17 November 2010
Acupuncture has been used as a treatment modality for over 3000 years in China and throughout Asia. While acupuncture does indeed have an ancient history, it has become both accepted and prescribed as an effective treatment for many painful conditions. Both the National Institute of Health and the World Health Organization has acknowledged acupuncture as an effective treatment modality for conditions involving pain and nausea.
The principle behind acupuncture involves a type of energy called qi. The qi flows along acupuncture channels or meridians of the body. There are 12 meridians on the body which are divided into two groups’ yin and yang, representing masculine and feminine. There are three yang meridians of the upper extremities, three yang meridians of the lower extremities, three yin meridians of the lower extremities, three yin meridians of the upper extremities. There are 8 additional meridians that are not designated yin or yang. Block ages and imbalances in the flow of qi result in disease and symptoms. The flow of qi can be corrected by inserting fine needles at specified points along the meridians.
Acupuncture was first in the spotlight of the American public in 1971. A New York Times reporter named James Reston was covering Henry Kissinger on a trip to China in 1971 and fell ill to acute appendicitis. His appendix was removed in a modern Chinese hospital using general anesthesia. However for his post surgical pain he was offered and accepted acupuncture to help alleviate his symptoms. He wrote an article in the NY Times July 25th 1971 detailing his experience.
Benefits: Scientific Evidence for procedure
NIH Consensus Conference on acupuncture in 1997 concluded; “There is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and encourage further studies of its physiology and clinical value.”
The mechanism of action for acupuncture has been studied leading to the current theories on how acupuncture is actually affecting the body regarding pain control. Current research suggests acupuncture can affect the neurotransmitters, resulting in an increase of endogenous opioates which influence pain sensitivity. There are three major types of endogenous opiates: beta endorphins, enkephalins and dynorphin. Beta endorphins are found primarily in the pituitary gland, and enkephalins and dynorphin are both distributed throughout the nervous system. With electroacupuncture frequencies of the electrical current can be altered to focus more a release of dynorphin or beta endorphin.
New research showed that adenosine plays a large role in the pain relieving benefits of acupuncture. Adenosine, a molecule that influences inflammation and sleep, also acts as an endogenous opiate. Using mice with injured paws, the scientists first demonstrated that adenosine was released during acupuncture. In mice that didn’t have adenosine receptors there was no relief from pain. A group of mice were given an approved leukemia drug that lengthens the amount of time that adenosine sticks around. With the drug, the animals experienced relief for three times as long: three hours instead of an hour.
Nat Neurosci. 2010 Jul;13(7):883-8. Epub 2010 May 30.Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture.
A 2006 Mayo study for fibromyalgia found that acupuncture significantly improved symptoms of fibromyalgia. Symptomatic improvement was not restricted to pain relief and was most significant for fatigue and anxiety.
Mayo Clin Proc. 2006 Jun;81(6):749-57. Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial. Martin DP, Sletten CD, Williams BA, Berger IH.
Gate Control Theory is another theory behind the effectiveness of acupuncture. This theorizes that acupuncture activates sensory receptors, which will block pain receptors and thus “gate out” painful stimuli.
Description of procedure:
Single use, sterilized, disposable needles are used in acupuncture. It is important to note acupuncture needles are solid and very thin which allows them to slide into the skin without pulling epidermis or foreign material into the body. The process of the treatment is typical not painful; most patients do not even feel the hair-thin needles as they are inserted or tapped in. In fact, many find the experience relaxing. Others become energized by the treatment. There are many subtle differences in styles and point selections. Traditional stimulation of the needles involves physical tapping, rotating, or warming the needles with incense called moxibustion. Electrical stimulation of the needles dates back to the 1930’s . Location of the acupuncture points typically involves some needles at the local area of involvement, but also at distal points related to the meridians that are involved. Typical treatment sessions lasts for about 20 – 30 minutes.
Risks:
Although every year we are gaining knowledge on how acupuncture works , it works in ways that we don’t fully understand. Acupuncture seems to be giving the body a physiological message utilizing neurotransmitters to help restore normal function, so that if there’s no need for a particular condition, acupuncture isn’t going to do anything. The adverse effects from acupuncture have been documented, and most of them predate the current use of single, sterilized, disposable needles. When sterile techniques are adhered to, then there are very few cases of adverse effects. There are also a few cases of needles being used by people who have been improperly trained, using them at depths that are inappropriate. The risks of acupuncture, in terms of negative effects are rare when performed by someone with proper training.
There are two main populations of people who do acupuncture. One population have the initials LAC, a licensed acupuncturist, and that’s someone who has graduated from an accredited acupuncture college and has taken and passed a national board exam. But, the other population of acupuncture practitioner consists of medical professionals; MD, DO, DC, or NP who have taken a special courses and are certified in acupuncture.
Links:
Accreditation Commission for Acupuncture & Oriental Medicine (ACAOM): www.acaom.org
American Association of Acupuncture and Oriental Medicine AAAOM: www.aaaomonline.org
Acupuncture and Integrated Medicine Specialists (AIMS): www.aimsaction.org
International Acadamy of Medial Acupuncture(IAMA): www.iama.edu
National Acupuncture Foundation: www.nationalacupuncturefoundation.org
National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM): www.nccaom.org
National Center for Complementary and Alternative Medicine: www.nccam.nih.gov
Society for Acupuncture Research: www.acupunctureresearch.org
