Analysis of “Acupuncture for Low Back Pain in Pregnancy”

Western doctors admittedly know little about acupuncture and with that lack of understanding comes apprehension and concern. In a British Medical Journal Acupuncture in Medicine, Mike Cummings’ article “Acupuncture for Low Back Pain in Pregnancy” critically discusses the benefits of practicing acupuncture on pregnant women, despite increasing litigations and various concerns voiced by prevalent doctors claiming that such a practice causes spontaneous early pregnancy loss. Through his own case study, the author uses deep paraspinal and periosteal acupuncture throughout a patient’s pregnancy at her insistence to help control her lower back pain, and documents his results to convince his audience of the safety of acupuncture during pregnancy. Through his use of questions, examples, organization, style, and graphics, Cummings effectively defends his belief that acupunctural treatment on pregnant women is both safe and reliable.

The author first poses questions to his audience to convey his personal feelings and to help his audience better identify with him. He establishes his firm ethical stance in this way by engaging the reader and illustrating his integrity as a medical professional. As an existing acupuncture patient, the woman in this study had been receiving acupuncture treatment for weeks before she revealed to Cummings that she was in fact pregnant. He then explained how he halted treatment due to the apprehension in his field about using acupuncture on a pregnant woman, but resumed treatment after exhausting every other option and after the request of the patient. Is “it ethically defensible” Cummings asks, “to withhold treatment on purely medicolegal grounds (i.e. the concern about being blamed for a coincidental adverse event in the pregnancy), when the patient, who was aware of the material risks, had made the decision to continue treatment?” (44). Other professionals in the medical field have asked this same question, and this issue about acquiescing patients' requests has been particularly tense in the UK. By posing this question, then, Cummings supports the choice to begin treatment on a consenting patient and presents a background where readers with prior biases will more easily agree with the author's treatment and accept his study. Coupled with the author’s earlier inhibitions about administering the treatment, questions such as these establish his ethos and helps persuade the reader to accept acupuncture as a safe and legitimate option for pregnant women.

Second, through describing his personal study as well as referencing other research presented on this topic, Cummings gives more legitimacy to his results. He logically attests that due to the nonoccurrence of any complications resulting from the administration of acupuncture to the pregnant woman in his study, acupuncture is therefore safe. To prove that his study is not an isolated incident, he further refers the reader to case reports and studies conducted by other doctors on pregnant women who also found this treatment to be a safe and effective treatment. These references include Wedenberg’s “A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy” and Thomas’s “Use of acupuncture for managing chronic pelvic pain in pregnancy.” Because the acupuncture Cummings prescribed did not cause any adverse effects on his patient, he concludes that this study, coupled with others’ research, provides conclusive evidence to dismiss the earlier claims that acupuncture begets abortions in pregnant women. With the evidence cleverly stacked in his favor, Cummings' audience is logically led to agree.

Furthermore, the article’s organization is deliberately chosen to accommodate quicker and more enjoyable reading. Cummings organizes his article chronologically, separating different ideas and events into paragraphs. This organizational style makes it easier for the reader to follow the study more naturally and provides more insight to the author’s feelings. The events are mostly grouped together by visitation, the first visit from the patient coming at the beginning, the second following that and so on, with a summary at the beginning of the article and a conclusion at the end. In this way, we learn as the author learns, and are more inclined to treat the presented case in its own light rather than applying any previous biases. Also, a notable foundation of trust is built as Cummings leads us through his mind and shares with us his experiences in a story-like manner. Readers feel like they are there with Cummings through every step of his study, hence drawing the audience closer to the text emotionally. Organizational arrangement is further apparent when Cummings introduces new topics. When presenting new information that he assumes the reader does not already know, Cummings laboriously elaborates on every fact that is applicable to the situation. These facts are then used as evidence to support his insights on the given subject in the following paragraphs. This format of new topic to description to explanation to supporting conclusion remains constant throughout his article. Presenting the facts before he gives his opinion helps to establish the author’s logos, as does his well-placed introduction of himself as a Medical Director at the beginning of the piece.

Although he refers to many other examples conducted in other hospitals throughout his paper, Mike Cummings uses just one first-hand example to describe his position. By using only one example in a story-like manner, the author appeals to our emotions by emphasizing the humanness of the patient. This kind of pathos used by Cummings helps us feel attached to the patient rather than citing many examples where each patient seems insignificant. Since the patient said she was experiencing severe pain, the audience begins to feel sorry for her. In this way, the author subtly persuades us to agree with the author to do something to help curb this horrible agony. Cummings expertly creates a singular, thoughtful story which presents an emotional aspect to his work that a statistical study could not have captured.

Most of the graphics Cummings uses in his article help illustrate the pain sites his patient describes and visually portray the severe nature of his patient’s condition. These visuals add a human element to make the article seem more genuine, and they serve to explain and supplement the text. He inserts them on the sides of the page forecast the topics soon to be explained. If a graphic appears on the left side of the page, for example, the audience can assume that topic will be discussed later on in that particular page. In this way, Cummings emphasizes important information not only by creating “landmarks” which make it easier to find particular topics, but also by illustrating concepts or ideas that might otherwise be hard to understand. The figure showing the areas of discomfort on the patient, for example, helps the audience know exactly where and to what extent the patient was experiencing her pain, and to emphasize the necessity of Cummings treatment to provide relief. The author utilized these visuals to present his information in a clear and systematic way, introducing his topic first, explaining it in words, then referring to the graphic in the text parenthetically so his audience would be able to understand and more fully internalize the text.

In his article, Mike Cummings uses a story about a pregnant woman who needed acupuncture in order to persuade his audience to question the predisposing suspicion that acupuncture causes abortions in pregnant women. By chronologically organizing his paper, including pictures, and referring to just one patient, the audience feels more emotionally attached to this case. The author offers emotional and logical evidence to support his belief that refusing treatment to a patient merely on unproven, superstitious beliefs is both unethical and archaic. Through effective use of questions, examples, organization, style, and graphics, this case study actively persuades its readers to disregard primitive and unfounded biases and acknowledge the research presented in this report.



Works Cited


Cummings, Mike. “Acupuncture for Low Back Pain in Pregnancy.” Acupuncture in Medicine 2003: 21;42-46. Print.