PRACTICE OF ACUPUNCTURE IN FUNCTIONAL READAPTATION

P. SAUTREUIL
 

Acupuncture is remarkable in that it is an age-old medicine, dating back to ancient Chinese times, and a component of our modem technological medicine.

It opens up new tracks for our scientific medicine in semeiology, physiopathology and therapeutics.

Transmitted from. master to disciple over the generations, it has been taught in our country for the past fifty or so years.

For my part 1 have integrated components of acupuncture in my physical medicine and readaptation consultations (extemal, hospital) for the treatment of muscular osteoarticular pathologies and more specifically those concerning the rachis (cervicalgias, neuralgias cervicobrachialgias, lumbalgias, lumbosciatalgias, adult scolioses ... ) of degenerative or traumatic origin.

The description of his pain by the patient is the key moment of the clinical examination.

The diagnosis is based partly on the search for a 'cellular-teno-myalgic' syndrome (Robert Maigne, Hôtel Dieu, Paris) and for trigger points (most often bundles of contractured muscular fibre) as well as on the palpation of acupoints and of meridians.

The clinical examination should find the pain described by the patient. This corresponds to the pragmatic Chinese search for ah-shi points ('ah shi' meaning 'that's it' in Chinese, that's where it hurts).

Biological and above all radiological examinations are made whenever necessary.

The therapeutic stage is based on muscular relaxation techniques and on a local, loco-regional and someti-mes general use of acupuncture needles (sterile, throwaway).

The needle is inserted at the acupoint or the painful point to a depth which depends on the clinical locating. It is then manipulated with altemating rotation and in depth so as to obtain the 'de qi', the specific pain which leads to the following dialogue during a consultation in China: Yo ma?: 'Do you have it?' (meaning, do you feel the pain?)

-'Yo!': 'Yes 1 do'.

Concordance of the three pains-that felt spontaneously by the patient, that found on examination and that caused by the needle, in their forms and even in their intensity---ensures therapeutic efficacy.

Depending on the clinical practice, these local points are combined with regional or general master points.

In the specific context of my hospital practice, I currently do not use either electric stimulation or moxibustion* (burning dried artemesia sticks).

The nuraber of sessions varies from 3-5 to 10. 'Booster' sessions are sometimes necessary when the disease is chronic. The rhythm depends on the clinical practice and the impact of the therapy. These routine sessions can take place every month, two months, three months...

A certain number of patients, especially with lumbosciatalgias, receive treatment in a pluridisciplinary framework associating a physiotherapist, ergotherapist, psychologist, psychiatrist and sometimes a social worker. This way of operation is quite specific to the physical medicine and readaptation departments in France.

* Zhen Jiu corresponds, in China, to the indissociable combination of acupuncture (zhen) and moxibustion Giu).

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