Overview of Acupuncture
Acupuncture is a type of treatment that doesn’t involve medication and can help with a range of different health problems and symptoms. While a lot of studies have been conducted to understand how well acupuncture works, only a handful of really high-quality ones stand out. This procedure, which is done in a doctor’s office, can really vary in how effective it is. Acupuncture can help with things like nausea, pain, allergies, hot flashes, difficulty breathing, mood disorders, dyspepsia (which is a type of indigestion), and even quitting smoking. Acupuncture is generally safe, with any local side effects typically going away soon after the needles are removed. Acupuncture is often used to treat chronic (long-term) pain that’s not cancer-related in adults.
Acupuncture basically involves inserting small needles or applying pressure to specific points on the body. It’s a method of treatment that comes out of traditional Chinese medicine (TCM), which is based on principles linked to Confucianism and Taoism philosophies. According to TCM, being healthy means having a good balance of ‘qi’ (pronounced “chee”), a vital energy that travels throughout the physical world and follows the yin/yang concept. This theory involves five elements: wood, water, fire, earth, and metal. If any of these elements get blocked or become excessive, it can disrupt this vital energy. Acupuncture aims to remove these blockages or reduce the excess of qi that flows through certain pathways in the body called meridians. In this view, health isn’t just about not being sick, but about having everything working well together. Each symptom comes up in the context of a blockage or excess that’s specific to the individual. By balancing the qi, acupuncture can help restore overall wellness.
Although acupuncture started in China, it came to the West through other Asian countries, mainly Korea and Japan. Some people think this is a fairly new thing. But actually, Osler, a notable medical figure, talked about acupuncture in his writings on medicine as far back as the 1700s. For a long time, acupuncture was seen as an alternative treatment and not a key part of medical care. But this perception is changing. Up to 1.5% of the US population has tried acupuncture at some point, and you can even get it at many top medical centers across the country. However, acupuncture is usually not the only treatment used. It’s often used in conjunction with, or as an add-on to, traditional medical care.
As more studies are carried out showing how well acupuncture can help with different kinds of pain, insurance companies are starting to pay attention. Acupuncture can now be covered by a number of insurance providers. Many studies have shown that acupuncture can be effective in treating back pain (whether it’s acute, meaning sudden and severe, or chronic), knee pain caused by osteoarthritis, myofascial pain (a kind of muscle pain), and headaches. It is worth noting though that there is a significant placebo effect. This means that just believing in the power of the treatment can make people feel better. But seeing as acupuncture generally has a positive response from patients, has limited side effects, and doesn’t really add to healthcare costs, it’s an important alternative treatment option.
Anatomy and Physiology of Acupuncture
Acupuncture is a process where tiny needles are inserted into certain points on the body. These points, known as “acupoints”, are identified in traditional Chinese medicine (TCM) as areas that can help regulate the body’s energy flow, also known as “qi”. Qi is believed to move along certain paths or “meridians” in the body.
Usually, inserting the needles is the standard way to regulate the flow of qi. Other methods such as hand pressure, electric stimulation, laser treatment, heat, and even ultrasound, can also be used. These methods are believed to impact the energy flow, or qi, in a similar way to the needles.
Why do People Need Acupuncture
The deciding factor in recommending acupuncture treatment often depends on the patient’s interest in trying this type of therapy. The most important guiding principle in medicine is ‘do no harm.’ While acupuncture (or even sham acupuncture, which is like a placebo) has been shown to improve a patient’s well-being, often due to psychological factors, just as with any treatment or medication, its effectiveness is strongly linked to the healthcare provider’s endorsement of the treatment. For instance, if a doctor or other healthcare provider suggests to a patient suffering from chronic low back pain that acupuncture may help them feel better, the patient is likely to believe it will and can benefit more from the treatment. On the other hand, if the provider tells the patient they don’t think acupuncture works, the patient may have doubts and the treatment may not be as effective.
Given the principles that guide acupuncture, it has been used to treat nearly every medical condition in Eastern medicine. Even in Western medicine, a wide range of conditions and disorders, such as seasonal allergies and fibromyalgia, have been treated and studied using acupuncture.
However, acupuncture is most often used for treating pain, both chronic (long-term) and acute (short-term), as well as for nausea and vomiting following surgery, during pregnancy, or caused by chemotherapy.
When a Person Should Avoid Acupuncture
Acupuncture, a form of alternative medicine where thin needles are inserted into the body, has very few reasons why it shouldn’t be used. It has been helpful even for more delicate groups, like pregnant and pediatric (child) patients. For these groups, acupuncture has been particularly effective in reducing nausea and vomiting. The needles used in acupuncture are thinner and less harsh than regular needles used for things like IVs (intravenous therapy where medicine or fluid is given through a needle) or drawing blood.
Being on a medicine to prevent blood clots (an anticoagulant) does not stop you from getting acupuncture, as the needles are gentler. However, doctors usually suggest avoiding acupuncture if there’s an active infection or skin cancer present, as it could spread cancerous cells or increase infection risk if the body’s defense system against disease (neutropenia) is weak. The decision to get acupuncture treatment, for the most part, is left to the discretion of the practitioner (the person who administers the acupuncture).
Two specific cases require particular attention. People with an AICD, a device in the chest used to control irregular heart rhythms, should not use any acupuncture that involves electromagnetic stimulation. Also, acupuncture is not suggested for individuals who have or are prone to mental health conditions like psychosis or delusion.
However, people who are on anticoagulants like warfarin, or have a history of bleeding disorders, can still get acupuncture. Pregnancy also doesn’t prevent someone from receiving an acupuncture treatment.
Equipment used for Acupuncture
1. For acupuncture, the key tool used is usually a flexible, stainless steel needle that measures anywhere from 10 to 100 mm. Needles have to be longer if they’re meant to go into body parts with a thicker padding of tissue. For the head and neck, the needles used are generally thin and short. Every needle should be used only once, or cleaned properly before it’s used again. Acupuncture treatments usually involve specifically chosen “acupuncture points” where about 5 to 20 needles are placed.
2. During an acupuncture session, the acupuncturist will insert the needles into your body and leave them there for 10 to 20 minutes. You’ll be lying down and relaxed during this time. When the needles are inserted, you should expect to feel something, but if they’re put in quickly, it shouldn’t hurt much. An acupuncture session should be a peaceful, quiet experience that takes place in a space where your privacy is respected.
Who is needed to perform Acupuncture?
In the US, there are two main bodies that credential acupuncturists, the American Board of Medical Acupuncture for clinical acupuncturists, and the National Certification Commission for Acupuncture and Oriental Medicine for non-clinical acupuncturists. These bodies ensure that acupuncturists undergo a rigorous 3-4 year program involving 2000-3000 hours of training. The process to become board certified also includes a final exam and proof of proper training.
Interestingly, some states allow doctors to practice acupuncture without extensive training, while others mandate additional training and certification that totals a few hundred hours.
When it comes to where patients receive acupuncture, over 30% in the US do so in settings where multiple health professionals are present. This might be in places like a naturopathic office, a physical therapist’s office, a general practitioner’s office, an integrative medicine office, or a pain clinic. On the other hand, the majority, around 70%, prefer to receive acupuncture from solo practitioners.
Preparing for Acupuncture
Before an acupuncture session begins, the practitioner will typically conduct a thorough interview with the patient and check them over. This process, like a traditional medical examination, delves into the patient’s medical history, but it also covers in-depth inspections of unique aspects like the tongue and pulse at the wrist. Notably, it’s not just about physical symptoms. The acupuncturist also takes into account the patient’s mental and emotional state because acupuncture believes these aspects are often linked to the body’s physical conditions.
The practitioner identifies certain points, known as acupuncture points, where the needles will be inserted. There are about 350 of these points spread across 14 pathways on your body, referred to as meridians. These points are often connected with specific organs or bodily systems, however, they aren’t necessarily targeted based on the exact anatomy. Acupuncture treats the body as a whole, rather than focusing in on individual parts.
How is Acupuncture performed
For the procedure, single-use needles made from sterile, stainless steel are used. If the needles are very thin or fragile, a plastic guide tube may be needed to help put them in. The practitioner will quickly put the needle into the specific point chosen for the treatment. Normally, people describe feeling a “tugging” or “grasping” sensation when the needle goes into their skin.
Once the needle is in, it usually stays there for about 10 to 20 minutes. It’s common for people to feel a little numbness or even some mild, spreading sensations that might feel like tingling or pins and needles. These sensations are actually a good thing. They’re called “de-qi”, and are seen as a sign that the treatment is working. If you don’t feel these sensations, the practitioner might move the needle a bit to make sure it’s in the right place.
Possible Complications of Acupuncture
Whenever something foreign, like a needle, is put into your body – even just on the skin surface – there’s always a slight risk of bleeding, irritation, or infection. These risks are similar to those tied to any procedure that uses needles. So, when you get acupuncture, some possible problems could include infection, spreading of disease, injury to your skin or nerves, or bleeding. Also, where the needle is placed can affect what kind of complications might happen. For example, if the needle goes too deep, it could puncture a lung (which might lead to a condition called pneumothorax or pneumoperitoneum) or even an organ.
But don’t worry too much – problems from acupuncture don’t happen often and are usually linked to practitioners who don’t have much experience or training.
What Else Should I Know About Acupuncture?
Acupuncture is a popular alternative to traditional Western medicine. Although it is widely used, the exact way it works is not fully understood. Some theories suggest that it affects inflammation, hormones, or even influences the immune system. These changes might help to relieve pain by releasing the body’s natural painkillers. Brain scans have managed to show changes in the way the brain works during acupuncture treatment.
However, proving how effective acupuncture is can be tricky. Traditional medical research relies on randomized controlled trials – studies where some people get the real treatment and others get a ‘fake’ or control treatment to compare the results. But with acupuncture, there are challenges in creating a ‘fake’ version. For one, each acupuncture treatment is tailored to the individual, so creating a standard treatment for a study is difficult. Also, there are many techniques and styles to choose from, which further complicates things. Because of these challenges, the effectiveness of acupuncture, as per Western medical standards, remains unclear.
There are debates around whether acupuncture is more effective than ‘sham’ acupuncture (the ‘fake’ version). Despite this, both real and sham acupuncture have been seen to ease symptoms and improve function in people with conditions like back pain, headaches, knee pain, and hot flashes. Both treatments are better than having no treatment.
Here are some conditions where acupuncture is used:
– **Back Pain**: This is a common reason people seek acupuncture. Back pain is widespread and often doesn’t respond well to conventional treatment. Some studies have shown that acupuncture can relieve back pain and improve function. Acupuncture has also been suggested as a first-line treatment for chronic back pain by the American College of Physicians. Its effectiveness in treating acute back pain is less clear.
– **Osteoarthritis**: Studies have shown acupuncture could be a useful treatment for osteoarthritis, alongside physical therapy, medical management, and exercise.
– **Rheumatoid Arthritis**: Acupuncture does not seem to affect inflammatory markers in rheumatoid arthritis or reduce muscle pain, disease activity, or use of medications.
– **Migraine**: Migraine headaches can be challenging to treat with medication alone. Acupuncture has been shown to reduce the frequency and severity of migraines.
– **Postoperative Nausea and Vomiting (PONV)**: Acupuncture can be as effective as medication for PONV. There’s a specific acupuncture point on the wrist (P6) that’s known to help with this. Acupuncture can also help with nausea and vomiting from chemotherapy.
Acupuncture is used for a variety of other conditions, though more research is needed to determine its effectiveness. It’s important to note that its effects may be limited and it might not be covered by all health insurance providers. Despite this, it is considered a low-risk treatment and could be helpful in managing several conditions that don’t respond well to traditional treatments. For example, it can also be used for reducing pregnancy-related nausea and hot flashes, and managing seasonal allergy symptoms.
Despite its widespread use, well-designed studies are needed to determine acupuncture’s effectiveness in treating conditions like chemotherapy-induced nausea and vomiting, and managing pain in cancer patients. However, considering its relatively low risks, it may provide added relief for various health conditions.
