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Acupuncture |
Acupuncture is an ancient Chinese form of treatment used to help restore health. Thin needles are inserted into the skin at special points where the body’s energy is believed to flow. This is done to stimulate the flow of the body’s energy. It can also be done by applying heat, pressure, electrical currents or laser light. In the UK acupuncture is used to treat many problems but is most commonly used for pain relief.
The majority of reliable evidence shows that acupuncture works on pain, especially back and dental pain, relieves migraines, and helps with nausea and vomiting. Evidence shows that acupuncture has not worked any better than dummy treatments for quitting smoking or for weight loss.
Acupuncture is not entirely free of risks, but generally speaking, it is a fairly safe treatment in the right hands. On balance, therefore, acupuncture can do more good than harm.
What is it?
Acupuncture is an ancient Chinese form of treatment. Many forms have developed over the years. In the most widely used form small needles are inserted into the skin at special sites called acupoints. Instead of needles, other ways of stimulating acupoints can be used, including heat, pressure, electrical currents or laser light.
In the 1970s, acupuncture became very popular in the West, and two types of acupuncturists developed – traditional acupuncturists and medical acupuncturists.
Traditional acupuncturists regard health in very general terms; they don’t use Western categories of disease. That is, they use acupuncture not for treating specific conditions, but for restoring the balance of energy in the person. This, they believe, paves the way for the body to heal itself. Traditional acupuncturists do not claim that acupuncture cures cancer, for instance, but they might use it to help people with cancer cope better with the illness.
While traditional acupuncturists don’t need previous medical training, medical or Western-style acupuncturists are usually medically trained – doctors or physiotherapists, for example. They use acupuncture alongside conventional treatment. They are likely to use acupuncture to treat a specific condition that has already been diagnosed by conventional methods. Medical acupuncture tends to look for modern scientific explanations for how acupuncture works.
Does it work?
There is plenty of evidence from people’s experience of acupuncture to suggest that it works – those who use acupuncture are usually satisfied with its success. But this type of anecdotal evidence rarely convinces the sceptics. They want to know whether it is more effective than a dummy treatment (placebo) or conventional treatments for specific conditions.
Several hundred controlled clinical trials of acupuncture have been published. As in most areas of medicine, such studies do not always arrive at the same conclusion: some show that acupuncture works, others that it is no better than a placebo.
Rather than selecting those studies that one happens to like, one must look at all of the evidence if one wants an unbiased, fair overall result. To do this, researchers use a method called systematic review or meta-analysis. About a dozen such reviews have been completed.
According to their findings, acupuncture has been shown to work for
- back pain
- dental pain
- migraine
- nausea/vomiting.
- stopping smoking
- weight loss.
The problems most frequently treated with acupuncture today are (in descending order):
- musculoskeletal pain
- emotional problems
- arthritis
- ear, nose and throat conditions
- lack of energy and fatigue
- digestive conditions
- back pain
- headache/migraine
- gynaecological problems
- skin problems
- cardiovascularconditions
- respiratory conditions
- neurological conditions
- stopping smoking.
Is it safe?
Acupuncture is not entirely free of risks, but generally speaking it is a safe treatment in the right hands.
Fairly often it is linked with mild and short-term side affects such as minor bleeding at the site of needling, pain during needling, or temporarily making the symptoms worse. In addition, acupuncture has been linked with much more severe side affects (even deaths), but this is very rare. These come about because of infections (such as hepatitis) introduced by non-sterile acupuncture needles, or damage to organs beneath an acupoint.
It is important to note that such complications can be avoided through adequate training and responsible behaviour of the therapists. This is why the medical competence of acupuncturists is so important.
Acupuncture should not be used to treat people with severe bleeding disorders, for women in early pregnancy (except for treating morning sickness), and for people who have an implanted cardiac pacemaker (electro-acupuncture).
After a treatment session you may feel drowsy and therefore should not operate hazardous machinery (including driving a car) until you are completely back to normal.
If you are being treated by your GP you should let them know you plan to have acupuncture. Also tell your acupuncturist about any medication you are taking as it could affect your response to the acupuncture treatment. Don’t stop taking your medication unless you have discussed this fully with your GP.
Method of treatment
Small needles – thinner than those used for injections and blood tests – are inserted into the skin at special sites called acupoints. About 100 acupoints are commonly used (but only a few are used during a single treatment).
Other ways of stimulating acupoints include applying heat, pressure, electrical currents or laser light. Tapping or massage can be used for children or people who are scared of needles. Each method is thought to have slightly different effects – needles are believed to be the most direct line to the energy, for example, while heat is thought to encourage smooth energy flow. Your practitioner may use several methods or may stick with one.
Needles are usually inserted to a depth of 3mm to 5mm – shallow if there is important tissue underneath the point and deeper if not. Needles may be taken out after just a second or two or left in place for 20 minutes or so. You may feel tingling or a dull ache when the needle is put in but once it’s in you should feel little or no pain. Afterwards it is not unusual to have slight bruising where the needle has been.
Usually two to 40 needles are used, sometimes more. The needles may be inserted in parts of the body away from where your problem is. This is normal. The acupuncturist may also use a treatment called moxa at the same time as needles. This is a herb, burnt like an incense stick, used to warm acupuncture points. This is thought to encourage the body’s energy to flow smoothly.
One school of acupuncture specialises in putting needles exclusively into the ear.
Seeing an acupuncturist for the first time
The first time you see a traditional acupuncturist you may be asked about a range of things including your symptoms, your diet, sleep patterns and medical history. The acupuncturist may feel your pulse and may look at your tongue – these are traditional Chinese methods of diagnosing your state of health.
Seeing a medical acupuncturist will be very similar to seeing your GP as diagnosis is made on conventional criteria.
Don’t eat a big meal before you see the acupuncturist and avoid things that might colour your tongue (such as coffee) immediately before treatment. Nor should you drink alcohol just before a treatment or for about six hours afterwards.
Other things
Depending on where the needles have to go, you may be asked to take your clothes off. If needles are to go in the legs or arms you can probably stay fully clothed. Otherwise one or two pieces of clothing may need to come off or you may be asked to undress to your underwear. If you do undress your acupuncturist should cover you with a blanket once the needles have been inserted.
During the treatment you may feel heavy, relaxed or drowsy. Afterwards most people feel calm and relaxed. Some feel tired or drowsy for a few hours. Your symptoms may get temporarily worse. You might notice general changes in your appetite, sleep patterns, how often you need to use the toilet, or your emotions. These are regarded as signs that the acupuncture is working. If you are worried tell your acupuncturist about them.
Only in rare situations would one single acupuncture session be sufficient to solve the problem. Usually, six to ten sessions are initially recommended, and such a course of treatments might need repeating if symptoms come back. There are no golden rules as to how much is enough; everything depends on the type of problem a person suffers from and the progress that is being achieved with acupuncture.
Questions people ask
Does acupuncture hurt?
No, normally not, but a dull discomfort is frequently felt during treatment.
Can children be treated?
Yes, they can. Visit a therapist who has experience in treating children.
Can I get acupuncture on the NHS?
It is possible but may not be easy. Some GPs will be able to refer you to an acupuncturist; some GPs have trained in acupuncture and could treat you. The pain-clinic or physiotherapy department at your local hospital may use acupuncture.
Can acupuncture stop me smoking?
Many people have acupuncture to help them stop smoking but research has shown that it is no better than a dummy (placebo) treatment.
How can I make sure the needles used are clean?
You should insist on disposable needles (but even then there is no guarantee).
How is it thought to work?
In traditional acupuncture illness is seen as the result of an imbalance in the body’s energy. This energy is called Qi (pronounced ‘chee’). Qi is thought to move along special channels in the body called meridians. The theory is that Qi is made up of opposing energies known as Yin and Yang energies.
Everything in the universe – including in the body – can be seen as pairs of opposites. One half of the pair will be classed as Yang and the other half as Yin. Yang is heat and male, for example, while yin is cold and female.
It is thought that when these energies get out of balance ill health arises.
As acupuncture became popular in the West some basic research was done to find a scientific explanation for how it might work. These investigations have come up with several ideas. One is that acupuncture increases endorphins in the brain. Endorphins are the body’s own painkillers and also increase general well-being. This effect could explain why, in some of the results from research and everyday practice, acupuncture reduces pain.
Another hypothesis is that acupuncture influences the way nerve fibres conduct electrical impulses which could at least in part explain how acupuncture lessens our awareness of pain.
It is important to note that, at present, all these explanations are just possibilities. Nevertheless their mere existence has helped to make acupuncture more accepted by previously sceptical scientists and doctors throughout the world.
Where does it come from?
Acupuncture is an ancient Chinese form of treatment. It started in China several thousand years ago and first came to Europe in the 17th century. Acupuncture became particularly popular in the West in the 1970s.
Doctors looked into how it might work and whether it is proven to work in treating specific medical conditions. One category of conditions that proved to be most interesting to them was pain. Thus acupuncture became a popular treatment for all sorts of painful conditions from back pain to migraine; a remarkable development because, in China, pain was not its main traditional use.
Where can I get it?
Acupuncture is available on the NHS but you can only get it if your local health authority or GP offer it. Some GPs are trained acupuncturists and will offer treatment through their surgery. Some physiotherapists are also trained in acupuncture and may offer it on the NHS. Most NHS hospital pain clinics use acupuncture, but you will only be seen by one of these clinics in severe cases.
Some private healthcare providers will pay for acupuncture for members. They will probably want you to use a medical (Western-style) acupuncturist.
If you choose to pay for acupuncture yourself expect each session to cost between £20 and £70 depending on where you live. The fees depend where your acupuncturist is based and how much training they have had.
Bear in mind that anyone can set up as an acupuncturist even if they have only had a small – or indeed no – amount of training. The usual training is about two years of full time education at a college approved by the British Acupuncture Accreditation Board. When you are choosing an acupuncturist ask to see their qualifications to make sure you are happy. Medical acupuncturists may have had shorter courses because they have already covered parts of the training in their medical studies.
It is advisable to visit an acupuncturist who is a member of the British Acupuncture Council or The British Medical Acupuncture Society. Together these organisations have nearly 4,000 members throughout the UK.
The future
We need to understand more about how acupuncture works and for what conditions it is effective. We also need to find out under which circumstances adverse effects occur in order to avoid them in future. Provided the evidence in favour of acupuncture increases, we are likely to see it being more frequently adopted into conventional healthcare.
Most GPs would like to see acupuncture provided on the NHS according to a recent report by the British Medical Association. For this to happen, says the report, we need further research into the safety, costs and benefits of acupuncture. The amount of money given by the NHS to research complementary therapies (including acupuncture) is tiny and needs to increase, says the report.
Two studies are currently looking into how often people have adverse reactions to acupuncture and what sort of reactions these are. Other studies are investigating what conditions can be helped by acupuncture.
Disclaimer: The material appearing on this website is for general medical information only. This information must not be used for diagnosis, choice of treatment or as a substitute for the advice of your healthcare advisor.
© Realdo Ltd 2003