Acupuncture is the method of treatment based on influencing the body by inserting needles in the specific points of human body, called acupoints.
The name originates from Latin and literally means “inserting needles” – Latin „acus” – needle and „punctura” – to needle/to stick needles.
Chinese word for acupuncture is 针灸,ZhenJiu. This word consists of two characters, which- before the reorganization of Chinese writing- looked like as follows: 針灸 and mean, respectively: metal needle and heating, or cauterization using mugwort wormwood (Latin: artemisia vulgaris). The name itself indicates that not only needles are utilized in acupuncture for stimulation of acupoints.
Broader definition of acupuncture
A broader definition of acupuncture therefore includes various techniques of acupoints’ stimulation, using:
- heating/cauterization – moxa, moxibustion
- pressure/massage – acupressure
- coherent laser light- photopuncture or laser therapy
Acupuncture is, apart from specific dietetics, herbal therapy and the system of physical exercises [QiGong], one of treatment methods originating from Far Eastern medical systems, called -for the matter of simplification- Chinese Medicine. As these systems were codified no later than between II century BC and II century AD, they were described using the state of knowledge of the then contemporary inhabitants of South-Eastern Asia. It must be underlined that Chinese Medicine is a coherent, complete, closed medical system, including its specific human physiology, pathology, disease terminology, methods of diagnosing and therapeutic methods.
Indications for acupuncture according to the World health Organisation
Diseases, symptoms or conditions for which acupuncture has been proved – through controlled trials—to be an effective treatment:
- Adverse reactions to radiotherapy and/or chemotherapy
- Allergic rhinitis (including hay fever)
- Depression (including depressive neurosis and depression following stroke)
- Dysmenorrhoea, primary
- Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm)
- Facial pain (including craniomandibular disorders)
- Hypertension, essential
- Hypotension, primary
- Induction of labour
- Knee pain
- Low back pain
- Malposition of fetus, correction of
- Morning sickness
- Nausea and vomiting
- Neck pain
- Pain in dentistry (including dental pain and temporomandibular dysfunction)
- Periarthritis of shoulder
- Postoperative pain
- Renal colic
- Rheumatoid arthritis
- Tennis elbow
Diseases, symptoms or conditions for which the therapeutic effect of acupuncture has been shown but for which further proof is needed:
- Abdominal pain (in acute gastroenteritis or due to gastrointestinal spasm)
- Acne vulgaris
- Alcohol dependence and detoxification
- Bell’s palsy
- Bronchial asthma
- Cancer pain
- Cardiac neurosis
- Cholecystitis, chronic, with acute exacerbation
- Competition stress syndrome
- Craniocerebral injury, closed
- Diabetes mellitus, non-insulin-dependent
- Epidemic haemorrhagic fever
- Epistaxis, simple (without generalized or local disease)
- Eye pain due to subconjunctival injection
- Female infertility
- Facial spasm
- Female urethral syndrome
- Fibromyalgia and fasciitis
- Gastrokinetic disturbance
- Gouty arthritis
- Hepatitis B virus carrier status
- Herpes zoster (human (alpha) herpesvirus 3)
- Labour pain
- Lactation, deficiency
- Male sexual dysfunction, non-organic
- Ménière disease
- Neuralgia, post-herpetic
- Opium, cocaine and heroin dependence
- Pain due to endoscopic examination
- Pain in thromboangiitis obliterans
- Polycystic ovary syndrome (Stein–Leventhal syndrome)
- Postoperative convalescence
- Premenstrual syndrome
- Prostatitis, chronic
- Radicular and pseudoradicular pain syndrome
- Raynaud syndrome, primary
- Recurrent lower urinary-tract infection
- Reflex sympathetic dystrophy
- Retention of urine, traumatic
- Sjögren syndrome
- Sore throat (including tonsillitis)
- Spine pain, acute
- Stiff neck
- Temporomandibular joint dysfunction
- Tietze syndrome
- Tobacco dependence
- Tourette syndrome
- Ulcerative colitis, chronic
- Vascular dementia
- Whooping cough (pertussis)
What does acupuncture treatment involve?
Acupuncture treatment involves fine needles being inserted through the skin and left in position from seconds to minutes. The needles can also be stimulated to obtain the required physiological effect, and may be local to, or segmentally linked with, the presenting condition. Additionally, extrasegmental or general effects may be sought by needling general points, particularly in hands and feet, that are common to many Chinese formulae. Sometimes manual or low voltage electrical stimulation is applied to assist the process. The number of needles varies but may be only two or three.
The practitioner will assess you and treatment will be tailored to you; so it is impossible to give more than this general idea of what your particular treatment might involve.
Treatment might be once a week to begin with, then at longer intervals as the condition responds. A typical course of treatment lasts 5 to 8 sessions.
How does acupuncture work?
Acupuncture stimulates the nerves in skin and muscle, and can produce a variety of effects. We know that it increases the body’s release of natural painkillers – endorphin (natural opioid) and serotonin – in the pain pathways of both the spinal cord and the brain. This modifies the way pain signals are received.
The clinical effects on musculoskeletal pain are best explained by inhibition of the nociceptive pathway at the dorsal horn (segmental effects)by activation of the descending inhibitory pathways,and possibly by local or segmental effects on myofascial trigger points.
Acupuncture stimulates the nervous system in various ways that results in the release in the body of natural chemicals which promote healing and the return to a normal healthy functioning of the body.
There are clearly other actions of acupuncture on the central nervous system that remain to be fully explored, including its effect on nausea. Imaging studies with functional MRI and positron emission tomography have provided good evidence of effects on various brain centres involved in pain control.
Acupuncture increases local nutritive blood flow to the area where it is applied which is an important factor for healing.
Acupuncture also works by addressing the problems caused by “Qi” energy blockages that otherwise flow uninterrupted in a healthy person.
Traditional acupuncture versus Western medical acupuncture
Western medical acupuncture is an adaptation of Chinese acupuncture using current knowledge of anatomy, physiology and pathology, and the principles of evidence based medicine.
The term “Western medical acupuncture” is used to distinguish it from acupuncture used as part of Chinese traditional medicine. Two important distinctions between Western medical acupuncture and Chinese acupuncture are that Western medical acupuncture does not involve the traditional concepts such asYin/Yangand circulation of “qi”, and that Western medical acupuncture does not claim to be an “alternative” medical system.
Traditional acupuncture holds that individual points have specific effects, but in Western medical acupuncture attention is less focused on choice of one point over another. Classical points are used by many—though not all—practitioners of Western medical acupuncture on the assumption that they are probably optimal for sensory stimulation of the nervous system. More attention is focused on the tissue level (eg, muscle rather than skin) and the type and amount of stimulation given. The classical nomenclature of points is generally used for convenience of communication with other acupuncturists.
Thus there are relatively few differences between traditional acupuncture and Western medical acupuncture in terms of treatment techniques. Both manual and electrical stimulation of needles are used; duration of needling is variable, ranging from very brief to up to 20 or 30 minutes
Use of acupuncture
Western medical acupuncture is mainly practised by conventional doctors, osteopaths, physiotherapists, nurses and other healthcare practitioners working within the Western health service, mostly in primary care but also in rheumatology, orthopaedic and pain clinics.
The most widespread application of acupuncture is for pain relief, most commonly musculoskeletal pain including myofascial trigger point pain but also other forms of chronic pain such as neuralgia and cancer pain. It is also effective for postoperative pain and nausea.
It is used in management of infertility, particularly as an adjunct to conventional treatments such as in vitro fertilisation, though the evidence is equivocal.