TCM acupuncture: How does it work?

Acupuncture is huge in Singapore. TCM doctors use it to regulate the flow of energy (Qi) by unblocking median points. Singapore General Hospital offers the traditional needling therapy as a pain management option.

Even medical doctors and dentists can undergo additional training to offer it in their practices!

In the latest Lancet Low Back Pain series, acupuncture is recommended as second-line treatment with other therapies such as spinal manipulation (chiropractic adjustment) and massage.

Maybe you are considering seeing a Traditional Chinese Medicine (TCM) physician for your chronic pain issues. Here is everything you need to know.

What are the benefits of acupuncture?

According to the British Acupuncture Council, World Health Organisation had published that acupuncture has been proven effective for conditions such as:

• Adverse reactions to radiotherapy and/or chemotherapy
• Induction of labour
• Knee pain
• Low back pain
• Rheumatoid arthritis
• Sciatica
• Sprain
• Tennis elbow

As you can see, quite a fair few of conditions relating to musculoskeletal conditions, which is also within the scope of practice for chiropractors and physiotherapists in Singapore.

When I looked up the traditional needling technique in the Cochrane Library:

• Neck Pain (May 2016): “Moderate‐quality evidence suggests that acupuncture relieves pain better than sham acupuncture”
• Cancer Pain (October 2015): “There is insufficient evidence to judge whether acupuncture is effective in treating cancer pain in adults”
• Fibromyalgia (May 2013): “Moderate-level evidence that the effect of acupuncture does not differ from sham acupuncture in reducing pain or fatigue, or improving sleep or global well-being”
• Osteoarthritis (Janurary 2010): “The effects of acupuncture relative to sham acupuncture are too small to be perceived by participants as beneficial”
• Lower Back Pain (January 2005): “Acupuncture is not more effective than other conventional and “alternative” treatments”

It seems like needling does help with neck pain. It is possible that it also works for low back pain.

However, it is unclear how useful acupuncture is for non-spine conditions.

What are the differences between acupuncture and dry needling?

Some of you may remember that I used to offer dry needling as a treatment in the past. I’ve since stopped that because current research/evidence doesn’t particularly support it.

Before we talked about the differences, perhaps it’s better to understand how are they similar. Both acupuncture and dry needling:

• Use very thin needles that are inserted into your body (i.e. pierces through the skin)
• Are used to help to relieve pain

Their differences?

Acupuncture follows Traditional Chinese Medicine principles. The acupuncture needles are inserted into acupuncture points typically to balance the energy state of the patient.

In dry needling, a physiotherapist or chiropractor will directly insert sterile needles into a muscle belly – often at the “trigger point” sites. Dry needling can also be performed by osteopaths and even some massage therapists or personal trainers.

In all applications, patients can expect to feel a deep, dull ache. Some described it as an increased in blood flow to the area.

Is dry needling evidence-based?

Many physiotherapists and chiropractors claim trigger point dry needling to be an evidence-based version of acupuncture.

While it is largely true that there’s more biological plausibility (i.e. scientifically possible) for dry needling to provide pain relief, there’s no research to suggest that it will help with long-term pain solutions.

The temporary symptom relief associated with dry needling is largely due to a neurophysiological change. That is an altered state in the nervous system. These changes are short-term. To some extend, it is no different from why it feels better when you rub your elbow after hitting it against a wall.

• July 2019: “The evidence for dry needling and cupping is not greater than placebo.“
• January 2018: “Moderate evidence showed that dry needling of myofascial trigger points, especially if associated with other therapies, could be recommended to relieve the intensity of low back pain at postintervention (meaning only short-term relief); however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear.”
• March 2017: “Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments … Evidence of long-term benefit of dry needling is currently lacking.”

You get the drift. Studies that show that dry needling are effective are generally of low or poor quality.

Most studies also agree that there is no research to support that dry needling is a long-term pain solution!

How much does acupuncture cost in Singapore?

Here is big question that most people ask: what are the fees and charges to see an acupuncturist in Singapore.

According to Ma Kuang and Eu Yan Sang, consultations start from $15 to $18 while acupuncture treatments cost between $30 to $80. In short, be prepared to spend around $45 to $100.

Raffles Medical Group charges a fixed $107 for acupuncture consultation + treatment.

As for the cost of dry needling in Singapore, expect to pay between $120 to $160.

Does acupuncture really work?

To be absolutely honest, there isn’t a lot of evidence to suggest it does. Likewise, there isn’t enough research to shows that it doesn’t.

Needling therapies are becoming popular with more and more patients seeking a complementary and integrative health approach to their pain management. People feel that integrative medicine may have more to offer than other conventional treatments such as medication.

The risks of acupuncture is fairly minimal and its side effects (e.g. post-needling soreness, mild bruising) tend to be fairly manageable.

If you are suffering from chronic pain and don’t mind trying treatments with shorter-lasting results, you may want to consider trying acupuncture or dry needling. For now research still strongly supports exercise and lifestyle changes over passive modalities (e.g. chiropractic adjustments, needling, massage).

If you are looking for a long-term pain solution, do consider giving our exercise-based approach a shot. To discover the difference the right care can make, book an appointment with us via the form below.