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Acupuncture: Pinning the tail on the treatment

Hillary Bobys

"In pain, puncture the tender point." - Ling Shu (1)

Imagine going to your doctor's office with chronic pain. You describe your pain to the physician, telling her how standard treatments have failed to help. She suggests trying something new, yet old. She suggests inserting fine needles into your skin to relieve the pain, although it sounds like it may, in fact, cause more. The physician's suggestion of acupuncture may sound a bit disconcerting, but it is increasing in popularity in Western cultures. The practice of acupuncture originated in China, possibly as long as 5,000 years ago, and it continues to be an instrumental part of health care in the East (2). Western societies, however, have been slow to adopt the practice and have maintained a general skepticism about it. Yet, the interest has gradually increased with a current trend toward wellness through herbal remedies and homeopathic medicine.

Acupuncture is the insertion of small needles into the skin where they are left in or stimulated manually or electrically (3). The locations of insertion are very distinct points on the body connected to channels of energy called meridians. These channels are a system of ducts, which direct the flow of energy (Qi or Chi), through the body. If these ducts are disrupted, the acupuncture needles serve to correct the disturbance to return the body to balance (2).

This restoration to balance includes not only pain relief, but also the possible alleviation of a multitude of problems. Individuals have found success in battling depression, anxiety, headaches, arthritis, back pain, allergies, acne, smoking, eating disorders, and drug addiction to name a few (2), (3). A typical session of treatment lasts approximately 30 minutes and costs between $75 and $100 (2). Patients usually require five sessions to see discernible results (3), but many report feelings of relief and comfort after the first treatment.

Much of the doubt surrounding acupuncture has stemmed from popular discussion of the placebo effect. Yet, current research on acupuncture has produced encouraging results for the legitimacy of the practice. Treatments have been performed on children and animals with great success and the use of imaging technology has exhibited positive results, as well. Most practitioners concede that acupuncture will never replace "conventional medicine," but greater acceptance of the technique might sanction acupuncture as an additional option for patients (3). This could be of particular importance to those sensitive to medications; acupuncture shows no side effects and is long lasting (4). Further investigation may lead to greater insights on homeostasis in the body, placing emphasis on wellness rather than treatment of symptoms.

The body of research on acupuncture is rapidly growing as the West has taken a greater interest in it. A recent investigation in Japan studied the effects of acupuncture on the endocrine system (6). The endocrine system is responsible for the production and release of hormones that play roles in reproduction, growth, metabolic rate, arousal, and sleep. Researchers removed the ovaries from female mice (to simulate aging and menopause) and applied continuous stimulation to acupuncture points for 20 days, during which time mice performed learning tasks. In a postmortem analysis, the neurotransmitter levels of norepinephrine and dopamine were higher than normaland treated mice showed improved memory on learning tasks. The researchers concluded that several changes were seen in the nervous system and in immune functions, suggesting that acupuncture may be an important new tool in treatment of memory loss and effects of again for the elderly.

Another extraordinarily important effect of acupuncture may be its potential to help lower blood pressure (see image below) (7). According to one study, acupuncture treatment may function through the release of endorphins, the chemicals "that regulate the activity of a group of nerve cells in the brain that relax muscles, dull pain, reduce panic and anxiety...lower blood pressure and reduce the heart's workload" (7). This was shown through by first treating a subject and then trying to reverse the effects with the drug naloxone (an endorphin blocker). Like the study discussed above, this research shows acupuncture's apparent capacity to effect the brain through chemical release and allows one to imagine other exciting possibilities.

Meridians for the heart (10)

One of the most extraordinary aspects of research on acupuncture is the connection between the body and spirit. Acupuncture questions where lines are drawn in this dichotomy (if one chooses to call it that). Because the practice is originally Eastern, the West has a more difficult time understanding the basis of it. The language and beliefs of acupuncture, including energy flow, spirit, and balance, are integrated into Eastern cultures and therefore warrant acceptance. Even within the research on acupuncture, one must aware of such differences. One study on the neurodegenerative disorders and acupuncture devotes an entire section to spirit (Shen) in relation to the ailment (8). The report discusses ways in which "spirit is affected by the overall mental and physical health of a person" and, conversely, how "if the spirit is damaged, both the mental and physical function of a person are compromised." Treatment for disorders such as Alzheimer's disease, Parkinson's disease, and stroke concentrate on "awakening the spirit."

Important questions of brain and behavior are called into focus with the use of acupuncture in treating such serious illnesses as Alzheimer's and Parkinson's. The discourse on acupuncture centers on Taoist philosophy and world views. These conceptions of mind, body, and energy are not easily accepted in today's (Western) society. Current research is working to make these terms conceivable through technology, equalizing "balance of energy" and "nervous system" as expressions of the same physical quality (3). For example, a "stroke is characterized by the spirit trapped inside the head, with a complete or partial closure of sensory orifices" (8). One can see the similarity between this definition and that of "orthodox" biology's explanation as "changes in the flow of blood in the brain produced by blockage or rupture of blood vessels" (5).

Identifying and uniting similar concepts, like the previous example, is an important step in the acceptance of acupuncture. An article written in Medical Acupuncture by a pathologist seeks to do exactly that. She discusses the energetic principles of acupuncture in accordance with physiological development and embryology (8). In a less complex example, electrical conductance was measured at acupuncture points and meridians in hopes of explaining why needle insertion works as medical treatment (8). Previous investigation revealed "that most acupuncture points correspond to the high electrical conductance points on the body surface" and findings of a "high density of gap junctions at the epithelia of the acupuncture points." These junctions aid in communication between cells and areas of high density are "found to have a higher temperature, higher metabolic rate, and greater carbon dioxide release." It is discoveries like these that link East and West, past and present to one another in order to provide the best understanding possible of humans and their behavior.

A 1999 study (4) using functional magnetic resonance imaging (fMRI) showed neurological evidence of pain relief using acupuncture. Preliminary portions of the study measured the pain threshold of subjects who were repeatedly stimulated on the lip with a filament. The fMRI from this part of the experiment showed a great deal of activity in the parietal lobe, sensory centers, and brain stem. Roughly half of the subjects then received manual acupuncture and the other underwent the electrical variety. During the treatments, additional fMRI's were taken and subjects were asked to rate their pain on a 1 to 10 scale. Self-reports and images corresponded well along a decreasing dimension of pain. (All subjects (100%) receiving the electrical treatments showed notable decline in activity, as compared to just over half of those receiving manual stimulation.)

Findings like these suggest the use of acupuncture as an anesthetic. This application of the procedure in this way is gaining popularity as anecdotal stories of its success abound. Patients are able to come out of surgery easily and without the often-debilitating side effects of heavy anesthesia. The story of one woman in Shanghai describes open-heart surgery, performed under acupuncture. Her only anesthesia was one needle in her right earlobe, stimulated by an electrical source (2). The implications of such illustrations are impressive. Acupuncture is already widely used during childbirth as an alternative to an epidural and could conceivably replace anesthetic in a variety of other situations. While Western science is looking hard to find reasoning behind effects like these, it is also hindering greater use of the procedure. Society's need to explain the efficacy of acupuncture takes away from some of the principles that it was founded on.

An assured belief that it works has made it an integral part of Eastern medicine (and is less expensive than many pharmaceuticals). Eastern use of acupuncture is not as simplistic as many would like to believe. There are precise rules to abide by and training to undergo in order to become a practitioner. Still, one must ask, why are we so hesitant?

A student from the Neurobiology and Behavior class in 1998 proposed an explanation of acupuncture in accordance with the "box theory." She suggest that "the insertion of a needle into a trigger point [could] be regarded as a simple road sign urging the action potential in one direction or the other as it travels from one neuron to the next" (9). This uncomplicated reasoning again translates the energy flow to neuroscience terminology. It is this kind of compromise that will eventually lead to great approval of acupuncture as a standard medical procedure. And, yet, still questions remain of our conceptions of spirit and body in the ever-present challenge in understanding human behavior.

WWW Sources

1)Healthy.Net , The History of Acupuncture in the West

2)Alternative Medicine site, An overview of acupuncture

3)The British Medical Acupuncture Society

4)Public Communications, Inc., Imaging Study

5)Biological Psychology Textbook

6)Med line, Effects of acupuncture in ovariectomized mice

7)Natural SITE, Online health resource

8)Medical Acupuncture,Online acupuncture journal

9)Theories on the Effects of Acupuncture on the Nervous System , 1998 Neurobiology and Behavior web paper

10)Meridian Charts

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