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What is Acupuncture?

Acupuncture
Acupuncture is said to work because needles stimulate acupuncture points, releasing a flow of energy called qi, or chi.
Credit: Bork | Shutterstock

Acupuncture is a complementary medical practice that entails stimulating certain points on the body, most often with a needle penetrating the skin, to alleviate pain or to treat various diseases.

Developed millennia ago in China, numerous recent studies conducted by "Western" scientists in Europe and the United States have found that acupuncture is at least moderately effective in treating pain and nausea.

For example, one of the largest studies to date on acupuncture and chronic pain — a meta-analysis of 29 well-conducted studies involving nearly 28,000 patients, conducted by doctors at Memorial Sloan-Kettering Cancer Center in New York, and published in October 2012 in the Archives of Internal Medicine — found that acupuncture is effective for treating chronic pain and therefore is a reasonable referral option. The doctors wrote that "[s]ignificant differences between true and sham acupuncture indicate that acupuncture is more than a placebo" but added that "these differences are relatively modest."

However, most doctors outside of the practice of traditional Chinese medicine (TCM) are not convinced that acupuncture can treat diseases, such as diabetes or liver or kidney diseases, as is prescribed by some practitioners in China.

How acupuncture is said to work

Acupuncture dates back to at least the Shang Dynasty, approximately 1600 B.C. Its modern practice, though, has been heavily influenced by China's first communist leader, Mao Zedong, who attempted to align TCM more with Marxism and anti-superstition. Moreover, Western acupuncturists tend to ignore various spiritual components of TCM. Thus, in the field of TCM, there is disagreement on how TCM and acupuncture should be conducted.

Acupuncture
A model identifies acupuncture points in the head.
Credit: hjschneider | Shutterstock

In theory, acupuncture treatment is said to work by regulating a flow of energy in the body called qi, or chi, a central tenet to TCM. Disruptions in the flow of qi are thought to be responsible for all disease. Acupuncture stimulates points on or under the skin called acupuncture points or acupressure points, releasing the qi. The qi travels through channels called meridians.

Over the centuries, volumes have been written on the nature of qi (there are at least five kinds) and mechanics of acupuncture. Nevertheless, modern science has yet to identify qi, the meridians or the acupuncture points. The notion that imbalances in energy flow cause disease is antithetical to modern Western medicine, which is based on empirical evidence and which has greatly advanced world health with the discovery that disease is caused by microbes, genetic instructions, and other chemical messaging at a cellular level.

But broadly generalizing this theory, one could argue that qi and its meridians and points resemble the central nervous system and its neurotransmitters and hormones. Needles, in theory, could stimulate this.

Limitations and misconceptions

Increasingly, mainstream doctors and medical institutions are accepting the practice of acupuncture, particularly for treatment of pain and nausea.  A 2011 review, for example, found that acupuncture could reduce vomiting and nausea among patients receiving chemotherapy. In this regard, acupuncture is seen as complementary to conventional treatments.

There is a growing body of evidence that acupuncture also can treat depression, sleep disturbances and drug addiction. Doctors have had difficulty in discerning, however, whether the positive effects seen from acupuncture are a result of needles stimulating specific body points or just lifestyle changes that often accompany acupuncture therapy.

The World Health Organization maintains an extensive list of diseases and conditions (mostly pain related) possibly treatable by acupuncture. Many doctors now do not discourage their patients from receiving acupuncture when conventional medicine fails them or when convention treatment entails too many adverse side effects.

One major misconception about acupuncture is that it can be used as anesthesia. This dates back to 1971, when New York Times reporter James Reston wrote about his encounters with TCM. Reston needed an emergency appendectomy during his travels to China in advance of the 1972 visit by Richard Nixon. Reston never stated that his doctors used acupuncture instead of anesthesia, not even post-operatively. He, in fact, wrote that he received standard anesthetics and painkillers. Yet subsequent retellings of this story decades later in magazines, and on the Internet, claim inexplicably that Reston received acupuncture as anesthesia.

Other reports about acupuncture as anesthesia during surgery in China fail to mention that the patients first get zonked out on Phenobarbital or morphine. Indeed, Chinese doctors view acupuncture an analgesic, something that reduces pain, not an anesthetic, something that blocks sensation.

Similarly, dentists who provide acupuncture in the United States use it not as a replacement to Novocain but rather as something to reduce the anxiety of their patients and to treat oral pain in general.

Christopher Wanjek is the author of the books "Bad Medicine" and "Food At Work."

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