1887

Acupuncture in palliative and rehabilitative medicine

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Abstract

It is worth defining acupuncture at the start of any discussion of its uses, since the term means different things to different people. Whilst a given drug will have the same formula and same accepted dose rate all over the world, acupuncture look – and feels – different depending on the training, approach and, sometimes, philosophy of whoever is delivering the treatment. This chapter looks at How acupuncture works; The role of acupuncture in veterinary palliative care and rehabilitative medicine; Clinical considerations; and Safety considerations.

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Figures

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11.1 Segmental acupuncture. Stimulation of Aδ fibres by acupuncture needles stimulates encephalinergic interneurons (ENC) in layer II (substantia gelatinosa) of the dorsal horn of the spinal cord. These interneurons inhibit substantia gelatinosa cells (SGc) from onward transmission of C-fibre pain. Thus, acupuncture ‘competes’ with C-fibre pain at the dorsal horn. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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11.2 Heterosegmental acupuncture. The acupuncture stimulus (of Aδ fibres) continues via crossed spinothalamic tracts to the brain. Consequent release of endorphins (from the periaqueductal grey, PAG), serotonin and noradrenaline (from centres including the nucleus raphe magnus, NRM) work (via the descending inhibitory pain pathways and humorally) to inhibit pain at every spinal segment. The effect is most potent at the segment stimulated. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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11.3 Pain relief is currently the most common use of acupuncture in veterinary practice. This Labrador has elbow arthritis and has responded well to acupuncture treatment.
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11.4 Segmental acupuncture for visceral conditions is most conveniently achieved in the veterinary species by paraspinal needling. The needle is inserted at an angle of 45 degrees through the epaxial muscles and into the multifidus muscle next to the spinous process.
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11.5 Some patients are profoundly sedated by acupuncture. This Labrador predictably and consistently lies down and closes his eyes within seconds of needle insertion.
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11.6 Cats often tolerate and appear to respond well to acupuncture.
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11.7 Electroacupuncture involves stimulating pairs of needles with an electrical impulse stimulator.

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