Acupuncture Is Still A Mystery
Introduction

Acupuncture is one of the oldest, most commonly used medical procedures in the world. Originating in China more than 2,000 years ago, acupuncture began to become better known in the United States in 1971, when New York Times reporter James Reston wrote about how doctors in China used needles to ease his abdominal pain after surgery. Research shows that acupuncture is beneficial in treating a variety of health conditions.

In the past two decades, acupuncture has grown in popularity in the United States. A Harvard University study published in 1998 estimated that Americans made more than five million visits per year to acupuncture practitioners. The report from a Consensus Development Conference on Acupuncture held at the National Institutes of Health (NIH) in 1997 stated that acupuncture is being "widely" practiced--by thousands of physicians, dentists, acupuncturists, and other practitioners--for relief or prevention of pain and for various other health conditions.

Acupuncture Theories

Traditional Chinese medicine theorizes that there are more than 2,000 acupuncture points on the human body, and that these connect with 12 main and 8 secondary pathways called meridians. Chinese medicine practitioners believe these meridians conduct energy, or qi (pronounced "chee"), throughout the body.

Qi is believed to regulate spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of yin and yang. According to traditional Chinese medicine, when yin and yang are balanced, they work together with the natural flow of qi to help the body achieve and maintain health. Acupuncture is believed to balance yin and yang, keep the normal flow of energy unblocked, and maintain or restore health to the body and mind.

Traditional Chinese medicine practices (including acupuncture, herbs, diet, massage, and meditative physical exercise) all are intended to improve the flow of qi.

Western scientists have found meridians hard to identify because meridians do not directly correspond to nerve or blood circulation pathways. Some researchers believe that meridians are located throughout the body's connective tissue;others do not believe that qi exists at all. Such differences of opinion have made acupuncture an area of scientific controversy.

Mechanisms of Action

Several processes have been proposed to explain acupuncture's effects, primarily those on pain. Acupuncture points are believed to stimulate the central nervous system (the brain and spinal cord) to release chemicals into the muscles, spinal cord, and brain. These chemicals either change the experience of pain or release other chemicals, such as hormones, that influence the body's self-regulating systems. The biochemical changes may stimulate the body's natural healing abilities and promote physical and emotional well-being. There are three main mechanisms:

1. Conduction of electromagnetic signals: Western scientists have found evidence that acupuncture points are strategic conductors of electromagnetic signals. Stimulating points along these pathways through acupuncture enables electromagnetic signals to be relayed at a greater rate than under normal conditions. These signals may start the flow of pain-killing biochemicals, such as endorphins, and of immune system cells to specific sites in the body that are injured or vulnerable to disease.

2. Activation of opioid systems: Research has found that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain.

3. Changes in brain chemistry, sensation, and involuntary body functions: Studies have shown that acupuncture may alter brain chemistry by changing the release of neurotransmitters and neurohormones. Acupuncture also has been documented to affect the parts of the central nervous system related to sensation and involuntary body functions, such as immune reactions and processes whereby a person's blood pressure, blood flow, and body temperature are regulated.

Preclinical studies have documented acupuncture's effects, but they have not been able to fully explain how acupuncture works within the framework of the Western system of medicine.

According to the NIH Consensus Statement on Acupuncture:

Acupuncture as a therapeutic intervention is widely practiced in the United States. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.

Increasingly, acupuncture is complementing conventional therapies. For example, doctors may combine acupuncture and drugs to control surgery-related pain in their patients. By providing both acupuncture and certain conventional anesthetic drugs, some doctors have found it possible to achieve a state of complete pain relief for some patients. They also have found that using acupuncture lowers the need for conventional pain-killing drugs and thus reduces the risk of side effects for patients who take the drugs.

Currently, one of the main reasons Americans seek acupuncture treatment is to relieve chronic pain, especially from conditions such as arthritis or lower back disorders. Some clinical studies show that acupuncture is effective in relieving both chronic (long-lasting) and acute or sudden pain, but other research indicates that it provides no relief from chronic pain. Additional research is needed to provide definitive answers.

FDA's Role

The U.S. Food and Drug Administration (FDA) approved acupuncture needles for use by licensed practitioners in 1996. The FDA requires manufacturers of acupuncture needles to label them for single use only. Relatively few complications from the use of acupuncture have been reported to the FDA when one considers the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. When not delivered properly, acupuncture can cause serious adverse effects, including infections and punctured organs.

The Sensation of Acupuncture

Acupuncture needles are metallic, solid, and hair-thin. People experience acupuncture differently, but most feel no or minimal pain as the needles are inserted. Some people are energized by treatment, while others feel relaxed. Improper needle placement, movement of the patient, or a defect in the needle can cause soreness and pain during treatment. This is why it is important to seek treatment from a qualified acupuncture practitioner.

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*Material on this web page courtesy of the NCCAM

URL: http://nccam.nih.gov/health/acupuncture/