Acupuncture

What is Acupuncture

Acupuncture is a type of treatment that involves stimulating specific points on your body by inserting thin needles through your skin.

Acupuncture is often used to treat pain, but it may also be used to help relieve other types of symptoms. Your health care provider may recommend acupuncture to help treat various conditions, such as:

  • Migraine headaches.
  • Tension headaches.
  • Arthritis pain.
  • Addiction.
  • Chronic pain.
  • Nausea and vomiting after a surgery.
  • High blood pressure (hypertension).
  • Chronic obstructive pulmonary disease (COPD).
  • Nausea caused by cancer treatment.
  • Sudden or severe (acute) pain.

Acupuncture is based on traditional Chinese medicine, which recognizes more than 2,000 points on the body that connect energy pathways (meridians) through the body.

The goal in stimulating these points is to balance the physical, emotional, and mental energy in your body. Acupuncture is done by a health care provider who has specialized training (licensed acupuncture practitioner).

Treatment often requires several acupuncture sessions. You may have acupuncture along with other medical treatments.

How is acupuncture applied?

The goal of acupuncture is to obtain a desired physiological effect via the insertion of needles into the skin at specified points on the body, which are chosen based on the desired effect and the pathology of the patient.

At its most basic level, acupuncture involves the piercing of the skin with metallic needles along the body’s meridians, as well as at points known as ah shi.

Further therapies can be performed using mechanical stimulation, electrical stimulation, applying heated needles, using moxa made of mugwort and other plants, or applying a laser.

While evidence is lacking for determining which forms of acupuncture provide superior treatment when compared to the others, some anecdotal evidence indicates that electroacupuncture demonstrates potential for myofacial pain applications.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe treatment. However, problems may occur, including:

  • Skin infection.
  • Damage to organs or structures that are under the skin where a needle is placed.

What happens before the treatment?

  • Your acupuncture practitioner will ask about your medical history and your symptoms.
  • You may have a physical exam.

What happens during the treatment?

The exact procedure will depend on your condition and how your acupuncture provider treats it. In general:

  • Your skin will be cleaned with a germ-killing (antiseptic) solution.
  • Your acupuncture practitioner will open a new set of germ-free (sterile) needles.
  • The needles will be gently inserted into your skin. They will be left in place for a certain amount of time. You may feel slight pain or a tingling sensation.
  • Your acupuncture practitioner may:
    • Apply electrical energy to the needles.
    • Adjust the needles in certain ways.
  • After your procedure, the acupuncture practitioner will remove the needles, throw them away, and clean your skin.

The procedure may vary among health care providers.

What can I expect after the treatment?

People react differently to acupuncture. Make sure you ask your acupuncture provider what to expect after your treatment. It is common to have:

  • Minor bruising.
  • Mild pain.
  • A small amount of bleeding.

How does acupuncture act to induce analgesia in patients?

Traditionally, TCM has viewed acupuncture’s method for improving patient status by altering the flow of qi to different areas via needling along meridians for increasing, suppressing, or otherwise changing the behavior of the patient’s qi. One currently suggested method for acupuncture’s analgesia is that the needles increase blood flow throughout the body, while also reducing prostaglandin, histamine, and other inflammatory agents at a local level. Electrical stimulation in combination with acupuncture has been indicated in several studies to affect the central nervous system, with special focus falling on the spinal cord, pituitary, and midbrain; insertion of acupuncture needles results in elevated levels of enkephalin, endorphins, and possibly gamma-aminobutyric acid released at the spinal cord, enkephalin, norepinephrine, and serotonin at the midbrain, and endorphins at the pituitary. The opioid antagonist naloxene has been demonstrated to be capable of partially inhibiting or reversing the analgesia induced by acupuncture, pointing to the involvement of endogenous opioids as a possible mechanism for analgesia. Another proposed mechanism for acupuncture is the inhibition of spinal microglia, which studies say perform a role in inflammatory responses and the pain induction process.

What is the stance of the National Institute of Health on the use of acupuncture?

In 1997 the National Institute of Health’s Acupuncture Consensus Panel issued a statement that, based on research conducted at the time, there was evidence for the use of acupuncture in management of postoperative dental pain for adult patients, as well as postoperative and chemotherapy-related nausea. Some studies indicated acupuncture demonstrated potential as an alternative therapy or as an adjunct to standard treatments for managing lower back pain, myofacial pain, fibromyalgia, lateral epicondylitis (tennis elbow), migraine headache, carpal tunnel syndrome, osteoarthritis, and menstrual cramps, though some of these uses were based on single studies at the time.

Is there a consensus on acupuncture as an effective treatment of fibromyalgia?

In 2013 a review of nine trials indicated that while moderate evidence existed for acupuncture improving pain and stiffness when compared to standard therapies, evidence indicated that sham acupuncture was capable of achieving the same results, though the review noted the absence of standardized, ideal sham acupuncture methods weakened these conclusions. The review also indicated that electroacupuncture showed greater potential for treating both pain and stiffness than manual acupuncture, but that the duration for improvements was less than 6 months.

Does evidence support the use of acupuncture for other chronic pain conditions?

Migraine headaches have been shown to be attenuated via the use of acupuncture. A 2015 review of 22 trials comparing acupuncture’s effects versus standard care, sham therapy, and/or prophylactic pharmaceuticals found evidence that acupuncture was beneficial in treating acute migraine attacks and in reducing the frequency of migraines. Additionally, though no evidence indicated a difference between acupuncture and sham treatment, when compared with prophylactic drugs, acupuncture produced slightly better outcomes and minimized adverse side effects from treatment.

What concerns and contraindications should be considered when conducting acupuncture?

Proper training for handling and placement of needles is critical for preventing complications with acupuncture, such as causing pneumothorax with poorly positioned needles at the chest. Practitioners should be cautious when working with patients on anticoagulants, so as to minimize side-effect severity. Electroacupuncture should similarly not be administered to patients with implanted pacemakers, due to possibly interfering with their function. Patients may experience an increased sense of euphoria, sedation, or pain for up to 24 hours following treatment. Acupuncture should be practiced using disposable, sterile needles to minimize the possible transmission of blood borne pathogens such as HIV or hepatitis B and C.

Follow these instructions at home:

  • Follow any instructions given by your provider after the treatment.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have questions about your reaction to the treatment.
  • You have soreness.
  • You have skin irritation or redness.
  • You have a fever.

Summary

  • Acupuncture is a type of treatment that involves stimulating specific points on your body by inserting thin needles through your skin.
  • This treatment is often used to treat pain, but it may also be used to help relieve other types of symptoms.
  • The exact procedure will depend on your condition and how your acupuncture provider treats it.
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