Acupuncture is a traditional medicine that’s been practiced in China and other Asian countries for thousands of years. Its proponents say it can do everything from relieving pain to bringing a general sense of wellness. Others think the only benefits you get from acupuncture are in your head. Recent studies have found that both sides may have a point. Acupuncture can be effective for certain health problems, such as some types of chronic pain. But how it works is something of a mystery.

Acupuncture is the stimulation of specific points on the body. The methods can vary, but the most well known type in the United States is the insertion of thin metal needles through the skin. At least 3 million adults nationwide use acupuncture every year, according to the latest estimates.

Acupuncture is part of a family of procedures that originated in China. According to traditional Chinese medicine, the body contains a delicate balance of 2 opposing and inseparable forces: yin and yang. Yin represents the cold, slow or passive principle. Yang represents the hot, excited or active principle. Health is achieved through balancing the 2. Disease comes from an imbalance that leads to a blockage in the flow of qi—the vital energy or life force thought to regulate your spiritual, emotional, mental and physical health. Acupuncture is intended to remove blockages in the flow of qi and restore and maintain health.

Researchers don’t know how these ideas translate to our Western understanding of medicine, explains Dr. Richard L. Nahin of NIH’s National Center for Complementary and Alternative Medicine. But the fact is that many well-designed studies have found that acupuncture can help with certain conditions, such as back pain, knee pain, headaches and osteoarthritis.

“In many research studies, it’s clear that if you’re comparing acupuncture to usual care, the acupuncture group almost always does better,” Nahin says. The problem, he explains, is that when researchers have compared acupuncture to carefully designed “control” treatments, the picture becomes more complicated.

Well-designed clinical trials need control groups—people who get a sham or simulated treatment called a placebo. Placebos might come in the form of a sugar pill or a saline injection. They give researchers something to compare the real treatment with. But designing a placebo for acupuncture is a challenge.

“I don’t really think you can come up with a great placebo needling,” says Dr. Karen J. Sherman, an NIH-funded acupuncture researcher at Group Health Research Institute in Seattle.

For example, when researchers have compared inserting needles with just pressing a toothpick onto acupuncture points, they’ve often found both treatments to be successful. But Sherman questions whether these are really controls. Many traditional acupuncturists would consider them true treatments, too. The important thing, in their view, is to hit the right spot, not necessarily how deep you go.

Another option for a placebo would be to test a different location. But Sherman says that would be inappropriate for treating pain because acupuncturists traditionally needle tender points. “To me, there’s no place on the back, if you have back pain, where you can say you have a great control,” Sherman says, “so I don’t think that’s a really solid idea.”

Further complicating things is that acupuncture treatments are about more than just needles. “There’ll be needles,” Sherman says, “but there’ll probably be other things they do in the course of the treatment. Acupuncturists will talk to you in a particular way. They might give you dietary advice or exercise advice that stems from a non-Western theoretical construct. They’ll try to engage you in your own healing. They might give you a different model for thinking about your health.”

“It’s hard to design placebo-controlled studies of acupuncture when we don’t understand what the active component of the intervention is,” explains Dr. Richard E. Harris, an NIH-funded researcher at the Chronic Pain and Fatigue Research Center in Ann Arbor, Michigan.

Treatment for pain is the best-studied aspect of acupuncture. Many parts of the brain are connected in the processing of pain, and how much pain you feel partly depends on context. “If a person has an injury in battle, they might not feel it,” Sherman explains, “but if they have a similar injury just walking down the street, they might just think it was dreadful.”

“If you look at some of the data, what you find is that sham acupuncture and true acupuncture both produce some pain relief in whatever condition they’re looking at,” Nahin says. “But while both treatments turn on areas of the brain, they turn on different areas of the brain.”

Harris and his colleagues, in studies of fibromyalgia patients, have found differences at the molecular level as well. “We were able to show that sham acupuncture and real acupuncture both reduced pain in fibromyalgia patients equally,” he says, “but they do it by different mechanisms.”

If acupuncture truly works by a different mechanism than sham acupuncture, Harris says, then they’re not the same thing, even if they both help relieve pain. Harris and others are now trying to get to the bottom of what acupuncture is actually doing. Their ultimate goal is to see if other treatments might pair well with acupuncture to reduce pain better than either alone.

Should you try acupuncture? Studies have found it to be very safe, with few side effects. If you’re thinking about it, talk to your doctor. “We tell people they really need to talk to their primary care provider and discuss whether acupuncture is a viable option for them,” Nahin says. “While you could go to an acupuncturist independent of a medical practitioner, we feel that an integrated approach to care is always the best approach.”

“Find somebody who’s dealt with your problem before,” Sherman advises. “Talk to the practitioner about your specific situation and then see if it’s something you can live with because it might not be the right treatment for you.”

If you do decide to try acupuncture, she adds, “You need to know that you should give it some time. You can’t expect one session will tell you whether it works or not. Be open minded and willing to at least entertain some of the notions that the acupuncturist brings up. Give it a try if you’re open to it.”

If You Want to Try Acupuncture

Talk to your health care provider about it, especially if you’re pregnant or nursing, or are thinking of using acupuncture to treat a child.
Find an acupuncturist who’s experienced working with your problem.
Check credentials. Most states require a license to practice acupuncture.
Don’t use acupuncture as a replacement for conventional care.
Don’t rely on a diagnosis of disease by an acupuncturist who doesn’t have conventional medical training.
To help ensure coordinated and safe care, tell your health care providers about any complementary and alternative practices you use.

Source:  NIH Office of Communications
and Public Liaison

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Comments

Although I believe acupuncture could work in a number of pain cases with fibromyalgia, I also believe that being proactive with diet and fibromyalgia exercises can be a benefit as well. Thanks for the info!

Whatever be the public opinion about alternative medicine, the fact that it is a safe and natural alternative to drugs and surgery cannot be denied.As you have rightly mentioned, open-mindedness and patience will give one positive results from the practice of acupuncture.Very informative and clear article. Thanks for sharing.
Regards,
Yvonne

Excellent article! Acupuncture helps to improve our health definitely!

Very interesting article. I have used acupuncture off and on for years, even when I was pregnant. When my mom injured her back we both went to a very old Chinese acupuncturist, and he was incredible.

Great article, thanks. It's good to see that people are taking acupuncture seriously, as it can have great benefits for us all!

Osteopathic treatment can avoid back pain.
In France osteopathic treatment is rated no. 3 in popularity treatment.

Doug471 Here!

I find your article interesting about the difficulty of an acupuncture clinical trials simulated placebo treatment.

What are the percentage of satisfied patient receiving the real acupuncture treatment and the percentage of un-satisfied patient receiving the real acupuncture treatment.

This is a very well written article. Lots of great information and I like that it explores both sides of the coin. Good job! I enjoyed it.

I have tried acupuncture as an alternative to Western medicine and found some success with it. I think the important thing is to be open minded and willing to find what works for you.

I have studied and practiced acupuncture for 7 years, and it should come as no surprise to anyone that I find it to be very effective for a variety of conditions. The problem researchers have is that acupuncture is based on meridians, and until now, they have had a hard time measuring them. If it can't be measured, it must not exist? Look at how many things did not "exist" until we could measure them: X rays, infrared light, subatomic particles, to name a few.

I have been using an Acugraph for several years. It is a meridian measurement tool that is computerized, and the files are backed up to Miridiatech in Idaho daily, so there are hundreds of thousands of files being compiled into a large database. Times are changing.
But, I digress... I also wanted to make the comment that the stimulus to the acupuncture point can be with a needle, a toothpick, a pencil eraser, a laser pointer, hand held microcurrent,etc. They all can work, some are more efficient than others, eg. needles.

Alternative forms of therapy such as acupuncture, chiropractic, and inversion therapy getting mainstream respect is long overdue. I use all three and have received more benefit than I have from any doctor. Great article!

great interesting. I love holistic therapies and I have found them incredably helpful with fibromyalgia and ME/CFS. Thank you for this great article! thanks

Very interesting. I love holistic therapies and I have found them incredably helpful with fibromyalgia and ME/CFS. Thank you for this great article!

Best wishes,

Ruth

Acupuncture has its place in holistic medicine, too bad doctors still turn their backs on it and in some cases actively deny any access to it.

Thank you for the great information about acupuncture. I have many patients that have told me that it works great for them. I can now give them some more informative information about acupuncture.

I went to acupuncture and got treated for my pain problems. I think that acupuncture is really working!

I am very interested on this kind of medicine. In fact, my mother made a therapy using accupuncture for losing weight and the results were successful.
All the best,
Gerard.

Works so well in the eastern world. I mean us in the U.S. cant seem to get anything right. :(

Thank you for posting such a well balanced article. As an acupuncture physician I always emphasis the evidence-based nature of how acupuncture works. I particularly admired your recommendation that patients need to give acupuncture the time necessary to do it's healing work. Too often new patient's arrive in the clinic expecting a "magic bullet." It is so important that we communicate to our patients that acupuncture is a therapy which can work wonders, but only when given the proper commitment and time.

All in all this is a very good article about acupuncture.T he similarities between that and Reiki are very pronounced. The chakra points in Reiki are very similar to Acupuncture points. I have found that using Reiki to compliment acupuncture is very beneficial to my clients they say they feel the warmth when using Reiki during an acupuncture session..

I have tried acupuncture in the past for back pain, but for me it didn't seem to help. I am a bit 'needle phobic' though, so maybe it made me tense up more than others and I guess this could have affected my results. Friends of mine say it has worked very well for them.

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