Who needs the PDR?

Only a few lines in this piece are about acupuncture, but I thought it was worth posting for the subject matter alone.  The thing they do not mention is that the PDR does not include drugs that are off patent, so it is basically a sales rep disguised as an important looking book.

8 drugs doctors wouldn't take
If your physician would skip these medicines, maybe you should, too
By Morgan Lord

With 3,480 pages of fine print, the Physicians' Desk Reference (a.k.a. PDR) is not a quick read. That's because it contains every iota of information on more than 4,000 prescription medications. Heck, the PDR is medication — a humongous sleeping pill. 

Doctors count on this compendium to help them make smart prescribing decisions — in other words, to choose drugs that will solve their patients' medical problems without creating new ones. Unfortunately, it seems some doctors rarely pull the PDR off the shelf. Or if they do crack it open, they don't stay versed on emerging research that may suddenly make a once-trusted treatment one to avoid. Worst case: You swallow something that has no business being inside your body. 

Of course, plenty of M.D.'s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, "Which medications would you skip?" Their list is your second opinion. If you're on any of these meds, talk to your doctor. Maybe he or she will finally open that big red book with all the dust on it.

Celebrex 
Once nicknamed "super aspirin," Celebrex is now better known for its side effects than for its pain-relieving prowess. The drug has been linked to increased risks of stomach bleeding, kidney trouble, and liver damage. But according to a 2005 New England Journal of Medicine study, the biggest threat is to your heart: People taking 200 mg of Celebrex twice a day more than doubled their risk of dying of cardiovascular disease. Those on 400 mg twice a day more than tripled their risk, compared with people taking a placebo.

Your new strategy: What you don't want to do is stop swallowing Celebrex and begin knocking back ibuprofen, because regular use of high doses of nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to gastrointestinal bleeding. A safer swap is acupuncture. A German study found that for people suffering from chronic lower-back pain, twice-weekly acupuncture sessions were twice as effective as conventional treatments with drugs, physical therapy, and exercise. The strategic needling may stimulate central-nervous-system pathways to release the body's own painkillers, including endorphins and enkephalins, says Duke University anesthesiologist Tong-Joo Gan, M.D.

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Competition!

Well, I knew it was bound to happen.  Doctors don't need acupuncture training to add it to their service list, chiropractors just assume they are qualified to be acupuncturists with or without a "certification course,"  and now physical therapists are getting in on the act!

Needling' Becoming More Popular To Treat Pain

DENVER (CBS4) ― Some physical therapists in Colorado are offering an alternative treatment for chronic muscle pain and stiffness.

On Tuesday, CBS4 health specialist Kathy Walsh sat in on a session of the new treatment called "trigger point dry needling."

Using very thin, solid needles to penetrate deep into areas of tension, dry needling promises to stimulate, reset and relax muscles.

One satisfied dry needling patient is Sgt. First Class Lee Holloway. According to Holloway, dry needling is an effective way to relieve muscle tension.

Although similar to acupuncture, Keil says that dry needling is actually its own distinct practice. 

"It's a very Western concept of muscle anatomy," said Keil. "As compared to the Eastern concept of the meridian through acupuncture."

Some licensed acupuncturists are skeptical of this claim.

The president of the Acupuncture Association of Colorado, Nancy Bilello, says dry needling is just a dubious form of acupuncture.

"Dry needling is the same thing as acupuncture with far less training and very little regulation," said Bilello.

While licensed acupuncturists must have a minimum of 1,800 hours of training, physical therapists hoping to practice dry needling require only 46 hours of training, according to Bilello,

Despite concerns like Bilello's, in 2005 the Colorado Department of Regulatory Agencies did approve dry needling for practice by trained physical therapists.

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