Acupuncture and Chiropractic – An Introduction Amber Ihrke, DVM, CCRT, CVA, CVSMT, CVPP Resident – American College of Sports Medicine and Rehabilitation
INTRODUCTION
Acupuncture and Chiropractic are frequent modalities used in rehabilitation setting. They both can play a role in pain management and can help to restore and/or maintain normal form and function. Incorporating acupuncture and chiropractic into your treatment plans can add useful tools that improve patient outcome.
ACUPUNCTURE
History1
Acupuncture has been practiced for over 4000 years in China and other Asian countries. In recent years our comprehension of neurophysiology has improved so that the mode of action of acupuncture is now more clearly understood. Acupuncture was introduced to the United States in the 1950’s and the International Veterinary Acupuncture Society started training veterinarians in 1974. Acupuncture has been shown to be well-tolerated for veterinary patients and a safe and effective means for pain relief with few, if any side effects.
Mode of Action1-3
Acupuncture effects are thought to be neurohormonal and immunomodulatory. Acupuncture inhibits inflammation, reduces muscle tension and spasm, resets proprioceptive mechanism and posture and affects the autonomic nervous system. Acupuncture involves the insertion of a long, thin, sterile needle into a distinct location in the body to cause a specific physiologic effect. Many of these points tend to occur at nerve bifurcations or where nerves penetrate tissue planes. The points correlate with nerve bundles and plexus, capillaries, venules and lymphatics. Acupuncture can exert effects at the local level, the peripheral level, the spinal level and the supraspinal level.
Types of Acupuncture1,3
• Dry needle – a sterile needle is inserted into a known acupuncture spot • Aquapuncture – a sterile solution is injected into an acupuncture spot • Electroacupuncture – electrical leads are attached to stainless steel acupuncture needles in place and electric current is applied. • Trigger point – Insertion of an acupuncture needle into a trigger point to release the trigger point • Laser Acustimulation – Low-level laser therapy to stimulate individual acupoint • Moxibustion – Burning Artemisia vulgaris (an herb) to provide heat stimulation directly to the acupoint • Acupressure – Digital pressure applied to the acupoint.
Contraindications1,3
• Bleeding tendencies • Needling infected/inflamed skin • Electroacupuncture patients with pacemakers, arrhythmias or seizures • Needling directly through or around a known malignant tumor • Caution with fractious animals – inappropriate needle placement
CHIROPRACTIC
History2,3
D.D. Palmer is recognized as the founder of modern-day chiropractic who performed the first adjustment in 1895. He believed in a fundamental relationship between the skeleton and the nervous system with the spine as contributing to the overall health of the patient and that abnormal spinal movement could lead to nervous system dysfunction The basic tenant of chiropractic is to improve the mobility of hypomobile joints which in turn improves neurologic function.
Mode of Action4,5
Chiropractic care is based on the vertebral subluxation complex (VSC) which as defined by the American Chiropractic Association as the “theoretical model of motion segment dysfunction which incorporates the complex interaction of pathological changes in nerve, muscle , ligamentous, vascular and connective tissues. With compromised nerve functions, the communication of the entire nervous system becomes compromised which can lead to pain. The chiropractic adjustment, performed by a skilled and trained professional, is focused and restoring normal nerve function and improving nervous system communication by performing a precise high velocity, low amplitude (HVLA) thrust. The goal of this adjustment is to trigger the homeostatic mechanisms of vertebral or articular kinesthetics.
Typical Uses5
• Routine maintenance for the performance animal - canine or equine. • Lameness • Paresis • Pain management
Contraindications5
• Neoplasia • Fracture • Hypermobility • Hemorrhage • Active Infection • Acute or prolapsed disc • Area of significant pain • Joint Luxation • Meningitis
References: 1. Gaynor J.S MWW. Handbook of Veterinary Pain Management: Mosby Elsevier Publishing, 2015. 2. Egger CML, L; Doherty, T. Pain Management in Veterinary Practice: Wiley Blackwell, 2014. 3. Zink C, VanDyke, J. B. Canine Sports Medicine and Rehabilitation: Wiley Blackwell, 2013. 4. Pain Managment in Veterinary Practice: Wiley Blackwell, 2014. 5. Foundations of Chiropractic, 2005.