Journal of Bone & Joint Surgery - American Volume:
This book by Baldry, who is the president of the Acupuncture Association of Chartered Physiotherapists, consists of three sections. The first section, which is extremely well done, provides a historical review of acupuncture and gives some background as to its basis, which is the concept that musculoskeletal pain is referred from a focus of neural hyperactivity known as a trigger point. It is thought that insertion of a needle into those tissues will stimulate the A-delta medium-diameter myelinated nerve fibers in the vicinity and thereby relieve pain. This is the principle on which the recently developed Western approach to trigger-point acupuncture is based.
In the second section, the principles of trigger-point acupuncture are discussed in eight well written chapters that provide an extensive review of the literature. I found all of these chapters very interesting and derived a much better understanding of the neurophysiology of pain, trigger points, and the electrical stimulation of peripheral nerves. This is not to say, however, that one must accept all of the conclusions that Baldry draws from his review. The final chapter in this section, “Scientific Evaluation of Acupuncture,” concerns methods of performing a scientific study that would be relevant for any new treatment. This chapter will be extremely informative for anyone who provides care that does not quite fall within the boundaries of the standards of care for his or her particular field of medicine.
The final section, which describes the application of trigger points for specific problems, is more of a “how-to” section.
Over-all, this book should be of interest to those who manage patients who have chronic pain and to general practitioners, who are the gatekeepers of medical care. Baldry makes a good case for the use of acupuncture, and he seems to be conservative and reasonable in his approach.
Leela Rangaswamy, M.D.