Pain Management With Acupuncture

Acupuncture as a healing tool has been around for many, many years. In fact, it is one of the oldest medical arts. The use of modern acupuncture is increasing in popularity for pain and other health conditions. In this report, Dr. Ji-Sheng Han from the Neuroscience Research Institute and Department of Neurobiology in Beijing, China brings us up-to-date on acupuncture for pain relief.

Since 1991, there have been almost 4,000 research articles published on the topic of acupuncture. Almost half of those (41 per cent) were just on the use of acupuncture for pain control. With advances in technology, more and more evidence is mounting to show the benefit of acupuncture.

The basic idea behind acupuncture is that by placing a needle through the skin, blocked channels of energy called meridians can be reopened. The result is a balancing of the body’s energy flow (called Qi, pronounced “chee”). Meridians flow through every part of the body from head-to-toe.

Now that there’s no doubt acupuncture is a valuable treatment tool, many more studies are underway. Scientists are looking for the best location for needle placement to get the most optimal results.

At the same time, methods of application (e.g., depth of needle placement, needle placement inside versus outside meridian pathways, length of time in place) are being studied. It’s likely that each medical condition treated will have specific points that are most effective.

And it’s possible that individual variability exists. In other words, each patient when matched by age, gender, body type, and condition or problem will respond slightly differently when the same acupuncture technique is applied.

What we know so far is that when used before and after surgery, acupuncture helps reduce pain, nausea, and vomiting. Chronic pain seems to respond after several treatments (usually one to two sessions each week for three weeks). Some people are more sensitive to this modality. They seem to respond better to weaker needle stimulation spaced out over a longer period of time.

For those who think a positive response is just a placebo effect (the person expects to get better and does), there is a grain of truth to that. But studies have also shown that the psychologic response is separate from an equally powerful physiologic response. And interestingly enough, the pathways in the nervous system and brain that light up on functional MRIs (fMRI) are different when studying sham versus real acupuncture.

Where does this leave the science of acupuncture study? There are still some areas where further study is needed. For example, are the meridians (channels or pathways of energy flow) separate from the nervous system?

Are the acupoints specific for diseases? What prescription (if any can be determined for each condition) is advised? Can needles be placed anywhere in the body and still get the same response?

Today’s acupuncture treatments can be stimulated manually (after the practitioner places the needles, he or she turns and twists them). Or they can be stimulated electronically, a technique called enhanced acupuncture (EA). Needles can be replaced with skin electrodes, a process called transcutaneous electrical acupoint stimulation (TEAS). The different electrical applications and frequencies of the electric pulses will require additional study and comparison.

Other questions that have been raised for future study include: should everyone who is having surgery also have before and after acupuncture treatment? Will that add to the cost of health care or save money in the long-run? And, of course, what every scientist wants to know: how does acupuncture really work?

These and many, many other questions will need to be studied before acupuncture will replace more traditional approaches in western medicine. But from the evidence gathered so far, acupuncture as a safe and effective treatment tool for pain as well as other problems looks very promising.