Acupuncture

Acupuncture:

An Ancient Treatment for a Current Problem

Acupuncture introduction

Acupuncture is widely understood to be a non-traditional (not a traditional part of western medicine) treatment option for back pain or neck pain. While acupuncture is often not the first line of treatment sought for most back or neck problems, an increasing number of patients, as well as physicians and other health professionals are starting to use acupuncture as a means to reduce neck pain and back pain.

Acupuncture is a form of Chinese medicine that can be traced back at least 2,500 years. The general premise of acupuncture is that the body contains patterns of energy flow. The vital energy or life force of the body is referred to as qi (pronounced "chee"), and proper flow of qi is considered to be necessary to maintain health.

The theory of acupuncture is that there are over 2,000 points on the human body that connect with 20 pathways (meridians). These pathways conduct the qi throughout the body. With acupuncture, hair-thin metallic needles are inserted into specific combinations of these 2,000 points in an attempt to correct and/or maintain a normal flow of qi.

How acupuncture works?

The mechanisms of acupuncture, though not solidly proven, have exhibited several commonly accepted effects to the body. Most notable is that acupuncture stimulates the central nervous system—the brain and spinal cord. Most people report a tingling sensation, feeling relaxed or even energized. Again, this is largely based on the individual receiving the acupuncture treatment and how he or she perceives it.

During an acupuncture treatment session, anywhere from 1 to 20 FDA-approved, metallic needles are inserted into the body, ranging from just breaking the surface to up to 1 or several inches long. The longer acupuncture needles (such as 5 to 9 inches) are inserted into areas of deeper muscle/fat layers or along, under the skin or even scalp, depending on what is being treated and the required depth or penetration. The acupuncture needles are often left in for approximately 15 to 30 minutes. Some practitioners insert needles, turn them either in one direction or the other or both, depending on what they are attempting to achieve, and these needles are inserted for perhaps 10 seconds only, removed and the same needle is used for treatment of other points on that same patient. In certain instances, needles are warmed or electrically charged after insertion. The electrical acupuncture can be used with needles or through the use of a non-penetrating probe.

People experience acupuncture differently, and rarely do they describe it as 'painful'. Unlike needles used for injections, the tip of an acupuncture needle comes smoothly to a point, instead of by way of a sharp edge. Acupuncture needles are also extremely thin—about 20 times thinner than a typical hypodermic needle used for injections. The acupuncture needles are solid and do not remove tissue as would occur with a hypodermic needle, making them safer. Some practitioners also use moxibustion and burn this on the needles during insertion. This is an herb compound that is often used.

Acupuncture also has a cupping component to it, whereby cups are heated and applied to the skin to create suction and bring blood close to the surface.

There are areas on the body that are considered a micro system and some acupuncturists may treat only those micro systems, such as treating only the ear (auriculotherapy), only the face, only the hand, only the foot, etc.

In the US, only sterile, one-time use needles (that are sealed prior to use) are allowed. After use, the acupuncture needles must be disposed in a proper hazardous waste receptacle.
During the course of the acupuncture procedure, specific chemicals release into the body, supposedly affecting back pain and neck pain physically and psychologically.

Acupuncture is thought to operate by:

• Release of opioid peptides. Opioids are naturally occurring chemicals in the brain that have an analgesic effect. The release of these opioids plays a significant role in the reduction of pain. There has been considerable evidence to support that acupuncture stimulates the central nervous system, releasing these chemicals.
  
• Alteration in the secretion of neurotransmitters and neurohormones. Acupuncture is said to activate the hypothalamus and pituitary gland and thereby alter secretion of these chemicals. These particular chemicals play a direct role in the sensation of pain as well as the activity of an organ or organs. Evidence has shown that acupuncture alters this secretion in a manner that reduces pain. Documentation has also shown that acupuncture positively affects immune functions in the body.
  
• Stimulation of electromagnetic points on the body. The 2,000 points of the body that acupuncture focuses on are theorized to be strategic conductors of electromagnetic signals. Stimulation of these areas is believed to start the flow of endorphins—the body's natural painkillers.
  

While there are many experts in the medical field who believe acupuncture is an effective way to treat certain conditions, there is no true consensus. Some define the benefits of acupuncture within the realm of traditional Chinese theories such as qi and meridians. Others understand and attribute acupuncture's benefits to certain scientific and biological changes they bring about in the body (as mentioned above). Alternatively, some question the ability of acupuncture to have any impact at all. The skeptics should give it a chance and seek proof for themselves.

Acupuncture Considerations

Acupuncture is considered a safe medical treatment. For this reason, many physicians and practitioners believe that acupuncture is a beneficial treatment as an adjunct to other medical treatments, and/or as an alternative to medical treatments. In certain situations, acupuncture may be used in combination with conventional painkillers, or to replace them all together.

In 1998, the National Institutes of Health (NIH) released a statement that said there is enough evidence to demonstrate that acupuncture had beneficial pain-relieving qualities in adults experiencing postoperative dental pain, as well as nausea from chemotherapy. The NIH also found that acupuncture might be useful as a treatment for low back pain, as well as many other conditions, such as headache, myofascial pain, osteoarthritis, and carpal tunnel syndrome.

In China and other countries in the orient, acupuncture is sometimes used in many other ways, such as in some surgical cases including brain, abdominal and other surgeries. Sometimes part acupuncture and part anesthetics may be used for surgery.

However, as with any treatment option acupuncture is not without its risks and costs. One should be well aware of the factors involved in acupuncture before making any sort of decision as to whether or not it is a possible treatment option.

Here are some guidelines regarding acupuncture:

• Get a referral from a health care practitioner or reputable source. Many physicians understand the theories behind acupuncture and may refer their patient to a licensed acupuncture practitioner upon request.
  
• Research the acupuncture practitioner's background and qualifications. Just as one would do with any health care practitioner, it is important to research the background and qualifications of an acupuncture practitioner. Generally in the U.S., a medical doctor (MD), Doctor of osteopathy (DO), Doctor of Chiropractic (DC), or Physical Therapist (PT) may be able to obtain a license to perform acupuncture. In certain areas, other health professionals (such as registered nurses) may also qualify qualify to be licensed acupuncture practitioners. In the US, each state has different requirements to be allowed to practice acupuncture. Some states require a degree in acupuncture and passing a Board examination, and other states have much less stringent requirements.
  
• Consider costs and benefits. It is advisable to ask about the success rates of acupuncture and the probability of achieving desired levels of pain relief. It should be a red flag to anyone if the acupuncture practitioner is unfamiliar with the patient's specific condition, or if the acupuncture practitioner's expectations for a successful outcome are low.
  

An acupuncture treatment program will typically include anywhere from 3 to 10 sessions, each lasting approximately one hour. Each session typically costs in the range of $45 to $100, depending on the practitioner and the local market conditions. Though not very common, acupuncture is sometimes covered by medical insurance. Discuss with the acupuncturist and insurance company the costs involved before beginning treatment.

As with any medical treatment, there are certain contraindications for acupuncture treatments, including:

• Drug or alcohol intoxication
  
• Use of a pacemaker
  
• A seizure disorder
  
• Bleeding disorder such as hemophilia or use of blood thinners
  
• Infections skin disorder or disease
  
• If pregnant, needling in the abdominal area or lumbosacral region should be avoided. It is also advisable to avoid any acupuncture that might stimulate the early delivery of the fetus or even lead to abortion. Not all these points are located on the abdominal area or lumbosacral region.
  

There have been numerous accounts of the beneficial qualities of acupuncture for back pain. Furthermore, there have been several studies which validate similar findings. However, in the US acupuncture is still considered an area of uncertainty.

Compared to other treatments, acupuncture is quite safe. Whether acupuncture is a viable option is ultimately up to the patient and their health care practitioner.

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