Transcription:
Acupuncture Can Help with Spinal Pain and Recovery

Prakash Chandran: Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the full. This episode is sponsored by University of Maryland Spine Network. Connected by the renowned University of Maryland School of Medicine, the UM Spine Network is home to the state's leading spine experts. With convenient locations throughout the state, UM Spine Network physicians collaborate to create comprehensive care plans for patients across the full spectrum of care. When you work with a UM Spine Network physician, you can expect to receive the high quality evidence-based care that you deserve.

I'm Prakash Chandran. And today, our guest is Brian Jackson, a licensed acupuncturist at University of Maryland Department of Orthopedics, who will be talking to us about acupuncture and spinal pain. Brian, thanks so much for joining us today. So I wanted to get started by asking what is acupuncture? How does it work and what does it feel like?

Brian Jackson: That's a really good question. So obviously, when you want to describe acupuncture, it's very simple in one sense. You know, it's just the process of sticking these solid stainless steel needles into certain points within the body to elicit some sort of physiological response that hopefully helps deal with one's pain and improves one's health. But obviously, it's also much more complex than that and there's a lot of different neurological responses that occur within the body throughout this process, a lot of biochemical reactions that occur in the body through this process. So that maybe makes the question a little bit harder to answer.

So in terms of what it feels like, I try to let my patients know going into the process that it's generally quite painless, right? That most people end up falling asleep during the procedure, so it's relatively painless. That being said, it will illicit some sensations if it's done well. And those sensations are typically characterized as heaviness or a fullness, sometimes a little bit of distension, sometimes just a warm sensation, so things of that nature. it will be subtle and you may not feel much. But hopefully, if it's done well, you should feel something in that genre, I guess.

Prakash Chandran: Yeah, that makes a lot of sense. And, you know, speaking from personal experience, acupuncture is something that I've done and not only was it not painful, but exactly as you mentioned, I kind of fell asleep. I went in there specifically for knee pain, but I really just enjoyed relaxing and just the kind of that heaviness of it all. So, I went in for knee pain, but maybe you can talk a little bit more about some of the conditions that acupuncture can help with.

Brian Jackson: I'm at the orthopedics department, so I'd say the majority of our cases are neck and spine-related, in terms of dealing with chronic pain, chronic lower back pain, chronic neck pain. That's probably the majority of our cases. You know, that being said, we are acupuncturist and we are classically trained, so we end up seeing a whole gamut of different conditions in the office from strokes to women who are experiencing fertility issues. It sort of runs the gamut, but I'd say for the most part, again, most of our patients are lower back and neck, spine issues.

Prakash Chandran: So just kind of staying with the lower back and spine issues, when we talk about putting a needle in someone's body, how is it that that can help with that neck and lower back pain? Can you explain that at a high level? Because I think this is something that just confuses a lot of people. They just know that it works, but they don't know how.

Brian Jackson: Right. It works on multiple levels simultaneously. So on a local level, if you just think about the physical process, the needle gets inserted, cells get disturbed or destroyed in that process. And it sort of elicits like a local inflammation response. That inflammation response is false, right? Because there's no actual infection occurring in that area or there's no gross cell damage going on in that area, besides what you've just done with the needle.

Locally, we try to sort of spur the body into repairing the tissues faster than they normally would by putting the needle into tissues that may already be affected or diseased or pathologically have changed. So there's a local reaction. And then on sort of a more global level in terms of the rest of the body, you're recruiting different blood cells to that region. You're improving circulation within that region. You're releasing neurotransmitters such as endorphins and exciting the opioid receptors and various other neurochemical stimulants get released in this process, which also help mitigate the pain response overall from like a neurological level.

Some things are happening locally and then some things are happening more globally throughout the body, just based on the body's response to having this process done. So all of those things are sort of happening in concert.

And then there's also the benefit of just asking somebody to remain still for 15 to 30 minutes to really take in some deep breaths to calm themselves because obviously when you have needles in you, you are generally less likely to move. So it's nice to just have that space and create that environment where the patient can sort of slow down, take a deep breath and also just kind of gather themselves. The mental aspects can't be denied or discounted either, obviously.

Prakash Chandran: Absolutely. And that's not something typically that you realize as an added benefit to getting acupuncture, but I definitely can attest that that is wonderful. Just taking the time to stand still, which is sometimes unnatural for people is amazing.

Brian Jackson: And I like the fact that within the medical community, that's not an idea that's widely perpetuated. As a service, like that's part of our job, that we can provide that environment for people.

Prakash Chandran: So you know, we're talking about acupuncture in conjunction with spine pain. And there are some people that it might get so severe that they might need spine surgery. So is acupuncture something that is tried to alleviate the pain or help things before or after spine surgery? Is this something that you can speak to?

Brian Jackson: Luckily, within our department here at the University of Maryland Department of Orthopedics, I'm within the spine division, and we have a number of really great spinal surgeons on our team. The good thing about being sort of integrated into that team of surgeons is that we can offer peri-operative care throughout the whole process, right? So again, when you come for your initial consultation, your spinal surgeon may say, "Okay. Look, let's try to manage this through a conservative approach. And certainly, acupuncture and physical therapy might be a big part of that conservative approach to managing your spinal condition or your spine pain before surgery might be necessary, right?

If your disease should progress and we see further deterioration, okay, now maybe we're at a point where spine surgery is our best option. So luckily, as acupuncturists, we can play a role in terms of getting you ready for your surgery in terms of dealing with any sort of residual anxiety, nervousness, probably helping you to heal a little bit faster by engaging through the acupuncture process before you go into surgery. We will be there within the day if you do have surgery within our facilities, to be there bedside for our patients in terms of pain management and trying to control pain through non-pharmaceutical means immediately after surgery as well. You know, so we round through the hospital, I try to check on as many of our patients as we can in terms of trying to help them control their pain post-surgically, in controlling other things like postoperative nausea and vomiting or postoperative constipation. So, there's a number of different conditions that acupuncture can effectively treat post-surgery. And then obviously, in terms of the rehabilitation that has to come afterwards, like I think acupuncture also has a role to play just in terms again, helping to control pain, helping to improve mobility after your spinal surgery. So it's really nice to be part of a large integrative team of spine specialists, who also have similar mindset and also want to take a very integrative careful approach to spinal surgery, and determining when it's applicable and what we might use to manage that in the meantime.

Prakash Chandran: Yeah, absolutely. And as you're using acupuncture either before the surgery, for the reasons that you mentioned or afterwards, I can imagine that it is important to let your primary care doctor or your surgeon know that you're using a complementary technique like acupuncture. But maybe you can talk to the audience a little bit more about why that's so important, even though it is safe.

Brian Jackson: Your doctor needs to know how you're managing your condition, obviously. He needs to be able to assist you hopefully in making the best medical decisions possible. So having more information is only going to be more benefit to the patient, and more benefit to the doctor in terms of their joint medical decision-making.

I don't think it's anything to be ashamed of or try to hide at this point. I think acupuncture is pretty widely accepted throughout the world at this time. We certainly see more and more people using it here within the west. So I don't think it's anything that you necessarily need to hide away or feel like you're going to be ridiculed by your doctor if you tell them that you're using acupuncture. It's something that's fairly commonplace and it's important just in terms of trying to make the next decision in terms of your care and how we might manage it.

So if your doctor knows that I've been trying injections, I've been using acupuncture, none of that seems to help and it's like, "Okay. Well, now we need to reformulate our strategies in terms of your pain management and also your condition and what is the next step." so, I think it's helpful in terms of just overall decision-making. I feel like there may still be physicians out there that may poopoo it and not do anything with that information, even if you tell them. But I think those numbers getting smaller as the weight of evidence for acupuncture in the treatment of things like chronic lower back pain get greater, better.

Prakash Chandran: Yeah, absolutely. So, we've talked about a lot of amazing things here with regards to acupuncture, but is there anything else that you would like to leave our audience with when it comes to getting acupuncture or as it relates to spinal pain?

Brian Jackson: I would say again just be careful about who you seek out for your treatment. It's important that you have an individual that has experience in treating lower back pain and I would say probably most well-trained acupuncturist do. But you also want to be sure that they have the proper qualifications, that they're licensed within their state to practice, obviously; that they have some sort of board certification in terms of being an acupuncturist. If they have additional training in treating sports injuries or musculoskeletal injuries, all the better.

It's really important that you find the right acupuncturist for the job. Because again, we're generalist for the most part, but we also do specialize or end up seeing maybe a majority of our cases in a certain domain. So, just because you sought out an acupuncturist who maybe sort of specializes in fertility issues or OB-GYN issues, and they could not treat your back pain, that shouldn't be a cause for alarm or a cause to discredit acupuncture or not seek out another acupuncturist. So, be selective in who you choose for your care. And again, choose somebody who has the experience in the domain that you're seeking, I would say.

Prakash Chandran: Brian, thank you so much for your time today.

Brian Jackson: A pleasure. Thank you.

Prakash Chandran: That was Brian Jackson, a licensed acupuncturist at University of Maryland Department of Orthopedics. Find more shows just like this one at umms.org/podcast. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.