Pinpointing the pain

Health Editor Barry Nelson investigates.

THE traditional Chinese art of acupuncture has always fascinated westerners. But the sight of someone's back, arm or leg bristling with dozens of long needles is one that often alarms - or at least unsettles - the average Brit.

Surely it flies in the face of common sense to believe that turning someone into a human pin-cushion can help ease pain or treat some other condition?

This suspicion that something very odd is going on is only confirmed by the esoteric Chinese terms often used by those who practise this ancient healing tradition, which dates back 3,000 years. Ying and yang. . . tongue diagnosis. . . Five Elements. . . balanced energy. . . all are unfamiliar oriental phrases, steeped in Eastern mysticism.

But increasing numbers of UK doctors, nurses and other therapists are turning to acupuncture as a practical way of treating a range of conditions, notably controlling pain - and many patients are reporting immediate and lasting relief from symptoms.

Many practitioners still work within the traditions of Chinese acupuncture and continue to use the methods of diagnosis that would be familiar to practitioners who lived centuries ago. But in recent years a significant number of doctors and nurses are turning to a stripped-down form of acupuncture which its founders say is based on the western values of medical science, rather than obscure Chinese philosophical concepts.

The objective - scientific value of acupuncture as a treatment technique - was finally confirmed as recently as April last year when researchers at University College London and Southampton University reported that they had proved that acupuncture works in its own right. Experiments which involved scanning the brains of patients receiving treatment for arthritis pain showed that an area thought to be associated with pain control was affected during acupuncture.

Last week The Northern Echo exclusively revealed that Darlington Memorial Hospital has become one of only two centres in the UK to train medics and nurses in the techniques of 'western acupuncture'.

As a result, the Darlington pain clinic has been described by the founder of western acupuncture, George Nieman, as "now one of the best in the country". This development is likely to see more and more North-East doctors and nurses practising acupuncture as a matter of routine.

So what is behind this move which looks set to revolutionise some aspects of healthcare in the region - particularly the control of chronic pain?

Until the Darlington training centre was set up last year, the only place in Britain where western-style acupuncture was taught was at Broadgreen Hospital in Liverpool. The reason why Merseyside played such an important part in this trend was down to Mr Nieman, a former nurse who became one of the UK's first acupuncture practitioners after seeing acupuncture in use in Canada.

Back in the 1960s, when Liverpool was becoming the centre of international Beatlemania, Mr Nieman started practising in Rodney Street, known as the Harley Street of Merseyside.

Trained in traditional Chinese acupuncture techniques at a Taiwanese hospital - the only way in those days -Mr Nieman was intrigued by the idea of being able to convince western doctors and nurses that acupuncture was a reliable, science-based technique.

On the back of UK-wide publicity, following a successful acupuncture trial in a national newspaper, which demonstrated that the technique really did help most of those treated for a variety of medical problems, Mr Nieman decided to try to set up a national training centre for westernstyle acupuncture.

The setting up of the British Academy of Western Medical Acupuncture in 1976 coincided with research by two scientists called Melzack and Wall who came up with a theory which suggested how acupuncture could interfere with pain pathways and be involved in the release of endorphins, 'feel-good' chemicals produced in the human body which can mimic the anaesthetising effect of opiates like morphine.

As the academy's own website states: "George had decided that there was a place for acupuncture in western medicine and that it would be possible to get away from some of the traditional mysticism of acupuncture and relate it directly to physiological change."

Mr Nieman was determined to get a better understanding of how acupuncture worked on the body and embarked on an intense period of research. "During my research, I found certain points in the human body that would match diagnosed conditions. Since that time we have built up a tremendous range of applications, which will suit many conditions, " says George, who at 76, is still president of the academy.

As more and more doctors and nurses applied to Mr Nieman to learn western acupuncture, the academy convinced bosses at Broadgreen Hospital that it would benefit patients if it was allowed to operate from the NHS site. "I worked there for five years, running a free weekly clinic to persuade them it worked, " he says.

Mr Nieman reckons that more than 1,500 people have been trained in western acupuncture techniques, many are working in the NHS. Others have gone abroad to spread the gospel.

The next step was to open a new satellite academy in Darlington.

"We get a lot of people coming here from the North-East. About three years ago we had a particularly enthusiastic group of doctors and nurses from Darlington on our course in Liverpool and it seemed a good idea open a second academy, " says Mr Nieman.

He is delighted that the Darlington academy has begun to train health workers, currently there are nine nurses from as far afield as Scotland and Sheffield who regularly return to the North-East to attend weekend training courses.

"They are doing very well at Darlington.

They are enthusiastic. . . it is really something to see, " says Mr Nieman.

The founder of western acupuncture is also upbeat about the wider prospects for the technique. "There has been a real breakthrough in recent years in the acceptance of acupuncture. We hope to expand the number of practitioners working in the NHS. We want to get them everywhere, " he says.

Dr 'Jambu' Jambulingam, one of two consultants working at Darlington Memorial Hospital's pain clinic, became a convert to acupuncture in 1998 when observing a now retired colleague, Dr David Bishop, using the technique to relieve pain.

"It's quite funny really, because I am actually frightened of needles, " says Dr Jambulingam, who works with his consultant colleague, Dr Hani Khalil.

When acupuncture helped him manage migraine to such an extent that he no longer had to routinely carry medication with him, he was convinced.

TWO of the leading lights in the academy are Sister Julie Hodgson and senior staff nurse Sarah Mooij, who are both course tutors. Sarah, who has using acupuncture on patients for about four years, is very impressed at its effects.

"We get a lot of people with chronic pain who are able to reduce or even stop medication altogether after acupuncture. A lot of people say their mobility improves, some say they sleep better and some are able to go back to work, " she says.

While the idea of inserting up to 40 stainless steel needles into your body alarms some people, most patients are open-minded and readily accept the treatment. "The needles are very fine. Sometimes there is a slight discomfort when they penetrate the skin but once they are in, you don't feel a thing, " she says.

Most patients are referred by GPs or other consultants. It usually takes six to eight one-hour sessions, usually once a week, to complete treatment.

Many people come back for booster session after eight weeks or so.

The clinic is hoping to increase the number of local doctors and nurses enrolling in the course to try to take the pressure off the increasingly popular service.

"We did have a nine-month waiting list but it is coming down now, " says Sarah.

Julie Hodgson is amazed at how far they have come so quickly. "Interest in accupuncture has exploded in the last five years, " she says. "It's great."