Acupuncture

Acupuncture is a treatment, which can relieve symptoms of some physical and psychological conditions and may encourage the patient's body to heal and repair itself, if it is able to do so.

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 and serotonin - in the pain pathways of both the spinal cord and the brain. This modifies the way pain signals are received.

But acupuncture does much more than reduce pain, and has a beneficial effect on health. Patients often notice an improved sense of wellbeing after treatment.

Modern research shows that acupuncture can affect most of the body's systems - the nervous system, muscle tone, hormone outputs, circulation, antibody production and allergic responses, as well as the respiratory, digestive, urinary, and reproductive systems.

The practitioner will assess each patient’s case and treatment will be tailored to the individual; so it is impossible to give more than a general idea of what treatment might involve. Typically, fine needles are inserted through the skin and left in position briefly, sometimes with manual or electrical stimulation. The number of needles varies but may be only two or three.

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.

Uses for acupuncture

Taking the above into consideration, here are some of the ways in which acupuncture may be effective:

• Pain relief for a wide range of painful conditions. It is commonly used to treat musculoskeletal pain, for example - back, shoulder, neck and leg pain
• It has been used successfully to treat headaches, migraines, trapped nerves, chronic muscle strains, sports injuries and various kinds of arthritic and rheumatic pain
• ………………

This list is by no means exhaustive, but it does give a rough idea of the wide range of conditions that respond to acupuncture treatment. Remember that before starting acupuncture, the practitioner must be sure of the diagnosis and that all the necessary tests have been carried out which might point to any serious or potentially serious condition, perhaps requiring other forms of treatment.

Acupuncture - past, present and future

Acupuncture-like techniques have been used for over 5,000 years. A comprehensive system was developed in the Far East and this was first introduced into Europe in the 17th Century. However, widespread interest in the technique did not develop until the political events of the early 1970's allowed travel restrictions between East and West to be eased.

In the past thirty years, because of the huge public interest in the subject, considerable scientific research on acupuncture has been carried out - although much remains to be done. We now know much more about how acupuncture works and some of the myths can be laid to rest. It is demonstrably untrue to say that the results of acupuncture are all in the mind.

As we learn more about it, the possibilities of using acupuncture alongside orthodox medicine increase. The distinction between complementary or alternative medicine and conventional medicine is becoming blurred as acupuncture is accepted in medicine. Acupuncture is already available in most hospital pain clinics and it is provided by an ever-increasing number of GPs and hospital doctors.

Where to go for acupuncture

At the moment, anybody in the UK is allowed to call themselves an acupuncturist and can start advertising and practising acupuncture immediately, regardless of qualifications or experience. This is not ideal within a healthcare setting, so patients must check the credentials of their practitioner.

BMAS http://www.medical-acupuncture.co.uk members are subject to our Code of Practice and Complaints Procedure in addition to meeting the requirements of the statutory regulatory body for their profession. Our Code of Practice is available to download.

Acupuncture is a potent therapy, and whilst it is generally safer than most conventional treatments, if used without due care it can have serious adverse effects or interactions with other treatments.

Acupuncture should only be used by trained practitioners who can adequately assess the risks and benefits of applying the therapy.

The ideal promoted by the BMAS is that acupuncture should be fully incorporated into orthodox medicine and used as one of the therapeutic tools available in treatment of a defined range of conditions.

German Acupuncture Trials (GERAC) for Chronic Low Back Pain. Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups. Michael Haake, PhD, MD; Hans-Helge Müller, PhD; Carmen Schade-Brittinger; Heinz D. Basler, PhD; Helmut Schäfer, PhD; Christoph Maier, PhD, MD; Heinz G. Endres, MD; Hans J. Trampisch, PhD; Albrecht Molsberger, PhD, MD
Arch Intern Med. 2007;167(17):1892-1898. http://archinte.ama-assn.org/cgi/content/abstract/167/17/1892

 A Reappraisal of Acupuncture
Dr Adrian White

In the last 30 years, a fundamental reappraisal has been taking place in the
Western world. This reappraisal has been occurring largely in the UK in the
wake of Felix Mann's pioneering declaration that acupuncture points don't
exist, acupuncture meridians don't exist, but acupuncture still works. He was
expressing the secret thoughts of many people who were trained in both
biomedicine and acupuncture, who could not come to terms with the
traditional way in which acupuncture was applied but could not see that it
could be very effective.

The traditional principles of acupuncture are very attractive and appealing. To
reject them provokes anxiety, particularly in a practitioner, perhaps unfamiliar
with modern biomedical science, who has invested along time in learning
them and sees them as the only possible explanation. But there is not the
slightest evidence to support the traditional ideas. Despite detailed research,
there is simply nothing can be found to suggest that energy really does
circulate in meridians, or that diseases can be caused (for example) by an
attack of dampness.

One important point about the reappraisal of acupuncture is that it is being
conducted by scientifically trained clinicians who have great respect for the
observational skills and accumulated experience of traditional Chinese
physicians. What these ancient Chinese doctors observed cannot be
disputed, it is only their explanations, based on Taoist philosophy and a
vitalistic view of the world, that are unacceptable in the face of current
knowledge.

It would be overstating the case to say that the reappraisal has been achieved
in an organised way, or that there is a universal agreement on the outcome.
But it is now possible to draw the general outline of the way acupuncture may
become acceptable within Western medicine, not just for its clinical benefits
but also for its underlying mechanisms. Most people agree that acupuncture
points are not fixed entities, but simply areas where the nervous system is
signalling that it needs to be stimulated. Points are not selected for treatment
on the basis of imbalance of energy but because they overlie trigger points, or
are in a particular segment, or even have been found to work empirically, with
no explanation yet discovered. Meridians are not energy pathways but reflect
referred symptoms and the direction of nerve pathways which converge in the
spinal cord. Stimulating the body with acupuncture needles does not 'balance
the energy' but activates a disturbed nervous system, generally in a direction
towards normal function. Acupuncture stimulation can reach important areas
deep within the brain, and this fact provides a possible explanation for its
distant and far reaching effects in a wide variety of conditions.

This reappraisal of acupuncture extends beyond how acupuncture should be
practised and what its mechanism might be. It also incorporates a modern
approach to health care, which recognises the need to provide clinical trial
evidence to back up anecdotal reports of acupuncture's successes. Only by
providing evidence can acupuncture stand alongside other therapies that are
already established, and be judged by the strictest criteria of evidence-based
medicine. This is the way forward for the acceptance of acupuncture and even
its integration in the health service, for appropriate conditions.

Adrian White is a Research Fellow,Dept of Complementary Medicine,
University of Exeter, UK

He is joint editor of the book Medical Acupuncture A Western Scientific
Approach.

British Medical Acupuncture Society