Acupuncture originates from China and has been practiced there for thousands of years. Although there are records of acupuncture being used hundreds of years ago in Europe, it was during the second half of the twentieth century it began to spread rapidly in Western Europe, the United States and Canada.
Acupuncture involves the insertion of very thin needles through the patient's skin at specific points on the body - the needles are inserted to various depths. The medical community is not in conclusive agreement about how acupuncture works scientifically. However, we do know that it does have some therapeutic benefits, including pain relief and alleviation from nausea caused by chemotherapy.
According to traditional Chinese medical theory, acupuncture points are located on meridians through which gi vital energy runs. There is no histological, anatomical or scientific proof that these meridians or acupuncture points exist. Acupuncture remains controversial among Western medical doctors and scientists.
Creating case studies that use proper scientific controls is difficult because of the invasive nature of acupuncture - a clinical study involves a placebo (sham product) compared to the targeted treatment. It is very hard to devise a sham acupuncture control that one can compare to proper acupuncture. While some studies have concluded that acupuncture offers similar benefits to a patient as a placebo, others have indicated that there are some real benefits. This article in a peer-reviewed British Medical Journal explains that the principles of acupuncture are firmly grounded in science, and you don't need Chinese philosophy either to make it work, or to practice it.
According to WHO (World Health Organization) acupuncture is effective for treating 28 conditions, while evidence indicates it may have an effective therapeutic value for many more. People with tension headaches and/or migraines may find acupuncture to be very effective in alleviating their symptoms, according to a study carried out at the Technical University of Munich, Germany. Another study at The University of Texas M. D. Anderson Cancer Center found that twice weekly acupuncture treatments relieve debilitating symptoms of xerostomia - severe dry mouth - among patients treated with radiation for head and neck cancer.
How does acupuncture work?
Traditional Chinese medicine explains that health is the result of a harmonious balance of the complementary extremes of yin and yang of the life force known as gi or chi. Qi is said to flow through meridians (pathways) in the human body. Through 350 acupuncture points in the body, these meridians and energy flows may be accessed. Illness is said to be the consequence of an imbalance of the forces. If needles are inserted into these points with appropriate combinations it is said that the energy flow can be brought back into proper balance.
In Western societies and several other parts of the world, acupuncture is explained including concepts of neuroscience. Acupuncture points are seen by Western practitioners as places where nerves, muscles and connective tissue can be stimulated. Acupuncture practitioners say that the stimulation increases blood flow while at the same time triggering the activity of our own body's natural painkillers.
How did acupuncture become popular in the USA?
James Reston, who worked for the New York Times had his appendix removed (appendectomy) during a visit to China in 1971. After surgery he experienced some discomfort and was treated for this with acupuncture. He was surprised to find that the acupuncture treatment helped his discomfort tremendously. He subsequently wrote an article that year titled "Now, About My Operation in Peking". Many believe this article triggered intense interest in acupuncture in the USA.
Reston wrote that the acupuncturist "inserted three long, thin needles into the outer part of my right elbow and below my knees and manipulated them...That sent ripples of pain racing through my limbs and, at least, had the effect of diverting my attention from the distress in my stomach. Meanwhile, Doctor Li lit two pieces of an herb called ai, which looked like the burning stumps of a broken cheap cigar, and held them close to my abdomen while occasionally twirling the needles into action. All of this took about 20 minutes, during which I remembered thinking that it was rather a complicated way to get rid of gas... but there was a noticeable relaxation of the pressure and distension within an hour and no recurrence of the problem thereafter."
However, a search in The New York Times shows that acupuncture was first reported in 1854, and about once yearly until 1971.
How is acupuncture treatment carried out?
Acupuncture generally involves several weekly or fortnightly treatments. Most courses consist of up to 12 sessions. A visit to an acupuncturist will involve an exam and an assessment of the patient's condition, the insertion of needles, and advice on self-care. Most sessions last about 30 minutes.
The patient will be asked to lie down, either face-up, face-down or on his/her side, depending on where the needless are inserted. The acupuncturist should use single-use disposable sterile needles. As each needle is inserted the patient should feel them, but initially without pain. However, when the needle reaches the right depth there should be a deep aching sensation. Sometimes the needles are heated or stimulated with electricity after insertion. Once inserted, the needles will remain there for about twenty minutes.
What are the health benefits and risks of acupuncture?
All therapies have benefits and risks.
The possible benefits of acupuncture are:
- When performed correctly it is safe
- There are very few side effects
- It is a very effective combination treatment
- It is effective in controlling some types of pain
- It may be considered for patients who do not respond to pain medications
- It is a useful alternative for patients who do not want to take pain medications.
The possible risks of acupuncture are:
- It is dangerous if the patient has a bleeding disorder
- It the dangerous if the patient is taking blood thinners
- There may be bleeding, bruising and soreness at the insertion sites
- The needle may break and damage an internal organ (very rare)
- Unsterilized needles may infect the patient
- When inserted deeply into the chest or upper back there is a risk of collapsed lung (very rare).
Who may benefit from acupuncture treatment?
Even though acupuncture is commonly used on its own for some conditions, it is becoming very popular as a combination treatment by doctors in Western Europe and North America. The use of acupuncture to alleviate pain and nausea after surgery is becoming more widespread. Even the US Air Force began teaching "Battlefield Acupuncture" to physicians deploying to Iraq and Afghanistan in early 2009. Using acupuncture before and during surgery significantly reduces the level of pain and the amount of potent painkillers needed by patients after the surgery is over, a study revealed.
Acupuncture is also starting to make inroads into veterinary medicine. This article explains how a mare which had an infection in her ankle was treated by a vet at Virginia-Maryland Regional College of Veterinary Medicine at Virginia Tech with a combination of acupuncture and traditional therapy.
As more and more physicians accept acupuncture, a wider range of illnesses and condition are being considered for acupuncture treatment. A study found that acupuncture may help indigestion symptoms commonly experienced by pregnant women.
Some studies have revealed that there are conditions for which acupuncture appears to have no beneficial effect. A study carried out by researchers at Daejon, Busan, South Korea, and Exeter, United Kingdom, found that acupuncture cannot be shown to have any positive effect on hot flashes during the menopause. However, acupuncture does offer effective relief from hot flashes in women who are being treated with the anti-estrogen tamoxifen following surgery for breast cancer, another study found.
As it is very difficult to devise clinical studies that measure the effectiveness of acupuncture against a placebo, it is hard to create a definitive list of conditions in which acupuncture may be effective. However, some studies have indicated that acupuncture may help in treating low back pain (according to the SPINE trial), fibromyalgia (Mayo Clinic trials), migraines, post-operative dental pain (the Cochrane review), hypertension (Center for Integrative Medicine at UC Irvine study) and osteoarthritis (according to researchers at the University Medical Center in Berlin, Germany), as well as chemotherapy-induced nausea and vomiting. Other studies have shown that acupuncture may help women with painful periods. A Cochrane trial found that although acupuncture helps people with headaches, fake acupuncture also seems to help them.
Exercise and electro-acupuncture treatments can reduce sympathetic nerve activity in women with polycystic ovarian syndrome, a study found.
In a controlled experiment with rats, acupuncture was effective against treating chronic stress, according to a report in the journal Endocrinology - with the results suggesting a mode of action similar to that of anti-anxiety and antidepressant drugs.
Treating children with chronic pain is challenging; there is limited evidence on the efficacy of pain-relieving therapies among this population. But according to new research, acupuncture may be a safe and effective treatment strategy.
Fibromyalgia affects an estimated 5 million Americans, 80-90% of whom are women. The disorder is characterized by widespread pain and diffuse tenderness. Although there is no cure, tailored acupuncture might provide some welcome respite, according to a new study.