Acupuncture and Oriental Medicine

Does Acupuncture hurt?

Oriental Medicine

Oriental medicine originated 5000+ years ago and has been used continuously to treat and prevent illness. Signs and symptoms lead to a diagnosis centered on the individual rather than the disease. The mental, emotional and physical are considered interrelated. Disease is usually viewed as a disharmony, and treatment is directed toward balancing. Therapy may include the use of acupuncture, bodywork, dietary advice, and herbal formulas.

This is the best description of acupuncture I have:

  • There is a kind of energy that flows in the body. It is not nerves, blood, or lymph. It is called Qi.
  • Qi is the transitional form between manifested and unmanifested energy.
  • Qi flows like rivers through the body (acupuncture meridians), collecting in pools (acupuncture points).
  • The pools are processing centers, where certain functions of the body are organized.
  • We interface with the Qi through the acupuncture points, modifying the function, restoring balance.

What can acupuncture and its therapies be used for?

Hundreds of conditions can be helped with acupuncture and adjunctive therapies. Some of the most common ones include:

  • Musculoskeletal pain/back pain
  • Headaches
  • Menopausal symptoms
  • Arthritis
  • Insomnia
  • Sciatica
  • Carpal tunnel syndrome
  • Menstrual disorders
  • Stress related conditions
  • Digestive disorders
  • Fatigue
  • Adverse effects of chemotherapy

Does acupuncture hurt?

No. You may feel a little prick for a second but if it is painful after that we will adjust it right away so that you can relax.

Is acupuncture safe? How long has it been in use?

Yes. Acupuncture is a therapy that has been used around the world for thousands of years. In the United States, only sterile, sealed pins are used and they are never reused.

How big are the needles?

When you think of acupuncture, you probably think of needles. Think of very tiny pins instead. These tiny pins (which are about the diameter of a hair) are inserted into particular points on the body to promote a “qi” response. “Qi” (pronounced chee) is the energy/life force that makes us living, thinking, moving, feeling beings.

How long is the treatment?

The first visit is longer than subsequent visits. First, you would be asked to read and complete some forms. Then, you would be asked questions about your “chief complaint(s)”, other health issues, medical history, lifestyle, diet, sleep and more. Your tongue and the pulses on both wrists would be examined and some other pertinent assessments may be done depending on your “chief complaint(s)”. Then, you get to lie down for your acupuncture treatment. Sometimes treatment is done with the patient face down, sometimes face up.

If you are looking for a scientific explanation, here are a few articles:

How does Acupuncture work?

(Taken from South Med J. 2005; 98 (3): 330-337.)

Perhaps the most puzzling aspect of acupuncture to both the lay person and physician with a knowledge of anatomy, neuroanatomy, and physiology is how an unmedicated needle, inserted at a site remote from its desired application can work, eg, a point on the lower leg affecting gastric function, or a point on the hand affecting headache.

Skeptics maintain that acupuncture has basically a placebo effect, since the acupuncture meridians and their energy or chi (Qi) as described in TCM cannot be directly observed, dissected, or measured with standard anatomic approaches or physiologic instrumentation. The acupoints are located at sites that have a high density of neurovascular structures and are generally between or at the edges of muscle groups. These locations, curiously, are less painful than random needle sticks into a muscle group. An interesting study demonstrating the map of a meridian pathway involved the injection of Technitium99, a radioactive tracer, into both true and sham acupoints. The scan of the injection sites showed random diffusion of the tracer around the sham point but rapid progression of the tracer along the meridian at a rate that was inconsistent with either lymphatic/vascular flow or nerve conduction. Another study demonstrated that needling a point on the lower leg traditionally associated with the eye activated the occipital cortex of the brain as detected by functional magnetic resonance imaging.

Opium addicts who underwent acupuncture analgesia for surgery were noted not to go through narcotic withdrawal compared with similar patients who received conventional anesthesia. This gave birth to the endorphin hypothesis, which has been explored as one of the mechanisms of action of acupuncture. Needling affects cerebrospinal fluid levels of endorphin and enkephalin, and such effects can be blocked by the opiate antagonist naloxone. A number of other imputed mechanisms of action have used the model of the acupuncture needle as an electrode, which activates changes in the ionic milieu of the interstitial fluid, these changes being rapidly conducted along the fascial lamellar planes by the highly conductive electrolyte medium. Because nociceptive stimulation, such as with a transcutaneous electrical nerve stimulation unit, is known to block pain perception, the neurogate theory has also been suggested as a mechanism of action for acupuncture.

The presence of a foreign body (the needle) may act to stimulate vascular and immunomodulatory factors, including locally occurring mediators of inflammation. Measurements of adrenocorticotropic hormone (ACTH) have been demonstrated to be elevated after acupuncture treatments, suggesting that adrenal activation and release of endogenous corticosteroids may also result from acupuncture. Various physics concepts such as quantum physics, electromagnetic force field changes, and wave phenomena have been proffered to explain the nonlocal effects of acupuncture.

Explanation of the TCM system of medicine, including the effects of acupuncture, is rich with metaphor and allegory. Such explanations refer to different kinds of Qi, the influence and interaction of the five elements (fire, earth, metal, water, and wood), yin and yang, and other terminology that requires contemplation and long study of a culturally distinct system. It is a model so different from the standard medical model that we advise Western-trained physicians and students to hold a temporary suspension of disbelief to nonjudgmentally approach learning about it as a system of medicine, and, if interested, to review the topic in more depth in some of the references listed. It is probably best to tell patients, students, and colleagues, in answer to the question of how acupuncture works, that the conclusive answer is yet to be determined, though research has given us some windows of insight into possible mechanisms of action.

Scientific Evidence for Clinical Application

(Taken from South Med J. 2005; 98 (3): 330-337.)

The National Institutes of Health (NIH) convened a consensus panel to review the available literature about acupuncture. They wished to assess not only clinical efficacy and effectiveness but also biological effects, implications on the healthcare system, and the need for further research. Because much acupuncture research has been done by enthusiastic practitioners rather than trained researchers, the quality of many studies was poor. Because of this, the NIH Consensus Panel concluded that acupuncture was proven to be evidence-based for only two indications: dental pain and nausea (postsurgical, chemotherapy induced, or nausea related to pregnancy). Their panel concluded that it was time to take acupuncture seriously and that their systematic review of the literature indicated that it might also be useful for a longer list of indications , but that better-designed studies were needed to confirm its utility in these areas. These include investigations of the basic science of acupuncture and appropriate sham needle approaches for the placebo arm.

Further acupuncture research trials have been funded by the NIH/National Center for Complementary and Alternative Medicine (NCCAM) and other agencies. Examples of recent NCCAM-supported projects include:

  • Studying the safety and effectiveness of acupuncture treatment for osteoarthritis of the knee
  • Investigating whether electroacupuncture works for chronic pain and inflammation
  • Finding out how acupuncture affects the nervous system by using magnetic resonance imaging technology
  • Looking at the effectiveness of acupuncture for treating high blood pressure
  • Studying the effects of acupuncture on the symptoms of advanced colorectal cancer
  • Testing the safety and effectiveness of acupuncture

Other organizations have also addressed the potential benefits of acupuncture. Their recommendations are derived by consensus panels as well as current standards of practice and common clinical applications rather than through rigorous, evidence-based review of the literature. The World Health Organization has identified more than 40 medical conditions effectively treated with acupuncture. The American Academy of Medical Acupuncture has suggested a listing for use by hospital credentialing committees in which the matter of medical acupuncture privileges are considered . Although there is some overlap in these categories, they are by no means identical. It is curious that the NIH consensus panel findings on the efficacy of acupuncture for nausea and vomiting do not appear explicitly in the other lists, emphasizing the rather subjective and consensus nature of these tables of indications.

Overall, in the United States, acute and chronic musculoskeletal indications for acupuncture treatments have found greatest acceptance. Although traditional usage and consensus recommendations encompass many conditions, a number of limitations must be noted. Limited benefit can be expected when using acupuncture for spinal cord injuries, cerebrovascular accidents, neurodegenerative diseases, thalamically mediated pain, severe and chronic inflammatory and immune-mediated disorders, especially those having progressed to requiring corticosteroid usage, or as a primary treatment for human immunodeficiency virus infection, malignancy, or chronic fatigue states. It may, however, serve an important adjunctive role in several of these conditions by improving quality of life, reducing pain, and potentially improving immune status. Acupuncture treatment may be useful in difficult conditions such as asthenic states (tired all the time, low energy), autonomic dysregulation disorders (anxiety, sleep disturbance, bowel dysfunction), and immune dysregulation disorders (recurrent infections and inflammations).

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