It is quite common these days to hear about people turning to
acupuncture as a last resort for relief from chronic health problems. The
popularity of alternative therapies such as acupuncture is variable among
developed countries, but public demand is strong and growing. In recent surveys
published in the Journal of American Medical Association (1998), the
percentage of the public reporting use of at least one alternative therapy in
the U.S. increased from 38 % in 1990 to 42 % in 1997. Estimates available
from Europe show the corresponding percentage to be much higher, particularly
for acupuncture and homeopathy (British Medical Journal, 1994). A few
years ago, the Food and Drug Administration estimated that 9 to 12 million
acupuncture treatments were being performed annually, and this estimate is
surely much higher now.
Acupuncture was developed by the Chinese and has been in use for more than 3000 years. The practice is part of a larger integrated system, the Traditional Chinese Medicine (TCM) system. Simply put, acupuncture is performed by stimulating designated points on the body—through the insertion of needles, finger pressure, the application of heat, or a combination of all these treatments.
Network of energy
In its first encounters with acupuncture, Western medicine was
understandably suspicious, since explanations of exactly how the procedure works
are bound up in seemingly mysterious concepts formulated 3000 years ago.
However, in light of recent advancements in understanding the neurophysiology of
pain—and scientific explanations of how acupuncture relieves it—suspicion is
giving way to tolerance and acceptance.
Findings emerging from both basic science and epidemiological research have been encouraging, since many studies have shown the potential usefulness of acupuncture. Some studies, however, have provided equivocal results because of methodological problems in conducting acupuncture research.
To address important research issues, the National Institutes of Health (NIH) Office of Alternative Medicine organized a 2 ½ week conference on acupuncture that took place in November of 1997. The panel concluded that research shows promising results in favor of acupuncture in both the treatment of nausea associated with chemotherapy and post-operative situations, as well as with post-operative dental pain. The panel also pointed to sufficient evidence that acupuncture may be a useful adjunct in the treatment of a variety of other conditions.
The way acupuncture works neurologically is also rapidly becoming apparent, speeding up its acceptance into traditional medicine. Needles used in acupuncture activate small nerve fibers in the muscle, which transmit impulses to the spinal cord and activate centers in the central nervous system, releasing a variety of neurotransmitters. Pain relief, for example, is mediated by the release of opioid-like substances. Although much still needs to be learned, the emergence of biological plausibility for the therapeutic effects of acupuncture is certainly encouraging.
While skeptics argue that acupuncture mediated response might be due to placebo, several reviews have concluded that it is more effective than placebo, indicating that it has a genuine physical effect.
In 1996, after careful review of acupuncture knowledge and
research, the Food and Drug Administration (FDA) removed acupuncture needles
from the category of “experimental medical devices.” This means that
acupuncture is no longer considered to be experimental in nature.
In my practice, I see patients who suffer from chronic painful debilitating medical problems. Many view the conventional health care system with skepticism and wonder why they could not be helped. Eventually, they turn to acupuncture to find relief from pain and other troublesome symptoms.
Supporters of acupuncture claim that this remedy is more
accessible, and less expensive, than conventional medicine. Also, the
effectiveness of conventional treatments is limited in treating chronic health
problems. Chronic pain is a case in point. For example, treatment of pain
associated with osteoarthritis and fibromyalgia with non-steroidal
anti-inflammatory drugs (NSAIDS) is seldom beneficial. Additionally, patients
are concerned about side effects associated with surgery and conventional
medications. An article in the Journal of the American Medical Association (1998)
estimates there are 100,000 deaths each year in U.S. hospitals caused by
Patients who seek acupuncture are mainly those who suffer from long-standing chronic problems such as back and neck pain, headaches and migraines, arthritis, cancer, neurological disorders, anxiety, and depression. These problems strike women more than men, which could certainly explain why currently more women are using acupuncture than men.
Conventional healthcare providers are beginning to view acupuncture as an effective complementary modality to conventional care, and its use is being recommended more and more. Acupunture is also gaining a reputation for efficacy, and as an attractive drug- and surgery-free option for many patients. An extensive review of studies has shown that acupuncture is effective for the following conditions:
Acupuncture is done with extremely thin, flexible needles made
of steel metal alloy. There is nothing special about the needle itself; it is
merely a tool used to correct the energy imbalance in the body (or to release
neurotransmitters). There is often a brief pricking sensation when the needle
passes through the skin. As the needle begins to work and effects begin to
occur, the patient may feel numbness, heat, dull aching or a tingling sensation
in the vicinity of the needle insertion. Generally, the needles are left in
place for about 15 to 30 minutes. They may be rotated by the practitioner or
stimulated by electricity or heat. Most side effects associated with acupuncture
are minor and transient. They include occasional dizziness, light-headedness,
and very slight bleeding after needles are withdrawn. Infection and other
serious side effects such as lung puncture are rare. Patients should always
insist that the acupuncturist use sterile and disposable needles to avoid the
risk of infectious diseases such as Hepatitis B and AIDS.
It is reported that several thousand Americans receive acupuncture treatments each year. Access to qualified practitioners is of paramount importance. The health care systems should facilitate and allow for effective communication between acupuncturists and conventional health care providers, since integrating acupuncture with conventional care will better serve the interests of our patients.
Finding an acupuncturist in your area
Integrating conventional and acupuncture
methods of care
Acupuncture shows promise as one of the many healthcare options available to patients. Its role as an adjunct in the management of a select number of conditions, particularly chronic pain, should be explored. Its use should be given serious consideration, particularly by persons who are concerned about the efficacy and side effects of surgery or medications for pain relief.
While it is not being suggested that acupuncture provides a cure for all problems, there is sufficient evidence that, if appropriately used, this discipline of medicine can successfully complement conventional treatments so as to provide patients with the best healthcare available.