tips
When it comes to treating pain, Dr Relf’s advice is to look at the patient’s physiology for the cause.
“For example, immobility, sympathetic nervous system changes, insomnia, anxiety-depression – each component can be treated effectively with acupuncture, which is why its effectiveness rates can be higher than traditional treatment,” he said.
“Have a close look at the effectiveness of what you prescribe, for example, antidepressants, and whether they make a long-term difference.”
AMAC’s Part 1 course in medical acupuncture is approved by the Australian Health Practitioner Regulation Agency.
Registrars can choose to enrol as an elective in the Royal Australian College of General Practitioners’ rural pain course, or as New Fellows after completing their GP training.
Dr Relf said they could then go on to attain the higher medical acupuncture qualification through AMAC’s Fellowship Course (Part 2), where students learn how to treat complex pain, such as tertiary-level cancer pain.
For more information, visit the AMAC website.
