What does Acupuncture treat? • What is Acupuncture? • How does Acupuncture Work? • Does Acupuncture Work? • What can I expect and how long does it take? • Acupuncture Point Selection • Nerves vs. Meridians

What does Acupuncture treat?

“Acupuncture does not treat any particular pathological symptom but normalizes homeostasis and promotes self healing. Thus acupuncture, in terms of its therapeutic mechanisms, is non-specific: acupuncture does not target any particular symptom or disease but treats the body as a whole.”

What is Acupuncture?

Acupuncture is one of the oldest, most commonly used medical procedures in the world. Originating in China more than 2,000 years ago, acupuncture began to become better known in the United States in 1971, when New York Times reporter James Reston wrote about how doctors in China used needles to ease his pain after surgery.

The term acupuncture describes a family of procedures involving stimulation of anatomical points on the body by a variety of techniques. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries. The acupuncture technique that has been most studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.

Acupuncture is part of a larger paradigm of medicine found throughout Asia known as Oriental Medicine. While China has contributed much to the recognition of Oriental Medicine, all countries in Asia have their own traditional healing systems, which include dietary medicine, herbal medicine, massage therapies, and movement therapies. Acupuncture is one such modality and is practiced traditionally in China, Japan, Korea, Vietnam, and Tibet and as far west and south as South India and Sri Lanka. Oriental Medicine in the US is taught in 4 year medical schools more commonly referred to as acupuncture schools, though acupuncture is only one part of the curriculum. Oriental Medicine is also known as Traditional Chinese Medicine (TCM) by its Chinese practitioners, and generally as Oriental Medicine by non-Chinese practitioners.

How does Acupuncture Work?

Acupuncture is one of the key components of the system of traditional Chinese medicine (TCM). In the TCM system of medicine, the body is seen as a delicate balance of two opposing and inseparable forces: yin and yang. Yin represents the cold, slow, or passive principle, while yang represents the hot, excited, or active principle. Among the major assumptions in TCM are that health is achieved by maintaining the body in a “balanced state” and that disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi (vital energy) along pathways known as meridians. It is believed that there are 12 main meridians and 8 secondary meridians and that there are more than 2,000 acupuncture points on the human body that connect with them.

Preclinical studies have documented acupuncture’s effects, but they have not been able to fully explain how acupuncture works within the framework of the Western system of medicine that is commonly practiced in the United States. It is proposed that acupuncture produces its effects through regulating the nervous system, thus aiding the activity of pain-killing biochemicals such as endorphins and immune system cells at specific sites in the body. In addition, studies have shown that acupuncture may alter brain chemistry by changing the release of neurotransmitters and neurohormones and, thus, affecting the parts of the central nervous system related to sensation and involuntary body functions, such as immune reactions and processes that regulate a person’s blood pressure, blood flow, and body temperature.

Does Acupuncture Work?

According to the NIH Consensus Statement on Acupuncture, there have been many studies on acupuncture’s potential usefulness, but results have been mixed because of complexities with study design and size, as well as difficulties with choosing and using placebos or sham acupuncture. Promising results have emerged, showing efficacy of acupuncture, for example, in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations–such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low-back pain, carpal tunnel syndrome, and asthma–in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. An NCCAOM-funded study recently showed that acupuncture provides pain relief, improves function for people with osteoarthritis of the knee, and serves as an effective complement to standard care. Further research is likely to uncover additional areas where acupuncture interventions will be useful. NIH has funded a variety of research projects on acupuncture. NCCAOM, its predecessor the Office of Alternative Medicine, and other NIH institutes and centers have funded these grants.

* Visit the NCCAOM Web site, or call the NCCAOM Clearinghouse for more information on scientific findings about acupuncture.

What can I expect and how long does it take?

Before acupuncture treatments can be administered, an initial consultation is required. These consultations are diagnostic, highly educational and practical sessions. The practitioner must assess the cause and pathology of the situation. This can range from the obvious to the very subtle. Orthopedic conditions require a physical assessment to determine whether the condition is purely channel based and orthopedic (ie, injury) or whether internal organ pathology is involved. Regardless, there is usually some degree of both involved, even more so in chronic conditions.

With acupuncture assessments, time usually allows for treatment on the first visit. The first visit is usually 90 minutes long and includes both assessment and first treatment. Follow-up treatments are one hour or less.

The initial acupuncture assessment yields several important pieces of information unique to the practice of acupuncture and Oriental Medicine:

(1) Internal organ pathology: this is essential to the practice of Oriental Medicine, which has a rich history of internal medicine involving sophisticated assessment of each of the bodies 6 yin organs and 6 yang organs, and the treatments used to restore harmony between the organs. One or more of the 6 pathogens can invade and effect the functioning of the organs. Such pathologies can go undetected for years giving rise to serious illness if left untreated.

(2) Channel pathology: this is essential to the practice of acupuncture and acupressure, which draws upon extremely complex understanding of the 14 primary channels (Jing Lou). Channel pathology can reflect internal organ pathology or localized channel pathology not involving the organs. A skilled practitioner must differentiate the two.

(3) The balance of yin and yang: this is classic to both Oriental Medicine and its Taoist philosophical roots. The balance of yin and yang within all the tissues and organs is key to longevity. Some organs and tissues may express more yin, while others more yang activity.

Acupuncture Point Selection

The selection of points in the clinical treatment of pain is a combination of sophisticated diagnostic training, knowledge of traditional point functions and intuitive judgment, and depends greatly on the patient’s unique clinical expression. There have been several attempts to create recipe books of point selections for specific types of pain, but often in clinic it is never that simple. Several issues are considered in the selection of points. Besides which points to use, the practitioner must judge how many points to use, whether to use local points or distal points or both, whether to needle unilaterally or bilaterally, how long to retain the needles for, how strong the stimulation of the needles should be, and how many treatments it will take until the pain is either under control or gone? These are only a few of the major questions the acupuncturist is trained to consider, and no two persons may receive the same treatment for seemingly similar types of pain.

Nerves vs. Meridians

It is natural for us to speculate that the actions of acupuncture points and meridians would have a direct correlation to the nervous system. How else can “information” leading to pathological changes be distributed from one area of the body to another? How can inserting a hair-thin needle between your thumb and index finger affect one’s headache? There is evidence that the connection may be neurological, and yet there is also evidence that it is not. Studies of what are called Propagated Sensations along the Channel, or PSC ‘s have demonstrated that the propagation rate of electrical signaling along nerves is 100 times faster in unmyelinated neurons and as much as 10,000 times faster in myelinated neurons than the propagated sensation along meridians. This would seem to demonstrate that the channels are at least functionally different from nerves. Evidence that they are the same would include a study of phantom pain PSC, which would suggest that they share similar mechanisms of propagation within the spinal cord.