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Acupuncture

Acupuncture

Introduction

Acupuncture originated in China more than 2000 years ago and is an important component of Traditional Chinese Medicine (TCM). As per the TCM, health is maintained by keeping the human body in a ‘balanced state’ by maintaining the balance of yin yang. Acupuncture consists of stimulating some special points on the body using fine needles, so as to restore the balance of body. With its growing worldwide popularity, acupuncture is now considered as one of the important complementary and alternative medicine (CAM) therapies.

History

Acupuncture is believed to have originated in China. Some documents that were found in the Ma-Wang-Dui tomb in China, which was sealed in 198 BCE, contain some reference to a system of meridians. The Yellow Emperor’s Classic of Internal Medicine, dating from about 100 BCE, was the first document that described ‘acupuncture’ as a treatment option. Acupuncture was passed in codified text over centuries to evolve as one of the standard therapies used in China.

The practice of acupuncture declined in the seventeenth century as it was regarded as superstitious and irrational. However, after the installation of the Communist Government in 1949, practice of acupuncture was restored, and included in a consensus known as TCM. Acupuncture became famous in America and Britain in the first half of the nineteenth century, when it also appeared in some of the scientific publications including a Lancet editorial article entitled ‘Acupuncturation.’

How is Acupuncture Performed?

Acupuncture involves insertion of fine needles (32–36 gauge) through some specific points, known as acupoints, located on the meridians or the channels of energy flow. As per the classic texts, there are 12 main meridians, and eight secondary meridians. It is believed that there are more than 2000 acupoints in the human body that connect with the meridians.

A skilled practitioner known as “acupuncturist” performs acupuncture. The needles are inserted to a depth of 4 to 25 mm. The sensation of needle insertion is felt as a tingling or dull ache at the entry point. The number of needles inserted, and the time for which they are held in place varies from few seconds to few minutes. This is determined by the acupuncturist, and mainly depends upon the disease state of a patient. Many patients are hesitant to receive acupuncture treatment due to needle phobia, or occurrence of adverse events, such as bleeding, infection, etc. However, evidence suggests that serious adverse events occur rarely, and skilled practitioner knows how to reduce these risks.

Electro acupuncture (EA) is a type of acupuncture that uses a tiny focused electric current applied to the needle, or directly to the skin at the acupoints. Similarly, in laser acupuncture, a fine low-energy laser beam is directed onto the acupoint.

Biological Mechanism

As per the TCM, the human health is achieved by maintaining the balance of yin yang. Any imbalance in the body causes blockage in flow of Qi (vital energy), leading to a diseased state. Acupuncture is thought to show its pain relieving effects based on several theories.

Gate Control Theory: According to the Gate Control Theory, effect of painful stimulus can be suppressed with another stimulant (pricking a needle).

Release of Chemicals: Another theory explains that acupuncture stimulates the production of chemicals, such as endorphin, serotonin, and acetylcholine, which relieves the pain.

Raising Pain Threshold Theory: According to this theory, acupuncture stimulates the analgesia (pain reduction) mechanism of the body by causing pain in the area that needs to be treated for pain.

Therapeutic Benefits

Reduction of pain

The use of acupuncture has been proven clinically in treatment of various painful conditions, such as post-traumatic somatic pain, knee pain, and rheumatoid arthritis.

Depression

Acupuncture promotes physical and emotional wellbeing in depressed people. It can also help resolve physical ailments, such as chronic pain, which may be a contributing cause of depression. Acupuncture can be safely combined with conventional medical treatments, such as anti-depressants, helping to reduce their side effects and enhance their beneficial effects.

Eating Disorder

Acupuncture is believed to stimulate the nervous system, which produces certain biochemical changes in the body. This can address the emotional and physical discomforts of eating disorders. Acupuncture is known to improve the quality of life and decrease anxiety in people suffering eating disorders.

Menopause

Acupuncture can contribute to a marked clinical improvement in hot flashes and menopause-related symptoms in women. The results of few studies suggest that acupuncture can be effective in treating anxiety and depression related to menopause.

Diabetes

Acupuncture lowers hyperglycemia, attenuating symptoms like polyphagia (increased appetite), polydipsia (increased thirst), and polyuria (increased frequency of urination). The therapeutic effects of acupuncture in diabetes are thought to occur due to release of variety of neurotransmitters (hormones) that produce various anti-inflammatory signals.

High Blood Pressure

Clinical studies indicate that acupuncture when combined with anti-hypertensive drugs, shows significant reduction in both, systolic and diastolic blood pressure. However, since the mechanism by which acupuncture lowers blood pressure is not clear yet, it is not recommended in clinical practice.

References:

  1. Wilkinson J, Faleiro R. Acupuncture in pain management.ContinEducAnaesthCrit Care Pain (2007) 7 (4): 135-138.
  2. Demir Y. Non-Pharmacological Therapies in Pain Management. In:Racz GB, Noe CE. Pain Management – Current Issues and Opinions, ISBN 978-953-307-813-7. http://cdn.intechopen.com/pdfs/26152/InTech-Non_pharmacological_therapies_in_pain_management.pdf, Accessed September 6, 2013.
  3. Audette JF, Ryan AH. The role of acupuncture in pain management. Phys Med RehabilClin N Am. 2004; 15(4):749-772.
  4. White A, Ernst E. A brief history of acupuncture. Rheumatology 2004; 43:662–663.
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