Acupuncture is an ancient Chinese remedial technique used traditionally to treat pain and inflammation. This technique has also become quite popular in the United States and other Western countries. However, the science behind this technique was not clearly understood.
Recently, a team of researchers from the Harvard Medical School, led by neuroscientists, found that acupuncture can activate a specific signaling pathway that helps relieve chronic pain and inflammation. This article will review the research on the effectiveness of acupuncture on pain and inflammation.
What is Acupuncture?
Acupuncture is an alternative therapy that involves inserting thin needles into the body at specific locations and depths to help treat different health conditions. Ancient acupuncture practitioners believed that the therapeutic properties of this technique come from its ability to balance vital energy known as ‘Qi’ (pronounced as Chi).
Anecdotal evidence suggests that acupuncture can help manage lower back pain, neck pain, shoulder pain, knee pain, ankle pain, etc. Acupuncture can also help manage sports injuries like elbow pain, tennis elbow, golf elbow, etc., stroke, and even insomnia and dementia.
Electroacupuncture: What is it?
A modern variation of this ancient Chinese technique is Electroacupuncture. This technique uses electricity to improve the therapeutic benefits of acupuncture. Small electrodes are attached to the needles and placed in different spots of the body. Small spurts of electricity are passed through those electrodes when the therapy starts.
The Electroacupuncture treatment is also shorter as the electrodes get activated more quickly, ensuring that the patient receives the right amount of stimulation. In addition, electroacupuncture can cover a larger area than traditional acupuncture.
How Does Acupuncture Work?
Usually, an acupuncturist inserts 5 to 10 needles in different areas of the body and leaves them for 15 to 30 minutes. A usual course of treatment includes six to 12 sessions over three months.
Acupuncture helps block pain sensations by activating bioactive chemicals in the body. For example, it triggers the sympathetic nerve fibers and stimulates the body to release endogenous opioids (e.g., endorphins), which help reduce inflammation. The activated nerve fibers help relieve persistent pain and stress. It might also have beneficial effects on patients with paralysis, muscle disorders, and even neurological conditions like Parkinson’s disease.
Now that we have a basic idea about acupuncture let’s look at what research says about it.
Taking a Closer Look.
In a 2012 meta-analysis published in the Journal of Pain, the authors concluded that acupuncture is effective for treating chronic pain and that its effects persist over time.
For the meta-analysis, the researchers included data from Randomized Controlled Trials (RCTs) published in different journals through November 2008. Another meta-analysis published a few years later considered eligible RCTs published between December 2008 to December 2015.
The trials included in the meta-analysis matched the following criteria.
- Patients reported at least one of the four chronic pains (i.e., back or neck pain, chronic headache, shoulder pain, or osteoarthritis).
- If the duration of pain associated with musculoskeletal disorders lasted more than four weeks.
- At least one patient in each study group received acupuncture treatment, and the control group received a placebo or no treatment.
- If the primary endpoint of the study determined at least four weeks after the first acupuncture treatment session.
- Patient allocation concealment for the study was set unambiguously.
Let’s Deep Dive into Research:
A 2014 study found that electric stimulation by electroacupuncture can help reduce cytokine levels in mice by stimulating the vagal-adrenal axis. The vagus nerve signals the adrenal glands to release dopamine, which consequently helps relieve pain and bring down inflammation.
Another study published in 2020 states that the effects of electroacupuncture are region-specific. The authors, Ma and his team, found that while electroacupuncture was effective when administered in the hindlimb region, it did not have an effect when applied in the abdominal area. The study indicated that sensory neurons unique to some specific regions are responsible for the difference in response to electroacupuncture.
Further studies conducted by the researchers identify a small subset of sensory neurons characterized by PROKR2cre receptors. In addition, Ma and his colleagues established that these neurons were multiple times more in number in the deep fascia tissue of the hindlimb than in the fascia of the abdomen.
Ma and his team, in their final experiment, studied the distribution of the nerve cells in the hindlimbs. The study found that there were considerably higher numbers of neurons in the anterior muscles of the hindlimb than in its posterior region. Therefore, it is anticipated that the higher number of neurons on the anterior hindlimb is responsible for the stronger response to electroacupuncture in the anterior region.
Ma explained that based on the neuron distribution, we could speculate in which spots the electrical stimulation will be effective.
Does Acupuncture have Any Downside?
Acupuncture is generally considered safe. However, a few acupuncture-related complications have been reported in the past. Though rare, one of the most serious issues caused by acupuncture was the accidental insertion of a needle in the pleural space between the lungs and the chest walls. In addition, blood-borne infections like Hepatitis B and HIV might be a risk if needles are reused.
Other possible risks of acupuncture include the following:
- Bleeding, bruising, and soreness at the insertion sites.
- Unsterilized needles may cause infection.
- Risk of needle breakage and damage to internal organs.
The Bottom Line:
Acupuncture has had a long history in traditional Chinese medicine. Its effectiveness has made it popular in the world. However, for a long time, scientists failed to explain its mechanism of action and the reason behind its effects accurately.
Though more studies in this field are required to understand the effects of acupuncture in depth, modern science and technology have made it possible to understand how acupuncture works. As a result, expert now believes that acupuncture can help treat several severe chronic diseases such as chronic pain, tennis elbow, golf elbow, carpal tunnel syndrome, inflammatory bowel syndrome, arthritis, shingles, etc.
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By Dr. Kuoting Lee, LAc, DAIM