Acupuncture

What is acupuncture?

Acupuncture is the practice of puncturing the skin with needles at certain anatomical points in the body to relieve specific symptoms associated with many diseases. The anatomical points (acupuncture points) are thought to have certain electrical properties, which affect chemical neurotransmitters in the body.

Acupuncture is one of the oldest, most commonly used medical practices in the world. Originating in China more than 2,500 years ago, acupuncture gained attention in this country in the 1970s, when China and the US opened relations. The practice has been growing in popularity since. Interest in the U.S. was stimulated by James Reston's 1971 landmark article in the New York Times describing his experience with successful post appendectomy pain management using acupuncture needles.

According to theories of traditional Chinese medicine, the human body has more than 2,000 acupuncture points connected via pathways, or meridians. These pathways create an energy flow (Qi, pronounced "chee") through the body that is responsible for overall health. Disruption of the energy flow can cause disease. Acupuncture may correct these imbalances when applied at acupuncture points and improve the flow of Qi.

Acupuncture theories today are based on extensive laboratory research, and have become widely known and accepted. In addition, controlled studies have shown evidence of the effectiveness of acupuncture for certain conditions. At present in the United States, about 3,500 physicians and 11,000 to 12,000 non-physician acupuncturists use this medical art. About 40 acupuncture schools train non-physicians and about 500 to 600 physicians, according to the American Academy of Medical Acupuncture.

Approximately 3.1 million American adults have used acupuncture, and the numbers are growing, according to the National Center for Complementary and Alternative Medicine (NCCAM).

Acupuncture is not for everyone. If you choose to see an acupuncturist, discuss it with your physician first and find a practitioner who is licensed as having appropriate training and credentials.

What does acupuncture feel like?

Acupuncture is generally performed with metallic, solid, and hair-thin needles. Patients report different feelings associated with acupuncture, but most feel minimal pain as the needle is inserted. The needles is inserted to a point that produces a sensation of pressure or ache. Needles may be heated during the treatment or mild electric current may be applied to them. Acupuncture makes some people report feeling energized by the treatment, while others say they feel relaxed.

Improper placement of the acupuncture needle can cause soreness and pain during treatment. Needles must be sterilized to prevent infection. That is why it is important to seek treatment from a qualified acupuncture practitioner. The US Food and Drug Administration (FDA) regulates acupuncture needles just as it does other medical devices under good manufacturing practices and single-use standards of sterility.

Instead of needles, other forms of stimulation are sometimes used, including:

• Heat

• Pressure (acupressure)

• Friction

• Suction

• Impulses of electromagnetic energy

How does acupuncture affect the body?

Many studies have documented acupuncture's effects on the body, but none has fully explained how acupuncture works within the framework of Western medicine. Researchers have proposed several processes to explain acupuncture's effects, primarily on pain.

In general, acupuncture points are believed to stimulate the central nervous system, which, in turn, releases chemicals into the muscles, spinal cord, and brain. These chemicals either alter the experience of pain or release other chemicals that influence the body's self-regulating systems. These biochemical changes may stimulate the body's natural healing abilities and promote physical and emotional well-being.

Attention has been focused on the following theories to further explain how acupuncture affects the body:

• Conduction of electromagnetic signals Evidence suggests that acupuncture points are strategic conductors of electromagnetic signals. Stimulating these points enables electromagnetic signals to be relayed at greater-than-normal rates. These signals may start the flow of pain-killing biochemicals, such as endorphins, or release immune system cells to specific body sites.

• Activation of the body's natural opioid system Considerable research supports the claim that acupuncture releases opioids, synthetic or naturally-occurring chemicals in the brain that may reduce pain or induce sleep. These chemicals may explain acupuncture's pain-relieving effects.

• Stimulation of the hypothalamus and the pituitary gland Joined at the base of the brain, the hypothalamus and pituitary glands are responsible for many body functions. The hypothalamus activates and controls part of the nervous system, the endocrine processes, and many bodily functions, such as sleep, regulation of temperature, and appetite. The pituitary gland supplies some of the body's needed hormones. Stimulation of these glands can result in a broad spectrum of effects on various body systems.

• Change in the secretion of neurotransmitters and neurohormones Studies suggest that acupuncture may alter brain chemistry in a positive way. This is accomplished by changing the release of neurotransmitters (biochemical substances that stimulate or inhibit nerve impulses) and neurohormones (naturally-occurring chemical substances that can change the structure or function, or impact the activity of, a body organ).

Acupuncture and the National Institutes of Health

Clinical studies presented by the National Institutes of Health (NIH) have shown that acupuncture is an effective treatment for nausea caused by surgical anesthesia and cancer chemotherapy, as well as for dental pain after surgery.

The NIH also has found that acupuncture is useful by itself, or in combination with conventional therapies, to treat addiction, headaches, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, and to assist in stroke rehabilitation.

What conditions may benefit from acupuncture?

Many Americans seek acupuncture treatment for relief of chronic pain, such as arthritis or low back pain. Acupuncture, however, has expanded uses in other parts of the world. However, before considering acupuncture, consult your physician to discuss your current medical conditions, symptoms, and treatment options. Conditions that benefit from acupuncture include the following:

Considerations when choosing acupuncture

Because scientific studies have not fully explained how acupuncture works within the framework of Western medicine, acupuncture remains a source of controversy in the medical world. It is important, therefore, to take the precautionary steps listed below:

• Discuss acupuncture with your physician first to determine if the treatment is right for you. Acupuncture is not for everyone. Discuss all the treatments and medications (prescription and over-the-counter) you are taking. If you have a pacemaker, are at risk for infection, have chronic skin problems, are pregnant, or have breast or other implants, be sure to tell your physician. Acupuncture may be risky to your health if you fail to mention these matters.

• Do not rely on a diagnosis of disease by an acupuncture practitioner who does not have substantial conventional medical training. If you have received a diagnosis from a doctor, you may wish to ask him/her whether acupuncture might help.

• Choose a licensed acupuncture practitioner. Your own physician may be a good resource for referrals to a licensed or certified practitioner. Friends and family members may also be good sources of referrals. You do not have to be a physician to practice acupuncture or to become a certified acupuncturist. Approximately 35 states have established training standards for certification in acupuncture, although not all states require acupuncturists to obtain a license to practice. Although not all certified acupuncturists are physicians, the American Academy of Medical Acupuncture can provide a referral list of physicians who practice acupuncture.

• Consider costs and insurance coverage. Before beginning treatment, ask the acupuncturist about the number of treatments needed and how much the treatments will cost. Some insurers cover the cost of acupuncture while others do not. It is important to know before you begin treatment whether acupuncture is covered by your insurance.