Complementary and alternative medicine (CAM) is rising in use within healthcare settings in Western countries as either a replacement for or in addition to conventional Western medicine. According to the National Centre for Complementary and Integrative Health, CAM includes a wide range of non-conventional health practices and products such as dietary supplements, meditation, and chiropractic manipulation. Acupuncture, one such practice, is an increasingly popular treatment for a variety of ailments, most commonly acute and chronic pain. So, how does acupuncture work?
Acupuncture is a health practice that started within Traditional Chinese Medicine (TCM). TCM is a medical system that has been in use for thousands of years in China. While it spread to Japan and Korea centuries ago, the ideology and practices of Traditional Chinese Medicine only recently became popular within Western countries over the past century. Traditional Chinese Medicine not only includes acupuncture treatment but herbal products and Tai Chi – postures and movements with a focus on breathing. Traditional Chinese Medicine is rooted in the Chinese philosophy that approaches health holistically. Specifically, it describes the interconnectedness of the body through channels – called meridians – which branch out to connect all parts of the body. Through these channels, qi – vital energy within each human being – flows through the body to achieve health and wellness. According to Traditional Chinese Medicine, ill health occurs when there is a blockage in the channel system which disrupts the normal flow of qi.
Acupuncture treatment is intended to restore energy flow by unblocking the channels with acupuncture needles at specific points along the channels where a blockage may occur. While it has been used to treat a variety of symptoms and diseases, studies suggest that its most effective use is to relieve pain, both chronic and acute, including lower back, shoulder, and neck pain. Other uses for acupuncture include treating menstrual cramps, migraines, and insomnia.
How does acupuncture work?
Acupuncture treatment usually begins with the practitioner performing a general physical exam and collecting the patient’s medical history. Then, the practitioner will identify the acupuncture points of focus for the patient’s symptoms. The process of identifying acupuncture points has been studied extensively, however, their existence has not been readily supported by research. In Traditional Chinese Medicine, acupuncture points were identified after centuries of observing the relief of symptoms when certain tender spots on the body were stimulated. As such, practitioners typically select acupuncture points based on the location and type of patient’s symptoms.
Once acupuncture points have been selected, the practitioner will place into the body anywhere between five and 20 small sterile needles. Upon insertion, patients will likely feel an immediate numbness sensation that is supposedly a sign of the treatment working. Usually, the needles remain in the patient’s body for 10-30 minutes. While needles are most commonly used in acupuncture treatment, stimulation of acupuncture points can be achieved with mild electromagnetic stimulation or heat. An important aspect of acupuncture treatment is the room’s atmosphere; ideally, acupuncture is performed in a quiet and calming environment. The mechanism underlying the effects of acupuncture is not fully understood by researchers, however, studies suggest that in the case of pain relief, acupuncture may block or delay the pain signal from being sent to the brain which reduces the feeling of pain. Other studies suggest that the insertion of the needle promotes the release of pain-relieving chemical messengers – called neurotransmitters – by one’s body.
Does acupuncture work?
The number of quality clinical trials testing the efficacy of acupuncture has increased providing more extensive support for acupuncture treatment. Results from clinical trials indicate that acupuncture is an effective treatment for a variety of symptoms or diseases, especially pain. A number of studies show that acupuncture is more effective in relieving pain than no treatment or sham acupuncture – placing needles in non-acupuncture points. Some studies suggest, however, that real acupuncture treatment is not significantly better at reducing pain than sham acupuncture. Despite this, most studies concur that both real and sham acupuncture treatments are better at reducing pain than no treatment or standard care. Some studies show that acupuncture treatment in combination with conventional medicine is more effective at reducing pain for patients than if they just use the medicine.
Is acupuncture safe?
Acupuncture is considered a relatively safe treatment for most individuals unless they are experiencing an ongoing infection or are diagnosed with neutropenia – a condition increasing one’s risk of infection. It is a treatment used in many vulnerable populations, including pregnant women. Both minor and serious complications can occur but are infrequently experienced by acupuncture patients according to safety studies. Possible complications include infection, bleeding, and nerve or tissue damage. The risk of these complications decreases with proper sterilization of acupuncture needles and when the treatment is performed by a trained practitioner. The training requirements of an acupuncture practitioner differ across states. Typically, a practitioner will undergo one of two qualification processes: clinical or non-clinical acupuncture certification. The clinical certification, given by the American Board of Medical Acupuncture requires a standardized exam and a demonstration of training after completion of between 200 and 300 hours of acupuncture training and a four-year medical program. In contrast, the National Certification Commission for Acupuncture and Oriental Medicine certifies non-clinical acupuncturists upon completing a three-year Master’s program in acupuncture and a certification exam. While acupuncture treatment appears to be effective and safe for a variety of symptoms and/or illnesses, the National Centre for Complementary and Integrative Health recommends talking to your doctor if you are considering using acupuncture as a complementary treatment to your conventional care.
References
Chan, M., Wu, X. Y., Wu, J., Wong, S., & Chung, V. (2017). Safety of acupuncture: Overview of systematic reviews. Scientific Reports, 7(1), 3369. https://doi.org/10.1038/s41598-017-03272-0
Kawakita, K., & Okada, K. (2014). Acupuncture therapy: mechanism of action, efficacy, and safety: A potential intervention for psychogenic disorders?. BioPsychoSocial Medicine, 8(1), 4. https://doi.org/10.1186/1751-0759-8-4
Lim, T. K., Ma, Y., Berger, F., & Litscher, G. (2018). Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. Medicines, 5(3), 63. https://doi.org/10.3390/medicines5030063
National Centre for Complementary and Integrative Health. (2018). Complementary, alternative, or integrative health: What’s in a name? Retrieved from https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name
National Certification Commission for Acupuncture and Oriental Medicine. (n.d.). The NCCAOM certification in acupuncture. Retrieved from https://www.nccaom.org/wp-content/uploads/pdf/NCCAOM%20Acupuncture%20Certification%20Fact%20Sheet060318.pdf
Van Hal, M., DyDyk, A. M., & Green, M. S. (2020). Acupuncture. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532287/#_NBK532287_pubdet_
Vickers, A. J., & Linde, K. (2014). Acupuncture for chronic pain. Journal of the American Medical Association, 311(9), 955–956. https://doi.org/10.1001/jama.2013.285478
