Acupuncture: A Brief Overview
Acupuncture has been a part of traditional Chinese medicine (TCM) practice for thousands of years. It is still one of the most frequently practiced forms of therapy in the Eastern Hemisphere. After the Communists took over China, they were very sensitive to the criticism that TCM had not been adequately studied and felt that it had no place in their modern society unless its effectiveness could be demonstrated.
To that end, they conducted thousands of experiments on both animals and people until they were convinced that acupuncture was effective in its own right. Since then many Chinese medical schools continue to offer courses and training in both Western medicine and TCM. While it is clear that many diseases respond better to Western medicine, some may respond better to TCM and acupuncture. Indeed, many diseases may respond best to the combination of acupuncture used together with Western medicine.
In the West, acupuncture is best known for its potential anesthetic properties. While sensational reports have come out of China about the use of acupuncture as the sole method of anesthesia in major surgery, more often in practice doctors in China use acupuncture to decrease the amount of drugs needed during surgery. The use of lower dosages of drugs results in fewer side effects for the patient. China therefore has a jump on us in the West regarding optimal ways to combine their old traditional therapies and newer scientific Western therapies.
In 1977 scientists discovered that the brain releases natural pain-relieving molecules known as endorphins. These are very similar to opiates (such as morphine), which are potent anesthetic agents. It has been shown that one possible mechanism of acupuncture is to increase the release of these endorphins by the brain.
This may provide one explanation of how acupuncture can help alleviate pain. However, acupuncture has other physiological effects besides pain relief. It often increases local blood circulation to areas of muscle spasm, and can decrease tonic muscular contraction that often causes or contributes to painful conditions. Thus, the local actions of decreased tissue swelling (due to better blood circulation) and less muscle spasm may release pressure on nerves or interior organs leading to relief.
The Chinese do not limit the use of acupuncture to only alleviating pain, however. They use combinations of herbs and acupuncture for the treatment of the entire variety of diseases which they encountered. There are traditional Chinese medical therapies for high blood pressure, asthma, diabetes, stomach ulcers, depression, infections, etc.
While in some cases the Western therapies for these conditions may be superior, in some cases acupuncture may be a reasonable alternative for use or for use in conjunction with other treatments. Until recently, acupuncture has been defined by the FDA as an “experimental” therapy. Due in large part to studies showing the effectiveness of acupuncture in asthma, the FDA is currently considering revising this classification. It is likely that as time goes on, more and more diseases will be proven to be helped by acupuncture and TCM.
There is no evidence that acupuncture is a form of hypnosis, although this is a common belief. Studies have shown no correlation between ability to be hypnotized or belief in the therapy and the subsequent outcome. People who receive acupuncture and do not believe that it will help are just as likely as people with full faith in the therapy to respond favorably.
What is an Acupuncture Treatment?
Acupuncture is the stimulation of nerves by placement and manipulation of very thin needles in specific locations of the body. These locations are chosen on the basis of the disease which is being treated, and are called acupuncture points. These points are at the same general location in everybody and follow along a series of hypothetical “channels” or meridians located on the surface of the body.
The traditional Chinese believe that “qi” (pronounced chee), or the life force, circulates through these channels in an orderly fashion and that what creates disease are blockages of the flow of “qi”. These blockages can be adjusted or corrected by the strategic placement of needles in its path. There is no equivalent of this meridian system in Western medicine, but many acupuncture points closely correspond to groups of nerves known as a nerve “plexus”. It may be that these areas are especially sensitive to stimulation due to the high concentration of nerve endings, and that this is what makes these areas especially useful.
There are other therapeutic techniques which are related to acupuncture but do not use needles. Shiatsu (acupressure) and many massage techniques utilize a knowledge of acupuncture points. Moxibustion and cupping are other Eastern techniques where heat and suction are applied to acupuncture points. Most acupuncturists believe their technique is superior because the placement of a needle acts to directly physically interact with the channel rather than to manipulate it indirectly through pressure or heat.
Acupuncture treatments can vary in the number of needles used and the locations of the needles, even between treatments for the same condition. That is because there are often a variety of points which may be effective for a given condition, too many to be given all at once. Some points used may be local points, that is near to the area of pain or disease; some points used may be distant points.
Many people find it unusual at first to come in for a problem in the head such as a headache, for example, and find that they are treated with points in the legs, arms, and ears. That is because we are used to thinking very mechanically and assume that treatment must be directed only to the area of the body with disease.
Chinese medicine, however, takes a more holistic view of the interrelationship of the body and may find the answer to a headache elsewhere. There is always a rationale for therapy given, and very often distant points are used because they lie on a channel which is believed to be diseased. Another way to look at this which might make more sense to us is the following: Slight unevenness of leg length can cause back pain even though the source of the problem is not in the back.
What is a Typical Acupuncture Treatment Like?
Different people have different experiences, but some generalities can be stated. In preparation for the treatment the patient is placed in a reclining position, either on their back, side, or belly (the position used depends on the points to be treated). A typical treatment takes between 15 and 30 minutes. It usually takes around 5 minutes to place all the needles and about 2 minutes or less to remove them at the end of the treatment.
All needles used are used only once and then discarded. Each needle comes individually wrapped and has been pre-sterilized at the factory; it is discarded in the medical waste after a single usage and is never used again. The placement of the needles follows certain principles. Points are often treated bilaterally, which means that the same point is treated on both the right and left sides.
Acupuncture needles are much thinner than needles used to take blood or even those used in sewing. As a result, they are less painful and in some cases you may not even feel the needles going through the skin. Dr. Stimler may decide to manipulate (rotate) the needle after insertion for a few seconds until you feel a sensation. The reason for doing this is based on traditional Chinese theory which suggests that the creation of a sensation yields superior results.
The sensations which you might feel could be a brief electric shock lasting only an instant, a deep ache, or a spreading sensation of warmth. After the manipulation ends, you will lie relaxed for about 15 minutes with the needles in place; during this phase you will probably not feel the needles at all. Most people find this period to be very pleasant and extremely relaxing and it is not unusual for people to fall asleep at this time.
Some people report feeling pleasing sensations like a tingling or soothing wave circulating around their bodies while they are relaxed. After the treatment has been completed Dr. Stimler will remove all the needles. In some rare cases, he may prescribe more permanent needles, known as press needles, to remain in the ear for an additional period of time (usually one week). This is sometimes done to encourage smoking cessation.
What Should I Expect After the Treatment?
In general, chronic conditions are more difficult to improve than acute conditions are. So that the longer you have suffered with a condition the more resistant to treatment it is, and the more treatments may be necessary to cause sufficient improvement. Some people, however, are especially responsive to acupuncture and may notice a complete or near complete resolution of their pain or complaint after only a single session; they are in the minority however (maybe only 5-10% of all patients).
Some people will have minimal or no improvement (around 15-20%). Most patients will notice some improvement after a single or a few acupuncture treatments although the improvement may not always be complete; sometimes the improvement is enough, however, so that with the addition of other adjunctive therapies the situation can be managed satisfactorily. It should be noted that a very few people might have a worsening of their condition which is usually temporary and may be followed by a subsequent improvement.
If not, then further acupuncture is usually not advisable in such a case. Most likely, you will require more than one session for optimal management of your condition. The frequency of treatments may depend on the characteristics of the disease. All the figures given in this paragraph are based on the personal experience of Dr. Stimler as well as other acupuncturists. Unfortunately there are few scientific studies which are designed well enough to answer all the questions regarding variation in a patient’s response.
In the case of addictions, such as treatment for smoking cessation, the percentages quoted above may be somewhat less in some cases. Success rates are reported to range from between 40 – 60% for smoking cessation at least in the short run.
The purpose of this summary is to give you some perspective on acupuncture and some background regarding the rationale for its usage. Currently, acupuncture is not recommended by any medical guideline for any condition and the decision to use it rests with the patient and physician.
Dr. Stimler is recommending its use to you because he has found it to be useful in cases where other therapies have failed, and believes that it can be helpful in conjunction with Western medical therapies. There is very little Western scientific proof available currently to demonstrate that it can be helpful for internal medicine diseases other than pain relief. Please feel free to ask any questions you might have about acupuncture to Dr. Stimler at any time, either before, during, or after a treatment