How Acupuncture Treats Pain
Acupuncture has become an increasingly popular alternative to pain medication. The undesirable side effects, tolerance and abuse potentials that exist with medications are not issues with acupuncture. In fact, most acupuncture patients find the treatments very relaxing. According to the 2007 National Health Interview Survey (NHIS), 1.4 percent of respondents (an estimated 3.1 million Americans) reported using acupuncture in the past year. A special analysis of acupuncture data from an earlier NHIS found that pain or musculoskeletal complaints accounted for 7 of the top 10 conditions for which people use acupuncture. Back pain was the most common presenting complaint, followed by joint pain, neck pain, severe headache/migraine, and recurring, nonspecific pain. [i] Menstrual cramps, shingles and other types of pain are also effectively treated with acupuncture; however, they have not been well studied.
Although many people use acupuncture to treat pain, there is scant scientific support for its use. There are promising findings in some conditions, such as chronic low-back pain and osteoarthritis of the knee; but, for most other conditions, additional research is needed. The National Center for Complementary and Alternative Medicine (NCCAM) sponsors a wide range of acupuncture research. Unfortunately, overall, it can be very difficult to compare acupuncture studies to draw conclusions from the cumulative body of evidence because these studies are not standardized as well as conventional Western medical studies. Acupuncture trials tend to use different acupuncture techniques, patient groups, controls (comparison groups), and outcome measures (definitions of successful treatments) from acupuncturist to acupuncturist and are therefore difficult to compare.
Scientific trials studying the effects of acupuncture on pain are difficult to standardize because pain trials in general are difficult to standardize. Pain is defined as an unpleasant sensation produced in the central nervous system (the brain and the spinal cord) by a variety of chemicals (neurotransmitters, hormones, etc). Both pain medications and acupuncture are thought to decrease pain by blocking a multitude of pain signals to the central nervous system and also by causing the release of endorphins (morphine-like chemicals produced by the body when in pain or stress) from the central nervous system. There is no one identifiable crucial pathway to isolate or focus on. There are some promising studies using functional MRI (pathways flash light when activated).
Traditional Chinese medicine, on the other hand, explains acupuncture in terms of “qi,” (pronounced “chee”) or the body’s “vital energy.” Pain and pathology result from disruption in the flow of qi. When qi is disrupted, the body’s “yin” and “yang” are also disrupted. Yin and yang are opposite, complementary forces that combine to form a whole. Acupuncture seeks to restore and then regulate the flow of vital energy and therefore the yin and yang.
Despite the lack of scientific evidence for acupuncture’s efficacy, anecdotal support for its benefits is strong. Acupuncture has been used successfully for centuries for pain management. Both the National Institutes of Health (NIH) and the World Health Organization (WHO) have endorsed its use as a primary treatment for pain management. Acupuncture’s holistic approach evaluates the entire body, which is particularly helpful when Western medicine cannot identify a particular cause for a condition.
[i] Barnes et al. “Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007.” National Health Statistics Report. Number 12, December 2008.