Page 325 Guide to Pain Management in Low-Resource Settings

Role of Acupuncture in Pain Management 313

• SP 6 (spleen/pancreas): approx. 4 cm directly • However, nowadays it may be more rational to
above the tip of the medial malleolus on the pos- use acupuncture outside the concept of tradition-
terior border of the tibia al Chinese medicine, according to the concept of
In headache, use: an integrative pain management approach within
• ST 44 (stomach): proximal to the web margin the biopsychosocial concept of pain.
between the 2nd and 3rd metatarsal bones, in a • In particular, in pain management it seems to
depression distal and lateral to the 2nd metatarsal be a worthwhile concept to combine blockades,
joint pharmacotherapy, and acupuncture, as well as
• GB 34 (gallbladder): in a depression anterior and physical and psychological therapy.
inferior to the head of the fi bula
• ST 44 (stomach): proximal to the web margin
Acknowledgment
between the 2nd and 3rd metatarsal bones, in a
depression distal and lateral to the 2nd metatarsal Th e authors would like to thank PD Dr. D. Irnich from
joint the Pain Management Center of the Ludwig Maximilian
University in Munich, Germany, for his advice on pre-
Step two: paring the manuscript.

Choose 2–4 spots at the site of the pain (Ashi points) as
acupuncture points.
References

Step three:
[1] Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain.
Choose 1 segmental spot corresponding with the der- Cochrane Database Syst Rev 2008: CD001929.
[2] Madsen MV, Gøtzsche PC, Hróbjartsson A. Acupuncture treatment for
matomal innervation of the painful region at the cor- pain: systematic review of randomised clinical trials with acupuncture,
placebo acupuncture, and no acupuncture groups. BMJ 2009;338:3115.
responding vertebral level and place the needle at the [3] Manheimer E, Linde K, Lao L, Bouter LM, Berman BM. Meta-anal-
identifi ed vertebral level some centimeters paraverte- ysis: acupuncture for osteoarthritis of the knee. Ann Intern Med
2007;146:868–77.
brally on the aff ected site. [4] Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-analysis:
acupuncture for low back pain. Ann Intern Med 2005;142:651–63. [5]
Trinh KV, Graham N, Gross AR, Goldsmith CH, Wang E, Cameron ID,
Step four: Kay T; Cervical Overview Group. Acupuncture for neck disorders. Co-
chrane Database Syst Rev 2006;19:3:CD004870.
Choose 2–4 mirror-like spots on the contralateral site [5] Sun Y, Gan TJ. Acupuncture for the management of chronic headache:
for segmental modulation. a systematic review. Anesth Analg 2008;107:2038–47.
[6] Sun Y, Gan TJ, Dubose JW, Habib AS. Acupuncture and related tech-
niques for postoperative pain: a systematic review of randomized con-
trolled trials. Br J Anaesth 2008;101:151–60.
Pearls of wisdom

• Although there is a centuries-long history of Recommended websites
acupuncture, its effi cacy has to be proven in evi-
www.acupuncture.com
dence-based medicine.
www.acupuncture.com.au
• According to recent literature, there are a number
www.pain-education.com
of indications in pain management where acu- http://nccam.nih.gov/health/acupuncture/
puncture can be applied successfully. www.tcmpage.com/index.html
www.panafricanacupuncture.org (the Pan-African Acupuncture Project,
Allen Magezi, Uganda coordinator)