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Acupuncture Entering the Mainstream

Once thought of as quackery and scoffed at, acupuncture is making it's way from alternative to mainstream medicine.

WebMD Feature

Reviewed By Brunilda Nazario

Acupuncture -- the 2,500-year-old mainstay treatment of traditional Chinese medicine popularized in the West when President Nixon checked it out in China -- was initially regarded by the medical establishment as fringe therapy, right up there with voodoo and snake juice cocktails.

Now, the U.S. National Institutes of Health and the World Health Organization smile on certain uses of acupuncture; it is part of the array of therapies offered at the famed Memorial-Sloan Kettering Cancer Center and other well-known hospitals offering an integrative approach; and is often routinely added to a massage or trip to the orthopaedist or chiropractor. A million people use acupuncture each year, according to the NIH (half of all adults in the United States use some form of complementary or alternative therapy).

"Explained classically," says Peter J. Degnan, MD, adjunct assistant professor of community and family medicine at Dartmouth Medical College in Portsmouth, N.H., "the body contains a life force the Chinese call "chi," which we have translated to mean energy, though it is more than that. When the chi is in proper balance and flow, one has a sense of optimal wellness and health. Disturbance in the chi, on the other hand, results in ailments, such as pain and allergies."

Pain and allergies are just the beginning of the conditions for which acupuncture is offered. A study done at Cornell University shows that treatment with acupuncture can increase fertility in women by reducing stress and increasing blood flow to the reproductive organs (similar claims have been made with respect to erectile dysfunction). The technique also holds promise for helping people kick cocaine, according to one study from Yale University.

A recent study published in the Journal of Contemporary Pediatrics shows that despite children's legendary fear of needles, about half of the youngsters who submitted to acupuncture said they achieved significant pain relief and found the experience pleasant. (Acupuncture needles are very thin, not chunky like a needle used for an injection, and most people cannot feel them being inserted.)

Scientific Evidence

The researchers who tested acupuncture on children recommended it for pain if the parents held "a world view consistent with acupuncture and were eager to try it" (meaning broad-minded), even "acknowledging the limitations on current scientific knowledge regarding its effectiveness."

Some scientists have tried to confirm the validity of the Chinese system of designating more than 200 points in the body connected by so-called meridians, or pathways, through which energy must pass freely.

"There is no blood test for chi," Degnan says. "But there have been studies that show that when the needles are in the skin, there are measurable changes in microelectrical currents in the body. The neurochemicals such as dopamine also are affected." Other studies, Degnan says, show that there are more nerve endings and capillaries at the recommended needle insertion points.

"It is a system of total body healthcare," he says. "So it's not unlikely that acupuncture could affect almost anything in the body. But the most common uses are for pain control, migraine headaches, low back pain, nausea, and postoperative pain. (The World Health Organization recommends it for postoperative dental pain and morning sickness.)

National Institutes of Health Speaks

In 1997, the National Institutes of Health brought together a 12-member panel in the fields of acupuncture, psychology, psychiatry, physical medicine and rehabilitation, drug abuse, epidemiology, and other disciplines to examine the state of the art. Some findings:

  • Acupuncture is already widely practiced in the United States.
  • Though there have been many studies, these provide equivocal results.
  • Promising results have emerged for adults with postoperative and chemotherapy-related nausea and vomiting and in postoperative dental pain.
  • For addiction, stroke, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel, and asthma, acupuncture may be useful as an additional therapy in a comprehensive management program.
  • There are "plausible" ways acupuncture might work -- such as the release of opioids and other substances in the brain that help alleviate the sense of pain when the needles are inserted.

Interestingly, the FDA no longer considers the needles to be experimental devices and regulates them as it would any other medical device.

Would Acupuncture Help You?

If you hold the "world values" consistent with acupuncture, meaning an open mind and willingness to try new things, it is not likely that acupuncture would have a severe downside for you. It is usually a complement to other, perhaps more westernized, approaches. You probably won't abandon other useful therapies to see if it "works" -- you can do several things at once.

David S. Kiefer, MD, of the University of Arizona in Tucson, says every time they use a "nonconventional" approach such as acupuncture, other avenues are also being pursued. For example, for back pain, acupuncture might be combined with physical therapy, diet, and perhaps herbal medicine. He says he himself uses acupuncture for sinus problems and allergies and gets good results.

The chance of side effects from acupuncture is low. Degnan recommends that people with bleeding problems or an active infection not try acupuncture. Those recovering from surgery or dealing with cancer treatments might also want to clear the technique with their doctors.

It is also important to select a licensed practitioner. More than 40 states license or register acupuncturists. Physician-acupuncturists are certified by the American Academy of Medical Acupuncturists (www.medicalacupuncture.org). Degnan recommends asking questions, for instance:

  • Have you worked with a condition similar to mine, and what were the outcomes?
  • What do you envision as a course of treatment? Usually you can tell with five or six treatments if it's going to help.
  • What will it cost? Some health plans now cover alternative therapies, but by no means all.
  • What are the possible side effects or complications, if any?

Kiefer says it helps to have an exploring mindset. "But even people who are not very open-minded and try it find they feel good during the treatments," he says. "Sometimes they are surprised." Interestingly, he says, using acupuncture with other treatments boosts the effectiveness of those treatments in some cases.

Star Lawrence is a medical journalist based in the Phoenix area.

Published Jan. 15, 2003.




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