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Acupuncture
For Reduction Of
Post-Trauma Medication
Patricia A. Richard, MD
ABSTRACT
Background Medical acupuncture has many uses in the field of
pain management. The physician's knowledge of conventional medicine,
pharmacology, and medical acupuncture can benefit patient care. This
case report describes a patient with multiple injuries who had been
treated by other physicians before receiving medical acupuncture.
Objectives To decrease the patient's medications through the
use of medical acupuncture.
Design, Setting, and Patient A woman in her 30s presented to
the private practice of a physician/dentist practicing medical acupuncture.
Intervention The patient was treated with medical acupuncture
to balance her meridians.
Main Outcome Measures Reduction in the patient's medication regimens.
Results The patient was able to decrease her medications by 50%
within a short time period.
Conclusions The introduction of medical acupuncture allowed this
patient to decrease neuropharmacological medications and at the same
time the treatment promoted healing of multiple injuries.
KEY WORDS
Pain Management, Traumatic Brain Injury, Multiple Injuries, Medical
Acupuncture, Neuropharmacological Medications
INTRODUCTION
This report describes a patient with many medical injuries. She had
seen a number of medical specialists but was still in severe pain. The
dosages of her medications had been doubled, but she had not experienced
the expected clinical results. Instead, she began to experience the
adverse effects of these medications.
Case Report
The patient was a woman in her 30s with multiple injuries, including
traumatic brain injury, traumatic arthropathy of the temporomandibular
joints, cervical / thoracic/ lumbosacral hyperextension / flexion injuries,
left shoulder acromioclavicular joint ligament injury, tendinitis of
her hand, and chondromalacia patellae.
She was taking gabapentin (5 times daily), ibuprofen, and sertraline
(1-2 times daily). She experienced the adverse effects of these medications.
Acupuncture Diagnosis
The patient had an imbalance in the Wood element affecting muscles,
tendons, and ligaments, and an imbalance in the Water elements affecting
the bone, and swelling and auditory aspects of the temporomandibular
joint. She had an imbalance in the Fire elements as a result of the
traumatic head injury.
TREATMENT
The patient was treated with methods described previously.1-5 Nogier
Pulse I, II, and III auricular acupuncture points were treated according
to the Auricular Meridian Maps of Bahr. All points treated were found
to be highly electroconductive. Stim Plus Diagnostic and Therapeutic
instrument was used at 5 Hz, 15-30 seconds per point. Likewise, all
electrically active Shu points (Bladder meridian) corresponding to injured
body parts were treated. Additionally, BL 54, KI 27, and ST 3 were treated.
Shu points were needled and treated electrically. Treatments were 7-10
days apart, each lasting an average of 30 minutes.
The patient's
temporomandibular joint injury was stabilized with an orthotic device
designed particularly for her to decompress the traumatized jaw joint
system and correct the internal derangement. She also received 4 sphenopalatine
ganglion nerve blocks using 4% lidocaine.
RESULTS
After 12 treatments, the patient had diminished intensity of pain and
spasm. She was able to decrease her medications by 50%. When first seen,
she had been taking 5 gabapentin a day; this was reduced to 3 a day
after 12 acupuncture treatments. Sertraline was reduced from 1 to 2
day to 1/2 dosage on alternate days. Consequently, the adverse effects
of these medications were lessened.
In addition, the patient demonstrated an overall imrovement in her pain
scores measured by a visual analog pain scale.
DISCUSSION
It is well known that increases in medication regimens correlate
with a potential increase in associated adverse effects of these medications.
Sertraline can affect the central as well as peripheral nervous system;
it can cause twitching and dizziness as well as skin rashes, hair loss,
weight gain, back pain, and myalgia. Psychiatric disorders associated
with taking sertraline include depression, emotional lability, and teeth
grinding. Patients can also experience tinnitus as well as frequent
urination or urinary retention.
The potential adverse effects of gabapentin have been well documented
in the Physician's Desk Reference.6 They range from fatigue, weight
increase, back pain, peripheral edema, vasodilitation, digestive system
abnormalities, leukopenia, and myalgia, and nervous system dysfunction
including tremors, depression, abnormal thinking, and double vision.
CONCLUSION
Patient care requires that the physician understand all aspects of the
patient's metabolism including the intermediary metabolism of the pharmacological
agents, as well as how the medications affect the body and their interaction
with one another. This case report illustrates the complexity of patient
care, and the benefit of medical acupuncture perfomed by a physician
who understands the patient's condition and needs.
REFERENCES
1. Matsumoto T. Acupuncture for Physicians. Springfield, Ill: Charles
C Thomas Publisher; 1974.
2. Kropej H. The Fundamentals of Ear Acupuncture. Heidelberg, Germany:
Karl Haug Verlag GmbH; 1979.
3. Bahr FR. The Chinese Meridians and Their Projection on the Auricle.
1999.
4. Nogier PFM. Treatise of Auriculotherapy. Moulins-les-Metz, France:
Maisonneuve; 1972.
5. Bourdiol R. Elements of Auriculotherapy. Moulins-les-Metz, France:
Maisonneuve; 1982.
6. Physician's Desk Reference. 52nd ed. Montvale, NJ: Medical Economics
Co; 1998:2110-2113, 2229-2234.
AUTHOR INFORMATION
Dr Patricia Richard's specialties are Internal Medicine, General Surgery,
and Temporomandibular Joint Disorders. Dr Richard is an MD and a dentist,
and is an Advanced Fellow of the International Academy of Medical Acupuncture.
Patricia A. Richard, MD, DMD
1735 Post Road
PO Box 702
Fairfield, CT 06430
Phone: 203-254-8080
E-mail: patricia.a.richard@snet.com
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