Acupuncture has been around for centuries and has been a part of Chinese medicine as a modality to treat a number of conditions. It is based on ancient theories of the body having flow patterns of energy. In the body there are 12 meridians for flow of energy and acupuncture either blocks bad energy flow or promotes the flow of positive energy. The placement of needles in certain places is to decrease bad pain and improve the flow energy promoting pain relief. Those who trust in acupuncture say it can treat numerous different conditions. Western medicine first was exposed to these interventions in the early 1970’s when China opened up to the western world.
Western research initially tried to discover how acupuncture worked by attempting to identify flow patterns and meridians. They looked at MRI scans to see if they could see changes in the brain scans, and none were seen initially. The research turned to studies to see if treatment with acupuncture was better than a fake treatment with only sham placement of needles, and they compared it to no treatment at all. Unfortunately, both traditional and “sham” acupuncture worked equally well, and both worked better than no treatment for many chronic pain conditions. Studies in the early 2000’s showed that for chronic low back pain, acupuncture did work better than no treatment and did have extended benefits lasting a year with increased functional ability.
So How Does it Work?
The question of how and why acupuncture worked was puzzling to researchers. A neuroscientist from the University of Toronto was responsible for making the first discoveries of how acupuncture worked. Initially, animal studies showed that acupuncture blocked painful sensations to the paw of the animal, however it took about 20 minutes for this to work. This was about the same time that it took opioids to become effective, and this researcher had the insight that there might be some relationship, like it stimulated the body’s own substances to act as a natural pain reliever. Now researchers have also found that the chemical adenosine increases with acupuncture, and this is another endogenous pain reliever.
Through the use of functional MRI scans, researchers can look at the brain in real time and view activity changes of various areas. Acupuncture has effects on the hypothalamus and amygdala, areas of the brain that control fear and influence pleasure. The scans have also identified that acupuncture promotes connectedness throughout the body.
Over time, acupuncture is now being better understood. It stimulates several of the body’s own compounds that help prevent pain. It also helps in the appropriate interpretation of signals. Furthermore, studies have shown it to be effective for low back and neck pain, at least in the short term. There is also data showing it can be helpful for headaches and osteoarthritis. It does not work for everyone, but there is at least some clear scientific evidence of how it works and there are reasonable studies showing its effectiveness.
Thomas Cohn, MD
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