Acupuncture

Acupuncture

Acupuncture is an important component of Traditional Oriental Medicine (TOM) that involves the insertion of thin needles at specific points (acupoints), which are primarily located along meridians. The TOM theory of acupuncture is based in part on the premise that there are patterns of energy flow composed of Qi (pronounced chee) throughout the body. This energy flow is required for good health; blockages in Qi lead to pain and ill health. (All traditional oriental medicine practices are focused on improving the flow and balance of Qi.) Thus, according to TOM practitioners, the use of acupuncture stimulates certain points in the energy channels, restoring (or maintaining) a healthy flow and balance. TOM practitioners use acupuncture to treat and prevent a range of conditions and illnesses, even colds and flu. In the U.S., one of its most common uses is to relieve pain, but it is also used for a host of other conditions ranging from ear, nose and throat disease to neurological and respiratory problems and even depression. Acupuncture may be the only intervention used, or it may be used in conjunction with other Oriental therapies such as herbs, or with more conventional therapies.

Acupuncture as a therapeutic intervention is widely practiced in the United States. An estimated 15 million Americans have undergone acupuncture, and about five million undergo the treatment each year. People may find the procedure painless, although some points in some patients may be quite sensitive. Depending on your practitioner, the needles may be twirled or warmed.

Widely practiced around the world, especially in Asia (the practice originated in China) and Europe, acupuncture didn't gain a notable following in the U.S. until the 1970s, after President Richard Nixon's visit to the People's Republic of China. James Reston, a member of the press corps accompanying Nixon, also piqued public interest when he wrote about how physicians in Beijing eased his post-surgery abdominal pain with needles. Acupuncture has been gaining popularity in the U.S. ever since.

The National Institutes of Health (NIH) has given a big boost to acupuncture, holding that it is safe and, for some conditions, proven effective. The NIH has funded a variety of research projects relating to the safety and effectiveness of acupuncture. (See the "Research" section of this report). An NIH panel found that acupuncture can relieve nausea associated with chemotherapy, anesthesia or pregnancy and lessen the pain from dental surgery. There's also evidence supporting it as an effective way to treat headaches, menstrual cramps, tennis elbow, fibromyalgia, low back pain and arthritis. Acupuncture also may be used for carpal tunnel syndrome, asthma, addiction, myofascial pain and for rehabilitation following stroke. More recent evidence suggests that hypertension and certain cardiovascular diseases can be improved by treatment with acupuncture, according to a June 2000 workshop sponsored by the NIH on complementary and alternative medicine in cardiovascular, lung and blood research.

The World Health Organization (WHO), using different criteria, has recognized acupuncture as an appropriate treatment for more than 40 conditions, including certain digestive, respiratory, neurological, muscular, urinary, menstrual and reproductive disorders.

The way acupuncture is practiced here, for the most part, is different from how it is currently practiced in China. "Medical acupuncture" refers to acupuncture practiced by a Western physician. Physicians as well as non-physicians who are licensed to practice acupuncture (LACs) will often use a variety of styles of acupuncture. The most common style taught in American schools is called Traditional Chinese Medicine (TCM) acupuncture, but five element, auricular, and neuro-anatomical acupuncture are also widely used.

Scientists are finding it hard to reconcile the traditional explanation of how acupuncture works with standard Western medical models. Although several studies have documented acupuncture's efficacy and effectiveness, much remains to be learned about the mechanisms of action from a Western perspective.

Human and animal studies show that acupuncture can generate various biological responses-some close to the insertion point and others at a distance. It is well established that acupuncture stimulates the release of naturally occurring chemicals and hormones, especially endorphins. Endorphins can change the experience of pain, influence the body's self-regulating systems, and. promote physical and emotional well-being. Research has shown that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain.

Associated mechanisms are also at work:

• Electromagnetic signals: Evidence suggests that acupuncture points are strategic conductors of electromagnetic signals. It is possible that electromagnetic signals can work outside of standard nerve conducted functions.
• Brain blood flow: Studies indicate that acupuncture clearly affects blood flow to centers of the brain and the central nervous system related to sensation and involuntary body functions, such as immune reactions and the regulation of blood pressure, blood flow, oxygenation and body temperature. Specific activation of certain brain regions, including some of the pain perception centers (such as the limbic area and hypothalamus) can be demonstrated during the application of acupuncture.

Ultimately, scientists don't know exactly which mechanisms make acupuncture effective; more research is needed. It is often believed that to get the best results, treatments need to be individualized. That's one of many reasons acupuncture is more difficult to research than a standard pharmaceutical medication.