In 1997, the U.S. National Institutes of Health issued a consensus statement recognizing acupuncture as a treatment for pain following dental surgery and nausea induced by surgical drugs and chemotherapy. It also believed that acupuncture might be useful in treating asthma, headaches, addiction and the debilitating muscle pain and fatigue associated with fibromyalgia. Acupuncture is not yet mainstream, but more and more people do seem to be getting the point.
Acupuncture originated in China at least 2,500 years ago. It’s based on the theory that vital energy or “qi” flows along 14 meridians connecting organs and vital systems in the body. According to this theory, imbalances in the opposing aspects of yin (feminine, cool, receptive) and yang (masculine, warm, dominant) disrupt the flow of qi and cause illness.
Today, traditional Chinese medicine (TCM) often combines acupuncture with herbs, exercise and lifestyle changes to restore the balance between yin and yang, and therefore the healthy flow of qi. Practitioners carefully observe and question each patient and then apply hair-fine needles and sometimes heat to specific therapeutic points along the meridians. For example, an acupuncturist might treat hypothyroidism–a condition characterized by low levels of thyroid hormone and symptoms including hair loss, constipation and feeling cold and sluggish–as a yang deficiency. The prescription might include applying acupuncture to two primary points on the back and four more on the front of the body, and burning an herb called moxa at the end of the needles to stimulate yang’s warming energy.
Acupuncturists treat each patient as a unique individual, which means people who are diagnosed with the same illness by Western standards might receive different treatments from TCM practitioners. While Western medicine focuses on particular symptoms and causes of disease, TCM seeks to treat “patterns of disharmony,” notes Harvard Medical School Assistant Professor Ted Kaptchuk in his seminal book The Web That Has No Weaver: Understanding Chinese Medicine. He observes that in Chinese medicine, “One does not ask ‘What is causing Y?’ but rather, ‘What is the relationship between X and Y?’”
Ever since acupuncture began spreading throughout the West in the 1970s, scientists have been searching for a physiological basis for its effects. Some studies have found acupuncture stimulates the release of endorphins, the body’s natural painkillers. Other research in animals and humans suggests acupuncture affects areas of the brain involved in the perception of pain. Studies also have found acupuncture can improve circulation.
Dr. Tong Joo Gan, an anaesthesiologist who also trained in TCM, is investigating acupuncture’s effects on people like Worsley who experience pain following surgery. Gan and his colleagues at Duke University Medical Center found that patients who receive acupuncture before and during surgery have less pain afterward and need fewer painkillers than those who receive only pain medication. Their findings are based on an analysis of 15 randomized controlled trials.
“Using less morphine reduces all the nasty side effects of opioids, including nausea and vomiting, itchiness, drowsiness and urinary retention,” says Gan, who reported the team’s findings at the American Society for Anesthesiology’s 2007 conference. He adds that these side effects can slow healing and lengthen hospital stays.
Two large-scale German studies suggest acupuncture can also help ease two of the most common forms of chronic pain: arthritic knees and achy backs. Dr. Hanns-Peter Scharf and his colleagues at the University of Heidelberg reported in the July 4, 2006, issue of the Annals of Internal Medicine that combining acupuncture with the standard treatment for osteoarthritis of the knee reduces pain and improves mobility more than that treatment alone. Another German team, led by Dr. Michael Haake of the University of Regensburg in Bad Abbach, found acupuncture was nearly twice as effective as conventional therapy in treating chronic lower back pain.
Both these studies of more than 1,000 patients, however, come with an interesting caveat. No statistically significant difference was found between the improvement of subjects who received real acupuncture and those in control groups who received the “sham” version, administered at non-acupuncture points. Are the beneficial effects of acupuncture merely the result of the placebo effect?
“We know that patients benefit from getting treated,” says Ted Kaptchuk. “Is that benefit because of the physiological activity of acupuncture or the effect of a therapeutic ritual? It’s unclear at this point.”
Typically not. Unlike large and hollow hypodermic needles, acupuncture needles, made of stainless steel, are as fine as a human hair and solid. The most common sensations are a gentle tap or tingling.
The first session includes a consultation which can take upwards of 30 minutes. This session costs approximately $140. Each repeat visit is usually shorter, depending on what is needed and how often the acupuncture is necessary. These visits are generally between $60 - $75. Regular weekly visits for severe arthritis conditions that require an injection performed by the nurse tend to run between $35 - $60 (depending how much medication your pet requires).
An acupuncturist will examine you based on the tradition he or she follows, often checking various pulses, the colour and texture of your skin and tongue, your speech and other criteria. The number of needles used depends on the diagnosis, but can range from one or two to more than 30. Chinese medicine practitioners may also apply heat and often prescribe additional herbs and lifestyle changes as part of an overall plan.
That depends on your condition and response, but treatment typically includes several sessions once a week. The goal, says acupuncturist Jennifer Woolf, is not to keep patients coming forever but to “get people to a place where they are functioning at a level where they can enjoy life.”