Shoulder pain and acupuncture/CAM provision in the NHS
As a physiotherapist trained to practise acupuncture I was delighted
to read the letter regarding the use of the acupuncture point, ST 38 to
treat shoulder pain. This letter highlights two very topical points.
Firstly related to the continued debate regarding the cost effectiveness
of using acupuncture and CAM (complementary and alternative medicine) in
the NHS, which recently was subject of a review (1) and secondly the scope
in which current NHS clinicians practise. Thompson and Feder (2)
contributed to this, suggesting that complementary and alternative
interventions could be provided in a more cost effective manner by being
carried out by existing clinicians. Physiotherapists, who received many
referrals for musculoskeletal conditions, including shoulder pain,
incorporate manual therapy, exercise and electrotherapy into their
treatments. For those physiotherapists trained and accredited to practise
acupuncture, this offers another treatment modality and a very useful
skill for the treatment of pain. Physiotherapists can carry out a variety
of acupuncture training courses, such as completing an undergraduate
module, a short or long postgraduate course, or a specific Master of
Sciences course (MSc). The Acupuncture Association of Chartered
Physiotherapists (AACP) monitors the standards of training and practise
offered by chartered physiotherapists and has nearly 5,000 members.
It seems like a particularly cost effective procedure to have
physiotherapists, or other NHS clinicians, including doctors and nurses,
trained to provide acupuncture. The cost of training current NHS staff to
deliver acupuncture or possibly other CAM modalities, would I expect be
much less than employing additional therapists trained exclusively in
these modalities to deliver them.
In addition, when using the point ST 38, I find it beneficial for the
patients to actively rotate the shoulder within the limits of pain while
this point is being stimulated.
Reference List
(1). Canter PH, Coon JT, Ernst E. Cost effectiveness of
complementary treatments in the United Kingdom: systematic review. BMJ
2005;331:880-881.
(2). Thompson T, Feder G. Complementary therapies and the NHS. BMJ
2005;331:856-857.
Competing interests:
None declared
Competing interests:
No competing interests
16 November 2005
Tanya Trayers
Research Training Fellow, Academic Unit of Primary Health Care and Physiotherapist
Rapid Response:
Shoulder pain and acupuncture/CAM provision in the NHS
As a physiotherapist trained to practise acupuncture I was delighted
to read the letter regarding the use of the acupuncture point, ST 38 to
treat shoulder pain. This letter highlights two very topical points.
Firstly related to the continued debate regarding the cost effectiveness
of using acupuncture and CAM (complementary and alternative medicine) in
the NHS, which recently was subject of a review (1) and secondly the scope
in which current NHS clinicians practise. Thompson and Feder (2)
contributed to this, suggesting that complementary and alternative
interventions could be provided in a more cost effective manner by being
carried out by existing clinicians. Physiotherapists, who received many
referrals for musculoskeletal conditions, including shoulder pain,
incorporate manual therapy, exercise and electrotherapy into their
treatments. For those physiotherapists trained and accredited to practise
acupuncture, this offers another treatment modality and a very useful
skill for the treatment of pain. Physiotherapists can carry out a variety
of acupuncture training courses, such as completing an undergraduate
module, a short or long postgraduate course, or a specific Master of
Sciences course (MSc). The Acupuncture Association of Chartered
Physiotherapists (AACP) monitors the standards of training and practise
offered by chartered physiotherapists and has nearly 5,000 members.
It seems like a particularly cost effective procedure to have
physiotherapists, or other NHS clinicians, including doctors and nurses,
trained to provide acupuncture. The cost of training current NHS staff to
deliver acupuncture or possibly other CAM modalities, would I expect be
much less than employing additional therapists trained exclusively in
these modalities to deliver them.
In addition, when using the point ST 38, I find it beneficial for the
patients to actively rotate the shoulder within the limits of pain while
this point is being stimulated.
Reference List
(1). Canter PH, Coon JT, Ernst E. Cost effectiveness of
complementary treatments in the United Kingdom: systematic review. BMJ
2005;331:880-881.
(2). Thompson T, Feder G. Complementary therapies and the NHS. BMJ
2005;331:856-857.
Competing interests:
None declared
Competing interests: No competing interests