July 28, 2011

Acupuncture is a medical treatment that has emerged from the naturalist school of thought in China over 2,000 years ago. It has been modified and perfected over the course of its existence and has been adapted by other cultures. Acupuncture is one part of a Chinese medical system based on the production and flow of Qi (pronounced “chi”), which may be described loosely as vital energy. Qi circulates through meridians and organs in an orderly fashion and it is the disruption in the production and flow of Qi that results in disease and pain. As a system of medicine quite different than the Western system, acupuncture has its own language and references to organs may be thought of as metaphorical when compared to the Western definition of organ function. Traditional acupuncture treatments consist of insertion of thin sterile needles at specific locations along the meridians. The exact locations used are determined by a careful assessment by the acupuncturist or the patient and the problem being treated. This assessment involves questioning, observation of the patient, assessment of the pulses and tongue, and locating areas of tenderness on examination through palpation. In essence, a history and physical exam similar to that done in Western medicine is performed, but with a different emphasis. Treatments are thus individualized, such that the same Western diagnosis may well be treated quite differently in different patients.

In Western countries, acupuncture has been primarily used to treat pain, but is increasingly receiving attention for treatment of other conditions. Due to the nature of the individualized treatments, acupuncture does not lend itself well to the constraints of controlled clinical studies, leading many Western trained physicians to doubt or underestimate its effectiveness. Despite these limitations, efforts to clarify the role of acupuncture are receiving more attention. A National Institutes of Health consensus panel has recently concluded that acupuncture is probably effective for postoperative and chemotherapy-induced nausea as well as postoperative dental pain. Further it was stated that acupuncture may be an acceptable alternative treatment for a number of other conditions including headache, menstrual cramps, low back pain, osteoarthritis, carpal tunnel syndrome, addiction, stroke rehabilitation, tennis elbow, fibromyalgia, myofascial pain, and asthma.

During an acupuncture treatment, needles are inserted at various points along a meridian. This usually involves the use of both local and distal points. A local point is a point at the location where the discomfort or pain is present. Distal points are chosen for their traditional effects and are distant from the location of pain. These acupuncture needles are extremely thin and solid—unlike the hollow needles used to draw blood.

Although treatments involve minimal discomfort, an aching or radiating sensation may be noted. This phenomenon of “De Qi” is often sought by the practitioner and is thought by many to be important for a treatment to be effective. Needles may then be manipulated manually or stimulated by low-level electricity. A smoldering herb may also be used to warm the needles in the technique known as moxibustion. As acupuncture has evolved, multiple different styles and approaches have emerged. one such approach involves the use of “reflex microsystems.” Reflex microsystems are localized areas of the body that have representations of the entire body within them. The most commonly used microsystem is the ear. Thus, for example, treatment of the ear can have effects on the entire body. other microsystems commonly used include the scalp and the hand. These are frequently stimulated in conjunction with other acupuncture treatments. In addition to the use of needles, stimulation of acupuncture points with lasers, magnets, and pressure show considerable promise.

A treatment may last up to 45 min and the patient not uncommonly experiences a sense of relaxed wellbeing following a treatment. Transient fatigue or euphoria is a less common effect. Other side effects that may be seen include bruising and pain at the needle insertion site, and a transient aggravation of the underlying problem. Of note, a mild increase in symptoms is often seen followed by improvement. Fainting may uncommonly occur, especially during a first treatment, but future treatments can usually be continued with caution. Serious complications are exceedingly rare, but could include bleeding, infection, and puncture of an organ. While one treatment may on occasion produce dramatic results, acupuncture is not magic, and usually 8-12 treatments are required. Periodic treatments may be necessary to maintain a response.

Acupuncture is used in conjunction with Western medicine and a recommendation to discontinue other treatments should be regarded with suspicion and discussed with your physician. Acupuncture practitioners may be medical doctors who have received further training in acupuncture, or licensed acupuncturists who also undergo extensive training. Further study should help further elucidate the role of acupuncture. For now it can be stated that acupuncture has been shown to be safe and effective for a number of conditions.

SEE ALSO: Back pain, Chronic pain, Headache, Pain


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