Biology 202, Spring 2005
First Web Papers
On Serendip

Living in America has taught me that common medical problems can be relieved with over-the-counter or prescription medicines. Pain relief comes in a pill. Or does it? Even if the pain subsides for the moment, the side effects from taking the pain killers may be unbearable for certain people, resulting in more problems than the medication seem to solve (1). An example of this is aspirin, which has been linked to gastrointestinal problems. Oxycontin has proven to be a dangerous painkiller for doctors to prescribe because of its addictive qualities. More recently the much publicized pain killer Vioxx, a cox-2 inhibitor, was taken off the market due to an increase in cardiac risks, which is correlated with taking this drug (2). Cox-2 inhibitors prevent inflammation by blocking the cox-2 enzyme from producing a chemical message that indicates pain to the brain (3). There are ongoing discussions about whether other cox-2 inhibitors should be taken off the market.

However, many people still experience pain despite taking such medications. This is why many Americans seek alternative methods and medicines to hopefully find an effective way to ease their pain with minimum side effects, such as acupuncture. When it comes to pain relief Western medicine is not meeting its demands from patients with chronic pain. Is acupuncture an effective alternative to taking pain medications?

Acupuncture, a traditional Chinese medical technique, has been used for many centuries by the Chinese to treat all types of disease and pain. This technique inserts very thin metal needles into specific points in the body. The needle will pierce the ski, but the patient should not be in pain (8). It is believed that the body contains about 500 acupuncture points connected to the 14 main meridians or channels (4). Certain acupuncture points are used to treat specific locations of the pain. For instance, acupuncture points on the thumb, knee and wrist are used to treat headaches (8).

To understand this ancient technique, one must grasp the concept of "chi". Traditional Chinese medicine is rooted in the idea that "chi", or energy, flows through all living things, including the human body. A disruption in chi, caused by an imbalance of ying (negative energy) and yang (positive energy), is the origin of illness and disease. Acupuncture brings ying and yang back into balance by unblocking the chi and restores the body to a healthy state (4). The concept of chi is not mentioned in any modern medical textbook, but for centuries, traditional Chinese medicine has based their system of diagnosis and treatment on the idea of keeping the chi in equilibrium.

Many studies have shown that acupuncture is an effective way to treat pain. One study reported patients experience less pain and more mobility when receiving regular acupuncture treatments than patients receiving fake treatments (5). Another similar study showed that acupuncture was an effective treatment for knee and back pain (6). However, it is still unclear how this technique actually works. Because traditional Chinese medicine is not based on a modern understanding of the human body, there are many people who are skeptical about acupuncture. Nevertheless, mounting evidence reveals that acupuncture can bring about pain relief. With all the medical advances taking place in Western medicine, a 2000-year-old technique for treating pain is making a comeback.

Even though no definitive answer is available at this moment, there are theories on how acupuncture might work. Studies have shown that acupuncture stimulates the nervous system to release natural pain killers such as endorphins, thereby reducing the pain experienced by the person (7). Another idea is that acupuncture blocks the sending of electrical impulses to the nervous system, thus preventing pain (4). When an outside stimulus is detected by sensory neurons, a pain message in the form of electrical impulses is sent to the spinal cord. The spinal cord then processes the information and sends it to the brain. A person is believed to experience pain when the message is relayed to the brain (1).

Acupuncture may also work through the placebo effect by leading the patients to believe that their pain is being treated (4). However, as mentioned previously, many studies have ruled out the placebo effect by giving both fake and real acupuncture treatments (5). Even if for some cases people with chronic pain get relief due to the placebo effect, why should they be discouraged from receiving acupuncture? Whether it is the placebo effect or actual benefits from the acupuncture treatments, people with chronic pain are getting the relief that they did not find while taking medications.

However, this does not mean that anyone seeking pain relief should try acupuncture. Although many people have found pain relief through acupuncture, there are just as many people who did not. Pain relief from acupuncture may be transient and individual results will vary. Usually a series of acupuncture treatments are necessary before any sign of pain relief happens (4). As with any medical treatment or medication, acupuncture will not likely dissipate the pain in one treatment. Immediate pain relief from an acupuncture treatment has been reported by only a few people (8). It may take many more treatments and lots of patience before any effect is noticeable.

Many people are willing to try acupuncture since there seems to be relatively little side effects to the treatments. However, there have been reports of punctured organs, broken needles, and allergic reactions to needles that were not surgical steel. Acupuncture needles should be made of solid metal and sterile when used (8). These reports are most likely due to treatments received from unlicensed acupuncturists, but in America, there are licensed physicians and non-physicians that practice acupuncture. This treatment should be discouraged for pregnant women because of the possible stimulation of increased levels of labor inducing hormones that can result in premature labor and miscarriage (4). The undesirable side effects in pregnant women receiving the treatment provide additional evidence that the body is reacting to acupuncture.

There are always risks involved with any medical treatment and the patient should assess each of these risks before deciding on the best method. Given that acupuncture is still used extensively in China and the side effects from western medicine, this treatment should be an option of which patients with chronic pain should be aware. Although a medical explanation of how acupuncture works is still in development, much research supports the fact that acupuncture brings about pain relief for many people. The question should not be on how acupuncture works, because people living with chronic pain today are looking for relief. I believe the medical community should make an effort to provide patients with all the viable options. Acupuncture is an effective method of pain relief as studies have shown. The unanswered question of why acupuncture works will be interesting for researchers to continue exploring. A new way of thinking about pain may come about from its discovery.

References

1) Pollack, Andrew. "The Search for the Killer Painkiller." New York Times. 15, Feb. 2005: F1.

2)MSN Health and Fitness, article about pain killers

3)Wellmed, LLC, information about cox-2 inhibitors

4)The Skeptics Dictionary on Acupuncture, information on acupuncture

5)Infotrac Onefile, database found in the Bryn Mawr College website

6)MSN Health and Fitness, article about study done on acupuncture

7)health.ivillage.com, study done on acupuncture

8)HealthLink Medical College of Wisconsin, information about acupuncture


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