Acupuncture is a method of alternative medicine originating from traditional Chinese medicine where extremely thin needles are inserted into the skin to stimulate specific points of the body. Starting with some brief history, this practice dates back to ancient China where it was first documented in the Huangdi Neijing (The Yellow Emperor’s Classic of Internal Medicine) around 100 BCE (White & Ernst, 2004). This text was an influential reference for traditional Chinese medicine for centuries and most likely acted as the foundation for modern acupuncture (Curran, 2008). This text also describes the flow of Qi (vital energy) which was believed to maintain good health when in balance. A Qi deficiency could mean that you are lacking in sleep, nutrition, or social interaction while excess Qi could mean stress, overeating, or exposure to toxins (Acupuncture & Massage College, 2017). (This idea seemed a bit silly to me as I am always stressed and lacking sleep. So, what does that mean for my Qi levels?) Acupuncture was believed to treat people by improving Qi flow and restoring balance by poking certain acupuncture points (Johns Hopkins Medicine, N.d.).
Acupuncture
is said to treat a wide variety of illnesses: musculoskeletal pain, headaches, addiction, and anxiety to name a few
(Johns Hopkins Medicine, N.d.). Ok, but how does acupuncture really work? Well, the answer is, we don’t
really know. Acupuncture is thought to stimulate the nervous system
(and probably your peripheral nervous system if you have a fear of needles)
to cause your body to release
chemicals that activates
its natural healing
abilities (Johns Hopkins
Medicine, N.d.). It is also believed that placebo effect
may play an important
role in the therapeutic effects of acupuncture. However, very
little is actually known about the mechanism, and we are just beginning to
understand its effects on the brain
and body. In fact, according to PubMed, in the recent years there has been an increase in research studying the clinical use of acupuncture.
It
seems that society now has become more open to alternative medicines, whether
it is because medicinal treatments
have failed or because people are simply seeking a more natural therapy. But the biggest question with
alternative medicine is, does it work? After all, even China thought it was bogus enough to completely ban the
practice in 1929 along with other forms of traditional Eastern medicine and it wasn’t until 1949 that the
Communist government reinstated such practices (White & Ernst, 2004). Despite the stigma we
Americans may have towards traditional Chinese medicine, there are actually significant amounts
of evidence showing
the benefits of acupuncture therapy.
A recent study conducted in The General Hospital of Western Theater
Command, Sichuan Province assessed
the effects of acupuncture of chronic lower back pain (Luo et al. 2019). In
this trial, participants were
randomly assigned to one of three treatment groups: hand-ear acupuncture,
standard acupuncture, and usual
care, which involved restorative exercise, strength training, medications, etc. (Luo et al. 2019). Ear acupuncture, or
auricular acupuncture, is thought to be similar to reflexology where the ear has regional organization
centers that represent different parts of the body created by pluripotent cells. When a certain region
is stimulated, it can relieve pathological symptoms from other parts of the body for a period of time
(Gori & Firenzuolli, 2007). The hand-ear acupuncture group were acupunctured at yaotongdian (lower back
pain points) EX-UE 7 on the hand every other day for 4 weeks followed by acupuncture at yaotongdian AH
9 on the ear twice a week for the remaining 3 weeks. The standard acupuncture group received routine needle treatment
curated by experts to specifically treat chronic
lower back pain every other day for 4 weeks and twice a week for the remaining
3. Finally, the usual care group
received usual care for the 7 weeks (Luo et al. 2019). The outcomes of this
study were assessed via a series of
blind interviews and measured at baseline, at 2 months after treatment, and at
6 months after. A modified
Roland-Morris Disability Questionnaire (RMDQ) was used to evaluate back dysfunction and the visual analogue scale
(VAS) was used to assess the severity of pain (Luo et al. 2019) This study found that both acupuncture
treatments were more effective than usual care; however, the hand-ear group improved notably better in
back function and lower back pain than the standard acupuncture treatment. The hand-ear group also showed better
improvement over time indicating better
long-term efficacy (Luo et al. 2019). This shows that acupuncture itself may
have therapeutic effects and it is
not dependent on placebo, as if that were the case, both acupuncture groups
would have similar results.
As
an Asian-America, I find traditional Chinese medicine really fascinating and I
think there is so much potential.
However, there is still a lot of doubt surrounding the practice. Now that we
have been conducting more research, I
believe that we are on the road to unlocking new and effective methods for treating patients. In a 2012
breakthrough documentary, Escape Fire:
The Fight to Rescue American Healthcare
(a fantastic film, I highly recommend), acupuncture was used as an
alternative to narcotics to reduce
pain in military soldiers during long and turbulent flights (Froemke &
Heineman, 2012). More research is
still needed to understand the underlying effects of acupuncture and there is
sill much to learn from ancient medicine.
By Emily Xu, A Bachelor's of Science Student at the University of Kentucky
References
Acupuncture
& Massage College. (2017, August 28). What
is Qi? Definition of Qi in Traditional Chinese
Medicine. https://www.amcollege.edu/blog/qi-in-traditional-chinese-medicine
A. White, E.
Ernst (2004). A brief history of acupuncture, Rheumatology, Volume 43, Issue 5, Pages 662– 663, https://doi.org/10.1093/rheumatology/keg005
Curran, J.
(2008). The Yellow Emperor’s Classic of Internal Medicine. BMJ : British Medical Journal, 336(7647), 777. https://doi.org/10.1136/bmj.39527.472303.4E
Froemke, S. & Heineman, M. (Director). (2012).
Escape Fire: The Fight
to Rescue American
Healthcare
[Film]. Aisle C &
Our Time Projects.
I loved this post! I am a big fan of natural and herbal remedies as I too grew up in an East Asian household where we practiced a lot of herbal remedies. I actually was recommended to do acupuncture by a family member who is a physician in Pakistan, and I did it when I was there and found it to be incredibly relaxing and beneficial. I experienced a lot of problems like insomnia, stress, and headaches so it was a good reset treatment. I do think this is a great form of treatment, and do think this could be a really effective alternative to medication for things like chronic pain where the use of opioids is far more difficult to use due to its addictive properties. I wonder if this is something that physicians could start prescribing if enough research were to be done. This was a study I actually was referred to a few years ago about acupuncture and its benefits to headaches.
ReplyDeleteLinde K, Allais G, Brinkhaus B, et al. Acupuncture for migraine prophylaxis. Cochrane Database of Systematic Reviews. 2009;(1):CD001218. Accessed at www.thecochranelibrary.com on July 2, 2014.
This blog was very well-written! I have never received acupuncture myself (it probably doesn't help that I am also slightly terrified of needles), so I have no personal anecdote to provide, however I am also loving this resurgence of appreciation for alternative remedies. I was also intrigued by how the hand-ear acupuncture group in the study you mentioned had the most improved back-pain out of the three experimental groups. At first, it may seem that treating the hand-ear area would be counterintuitive for back pain, but the results say otherwise! I definitely agree that this is an area that should be researched more and not so readily dismissed since it has clear potential to help.
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DeleteI really loved this blog post as I think it covers a topic that while I think it fascinating, I have not done much research on. The documentary you talk about is such an interesting one! I think I watched it last year for one of my classes. I recall the acupuncture section to be the one that stood out to me the most because it actually did help these military personnel. I had really only seen seen acupuncture in television shows, so I have always been interested in if it actually works; the evidence you provided shows that it has been implicated to work in several pain areas which I find fascinating. Like Madison, I have never received it but would be interested to try it (I do not have a fear of needles). Looking at several website (notably, Johns Hopkins) I see that it may also be used in stroke rehabilitation. I've been in a neuroscience lab that studies spinal cord injury (and has collaborated with a stroke lab) for the past 3 years and think that acupuncture could work for some of the issues stroke causes. There is absolutely more research that can be done with acupuncture, and I would be interested to see more widespread research done in animal models to fully understand the mechanism.
ReplyDeleteThis topic is a nice break from the more modern therapeutics that've been discussed in previous blogs. I have always wanted to try acupuncture, but have never had the opportunity to do so. I enjoyed learning more on how acupuncture is able to elicit healing mechanisms and the release of toxins, as I have always thought it was just a placebo. I think that understanding which musculoskeletal groups can be treated at each acupuncture point would be an interesting area of research. I would be interested to see how many areas of the body could be treated by acupuncture at a single point. I've also never really heard of the stigma regarding Chinese medicine and practices, so it would be very interesting to learn why there is such a stigma associated with them.
ReplyDeleteChinese medicine mostly gets bad rep because there's not very much research backing it legitimacy. There is also strong criticism from animal activists because some traditional Chinese medicines uses ingredients from endangered animals such as ivory. Racism is also a contributing factor. People are so used to "sterile" Western medicine that the more "exotic" traditional alternative is often seen as uncivilized in some ways.
DeleteAcupuncture is a fascinating topic. I find it incredible that it has been used for ages but we still are not entirely sure how it works mechanistically. As Sarah mentioned, alternatives to opioids for pain treatment is also an important issue that we need to address as a society, and acupuncture is certainly among those alternatives. You mention that part of the effectiveness may be due to placebo effect, but hey, if it works it works. I find it especially interesting that it is effective for chronic pain. When I think of acupuncture, I think more of muscle tightness and soreness than of genuine pain issues. Clearly there is more to it than that, and I was enlightened by your post!
ReplyDeleteThis is an interesting topic especially today since many people I think are trying to move away from going under the knife right away. Many people would prefer trying other less invasive treatments before have a surgery or another operation to fix an issue. I think that this offers a lot of promise. I also found that they can treat depression with acupuncture, which is interesting and I would like to understand more of how that works. However, as you mentioned this is still very hard to study due to the placebo effect. Hopefully in the future they can come up with a solid control group so that we can see the effectiveness of this treatment!
ReplyDeleteAcupuncture, along with other natural remedies are some what of an anomaly in the world of modern medicine. It is interesting that many of these remedies including acupuncture have no explanation, but show positive results. The theories behind acupuncture are something that has potential to make its way into modern medicine. Pressure points are something that we all feel and maybe there is really something about connecting these pressure points that can help the body heal or manage chronic pain. Chronic pain is something that we really are struggling with figuring out how to treat, and maybe acupuncture can be an answer to this problem.
ReplyDeleteI have always found acupuncture an interesting subject, being that it is a practice that always seems to be highly rated by people who use it, but seems to escape rational explanation of how the practice exerts its beneficial effects. I think one area to look at is the mapping of peripheral nerves compared to the diagrams in the older manuscripts. One thing to notice from this presentation is that the yaotongdian points seem to coincide with branches of the ulnar and median nerves. Maybe following along those lines will reveal something more concrete on the physiology of acupuncture.
ReplyDeleteI enjoyed reading this and see potential for this therapy to resurge into more mainstream practice. I have had a substantial amount of experience with this form of treatment and similar techniques using needles (dry needling, electrostimulation, etc.) and can attest to the effectiveness of the release of muscle tension and increased blood flow. I have received different explanations from the respective practitioners regarding the basis for the effectiveness, commonly pointing to the lymph drainage and subtle activation of localized inflammatory response associated with these treatments. I have read similar studies looking into the effectiveness of acupuncture with electrical stimulation in treating pain, which was found to significantly reduce pain beyond a placebo. The effective combination f the hand and ear points is an interesting finding and I wonder if there is some explanation in the embryology of these areas, if not peripheral nerve mapping like Jordan described.
ReplyDeleteI really enjoyed reading this post! I am from Mexico and in Mexico alternative medicine is commonly used so it's nice to read about other forms of alternative medicine. I do agree with the statement you mentioned that the benefits of acupuncture could also be a placebo effect. However, I can definitely see the benefits of acupuncture especially for chronic pain management and other conditions. The article "The role of Acupuncture in Pain management," discusses the role and involvement of acupuncture in relieving pain by altering intracellular mechanisms like calcium channels. however, since there is not much research on acupuncture as an alternative treatment method (or along With other treatments) do you think there could be negative risks associated with acupuncture and what it effects? If so, what risk do you think there could be?
ReplyDeletePatil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. https://doi.org/10.1007/s11916-016-0552-1
Alternative medicine has always been an interesting topic to me. Despite its lack of research, many practices of it been around for centuries with great success. This could be due to placebo effect though, because there have been no practical explanations as to how these practices create their beneficial effects. Despite its lack of research, there is lots of potential for its use in modern practice as alternative treatments for many problems.
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