A noble cause?

[purpletigron]

Backstory: Mater has a chronic hip problem, and was refered for physio in April. When she was in hospital for other reasons in May, the in-patient physiotherapist told her, "Don't do your exercises until I see you", and then never saw her again. When she came home, we resumed out-patient physio, and in July, Mater was signed off with a list of exercises and a recommendation to try massage and acupuncture. She is still in chronic pain. A day clinic physiotherapist took her exercises for review, and never saw her again Yesterday, she had her first acupuncture treatment, and was told to expect to see any positive results emerging by the end of the month.

Today, Mater's excellent named nurse was back from leave (Yay!), and arranged a proper consultation with yet another physiotherapist for this afternoon.

The new physiotherapist has not discussed the out-patient physio exercises with Mater at all, has told her to cancel all acupuncture appointments, and has treated Mater with a TENS machine.

I'm livid at the presumption! My plan: talk to the acupuncturist, who seems to have a good understanding of the Western science behind modern acupuncture. Then talk to the named nurse. If necessary, talk to the new physiotherapist.

But I need to know: are acupuncture and TENS treatment mutually exclusive in any way?

Edit I've found a hint that TENS works in a similar manner to massage, and differently from acupuncture. Our acupuncturist also offers massage, but considers that Mater's ~80% likely to benefit significantly acupuncture, and only ~20% likely to do so from ordinary massage. (The out-patient physio said that deep-tissue massage would be too painful and stressful for Mater at the moment).

Comments

[redbird]

For what it's worth, one of the physical therapists I'm seeing (one practice, several people working there) uses both massage and the TENS unit. They all use TENS, ultrasound, and stretching.

[purpletigron.livejournal.com]

Interesting. Many of Mater's prescribed exercises are stretches. If your physical therapist is interested in expanding upon why massage and TENS are complementary, I'm interested in hearing :-)

[alexmc.livejournal.com]

one contracts muscles, the other stretches them.

At the limits of my biological knowledge...

[purpletigron.livejournal.com]

Ah, right - muscle act in pairs, and electrical stimulation can only produce contraction. So TENS can't stretch a muscle?

Re: At the limits of my biological knowledge...

[alexmc.livejournal.com]

That is my *guess*. I dont know how much TENS works on the muscles or merely the nerves.

In any event I can see that massage and TENS seems like a good idea. I dont know anything about acupuncture and TENS.

[yonmei.livejournal.com]

If necessary, talk to the new physiotherapist.

With a very large SWORD.

I'm livid at the presumption!

I would be, too. Grrr. That's outrageous.

PS: Someone was trying to track down a post of mine from earlier this year - the one quoting Tolkien, about stories being true - and as a result, I re-read it, getting more and more aghast. I still think I was right, but I was also intensely self-righteous, and, um, it looks less and less appealling in retrospect, especially as you ended up having to abandon the argument due to a tummy bug. Belated apologies.

[purpletigron.livejournal.com]

With a very large SWORD.

Exactly.

As for the truth of stories... no offence taken, and apology most willingly accepted :-)

[hobbitblue.livejournal.com]

Physiotherapists are by and large completely useless. Forest's actually complained to our doctor about him never attending appointments and refusing to see her - except the only time we ever got an appointment was a phone call at 9am saying, "Hello, we can fit you in at 10.30 today, is that ok?" and when he said no, that was too short notice, we never heard a thing again. Her idea of treatment for fibro was intense physical exercise. Ouch. Contra-indicated to the extreme.

Anyways, onto your mum, I think the acupuncture is the best plan, because if that works it *really* works, and the only way to find out is to try it. Massage will likely prove helpful at a later stage when things are loosened up some. TENS machines can be good, and are able to be used with other therapies, but the "buzzing" of the electric stimuli can get annoying after a while and its often tricky to get the electrodes in the correct place and the machine at the correct levels. Again though, if they work, they work, funny how so many of these things are a bit hit and miss, but always worth trying in case you get a hit. You might want to leave off trying TENS while having acupuncture however as you don't want too many variables: if her pain is helped, you'll not be sure which treatment was responsible.

[purpletigron.livejournal.com]

The appointments thing is a general problem in the NHS as far as I can tell :-( Mater's back problem seems to have responded well to physiotherapy, and it is definitely an excellent treatment for my knees. But I can definitely see how physiotherapists could be crap in other cases... too narrow in their understanding.

The acu/massage expert said the same thing - save the massage until later. The physiotherapist seems not to believe in acupuncture - and didn't bother to find out that Mater was suggested it by the last physiotherapist.

You might want to leave off trying TENS while having acupuncture however as you don't want too many variables: if her pain is helped, you'll not be sure which treatment was responsible.

If that's the only reason not to combine the treatments, then I think Mater should do both until the pain is easing, and then stop the TENS to see if it's the acupuncture which is helping or not. She's been in pain for long enough, and it's holding up the rest of her recovery. If she's not much improved by mid-September, she will probably have to back into hospital. So this is a crisis... What do you think?

[hobbitblue.livejournal.com]

f that's the only reason not to combine the treatments, then I think Mater should do both until the pain is easing, and then stop the TENS to see if it's the acupuncture which is helping or not.

Absolutely, main priority is getting the pain under control by whatever means possible - just wanted you to be aware of the variables thing as that's caught us out before, trying to work out which of a dozen things has been the most effective. But yep, try them both and then futz about with specifics later on.

[purpletigron.livejournal.com]

Quite. If only the new physio was as perceptive...

[alexmc.livejournal.com]

You may wish to speak to the_major.

That is funny because I would have assumed that acupuncture and TENS machines do very similar things - if perhaps using different methods.

From the link in my Edit

[purpletigron.livejournal.com]

"Rubbing [a.k.a. massage? Ed.] stimulates vibration receptors, sending signals to the dorsal horn via large diameter A-beta fibres. ... TENS stimulates the A-beta fibres, and acupuncture stimulates the A-delta fibres."

[purpletigron.livejournal.com]

I'm not sure if I've had the pleasure of meeting the_major in Real Life. Could you do the honours, perhaps?

[alexmc.livejournal.com]

Eastercon would be the only time I think but I dont remember you being at Eastercon this year. I'll send an email.

[alchemyangel351.livejournal.com]

Why are physiotherapists always so awful?

You seem to have all the technical details on TENS, so just to add that TENS is definitely safe to use in conjunction with acupuncture. I used both while in labour and had lots of information at the time, of course I can't find any of it now, but this http://www.medical-acupuncture.co.uk/journal/may1998/four.shtml suggests that acupuncture and TENS can be the best combined treatment for some patients (meaning actually simultaneuosly rather than separately).

These people http://www.bodyclock.co.uk/ hire and sell TENS so may be a little sales based, but I found their helpline quite useful a couple of years ago at answering questions about combinations.

[purpletigron.livejournal.com]

Many thanks!

[sammywol.livejournal.com]

I have a TENS machine left over from the natural birth that wasn't. I certainly heard of people using both acupuncture and TENS for labour but then I guess when there is that much pain people don't worry about cocktailing. If you want a TENS kit to use at home you can have mine. I'd be glad that someone was using it. Let me know.