RESUMO
Objective: Magnetism has been known for >4,000 years. Recently static multipolar magnets have demonstrated analgesic clinical usefulness. Local application of magnets may be beneficial in reducing musculoskeletal pain, particularly when other modalities have failed. A recent series of clinical cases demonstrates how multipolar magnets may be incorporated as an effective adjunctive treatment in an acupuncture clinic. Materials and Methods: PubMed database was searched using the key words: magnets, medical magnets, magnets and pain management, therapeutic magnets, multipolar magnets, and history of magnet therapy. In addition, clinical cases were submitted by 4 different medical acupuncturists as examples of how the use of multipolar magnets is incorporated into an acupuncture clinic. Results: Over the past 20 years, 143 articles fulfilled the search criteria and unfortunately demonstrated considerable variability in research methodology. Magnetic tapes, needles, and beads of various magnetic strengths constituted the stimulating apparatus with durations ranging from minutes to years. This article highlights 10 cases, 9 of which reflected situations in which the use of 1 or more multipolar magnets provided an enhanced analgesic effect, often when traditional acupuncture had either failed to produce a satisfactory response or when the application of acupuncture needles needed to be limited. Conclusion: Despite the variability of the literature review, it appears that magnetism is related to pain reduction, and when properly employed, it can be an effective and safe modality as demonstrated by a recent series of cases submitted from the practices of 4 different medical acupuncturists. A clinical trial incorporating the latest technology of multipolar magnets with steep field gradients should be initiated for the more formal investigation of magnet-induced analgesia.
RESUMO
Introduction: Complementary and integrative medicine (CIM) use in the USA continues to expand, including within the Military Health System (MHS) and Veterans Health Administration (VHA). To mitigate the opioid crisis and provide additional non-pharmacological pain management options, a large cross-agency collaborative project sought to develop and implement a systems-wide curriculum, entitled Acupuncture Training Across Clinical Settings (ATACS). Materials and Methods: ATACS curriculum content and structure were created and refined over the course of the project in response to consultations with Subject Matter Experts and provider feedback. Course content was developed to be applicable to the MHS and VHA environments and training was open to many types of providers. Training included a 4-hr didactic and "hands on" clinical training program focused on a single auricular acupuncture protocol, Battlefield Acupuncture. Trainee learning and skills proficiency were evaluated by trainer-observation and written examination. Immediately following training, providers completed an evaluation survey on their ATACS experience. One month later, they were asked to complete another survey regarding their auricular acupuncture use and barriers to use. The present evaluation describes the ATACS curriculum, faculty and trainee characteristics, as well as trainee and program developer perspectives. Results: Over the course of a 19-mo period, 2,712 providers completed the in-person, 4-hr didactic and hands-on clinical training session. Due to the increasing requests for training, additional ATACS faculty were trained. Overall, 113 providers were approved to be training faculty. Responses from the trainee surveys indicated high satisfaction with the ATACS training program and illuminated several challenges to using auricular acupuncture with patients. The most common reported barrier to using auricular acupuncture was the lack of obtaining privileges to administer auricular acupuncture within clinical practice. Conclusion: The ATACS program provided a foundational template to increase CIM across the MHS and VHA. The lessons learned in the program's implementation will aid future CIM training programs and improve program evaluations. Future work is needed to determine the most efficient means of improving CIM credentialing and privileging procedures, standardizing and adopting uniform CIM EHR codes and documentation, and examining the effectiveness of CIM techniques in real-world settings.
Assuntos
Terapia por Acupuntura/métodos , Comportamento Cooperativo , Medicina Integrativa/educação , Ensino/normas , Currículo/normas , Currículo/tendências , Atenção à Saúde/métodos , Atenção à Saúde/tendências , Humanos , Medicina Integrativa/métodos , Medicina Militar/métodos , Medicina Militar/tendências , Militares/educação , Militares/estatística & dados numéricos , Desenvolvimento de Programas/métodos , Ensino/estatística & dados numéricos , Estados Unidos , United States Department of Defense/organização & administração , United States Department of Defense/estatística & dados numéricos , United States Department of Veterans Affairs/organização & administração , United States Department of Veterans Affairs/estatística & dados numéricos , Veteranos/educação , Veteranos/estatística & dados numéricosRESUMO
Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a number of military medical facilities throughout the Department of Defense (DoD). It has been used with anecdotal published positive impact with warriors experiencing polytrauma, post-traumatic stress disorder, and traumatic brain injury. It has also been effectively used to treat warriors with muscle and back pain from carrying heavy combat equipment in austere environments. This article highlights the history within the DoD related to the need for nonpharmacologic/opioid pain management across the continuum of care from combat situations, during evacuation, and throughout recovery and rehabilitation. The article describes the history of auricular acupuncture and details implementation procedures. Training is necessary and partially funded through DoD and Veteran's Administration (VA) internal Joint Incentive Funds grants between the DoD and the VA for multidisciplinary teams as part of a larger initiative related to the recommendations from the DoD Army Surgeon General's Pain Management Task Force. Finally, Uniformed Services University of the Health Sciences School of Medicine and Graduate School of Nursing faculty members present how this interdisciplinary training is currently being integrated into both schools for physicians and advanced practice nurses at the Uniformed Services University of the Health Sciences. Current and future research challenges and progress related to the use of acupuncture are also presented.