How Does Acupuncture Work?
Making a first appointment to see an acupuncturist can seem like a leap of faith. Many call after hearing about effective treatment results from a friend or in a news article, but have trouble believing that those little, hair-like needles can eliminate a chronic disease or painful condition. How can inserting tiny needles cause pain and disease to disappear?This is a big question that can be difficult to answer. There are two types of explanations. One is from a Traditional Chinese Medical (TCM) point of view that explains Qi flow in the acupuncture channels. The other is a western biomedical explanation that discusses the role of endorphins in the pain pathways of the central nervous system.
The TCM Explanation
Let's begin with the TCM explanation of Qi flow in acupuncture channels. Acupuncture, the insertion of tiny, hair-thin needles into acupuncture points on the body, stimulates your body's Qi, which then sends signals to the nervous and immune systems telling them how to inhibit pain and resolve disease processes. Qi (pronounced 'chee') is Chinese word meaning life energy. By Qi, we refer to the energy we use to move our arms and legs, for our organs to perform their functions of breathing, pumping blood and digesting food and for our brain to think. Without Qi, the body is a lifeless corpse.
Like blood, lymph or nerves, qi flows in a vessel system, called acupuncture meridians or channels (the Chinese word for channel is 'mai' which literally translates as vessel). The channels begin at the ends of the fingers and toes, and travel up the limbs to the torso. In the torso they pass through the various organs, making connections with one another, and then continue on up to the head. We give each channel the name of one of the organs it passes through, such as Lung, Spleen, Bladder or Kidney channel.
Along the channels are acupuncture points. The points are described as wells that reach the river of Qi in the channel below. By inserting a needle into the acupuncture point, the acupuncturist stimulates Qi in the channel. These points have certain functions. A few are analgesic: stimulating LI 4 (Large Intestine 4) has been show by MRI to release endorphins in the brain, natural pain killers. Some points stimulate the immune system, and some have empirical functions to treat conditions like rashes, constipation or hemorrhoids. Some points clear heat, important for treating infections or toxic conditions, like boils. Others tonify Qi (or energy), used for patients who are tired or weak. The acupuncturist chooses points by both function and location: for example, choosing points near the site of pain, such as the shoulder, knee or back.
Acupuncturists feel that when stimulated, the point sends a signal to the brain to tell the immune system what to do to heal the body. The body has the ability for spontaneous healing. When we get a cut in the skin, a cold, flu or mild headache, or even a bout of food poisoning, the immune system is able to resolve the condition with little or no outside intervention on our part. However, sometimes disease gets more complicated. The immune system can't handle it alone, and we seek outside intervention from a health care professional. Acupuncture needles stimulate Qi in acupuncture points that somehow signal the immune system to tell it what to do to resolve the condition.
Western Science Explains Acupuncture
Western biomedical science has tried to figure out this 'somehow'. First, let see what scientists have discovered about the acupuncture points. Acupuncture points are supplied by high concentrations of nerve endings and bundles, mast cells (used for immune function) lymphatics and capillaries. In addition, acupuncture points have a lower electrical resistance, compared with surrounding skin. Dry skin has a direct current (DC) resistance of about 200,000 to 2 million ohms. Resistance decreases to about 50,000 ohms at acupuncture points. Acupuncture points can be accurately located with acupuncture point-finders that measure ohms to determine point location. Acupuncture channels show up as a different color than surrounding tissue on photographs taken with infrared imaging.
Most of the western, scientific research attempting to discover or explain the mechanism of acupuncture has focused on pain relief. Nerve fibers travel from acupuncture points in the extremities to the spinal cord. Then, traveling through the spinal nerve column, they continue on to the brainstem and hypothalamus-pituitary gland. Stimulation of these areas in the brain and spinal cord cause the release of neurotransmitters such as endorphins, norepinephrine and enkephalin that cause inhibition of nerve pain fibers, effectively blocking the transmission of pain sensations.
B-endorphin is a natural opiate produced in the body, 10-100 times more potent than morphine. It circulates for several hours when released. Dynorphins are an extremely powerful opiate, 200 times stronger than morphine. Dynorphins are released in the spinal cord when electro-stimulation (e-stim) is applied to acupuncture points.Animal studies have shown that acupuncture can alter the release of various hormones, such as prolactin, oxytocin, luteinizing and growth hormone, and modulate thyroid function.The effect on hormone release might, in part, explain acupuncture's effectiveness in treating gynecological conditions such as PMS, amenorrhea (no menstrual periods) infertility and perimenapausal syndrome.
Is Acupuncture Effective?
Resoundingly YES! As early as 1980, the World Health Organization (WHO) published a list of forty conditions that western, scientific studies have shown are effectively treated with acupuncture. One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions. As an example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow, or epicondylitis, are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments. The evidence supporting these therapies is no better that that for acupuncture.
In addition, ample clinical experience, supported by some research data, suggests that acupuncture may be a reasonable option for a number of clinical conditions. Examples are postoperative pain and myofascial [muscle] and low back pain. Example of disorders for which . there are some positive clinical trials include addiction, stroke rehabilitation, carpal tunnel syndrome, osteoarthritis and headache.
Acupuncture can have a beneficial effect on almost any disorder. The National Institutes of Health and the World Health Organization have officially recognized the benefits of acupuncture in treating over forty conditions including:
Musculo-Skeletal Disorders: arthritis, low back pain, sciatica, tennis elbow, TMJ, carpal tunnel syndrome, frozen shoulder, fibromyalgia, tendonitis
Gynecological Disorders: PMS, menstrual irregularities, menopausal syndrome, ovarian cysts, infertility, IVF pre and post
Gastro-Intestinal Disorders: indigestion, constipation, diarrhea, nausea, acid reflux, ulcers, colitis, irritable bowel syndrome
Respiratory Disorders: allergies, asthma, common cold, flu, sinusitis
Neurological Disorders: headache, migraine, dizziness, Bell's palsy, post-stroke paralysis, neuralgia
Circulatory Disorders: high cholesterol, hypertensionPsycho-Emotional Disorders: stress, anxiety, depression, nervousness, insomnia, smoking and other addiction
sUro-Genital Disorders: urinary tract infection, incontinence, impotence
In addition, acupuncture can increase energy levels, strengthen the immune system, and promote deep relaxation and a sense of well-being.
Your First Treatment
After reviewing your paperwork we will discuss your chief complaint or goal of treatment. We will then review your medical history. The classic "ten questions" are asked as they relate to your chief complaint. The "ten questions" are about your overall health; they involve your sleep, energy, digestion, emotional life, and aches & pains. Your pulses are read at 3 positions on each wrist which accesses all of the organ systems in Chinese Medicine. Lastly, your tongue is looked at to access your overall health and specifically the health of your digestion. Pulse and tongue diagnosis are two of the more important diagnostic tools in Chinese medicine. They are both used to derive a TCM diagnosis for your condition which is used to plan your treatment. Your treatment plan may include the use of acupuncture, Chinese herbs, Moxabustion, Cupping, Asian Massage or Tuina, lasers, tuning forks, therapeutic yoga poses and dietary recommendations as well as lifestyle recommendations.
More About Needles
The needles are extremely thin compared to other needles in Western Medicine. Some of the thinnest needles are two to three times the thickness of a human hair. Since the late 80's all acupuncture needles are for single use only. They are sterilized and sealed until use. Afterwards they are disposed of in compliance with the law as regarding medical waste. The needles and handles are usually made of stainless steel, athough some are made of silver, gold or copper for energetic purposes. Needles are inserted using a guide tube. The thickness and length of the needle can also be varied to make the treatment better suited to the individual.Needles are retained or left in for about 20 minutes during which time the patient just relaxes and sometimes dozes off.
Moxa, Cupping, Gua Sha and Elctro-Stim Acupuncture
Moxa is 2,000 years older than acupuncture which is at least 2,000 year old. Being at least a 4,000 year old medical practice it is a sophisticated and elegant way to receive a treatment. The feeling of moxa on the skin is warm, nurturing and comforting. Moxa is the burning of the herb artemisia vulgaris, (mugwort or common wormwood) over acupuncture points and regions of the body. The ember of the moxa stick is not applied directly to the skin as is done in China but held above the skin or put on a medium like salt, ground herbs, a salve or on an acupuncture needles. The skin is warmed to help improve circulation or move qi, warm and nourish the channels and restore balance to the body. Moxa can be use instead of or in addition to acupuncture and can also be in liquid form, which is even more effective when used in conjunction with a TDP or mineral plate heat lamp. Studies have shown that using moxa over an acupuncture point on the mothers little toe can correct breech presentation of a fetus.
Cupping is a very ancient medical treatment. It was used by Western doctors in the U.S. up until the early 1900's and is found around the world. It is uses suction over the acupuncture points or whole regions of the body. A flame is inserted into a glass cup to burn off oxygen and create a vacuum on the surface of the skin. Cups with a pump inserted to make a vacuum can also be used. This method of treatment is great for sore muscles and to rejuvenate the immune system if one is coming down with a cold. Cupping is often done with another type of treatment like acupuncture or Asian Medical massage.
Gua Sha is a rubbing or 'scraping' of the skin with a smooth piece of copper, horn or porcelain. This results in the appearance of small red petechiae called "sha" that will fade in two to three days. Raising Sha removes blood stagnation considered pathogenic, promoting normal circulation and metabolic processes.The patient experiences immediate relief from pain, stiffness, fever, chill, cough, nausea, and so on. Gua Sha is valuable in the prevention and treatment of acute infectious illness, upper respiratory and digestive problems, and many other acute or chronic disorders.
Sometimes electro-stimulation can be used with the acupuncture needles for severe muscle aches or acute muscle spasms. Electrodes are attached to the needle handles and a very mild electro stimulation is applied; like a tens machine. The stimulation can send signals that will cause the muscle to stop contracting and provide instant relief. Electro stimulation on the lower back is also very effective for acupuncture labor inductions.