Acupuncture, Biofeedback, Hypnotherapy

January 09 2006 Monday

Acupuncture

What it's best for : Pain, nausea

May also help : Menstrual cramps, tennis elbow, carpal tunnel syndrome, asthma, fibromyalgia, and arthritis

How it works : That depends on who's doing the explaining. A traditional Chinese healer will say that inserting acupuncture needles helps to control the flow of qi (pronounced chee), a vital force that governs health. Qi is said to circulate from one organ to another along a network of pathways known as meridians. Illness occurs when this force becomes blocked or unbalanced.

Mainstream doctors typically don't recognize the concepts of qi and meridians. However, research shows that hair-thin acupuncture needles stimulate tiny nerves in the skin that transmit signals to the brain, which in turn release pain-killing proteins called endorphins.

"It's like you're having a morphine injection, without the side effects or complications," says Nader Soliman, MD, president of the American Academy of Medical Acupuncture.

The National Institutes of Health (NIH) in America has said that there's reasonable scientific proof that acupuncture can case pain.

(In one recent study, University of Maryland researchers found that a group of people with arthritic knees who had twice-weekly acupuncture sessions for 6 months were less stiff and sore than another group that didn't receive the needle treatment.)

Meanwhile, NIH officials feel there is "clear evidence" that pinprick therapy relieves nausea caused by chemotherapy and surgery.

In fact, a 2004 study found acupuncture to be more effective than standard antinausea drugs for women recovering from breast surgery, though why the treatment helps this and other nonpain-related conditions remains a mystery.

In a typical acupuncture session. which lasts a half-hour or so, you sit or lie in a comfortable position as the practitioner inserts anywhere from a half-dozen to 15 needles into your skin.

Some will be placed near the source of pain or illness - on your wrist for carpal tunnel syndrome, for instance. But needles may also be inserted at one of more than 400 "acupoints" on the body. These spots appear to somehow influence distant organs. Got a sinus headache? You may end up with needles in your feet.

Patients usually report some tingling or soreness that fades quickly. "It feels like a mosquito bite." says rheumatologist Charis Meng, MD, of New York's Hospital for Special Surgery, whose research has found that acupuncture helps relieve back pain. Most people tend to be pleasantly surprised. It's more relaxing than they thought it would be."

Some conditions clear up with just a few sessions, but persistent problems, such as chronic back pain, usually require monthly visits.

Biofeedback

What it's best for : Headaches, urinary incontinence

May also help : Attention deficit disorder, asthma, and high blood pressure

How it works : Stepping on the bathroom scale and seeing that you've lost a few pounds is often all the motivation you need to stick with a diet.

In one sense, that's a form of biofeedback, a fancy term for getting information about your body that helps to reinforce behaviour.

Biofeedback machines used by doctors and psychologists provide information about processes in your body you might think are beyond your control - like regulating your skin temperature, blood circulation, and muscle tension.

The information acts as positive reinforcement while you train your body to behave in a new way, usually with the help of relaxation techniques.

If you suffer from chronic headaches, for instance, a biofeedback therapist (usually a physician or a psychologist) might start by at-taching painless sensors to your scalp to measure the tension in your muscles.

As the therapist teaches you relaxation techniques, you'll watch a screen that displays informa-tion transmitted from the sensors, often in a visual form, like a line graph. (Some de-vices produce sounds, or are more like a computer game.)

If your muscles remain tense, the line on the graph rises; as you relax, it dips, encouraging you to relax more. Since most people probably don't want to walk around town with electrodes attached to their heads, the goal is for them to condition their bodies to respond automatically when things go awry inside.

"Their systems learn to self-regulate," says psychologist Steven Baskin, PhD, president of the Association for Applied Psychophysiology and Biofeedback. Baskin says about half of headache sufferers, including those who get migraines, experience at least a 50 per cent reduction in symptoms after a course of biofeedback - a success rate similar to those of the best preventive drugs.

Biofeedback can also teach you to control brain waves, heart rate, breathing, and even perspiration. But it isn't for everyone. You "have to be very motivated or it won't work," says urologist E. Ann Gormley of Dartmouth-Hitchcock Medical Centre in Lebanon, New Hampshire.

She frequently refers women with urinary incontinence to a biofeedback therapist to help them "find" their pelvic floor muscles, so they can exercise and strengthen them.

The popularity of biofeedback has waxed and waned over the years, but Baskin thinks the therapy is enjoying a renaissance, possibly because of the interest in gentler, more natural remedies. It's a promise that's hard to resist: the ability to control the inner workings of your body with a form of brainpower.

Hypnotherapy

What it's best for : Pain and anxiety (especially during surgery and labour), as well as breaking bad habits.

May also help : Addiction, stomach problems, and headaches

Now it works : You will not fall asleep. You do not become a zombie. And chances are. you will remember everything the theraqist said when it's over.

A stage hypnotist may put an audience member into a trance and convince him or her to bark like a dog; then the performer snaps his fingers and - presto! - the volunteer wakes up, unaware of why the crowd is laughing. But in a psychologist's office or a surgical suite, hypnotherapy is a much more powerful tool. While skeptics claim that hypnosis simply puts you to sleep, brain scans of people who have been "induced" show different patterns than those of someone who is dozing. Interestingly, the part of the brain that shows the most activity during hypnosis is the one that governs vision. "That suggests that if you can imagine certain things in your mind, the body starts to respond as though they are really happening," says psychologist Marc Oster, PsyD, a spokesman for the American Society of Clinical Hypnosis.

In a typical 60- to 90-minute session, the therapist speaks softly to help you become deeply relaxed and focused, to the point of ignoring all distractions. Once you reach a state of hyperconcentration, the therapist makes suggestions, such as saying to a smoker, "Cigarettes are poison for my body." These recommendations can alter the way you think and behave. For instance, an analysis of nearly 50 studies found that hypnosis helps smokers break the habit successfully in 36 percent of cases, while prescription medication helps just 17 per cent of would-be quitters.

Most people can be hypnotized to some degree, though it helps if you have a vivid imagination and are the type who easily becomes absorbed in books or movies, says Elvira Lang, MD, of Boston's Beth Israel Deaconess Medical Centre. As an interventional radiologist, which means she inserts catheters into blood vessels to correct blockages or starve tumours of blood, among other things, Lang frequently hypnotizes patients first by asking them to imagine floating in a safe, comfortable place.

Those procedures can be nerve-wracking for patients, but in a study published in the medical journal The Lancet, Lang found that people who were hypnotized needed only half as much medication for pain and anxiety, had fewer complications, and recovered faster.

Far from feeling out of control, many of her patients say they're proud to have participated in their own treatment. "Patients often feel quite accomplished," she says.

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