I have wondered how acupuncture worked as I grew up watching my grandmother receive doses of this "oriental medicine." She was relieved from her pain after the treatment of inserting needles through the parts of her aching body. Yahoo Health states that acupuncture gives 50 to 70 percent of patients with chronic pains a temporary or even a long-term relief (1). How does acupuncture actually work or does it even work at all?
First of all, the name itself describes this procedure: "puncture" stands for insertion of needles at specific surfaces of the human body. The general theory of acupuncture is that there are patterns of energy flow called Qi through the body that are essential for health. Disruptions of this flow are thought to be responsible for disease. Acupuncture is believed to correct the imbalances of Qi flow at identifiable points close to the skin through the needles.
There are a variety of approaches to diagnosis and treatment in American acupuncture that incorporate medical traditions from China, Japan, Korea, and other countries. The most common method is employing penetration of the skin by thin, solid, metallic needles, which are manipulated manually or by electrical stimulation. In practice, most practitioners of Oriental-style acupuncture administer a partial physical examination, including pulse-taking and tongue examination, during the first visit. They also tend to take a very detailed medical history, like nutritional habits and other environmental factors. After, if the practitioner decides that the patient is qualified for acupuncture treatment, the needle insertion takes place.
The actual insertion of the hair-thin, disposable needles is like a mosquito bite. After insertion, the needles are twirled or connected to a mild electrical current. This process can cause a mild tingling or aching sensation referred to as "de qi." The depth and time of needle insertions may range from a fraction of an inch up to about one inch deep, and the needles can be withdrawn a few seconds after insertion or kept in place for up to 30 minutes. Typically, a treatment session lasts from 20 minutes to 1 hour, though the initial visit may take longer. Duration of therapy may range from a few treatments for acute, temporary problems to regularly scheduled treatments over several months to treat chronic conditions.
According to ancient Chinese medical theory, the life force called qi or ch'i flows through the body via 14 invisible channels called meridians that regulate all of the body systems. The meridians are thought to run deep within the body's tissues and organs, surfacing at some 360 places identified as acupuncture points. Stimulating these points is said to balance and restore the flow of ch'i.
But what does acupuncture mean in a biological way? The National Institutes of Health (NIH) reports that studies in animals and humans have demonstrated that multiple biological responses are linked to acupuncture. These studies have found that responses can take place at or close to the point of insertion or at a distance. In the response at a distance, sensory neurons are mediators to many structures within the central nervous system. The findings suggest that pathways that affect numerous physiological systems in the brain and in the periphery may be activated by acupuncture (2).
Other NIH researchers have found that acupuncture may also activate the hypothalamus and the pituitary gland. The effects of acupuncture may include changes in the regulation of central and peripheral blood flow and in neurotransmitter and neurohormone secretions. Furthermore, NIH has found evidence that acupuncture produces changes in immune functions as well (3).
Whether acupuncture mediates these physiological changes still remains unclear. Furthermore, even after many attempts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. Moreover, the scientific basis for key traditional Eastern medical concepts, such as the circulation of Qi, the meridian system, and other related theories, are difficult to relate with contemporary biomedical information. Yet these concepts continue to play an important role in evaluating of patients and formulating acupuncture treatment.
Many factors may profoundly impact therapeutic outcome along with the treatment, including the quality of the relationship between the clinician and the patient, the degree of trust, the expectations of the patient, as well as a myriad of factors that together define the therapeutic milieu. Young Ahn, a patient who has received acupuncture, recommends this form of alternative medicine to people with an open mind: "I recommend acupuncture, but it depends on the mindset of the person. This form of medicine has been in existence for thousands of years, so I'm convinced there is some validity to it. However, if someone were to walk in completely doubtful, I think they would be able to convince themselves that there were no results." These individuals believe that acupuncture only has placebo effects. The health section of Yahoo reports that 50 percent of the patients receiving fake, imitation treatment experienced the same amount of relief as patients who are given an actual acupuncture treatment (1).
Regardless of reason, there are positive physical effects of treatment with acupuncture. NIH reports that there is clear evidence that needle acupuncture is efficacious for adult postoperative and chemotherapy nausea and vomiting and probably for the nausea experienced during pregnancy. There also is evidence of the efficacy for postoperative dental pain. Furthermore, NIH reports that there are studies of the impact of acupuncture on diverse pain conditions, such as menstrual cramps, tennis elbow, and fibromyalgia (3). This suggests that acupuncture may have a more general effect on pain. In addition, the World Health Organization reports that acupuncture has been successful in the treatment of addictions to alcohol, tobacco, and other drugs, treatment of pulmonary problems such as asthma and bronchitis, and rehabilitation from neurological damage such as that caused by stroke (4). The research suggests some exciting potential use of acupuncture, but the quality or quantity of the research evidence is not sufficient to draw a firm conclusion. Although more research is merited to better understand the effects of acupuncture, the benefits are apparent. As the practice and popularity of acupuncture continue to grow, it is anticipated that this type of treatment will become an important component of healthcare.
Steve is currently a sophomore majoring in chemistry. His aspiration is to become a missionary doctor.
