Yesou hear the term “acupuncture“, and visions of needles may dance in your head. But the 3 million Americans (and counting) who have tried it know that the treatment goes far beyond simple pokes and needles.
A typical visit to an acupuncturist may begin with examining your tongue, taking your pulse at several points on each wrist, and probing your abdomen. “2,500 years ago, they didn’t have MRIs or X-rays, so they had to use other ways to assess what’s going on internally,” says Stephanie Tyiska, an acupuncture practitioner and trainer based in Philadelphia.
These diagnostic procedures inform needle placement, Tyiska explains. But a visit to a acupuncturist might also include an in-depth discussion of your diet and personal habits, recommendations for avoiding certain foods or taking herbal supplements, and a range of additional in-office treatments, such as skin brushing or some sort of vacuuming known as “cupping”, which together are part of traditional Chinese medicine.
But does it work? Determining whether each of these practices can be therapeutically viable is challenging, and determining how they can all work in concert is virtually impossible. Combine this with acupuncturists’ frequent references to “qi” or energy flow, and it’s easy for many people to dismiss the practice as a hoax.
But not so fast. A recent meta-analysiswhich reviews existing research on a topic, compared acupuncture treatment to standard medical treatment (which involves a medical examination and medication) for musculoskeletal problems. pain, chronic headaches and osteoarthritis. He also compared real acupuncture to “sham” acupuncture, a procedure in which needles are randomly inserted to make patients believe they were receiving acupuncture when they were not. “There are many poorly designed acupuncture studies, so we tried to include only the best trials,” says Andrew Vickers, a biostatistician at Memorial Sloan Kettering Cancer Center and co-author of the meta-analysis.
When comparing legitimate acupuncture to standard care, acupuncture has a statistically significant advantage, Vickers says. “We saw a measurable effect,” he explains. “If acupuncture were a medicine, we would say it works.”
When Vickers and his team compared legitimate acupuncture to sham acupuncture, this benefit persisted but diminished. There are many ways to interpret this, Vickers says. “It could be that acupuncture has a significant placebo effect, or that the pressure points” – the precise places where the needles are inserted – “are less important than acupuncturists claim,” he explains.
Many people dismiss placebo effects as scams. “The term placebo has always had a very negative connotation,” says Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at Harvard Medical School. But Napadow says our poor view of placebo needs to be revised. The human body has built-in systems for stirring or calming pain and other subjective sensations. “If a placebo can target and modulate these endogenous systems, that’s a good and real thing,” he says.
But acupuncture could have even more profound effects than the placebo. Napadow has conducted dozens of brain imaging studies on acupuncture in an effort to determine how the treatment may or may not ease pain or associated conditions like headaches or arthritis. He says there are many ways acupuncture can work, and the specific mechanism may depend on the type of condition you’re trying to treat.
One possibility is that being pricked with a needle causes a small injury, causing your immune system to respond by sending inflammatory proteins and other infection-fighting chemicals that could heal at the source of that injury. “There’s the idea that by causing many of these very small injuries, you strengthen the immune system so that it can deal with bigger problems,” Napadow says.
It’s also possible that increasing blood flow and immune system chemicals to the poke site helps remove accumulated cellular byproducts that can trigger or worsen a condition like plantar fasciitis or tendinitis, he says. . “Or the needles can activate nerve receptors in the skin, which then transmit information to your spinal cord and brain,” he says. “This information could trigger a change in brain physiology, such as the release of endorphins or these types of neurotransmitters that could alleviate the sensation of pain associated with something like fibromyalgia.”
His research confirmed some of these potential mechanisms. One of his studies showed that after traditional acupuncture, opioid receptors were more available or more receptive to the body’s natural pain-relieving chemicals. There was no change after sham acupuncture.
This essentially means that opioid receptors were more available or more receptive to the types of body hormones and chemicals that help soothe pain.
Napadow says more research has been done on the effect of life expectancy on acupuncture outcomes, or whether people who believe the treatment will work will benefit more than those who don’t. not. Evidence suggests that life expectancy does not improve the effectiveness of acupuncture. “Often, it’s the man who says his wife made him try it who gets the most benefit,” he says.
Add to these promising findings the fact that acupuncture is an inexpensive treatment option with very few side effects, and Napadow believes it makes sense to consider it a useful partner to Western medicine, especially when These are chronic pain-related conditions for which Western medicine often relies on painkillers. “It won’t cure cancer,” he said. “But it could be effective for managing side effects of radiation or chemotherapy, such as pain, neuropathy or nausea.”
Tyiska, a Philadelphia-based acupuncturist, makes a similar argument. “I’m not telling people to stop seeing their doctor,” she says. “But if you’re prescribed opioids or considering surgery, you lose very little by trying acupuncture first.”
