Acupuncture

The origin of acupuncture...

Acupuncture evolved from principles and philosophies unique to Oriental medicine.  First references date back to the Han Dynasty in the ancient Chinese medical text "Huang Di Nei Jing" (The Yellow Emperor's Classic of Internal Medicine), originating between approximately 300 and 100 BC.

In the 17th century, Waichi Sugiyama developed the insertion tube, a small cylindrical tube through which the acupuncture needle is inserted.  This insertion method is still used today by practitioners worldwide, and in Japan by over 90% of acupuncturists.

Acupuncture began to gain popularity in the US in the 1970's, when New York Times reporter James Reston wrote about how needles were used by Doctors in China to ease his pain after surgery.

In 1996, the US Food and Drug Administration (FDA) classified acupuncture needles as medical instruments, and approved the needles for use by qualified practitioners.  The FDA requires that sterile, non-toxic needles be used and that they be labeled for single use by qualified practitioners only.  Very few complications from the use of acupuncture have been reported to the FDA in view of the millions of people treated each year and the number of acupuncture needles used.  

To prevent complications resulting from inadequate sterilization of needles and from improper delivery of treatments, practitioners always use a new set of disposable needles taken from a sealed package for each patient.  Each treatment area is also swabbed with alcohol or another disinfectant before inserting needles.  When not delivered properly, acupuncture has the potential to cause infection.

Respected & medically recognized...

Though acupuncture may seem strange to some people, not only has it received significant validation from the medical industry, but it is one of the most thoroughly researched and documented forms of natural healthcare.  A series of controlled studies has shown evidence for the effectiveness of acupuncture in the treatment of a many conditions, including chronic pain management, fatigue, digestive problems, osteoarthritis, chemotherapy-induced nausea, back pain, asthma, painful menstrual cycles, incontinence, and migraine headaches.

Today, acupuncture has become an integral part of the healthcare system and is often offered in conjunction with other more traditional therapies.  In the US, acupuncture has grown into what is now a common form of pain management therapy available in many pain management clinics and hospitals.  At least 1/3 of pain treatment centers within the US provide acupuncture as a therapy.  It is also either partially or completely covered by most of the major health insurance plans.

In November, 1997, the National Institute of Health (NIH) issued a report titled:  "Acupuncture:  The NIH Consensus Statement."  It stated that acupuncture is a very useful method for treating many conditions, acknowledging that the possible side effects are considerably less adverse than other medical procedures, surgery or medications.  In addition, the NIH made the recommendation to health insurance companies within the US to provide full coverage of acupuncture treatments for certain conditions.  This is a significant advancement in the status of acupuncture, which has in turn influenced the acceptance of acupuncture throughout the world.

How does acupuncture work?...

In Oriental medicine, there are 20 blood vessels throughout the body.  These vessels consist of 12 main channels and 8 secondary channels that form a network of channels.  The 8 secondary channels supply blood to the main 12 channels.

Each vessel is related to an organ and system of the body:

1. Lungs
2. Heart
3. Pericardium (heart protector) 
4. Liver
5. Kidneys
6. Spleen
7. Small Intestine
8. Triple Heater (regulates flow in 3 different heat sections of the body)
9. Large Intestine 
10. Urinary Bladder 
11. Stomach 
12. Gall Bladder

If a vessel is blocked or congested, the organs and systems related to that vessel will be affected.  The classical Chinese explanation is that oxygen flows in vessels in specific patterns throughout the body.  These vessels are like rivers flowing throughout the body that irrigate and nourish the tissues.  Any obstruction in the movement of the oxygen throughout these vessels affects the flow of oxygen throughout the rest of the body.

Along these vessels, there are approximately 2,000 "acupoints."  These acupoints are the locations where the vessels rise closest to the surface of the body.  Of these 2,000 acupoints, more than 400 are classified by the World Health Organization (WHO).  Each acupoint is listed by name, number, and the vessel to which it belongs.  The acupuncturist learns how to diagnose the symptoms of a patient by feeling for a special "pulse" under the surface of the skin.  The insertion of a needle into an acupoint triggers specific reactions within the body:

• The stimulation of oxygen and blood flow
• The stimulation of the body's built-in healing mechanisms
• The release of endorphins, norepinephrine and enkephalins, the body's natural painkillers
• The reduction of pain
• A relaxing of tense, shortened muscles

Acupuncture can very effectively increase the flow of oxygen throughout the body to help resolve health issues.  The points that the practitioner chooses to stimulate are often not at the same location in the body where the symptoms are.  This is because points are all connected via the blood vessels flowing throughout the body.

Many studies have been focused on understanding the mechanism of acupuncture.  Pre-clinical studies have documented acupuncture's effects, but despite the medical technology available today, modern physicists have yet to fully explain how acupuncture works within the framework of the western medicine.  The modern scientific explanation is that stimulating the acupoints located along the vessels causes the nervous system to release chemicals and/or hormones in the muscles, spinal cord, and brain.  These chemicals either change the experience of pain, or influence the body's own internal regulating systems.

The following two points have been established:

• The stimulation of acupoints causes changes in brain chemistry, sensation, and involuntary bodily functions. This is done by altering the release of neurotransmitters (chemicals produced by the body that modify nerve impulses) and neurohormones, affecting the parts of the central nervous system related to sensation and involuntary bodily functions, such as immune reactions, regulation of blood pressure, blood flow, and body temperature.  Immune system cells are then directed to specific sites in the body that are injured or more vulnerable to disease.
  
  
• Many acupoints are near nerves that cause the muscles to respond when stimulated.  The stimulated muscle sends a message to the central nervous system (the brain and spinal cord), causing the release of endorphins (morphine-like chemicals produced in our own bodies during times of pain or stress).  Endorphins, along with other neurotransmitters, block the message of pain from being delivered up to the brain.  This may help explain the pain relief experienced from acupuncture.

What conditions does acupuncture treat?...

Even though acupuncture is often associated with pain relief, it is considered very effective at treating a variety of health conditions.  Often, those who undergo acupuncture have conditions that resist modern medical care, or that traditional doctors struggle to formally diagnose.

The World Health Organization recognizes the use of acupuncture in the treatment of more than 40 medical problems, including:

• Psychological issues (worry, anxiety, and tension)
• Morning sickness
• Urinary and reproductive disorders
• Digestive disorders such as constipation and heartburn
• Back and neck pain
• Sciatica 
• Respiratory disorders
• Skin conditions
• Neurological and muscular disorders
• Edema 
• Postpartum depression
• Allergies
• Spastic colon
• Incontinence (see below)
• Pregnancy issues, including breech birth and to stimulate labor (see below)
• Chronic pain
• Headaches
• Arthritis
• Cancer, nausea from chemotherapy
• Aids
• Hormonal disorders
• Post-operative nausea and vomiting from anesthesia and narcotic painkillers
• Drug and nicotine addictions

Acupuncture can also improve the functioning of the immune system.

Acupuncture can be effective as the only treatment used, or can support other medical treatments.  Medical doctors may combine acupuncture with fewer conventional drugs, or with drugs to control surgery-related pain.  Using such combinations, some doctors have found it possible to achieve complete pain relief for some patients.  For example, adding acupuncture sessions to antihistamine treatments can achieve comparable results to higher doses of using just the medication alone.  This means that side effects from medications (such as drowsiness or stomach upset) are also decreased. 

Pregnancy

Breech Birth
Acupuncture can be used for breech birth (a baby that needs to be rotated in the uterus).  The technique is typically used 32-34 weeks into the pregnancy, as past the 36th week, there is usually not enough room to rotate the fetus).  It is applied twice each day for up to 10 days, though most babies turn within 3 days.  Once turned into the appropriate headfirst position, the technique is no longer used as it may cause the baby to turn back to the breech position.

Inducing Labor
Needling specific points to induce labor after due date pregnancies can help stimulate uterine contractions.

Incontinence

An incontinence study conducted in Sweden included 15 elderly women who received 12 acupuncture treatments.  Evaluations were performed upon patient discharge and at 1 and 3 month follow-ups.  Almost all measurements were significantly improved.  Global scorings showed that 12 of the 15 women considered themselves improved, even at the 3 month follow-up.(1)

What special equipment is used?...

The most commonly used equipment in acupuncture is solid, very fine needles made of stainless steel.  The FDA requires that sterile, non-toxic needles be used that are labeled for single use by qualified practitioners only.

Other forms of stimulation may be also used in conjunction with needles to intensify the effect of the treatment:

Fire Cupping
Fire cupping is method used by acupuncturists for diseases caused by cold and damp.  Cupping acts by increasing the flow of blood to the area being treated.  A glass or a plastic cup is placed on the thigh or the chest, after a burning paper has been inserted into it and removed.  A slight pull is exerted on the skin, caused by the light vacuum of the cup against the skin.  After a few minutes, the cup slips off the skin leaving a faint red mark.  Hand operated vacuum pumps are also now available for cupping.

Fire cupping in varying forms has also been found in the folk medicine of Vietnam, the Balkans, and modern Greece.

Moxibuxtion
Moxibuxtion is the burning of the herb moxa (dried mugwort leaves) on or above the skin to stimulate heat at an acupuncture point.  The name moxa is derived from the Japanese term "mogusa," which means "burning herb."  

Moxa can be applied using 3 different methods:

1. 1. Directly to the skin, where the acupuncturist holds a smoldering moxa stick approximately half an inch away from the skin.  
   2. Indirectly, with a slice of ginger or garlic placed over the acupoint.  The moxa is then placed on top and ignited.
   3. A small ball of moxa wool may be placed on the head of an acupuncture needle, which is then lit, allowing the needle to transmit the heat directly to the acupoint through the needle.

Moxa disperses the cold and is used in the treatment of diseases that are often caused by wind, cold, and damp, such as chronic bronchitis, bronchial asthma, chronic diarrhea, arthritis, and other conditions.

Electrical Stimulation
Conducting pads are placed over the skin and a low frequency electrical current is passed through them.  When electricity is applied, a tingling sensation is common and it can be modulated by the acupuncturist if any discomfort is experienced.

Gua Sha
Gua Sha is a method used in Oriental medicine that provides relief to tight and painful muscles (e.g. a stiff neck).  The skin is first lubricated, and then scraped with a blunt edge such as a spoon.

Acupoints may also be stimulated with pressure, lasers, and ultrasound.