Acupuncture and Pain

    This second part of the series on acupuncture explains how acupuncture works and for which problems it works best. A few thousand years ago, the Chinese developed and utilized a system of water courses.  Besides the ocean, they included man-made canals, tiny streams, irrigation systems and huge rivers. They believed the body had a similar system of moving, life-giving fluid called chi.  This chi flows through pathways called meridians. Chi is the life force energy that encompasses our natural healing bio-chemical process.           Acupuncture works by releasing endorphins, the body’s own pain reliever that acts much like an opiate, except it's free. Ordinarily, the body knows how and when to transmit healing chemicals when necessary.  However, when we stress the healing system beyond its natural ability, the meridians become blocked or restricted.  An example is when we have an injured or painful knee and continue to use or overuse it, the swelling and pain persist.  The healing system or chi's process of healing is impeded.

            The description of acupuncture for this hub is extremely simplified.  The doctor or Acupuncturist must make various decisions before deciding which treatment the patient needs to better expedite the healing process.  There are different needling techniques used to increase the flow of chi in a meridian.  Other techniques reduce the flow of excess chi.  These different methods of tonifying, draining, and transference, help move chi from one meridian to another, the general aim of balancing the flow of chi in the body. There are fourteen main meridians in the body.  They carry endorphins and other peptides that heal illness or pain when the meridians are clear and flowing naturally. Sometimes, in the case of pain, the initial injury may have caused a block in that meridian so the pain persists. Acupuncture deals mostly with the physical aspect of the energy block. When the meridian is unblocked, natural healing resumes.          Meridians are simply pathways where energy travels in tissue fluid between muscle planes or spaces. These have been shown with electrical measurement and radioisotope studies.  When an acupuncture point was injected with a radioactive substance, the substance traveled along an energy meridian to the next acupuncture point. In 1998 the University of California did functional MRI studies.  By stimulating acupuncture points on the little toe, the MRI showed the same effect on the visual cortex of the brain just as shining a light into the eyes. The subjects in the studies knew nothing about acupuncture points and could hardly guess that in acupuncture the meridian that starts near the eye goes to the little toe.

There are different points for different problems. From a western explanation, the acupuncture points can be near nerve endings or near where muscles and tendons meet. They may be near nerves that stimulate or cause pain, such as in a joint, ligament or muscle. Sometimes they are at trigger points, tender areas of muscle that cause pain. Trigger points in Chinese medicine are points of energy blockage.  Acupuncture points may also stimulate the autonomic nervous system, the system responsible for the flight or fight response and for bodily functions. Interestingly, the acupuncture points some problems are nowhere near the site of the problem. That's why some tests on efficacy have proved positive. For example,  a needle on the outside of the small toe can affect vision. Acupuncture also works on babies and animals, eliminating the placebo theory. 

Pain indications:  In 1997 the NIH looked at world-wide studies in acupuncture and found clear evidence in many good studies to support the efficacy in post operative pain, morning sickness of pregnant women and pain following dental surgery. In a second category, there were more reasonable studies that showed that acupuncture helped more than it did not. These included headaches, menstrual cramps, osteoarthritis, low back pain, carpal tunnel, fibromyalgia and early stroke rehabilitation if treated within the first three months after the stroke.

              In over 20 years treating patients with acupuncture, our experience is acupuncture has significantly helped greater than seventy percent of patients.  This includes acute pain, chronic pain, peripheral neuropathy, migraines, trigeminal neuralgia, addictions, especially smoking and anxiety.  Acupuncture is also very helpful for sinusitis and GI problems. We have found inconsistent results with the use of acupuncture alone for long-term weight loss. Five Element Acupuncture may prove to be a better treatment for some weight loss patients than medical acupuncture, as it deals with more than just the physical aspect of chi.  In our experience with weight loss and smoking cessation, a higher success rate results when acupuncture is combined with hypnosis and NLP and/or Five Element Acupuncture.

Complications are few and usually not serious. There may be bruising, about the size of a dime or nickel. Occasionally someone may experience nausea, which may last about ten to fifteen minutes. Sometimes treatment can increase the pain for up to twenty-four to forty-eight hours, which is usually a good sign, meaning an energy blockage has become unblocked. Infections are very rare. We have yet to see one. It is possible to damage a nerve or vessel, but is also usually transient, lasting a short while. Although rare, treatment can also mask an underlying medical problem, which happens less often with a medical acupuncturist or a licensed acupuncturist who works with a doctor.  For someone who is allergic to nickel they may have a minor allergic reaction.

Even though acupuncture is generally very safe there are some contraindications. Dr. Ronald Santasiero, MD, DABMA, has treated thousands of patients with over 800,000 acupuncture needles with no serious problems. Acupuncture during late pregnancy can precipitate labor. Treatment can be done on someone with hemophilia if done properly and with caution. Dr. Santasiero does treat hemophiliac patients. When treating someone with a pacemaker, however, needles cannot be near the area of the pacemaker if electro-acupuncture is performed, as it causes more electrical disturbance. However, treatment can be done for back pain.  Finally, the needles should never be placed in an infected area or on people who are needle phobic.

About ten percent of people notice a good response after the first treatment, yet it can take up to six treatments to see really good results. Symptoms may be better for a day or two and then reappear, until the right amount of treatment has been done.  Often nothing is noticed until the third or fourth treatment.  In Dr. Ron Santasiero’s experience, if there is not a good response after six treatments, acupuncture probably will not work.  Needles used for most acupuncture are slightly larger than the diameter of a human hair, so it may hurt a little, but for only for a few seconds. Needles should always be disposable so there is no risk of hepatitis or AIDS . There is absolutely no reason to use non-disposable needles. 

            Each treatment lasts about twenty to thirty minutes with the exception of Five Element Acupuncture, the more traditional acupuncture, which often lasts longer.  During a treatment needles can be stimulated manually or with heat or Mox’a (Eastern material derived from various plants that is burned on the skin for its counterirritant), effect to create a tiny electric disturbance which drops toward zero after about ten minutes. The stimulation keeps the energy flowing. Not all needles need stimulation however. For instance, very inflamed or swollen areas already have too much energy which needs to be “drained”. 

            Laser acupuncture is often touted as better, but that is not proven nor has it been our experience. Laser acupuncture stimulates the same points with cold light. The advantage is no needles, less time and no discomfort. The disadvantage is the laser does not go as deep into the acupuncture point, so it is not as potent. It takes many more treatments or does not work at all.