Acupuncture / Acupressure
Acupuncture is a form of traditional Chinese medicine and is one of the world’s oldest healing practices, having been practiced throughout China and Asia for thousands of years. The goal of acupuncture is to restore and maintain health via the stimulation of specific parts of the body. In general, the term “acupuncture” encompasses a multitude of procedures that involve stimulating various points on the body using a variety of techniques. The most frequently-studied technique involves penetration of the skin by thin, solid, metal needles which are then manipulated manually or by electrical stimulation.
Acupuncture is based on traditional Chinese medicine principles that view the body as a delicate balance of two opposing, yet inseparable, forces known as “yin” and “yang.” Yin is the cold, slow, and passive principle, whereas yang represents the hot, excited, or active principle. In traditional Chinese medicine, good health is achieved when the body maintains a balanced state (i.e., a balance between yin and yang), while disease results from an internal imbalance of the two forces. When yin and yang are imbalanced, the flow of vital energy – referred to as Qi – is blocked along various pathways in the body. These pathways are known as meridians. Practitioners of traditional Chinese medicine believe that Qi can be unblocked when acupuncture is applied to specific points on the body that connect to these meridians. The number of actual meridians is not agreed upon, but the total number ranges from 14 to 20, and there are over 2,000 acupuncture points on the body.
In the United States, acupuncture is frequently practiced by a variety of practitioners for the relief and prevention of pain and a number of health conditions. According to the National Center for Complementary and Alternative Medicine, over three million adults in the United States use acupuncture annually. Pain (back, joint, neck, migraine, and recurring) and musculoskeletal complaints account for seven out of the top 10 conditions for which acupuncture therapy is sought.
Types of Acupuncture and Associated Therapies
There are several forms of acupuncture, as well as several associated therapies.
- Ear acupuncture – also referred to as auricular therapy – has long been used in China and is generally incorporated into regular acupuncture treatment.
- Japanese acupuncture uses thinner needles (and even non-invasive techniques) and involves a more hands-on approach from the acupuncturist.
- Electrical acupuncture uses the application of a pulsing electrical current to the needles in order to stimulate them. This is in contrast to manual stimulation that is performed in basic, traditional Chinese medicine acupuncture.
- Cupping is a method used to stimulate acupuncture points and involves the application of a heated cup to the skin to create suction.
- Moxibustion involves burning moxa, which is a cone or stick made of dried herbs (typically mugwort), on or near the skin. Moxibustion is sometimes used along with acupuncture.
Risks of Acupuncture
Acupuncture needles are regulated by the U.S Food and Drug Administration (FDA) and available only to licensed practitioners. The FDA requires that the needles be sterile, nontoxic, and labeled for single use. In addition, the FDA also monitors complications and adverse events that result from the use of acupuncture therapy (as it does for any drug, medical device, or procedure). Few complications have been reported to the FDA, however among those that have, the most common complications result from inadequate sterilization and improperly delivered treatment. Sterilization is important to prevent infection, whereas improperly delivered acupuncture can puncture internal organs.
What to Expect
Some medical doctors and dentists are licensed to practice acupuncture, and those that do not may be a good source for referral to a licensed practitioner. Most states require a license to practice acupuncture but requirements to obtain licensure vary from state to state. It is important to note that a license does not guarantee quality of care; it means only that the acupuncturist meets certain established standards regarding the use and knowledge of acupuncture.
Before initiating therapy, a practitioner will take a detailed health history to better understand your past health issues, current health status, and the condition for which you are seeking treatment. It is important to inform your acupuncturist about any other treatment you are receiving, including medications.
Actual treatment involves inserting the hair-thin needles into various acupuncture points on the skin, at various points on the body. Most people experience little or no pain when the needle is inserted if therapy is administered correctly. Needles are generally inserted from 1/4 to one inch in depth depending on the location. Treatments are typically done over the course of several weeks. Some health insurance providers cover the cost of acupuncture therapy while others do not.
Acupuncture has been widely studied in relation to a number of conditions and diseases in an attempt to ascertain its health benefits, and the National Center for Complimentary and Alternative Medicine (NCCAM) funds research for the purpose of advancing the scientific understanding of acupuncture. However, acupuncture is difficult to study because of the variety of acupuncture techniques that can be used and the difficulty in choosing control subjects for a clinical trial. In terms of its effectiveness, acupuncture has been demonstrated to be effective for some conditions, while for others it has not. Carpal tunnel syndrome, lower back pain, neck pain and dental pain following oral surgery may all be helped by acupuncture. The evidence to support a beneficial role for acupuncture in headaches/migraine, menstrual cramps, myofascial pain, and arthritis is conflicting.
There is also insufficient evidence regarding the effectiveness of acupuncture to treat Fibromyalgia. Specific research is often geared to the individual symptom being treated (i.e., sleep disturbances, muscular pain, headache) rather than the condition of Fibromyalgia overall.
A 2006 study by Martin et al. investigated whether acupuncture could improve the symptoms associated with Fibromyalgia. This randomized controlled trial (a study design that is the “gold standard” for research) randomly assigned 50 Fibromyalgia subjects to receive either true acupuncture therapy or simulated acupuncture therapy (25 subjects per group). All Fibromyalgia patients had a confirmed diagnosis of the condition and were enrolled in the Mayo Clinic’s Fibromyalgia Treatment Program. Any subject who had a bleeding disorder or who had previously tried acupuncture was excluded. To measure the effectiveness of acupuncture, each subject completed questionnaires to measure their pain severity and the impact of Fibromyalgia on their daily activities throughout the course of their treatment, as well as at the beginning and end of the study, and one and seven months after completion of the study. Subjects received acupuncture every two to four days over the course of two to three weeks for a total of six sessions
At the end of the study, the researchers found that the Fibromyalgia symptoms were greatly improved for the group that received acupuncture versus the control group. The symptoms that were reported to improve the most were fatigue and anxiety. The researchers concluded that acupuncture may have a role in the symptom management of Fibromyalgia but cautioned that further research is needed.
A more recent randomized controlled trial looked at the use of acupuncture to treat Fibromyalgia in 16 subjects. The study found that those who received acupuncture had greater reductions in pain and improvement in quality of life as measured by standardized questionnaires. This study was quite limited by the small number of subjects who participated (Itoh and Kitakoji, 2010).
Martin-Sanchez et al. conducted a systematic review and analysis of the available randomized controlled trials regarding acupuncture and Fibromyalgia. Of the 59 studies that were identified, six met the authors’ inclusion criteria for analysis. Based on their review, the researchers found no support to suggest that acupuncture is an effective method to treat the symptoms associated with Fibromyalgia (Martin-Sanchez et al., 2009).
Learn more about Fibromyalgia Symptoms here.