PDF | 30 minutes read | In the year , I took a leap of faith to study Traditional Chinese Medicine (TCM). 'You aren't quitting medicine, are you?' my father. 𝗣𝗗𝗙 | In today's world, Western medicine has a dominant place in In this article , we propose that traditional Chinese medicine (TCM) is a. Traditional Chinese medicine (TCM) originated in ancient China and has the herbs used in Chinese medicine can interact with drugs, have serious side.
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Alternatively, patients may seek guidance from their provider about adding complementary therapies to their existing treatment plan. Evidence-based clinical studies suggest that there are Eastern and Western interventions treat FM symptoms, provide maximization of function and enhance quality of life.
However, Western educated health care providers may be uncertain as to the scope, efficacy or safety of TCM therapies. The purpose of this paper is to describe the components of TCM, overview the state of the science in regards to safety and efficacy, and, when appropriate help patients find the best trained TCM practitioners. What is Traditional Chinese Medicine?
TCM includes several modalities including acupuncture, herbal medicine, tai chi, qi gong, and tuina. The most commonly known and practiced modality in the US is acupuncture. While there is a wide variety of techniques used in acupuncture it is commonly defined as the penetration of the skin with thin, solid needles at specific anatomical points.
Generally acupuncture delivered by a licensed acupuncturist is extremely safe. The major risk of acupuncture is a pneumothorax from puncturing the lungs. Witt 6 indicates that is a very rare occurrence with an estimated frequency of 0.
The most common side effects are hematoma or bleeding 6.
A frequent concern is of disease transmission but this has been nearly eliminated with the standardization of disposable, single use needles. In China, this is the primary modality of TCM and is used for a wider range of ailments than acupuncture. In Nanjing University Hospital, fibromyalgia is treated primarily with herbal medicine and only secondarily with acupuncture.
Herbal medicine includes over different medicinal substances with commonly used for the treatment of fibromyalgia.
As practiced in the US, herbal formulas are generally given in decoction, powdered or pill form. The formulas tend to be herbs with a balanced approach that Mist et al.
For example, it is very common that formulas have a small amount of ginger added to make the formulas easier on the digestion. It is commonly thought that decoction or granulated formulas are superior to pill form as they can easily be modified to address different symptom profiles. However, it is often easier to get patients to take the formulas in pill form as they have little or no taste unlike the decoctions and to a lesser extent granules which can be very bitter or pungent. Tai Chi is a martial arts form that is often considered moving meditation.
It has been used as an adjunctive therapy for many ailments as well as general wellbeing. Qigong is a movement and breathing system developed specifically for medical purposes. Tuina is a form of manual therapy which includes specific types of massage, acupressure, and chiropractic adjustments. Tuina is often a subspecialty of the TCM practitioner but can be used in conjunction with any of the other modalities of TCM. In the US, those trained in tuina generally do not practice adjustments as they are not in their scope of practice.
This allows the practitioner to make informed decisions — based on TCM theory — of which modalities are likely to be more effective. State of Research While there are many modalities in TCM, the vast amount of research has been given to acupuncture.
In the last three years, there have been several different systematic reviews. When compared to first generation pharmaceuticals meloxicam, oryzanol, mirtazapine, or amitriptyline acupuncture was significantly better at reducing pain and number of tender points 8.
There was further evidence that the relapse rate of pain was better with acupuncture than amitriptyline. This review found that the active components of the various trials could not be grouped due to widely differing active components used in the studies. Of the six studies, five reported improvement compared to pharmaceuticals on measures including depression, VAS, symptoms and quality of life. Herbal decoctions tend to focus on reducing stress with formulas such as jiawei xiaoyao san or reducing blood stagnation and cold with formulas such as shugan jieyu huoxue tongluo wan.
The only single herbs studied for the treatment of fibromyalgia was rhizome drynariae, which showed no significant effect on VAS. Pract Pain Manag. Mist et al. Page 3 NIH-PA Author Manuscript While there is limited research on tai chi and qigong for fibromyalgia, clinically one would expect that these would be a good match for fibromyalgia patients.
One study of tai chi 10 reported improvements in the Fibromyalgia Impact Questionnaire 11 and the SF A systematic review of qigong for pain indicated that the study quality was low and called for additional research into this area of pain management.
A more general review of massage for fibromyalgia indicated that there is evidence supporting the use of massage for the reduction of pain but that the evidence was not conclusive. TCM providers should be licensed in the state, and, ideally graduated from an accredited program of study.
Additionally, the practitioner should be board certified in either acupuncture or Oriental medicine. Other ways are to meet with area practitioners and experience a treatment or two. For chronic pain conditions there is not likely to be a complete remission. With this in mind, the patient should adjust their expectations, and be prepared for frequent treatments early on, followed by weekly or monthly treatments for maintenance.
Cost Expense is probably the biggest barrier to TCM for most patients. Some states mandate that insurance companies cover a specified number of treatments WA , and some insurance companies offer alternative therapy riders.
However, most insurance do not cover TCM modalities and the patient is expected to pay out of pocket. If patients live in larger cities where Chinese medical schools exist, such schools often offer a very cost effective means for treatment.
Some cities have acupuncturists who practice a model of business called Community Acupuncture, where instead of individual treatment rooms and hour-long sessions, groups of patients are treated in reclining chairs or on gurneys with a substantially Pract Pain Manag.
Conclusions Current research, while preliminary, suggests that Traditional Chinese medicine has a number of modalities that could help treat primary and secondary symptoms in the fibromyalgia population. It is likely that this response is not due to placebo or expectation. An internet survey of 2, people with fibromyalgia. BMC Musculoskelet Disord. Bennett R. The Fibromyalgia Impact Questionnaire FIQ : a review of its development, current version, operating characteristics and uses.
Clin Exp Rheumatol.
Al-Allaf A. Work disability and health system utilization in patients with fibromyalgia syndrome. J Clin Rheumatol. Brooks R. EuroQol: the current state of play. Health Policy. Pain coping strategies and quality of life in women with fibromyalgia: Does age make a difference?
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