DR.S.IBRAHIM SHERIFF
P.T.
M.P.T.,M.D.(Acu).,M.D.(AM).,PGDHM.,PGDCE.,PGDip.varma.,MIAP.,
DIRECTOR
GLOBAL INSTITUTE FOR ACUPUNCTURE THERAPY
MADURAI
BRANCH OF TRADITIONAL CHINESES
MEDICINE(TCM)
 What is Acupuncture?
 INTERNATIONAL RECOGNITION
 TYPES OF ACUPUNCTURE
 PHILOSOPHY
 Mechanisms of Action
 Indications for Acupuncture
 GLOBAL COLLEGE-COURSES
 Acupuncture is an alternative medicine
 methodology originating in ancient China that
treats patients by manipulating thin, solid needles
that have been inserted into acupuncture points in
the skin. According to Traditional Chinese
medicine, stimulating these points can correct
imbalances in the flow of qi through channels
known as meridians
 United States- National Institutes
of Health,
  National Health Service- United
Kingdom
 World Health Organization
  National Center for
Complementary and Alternative
Medicine
 MOXIBUSTION
 CUPPING
 TUINA (ACUPRESSURE)
 ELECTROACUPUNCTURE
 EAR ACUPUNCTURE(AURICULAR)
 HAND ACUPUNCTURE (SUJOK)
 MEDICAL ACUPUNCTURE
 COSMETIC ACUPUNCTURE
 The general theory of acupuncture is based on the
premise that bodily functions are regulated by an
energy called qi which flows through the body;
disruptions of this flow are believed to be
responsible for disease.
  Acupuncture describes a family of procedures
aiming to correct imbalances in the flow of qi by
stimulation of anatomical locations on or under the
skin (usually called acupuncture points or acupoints),
by a variety of techniques
 The most common mechanism of stimulation of
acupuncture points employs penetration of the skin
by thin metal needles, which are manipulated
manually or by electrical stimulation.[
 Good health is balance btwn man & the
natural world; balance btwn Yin &Yang;
everything has a Y&Y component
 Yin - assoc w/ earth, coldness, dampness
 Yang - assoc w/ heaven, sky, warmth, dryness
 Balance is regulated by the flow of chi (qi); the
“life energy” flowing along meridians.
Imbalance disrupts flow of chi - resulting in
pain or illness - stimulation of points restores
balance.
 Most points are highly conductive
 High concentrations of free nerve endings and sensory
receptors have been are commonly found at points.
 Electroacupuncture causes increased levels of beta-
endorphin in the CSF
 Some parasympathetic effects have been documented -
lowered BP & stress; even fainting/hypnotic state
 Moderately strong relationship between trigger points,
motor points & acupuncture points (location)
 Possible placebo effect
 Unknown – traditional Chinese philosophy (mysticism)
 fMRI with blood oxygen level-dependent
(BOLD) measurements
 Acupuncture points: rich in
neuroreceptors
 Modulates pain network via analgesic
effects
 CNS hormones release in hypothalamus
and limbic system
 Causes changes in interpretation of pain
 Fascia is bath of conductive fluid
 General tx (2-8 Hz)
• Enkephalin released from periaqueductal gray
• Endorphin released from the hypothalamus
• May be reversed/blocked by Naloxone
 Local tx (above 10 Hz)

Dynorphin released in spinal cord

Activates low-threshold skin and muscle receptors

Serotonin/Norepinephrine released in midbrain
 Fascia is bath of conductive fluid
 General tx (2-8 Hz)
• Enkephalin released from periaqueductal gray
• Endorphin released from the hypothalamus
• May be reversed/blocked by Naloxone
 Local tx (above 10 Hz)
 Dynorphin released in spinal cord
 Activates low-threshold skin and muscle receptors
 Serotonin/Norepinephrine released in midbrain
INDICATIONS RELATED WITH
PHYSIOTHERAPY
(WORLD HEALTH ORGANIZATION-DECEMBER 1979
INDICATIONS OF ACUPUNCTURE)
Respiratory Diseases
• Acute sinusitis
• Acute rhinitis
• Common cold
• Acute tonsillitis
Bronchopulmonary Diseases
• Acute bronchitis
• Bronchial asthma
Eye Disorders
• Acute conjuctivitis
• Cataract(without complications)
• Myopia
• Central retinitis
Disorders of the Mouth Cavity
• Toothache
• Pain after tooth extraction
• Gingivitis
• Pharyngitis
Orthopedic Disorders
• Periarthritis humeroscapularis
• Tennis elbow
• Sciatica
• Low back pain
• Rheumatoid arthritis
Gastrointestinal Disorders
• Spasm of the esophagus and cardia
• Hiccups
• Gastroptosis
• Acute and chronic gastritis
• Gastric hyperacidity
• Chronic duodenal ulcer
• Acute and chronic colitis
• Acute bacterial dysentery
• Constipation
• Diarrhea
• Paralytic ileus
Neurologic Disorders
• Headache
• Migraine
• Trigeminal neuralgia
• Facial paralysis
• Paralysis after apoplectic fit
• Peripheral neuropathy
• Paralysis caused by poliomyelitis
• Meniere's syndrome
• Neurogenic bladder dysfunction
• Nocturnal enuresis
• Intercostal neuralgia
 Chronic Pain/Fatigue Syndromes
 Osteoarthritis
 Joint disease/back pain
 Acute Pain--Sprains, Strains,
 Post-Operative Pain
 Migraines
 Fibromyalgia
 Depression, Anxiety
The NIH consensus panel stated that promising results
emerged, for example, efficacy of acupuncture in:
adult post-operative and chemotherapy nausea and
vomiting
postoperative dental pain.
 Classic Acupuncture
- Needling
- Needling w/ manual stimulation of needle
- Needling w/ electrical stimulation thru needle
 Physical Therapy on acupuncture pts.
- Manual pressure (acupressure)
- TENS on the points
- Laser on the points
- Ultrasound on the points
 The Prescription method: certain points are
for particular clinical presentations &
symptoms. A Western adaptation
 Stimulate point in the same area as the pain /
stimulate known MTPs in the area / stimulate
Ah Shi points
 Classical method: Holistic assessment w/
detailed understanding on body, mind,
lifestyle, environment, etc.. (ie.Yin & Yang)
 Global college of paramedical college was started in the
year of 2009 at Alanganallur, Madurai district,tamilnadu,
aim is the meet the challenges of new era in the hospital
industry.
 The institution is affiliated by BSS, National Development
agency and promoted by Government of India.
Registration No:TN/1693
 Approved by Tamilnadu Physical Education & Sports
University, Chennai –DDE
 APPROVED BY
 BHARAT SEVAK SAMAJ ,NATIONAL
DEVELOPMENT AGENCY,PROMOTED BY
GOVT OF INDIA
 TAMILNADU PHYSICAL EDUCATION AND
SPORTS UNIVERSITY-DDE,CHENNAI
BSS COURSES TNPESU COURSES (distance
education )
MASTER DIPLOMA IN
ACUPUNCTURE
THERAPY(M.D.Acu)
DIPLOMA IN ACUPUNCTURE
THERAPY (D.Acu)
Nursing assistant
Medical laboratory Technician
Xray Technician
Operation theatre Technician
M.Sc /B.Sc (Yoga &naturopathy)
M.B.A.(General)
M.B.A.(SPORTS MANAGEMENT)
M.Sc (Psychology)
PG Diploma in onfield sports
injury mangement
PG Diploma in fitness and
nutrition
PG Diploma in Gym and Fitness
Instructor
PG diploma in Varma and
Thokkanam sciences
 GLOBAL COLLEGE OF PARAMEDICAL
SCIENCES
 275,VELLIMALAYAN II STREET,
 KALAIVANAR NAGAR,
 ALANGANALLUR,MADURAI-625 501
PH:04543-244255
 Dr.S.Ibrahim sheriff : 9659392525
 Dr.K.Saravanan : 9489966956
 EMAIL: globcps@gmail.com
SPECIAL CONCESSION FOR PHYSIOTHERAPY STUDENTS &
PHYSIOTHERAPISTS
Evidence based acupuncture

Evidence based acupuncture

  • 1.
  • 2.
    BRANCH OF TRADITIONALCHINESES MEDICINE(TCM)
  • 3.
     What isAcupuncture?  INTERNATIONAL RECOGNITION  TYPES OF ACUPUNCTURE  PHILOSOPHY  Mechanisms of Action  Indications for Acupuncture  GLOBAL COLLEGE-COURSES
  • 4.
     Acupuncture is an alternativemedicine  methodology originating in ancient China that treats patients by manipulating thin, solid needles that have been inserted into acupuncture points in the skin. According to Traditional Chinese medicine, stimulating these points can correct imbalances in the flow of qi through channels known as meridians
  • 5.
     United States- NationalInstitutes of Health,   National Health Service- United Kingdom  World Health Organization   National Center for Complementary and Alternative Medicine
  • 6.
     MOXIBUSTION  CUPPING TUINA (ACUPRESSURE)  ELECTROACUPUNCTURE  EAR ACUPUNCTURE(AURICULAR)  HAND ACUPUNCTURE (SUJOK)  MEDICAL ACUPUNCTURE  COSMETIC ACUPUNCTURE
  • 7.
     The generaltheory of acupuncture is based on the premise that bodily functions are regulated by an energy called qi which flows through the body; disruptions of this flow are believed to be responsible for disease.   Acupuncture describes a family of procedures aiming to correct imbalances in the flow of qi by stimulation of anatomical locations on or under the skin (usually called acupuncture points or acupoints), by a variety of techniques  The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles, which are manipulated manually or by electrical stimulation.[
  • 8.
     Good healthis balance btwn man & the natural world; balance btwn Yin &Yang; everything has a Y&Y component  Yin - assoc w/ earth, coldness, dampness  Yang - assoc w/ heaven, sky, warmth, dryness  Balance is regulated by the flow of chi (qi); the “life energy” flowing along meridians. Imbalance disrupts flow of chi - resulting in pain or illness - stimulation of points restores balance.
  • 9.
     Most pointsare highly conductive  High concentrations of free nerve endings and sensory receptors have been are commonly found at points.  Electroacupuncture causes increased levels of beta- endorphin in the CSF  Some parasympathetic effects have been documented - lowered BP & stress; even fainting/hypnotic state  Moderately strong relationship between trigger points, motor points & acupuncture points (location)  Possible placebo effect  Unknown – traditional Chinese philosophy (mysticism)
  • 10.
     fMRI withblood oxygen level-dependent (BOLD) measurements  Acupuncture points: rich in neuroreceptors  Modulates pain network via analgesic effects  CNS hormones release in hypothalamus and limbic system  Causes changes in interpretation of pain
  • 11.
     Fascia isbath of conductive fluid  General tx (2-8 Hz) • Enkephalin released from periaqueductal gray • Endorphin released from the hypothalamus • May be reversed/blocked by Naloxone  Local tx (above 10 Hz)  Dynorphin released in spinal cord  Activates low-threshold skin and muscle receptors  Serotonin/Norepinephrine released in midbrain
  • 12.
     Fascia isbath of conductive fluid  General tx (2-8 Hz) • Enkephalin released from periaqueductal gray • Endorphin released from the hypothalamus • May be reversed/blocked by Naloxone  Local tx (above 10 Hz)  Dynorphin released in spinal cord  Activates low-threshold skin and muscle receptors  Serotonin/Norepinephrine released in midbrain
  • 13.
    INDICATIONS RELATED WITH PHYSIOTHERAPY (WORLDHEALTH ORGANIZATION-DECEMBER 1979 INDICATIONS OF ACUPUNCTURE) Respiratory Diseases • Acute sinusitis • Acute rhinitis • Common cold • Acute tonsillitis Bronchopulmonary Diseases • Acute bronchitis • Bronchial asthma Eye Disorders • Acute conjuctivitis • Cataract(without complications) • Myopia • Central retinitis Disorders of the Mouth Cavity • Toothache • Pain after tooth extraction • Gingivitis • Pharyngitis Orthopedic Disorders • Periarthritis humeroscapularis • Tennis elbow • Sciatica • Low back pain • Rheumatoid arthritis Gastrointestinal Disorders • Spasm of the esophagus and cardia • Hiccups • Gastroptosis • Acute and chronic gastritis • Gastric hyperacidity • Chronic duodenal ulcer • Acute and chronic colitis • Acute bacterial dysentery • Constipation • Diarrhea • Paralytic ileus Neurologic Disorders • Headache • Migraine • Trigeminal neuralgia • Facial paralysis • Paralysis after apoplectic fit • Peripheral neuropathy • Paralysis caused by poliomyelitis • Meniere's syndrome • Neurogenic bladder dysfunction • Nocturnal enuresis • Intercostal neuralgia
  • 14.
     Chronic Pain/FatigueSyndromes  Osteoarthritis  Joint disease/back pain  Acute Pain--Sprains, Strains,  Post-Operative Pain  Migraines  Fibromyalgia  Depression, Anxiety The NIH consensus panel stated that promising results emerged, for example, efficacy of acupuncture in: adult post-operative and chemotherapy nausea and vomiting postoperative dental pain.
  • 15.
     Classic Acupuncture -Needling - Needling w/ manual stimulation of needle - Needling w/ electrical stimulation thru needle  Physical Therapy on acupuncture pts. - Manual pressure (acupressure) - TENS on the points - Laser on the points - Ultrasound on the points
  • 16.
     The Prescriptionmethod: certain points are for particular clinical presentations & symptoms. A Western adaptation  Stimulate point in the same area as the pain / stimulate known MTPs in the area / stimulate Ah Shi points  Classical method: Holistic assessment w/ detailed understanding on body, mind, lifestyle, environment, etc.. (ie.Yin & Yang)
  • 17.
     Global collegeof paramedical college was started in the year of 2009 at Alanganallur, Madurai district,tamilnadu, aim is the meet the challenges of new era in the hospital industry.  The institution is affiliated by BSS, National Development agency and promoted by Government of India. Registration No:TN/1693  Approved by Tamilnadu Physical Education & Sports University, Chennai –DDE
  • 18.
     APPROVED BY BHARAT SEVAK SAMAJ ,NATIONAL DEVELOPMENT AGENCY,PROMOTED BY GOVT OF INDIA  TAMILNADU PHYSICAL EDUCATION AND SPORTS UNIVERSITY-DDE,CHENNAI
  • 19.
    BSS COURSES TNPESUCOURSES (distance education ) MASTER DIPLOMA IN ACUPUNCTURE THERAPY(M.D.Acu) DIPLOMA IN ACUPUNCTURE THERAPY (D.Acu) Nursing assistant Medical laboratory Technician Xray Technician Operation theatre Technician M.Sc /B.Sc (Yoga &naturopathy) M.B.A.(General) M.B.A.(SPORTS MANAGEMENT) M.Sc (Psychology) PG Diploma in onfield sports injury mangement PG Diploma in fitness and nutrition PG Diploma in Gym and Fitness Instructor PG diploma in Varma and Thokkanam sciences
  • 20.
     GLOBAL COLLEGEOF PARAMEDICAL SCIENCES  275,VELLIMALAYAN II STREET,  KALAIVANAR NAGAR,  ALANGANALLUR,MADURAI-625 501 PH:04543-244255  Dr.S.Ibrahim sheriff : 9659392525  Dr.K.Saravanan : 9489966956  EMAIL: globcps@gmail.com SPECIAL CONCESSION FOR PHYSIOTHERAPY STUDENTS & PHYSIOTHERAPISTS

Editor's Notes

  • #11 Sham vs mock vs verum acupuncture Varying vs non-varying Blinding issues fMRI with blood O2 level-dependent (BOLD) most used to evaluate for cortical association Acupuncture points: rich in neuroreceptors Modulates the pain network via analgesic effects Central nervous system hormone release in the hypothalamus and limbic system Causes changes in the interpretation of pain Acupuncture points: rich in neuroreceptors A vertical column of loose connective tissue surrounded by less conductive dense connective tissue Activate small myelinated muscle nerve fibers A-delta efferents Modulates analgesic effects, modulates the pain network to include hypothalamus and limbic system Single needle—releases cGRP, Ach, stimulates sympathetic fibers in the paravertebral ganglia Releases Substance P—affects capillaries, mast cells, symp ganglia Causes changes in the interpretation of pain
  • #12 2-8 Hz Low-frequency, high intensity “Qi”—group III fibers, may be blocked by injecting procaine deep to site Aβ and Aδ, group II and III fibers that synapse w/ dorsal horn Enkephalin release from periaqueductal gray Endorphin dependent release from the hypothalamus May be reversed/blocked by naloxone Continues after stimulation More general effect More than 10 Hz High frequency, low intensity Endorphin independent Dynorphin in the spinal cord Activates low-threshold skin and muscle receptors 5HT, NE release in midbrain Rapid onset More segmental effect
  • #13 2-8 Hz Low-frequency, high intensity “Qi”—group III fibers, may be blocked by injecting procaine deep to site Aβ and Aδ, group II and III fibers that synapse w/ dorsal horn Enkephalin release from periaqueductal gray Endorphin dependent release from the hypothalamus May be reversed/blocked by naloxone Continues after stimulation More general effect More than 10 Hz High frequency, low intensity Endorphin independent Dynorphin in the spinal cord Activates low-threshold skin and muscle receptors 5HT, NE release in midbrain Rapid onset More segmental effect