Acupuncture

INTRODUCTION 

Acupuncture has been an essential part of medicine for thousands of years in the East, yet even as it catches on in the West, physicians in this part of the world have yet to figure out exactly how this ancient technique works. Whatever the mechanisms, acupuncture does appear to work. Scientific studies are offering real evidence that it can ease pain and treat ailments ranging from osteoarthritis to migraine headaches.

The technique of acupuncture involves placing hair-thin needles in various pressure points (called acupoints) throughout the body. Stimulating these points is believed to promote the body's natural healing capabilities and enhance its function.
Two very different theories exist as to how acupuncture works. According to Chinese philosophy, the body contains two opposing forces: yin and yang. When these forces are in balance, the body is healthy. Energy, called "qi" (pronounced "chee"), flows like rivers along pathways, or meridians, throughout the body. This constant flow of energy keeps the yin and yang balanced. However, the flow of energy can sometimes be blocked, like water getting stuck behind a dam. A disruption in the flow of energy can lead to illness.
Approximately 2,000 different acupuncture points lie along the body's meridians. The idea behind acupuncture is that stimulating these points with acupuncture needles or pressure relieves obstructions in the flow of energy, enabling the body to heal.
In the Western view, acupuncture likely works by stimulating the central nervous system (the brain and spinal cord) to release chemicals called neurotransmitters and hormones. These chemicals dull pain, boost the immune system and regulate various body functions.
 
 
Acupuncture Schools of Thought
Several different types of acupuncture exist, all originating from different parts of the world. In the United States, practitioners most often use the type of acupuncture based on Traditional Chinese Medicine, which restores the natural flow of energy by stimulating pressure points throughout the body that correspond to various organ systems.

Japanese acupuncture is more subtle than its Chinese counterpart. Its needles are thinner and shorter, and they barely pierce the skin. Japanese acupuncture is divided into two forms: root and local. Root acupuncture addresses the total energy imbalance in the body, while local acupuncture treats specific symptoms.

Five Element acupuncture is an ancient Chinese technique used to treat problems of both the body and the mind. It is based on the idea that health, just like everything else in the universe, is governed by the five elements: water, wood, fire, earth, and metal. Restoring a balance of these elements in the body, the theory goes, will result in good health.

Auricular acupuncture was developed in France, and it focuses all of the body's acupuncture points in just the ear. Two hundred points line the ears, and each point is connected to an area or areas of the body. When a point is stimulated, it creates electrical impulses that flow, via the brain, to a specific part of the body. For example, if the point on the ear that correlates to the knee is stimulated, it will affect pain or symptoms in the knee. Auricular acupuncture is believed to be just as effective as whole body acupuncture, because stimulating the ear is thought to affect chi flow throughout the body.

Korean hand acupuncture is similar to auricular acupuncture, except that the focal point is the hand, rather than the ear. Points on the hand meridians, when stimulated, correspond to various parts of the body.
 
 
Acupuncture Styles and Related Techniques
Traditional acupuncture involves placing needles at specific pressure points throughout the body. Several different variations of this technique exist, however. Some practitioners add heat or electrical stimulation to enhance the treatment effects, while others substitute pressure for needles.

Electroacupuncture sends an electrical current through the needles to stimulate pressure points during acupuncture.
Sonopuncture applies sound waves to the acupuncture points. The vibrations stimulate pressure points in a more subtle way than needles. Sonopuncture is often combined with acupuncture.

Acupressure follows the same principle as acupuncture, but it uses pressure rather than needles. The therapist presses on the patient's acupoints with his or her fingers, and holds for a few seconds.

Moxibustion uses heat to stimulate acupoints. The heat is generated by burning an herb called moxa, which comes from the mugwort plant. There are two types of moxibustion: direct and indirect. In direct moxibustion, a piece of the herb about the size of a grain of rice is placed directly on the skin and burned at an acupuncture point. Because this can be painful and can leave scars, many practitioners today opt for indirect moxibustion, in which the piece of moxa is wrapped in paper, lit and held close to the skin. Sometimes moxa is wrapped around the acupuncture needles and lit to add extra stimulation to the acupuncture treatment.

Cupping places heated jars or cups over the skin. Suction pulls the skin into the cups, creating a vacuum-like effect that stimulates the acupuncture points.


What Conditions can Acupuncture Treat?

Acupuncture is used to treat several different medical and psychological conditions, with varying degrees of success. These conditions include:
 

Addiction

Asthma

Bronchitis (acute)

Cancer pain and nausea
control after chemotherapy

Carpal tunnel syndrome

Chest infections

Constipation

Diarrhea

Headaches (including migraines)

Fibromyalgia

Low-back pain

Menstrual cramps

Osteoarthritis

Post-surgical pain and nausea

Shoulder pain

Sinusitis

Spastic colon

Stress and anxiety

Stroke rehabilitation

Tennis elbow

Urinary problems

 
Acupuncture can either be used on its own, or combined with traditional medical treatments (such as surgery or medication) or alternative remedies (such as chiropractic manipulation and herbal therapies).
 
 
The Evidence on Acupuncture
The research so far on acupuncture has been mixed, but several studies have indicated that it's effective for treating certain conditions. Here are a few highlights of the research so far:

• Osteoarthritis. A 2004 study in the "Annals of Internal Medicine" found that acupuncture significantly reduced pain and improved function in people with osteoarthritis of the knee that couldn't be helped by medicine. The study included 294 patients with chronic osteoarthritis. After eight weeks, participants who received acupuncture reported far less pain in their affected knee than those who didn't receive the treatment.

Fibromyalgia. A 2006 Mayo Clinic study of 50 patients found that acupuncture significantly improved the symptoms of fibromyalgia, a condition that causes muscle pain, fatigue, and joint stiffness.

Chemotherapy-induced nausea. A 2000 study in the "Journal of the American Medical Association" found that electroacupuncture plus an anti-nausea medication relieved nausea and vomiting caused by chemotherapy better than medication alone. The study included 104 women with breast cancer who had been given high-dose chemotherapy. Women in the electroacupuncture group had a third of the vomiting episodes of those in the medication group. An earlier analysis of 11 studies also found acupuncture to be effective for nausea related to chemotherapy, as well as surgery and pregnancy.

In-vitro fertilization. A trio of 2006 studies in the "Fertility and Sterility Journal" suggested that acupuncture may help women who are undergoing in-vitro fertilization (IVF) procedures. When women had acupuncture before and after embryo transfer, they were anywhere from eight percent to 18 percent more likely to get pregnant than women who had sham acupuncture (outlined below) or no treatment. The only caveat -- one of the studies found that women who had acupuncture were slightly more likely to miscarry.

Bladder control problems. A report in the July 2005 issue of Obstetrics & Gynecology found that acupuncture may relieve overactive bladder. Out of a group of 74 women, those who were treated with acupuncture for bladder control had 30 percent fewer urgent trips to the bathroom, compared with only 3 percent fewer trips in the group that received sham acupuncture.
 
 
Acupuncture Points and Acupuncture Needles  
Acupuncture, like any type of treatment, begins with a consultation. The acupuncturist will ask about your medical history and any conditions you're currently experiencing. Then, he or she will examine you and identify the organ(s) involved in your problem.

The next step is to map the pressure points on the appropriate meridian(s) that correspond to your ailment.

Twelve main meridians run throughout the body. Each meridian contains a number of pressure points. To represent each point, the initials of the meridian are followed by a number (e.g., LI 19 or GB 1).

Bladder (UB)

Gall bladder (GB)

Heart (HT)

Kidney (KD)

Liver (LV)

Lung (LU)

Large intestine (LI)

Pericardium (PC)

Small intestine (SI)

Spleen (SP)

Stomach (ST)

Triple heater (TH)

 
Needles may be placed in the immediate area of the problem, or at distant sites in other parts of the body. For example, low-back pain is treated by stimulating acupoint UB 54 in the bladder meridian. Often, points in different areas of the body (front and back, left and right side, or above and below the waist) are stimulated simultaneously to increase the treatment effectiveness.

What You Can Expect During Acupuncture

When the acupuncturist is ready to begin your treatment, he or she will swab the chosen points on your body with alcohol or another disinfectant to cleanse the area, and will then insert between three and 15 needles in your skin. How deep the needles go can vary from less than a quarter of an inch to three inches.

The needles are hair-thin and made of solid stainless steel. You may feel slight pain while the needles are inserted, but once they're in the skin, you shouldn't feel any discomfort. Some people say they feel relaxed during an acupuncture treatment.

The needles will stay in your body from 5 to 20 minutes. While the needles are in your skin, the acupuncturist may twirl, heat, or electrically stimulate them.
 
 
How Safe is Acupuncture? 
Acupuncture is considered to be very safe. In 1996, the U.S. Food and Drug Administration began classifying acupuncture needles as medical instruments, and it now requires that acupuncturists use only sterile, disposable needles.

The most common side effects with acupuncture are soreness, slight bleeding, irritation or bruising at the needle site. Some people may feel tired or lightheaded after a session. In very rare cases, more serious complications can occur if the acupuncture needles pierce the kidney, lungs or another organ.

Despite its general safety, acupuncture isn't for everyone. People who have a bleeding disorder or who are taking blood thinners (such as Heparin and Coumadin) should not have the treatment. It's also not recommended for people who have pacemakers, implanted electrical devices or infusion pumps.
 
 
The History of Acupuncture
Acupuncture is one of the oldest medical treatments in existence, originating in China more than 2,500 years ago. Its philosophy is rooted in the traditional teachings of Taoism, which promotes harmony between humans and the world around them, and a balance between yin and yang.