On Acupuncture

What is Acupuncture?

... an ancient form of medicine that works by physically stimulating specific places on the body using hair fine needles, heat, or massage. For 2,000+ years it has served a quarter of the world’s population and it continues to thrive today. In the UK professional acupuncturists provide some 3 million acupuncture treatments annually and worldwide 230+ million people receive acupuncture and Chinese medicine. You will not be the first to benefit from acupuncture!

is it safe?

The people who know most about risk are the insurance industry. Premiums for UK doctors are at least 20 times those for professional acupuncturists, this suggests that it is much safer to see a professional acupuncturist than a GP. In truth, both are low-risk. Large UK surveys have found no significant adverse reactions and concluded that “acupuncture is very safe indeed in skilled hands”. Try to see someone with at least 3 years acupuncture training and who has this as their main speciality. They will be pleased to be asked about it. Those with a few weekends training will not, they know that pretending to be a professional acupuncturist after a few weekends is essentially fraudulent.

single-use disposable needles are always used at my clinic

does it hurt?

Some people avoid acupuncture because they assume it will be painful. Using hair-fine needles means the discomfort is slight. You’ll feel only a tiny pricking sensation like a mosquito bite, followed by a mild achy-numb feeling - most find this relaxing rather than unpleasant and leave on a high.

How long will it take before things happen?

New problems may only need 2 to 5 sessions but if you have had an ailment for some time it may take 6 to 12 regular sessions before things really improve. As your symptoms get better treatments can be less frequent and should require only occasional top-ups after that. As a very rough guide you may need one session for every month you have had the problem. At your first visit we discuss your treatment plan, the timescales, goals and likelihood of success.

What does it actually do?

An interesting question! One that has been extensively researched and that would require a whole book to summarise what is known. Here I just offer a very short overview.

acupuncture releases natural pain-killers

Research has provided conclusive proof that it releases powerful natural opiate substances into the brain and spinal cord that reduce pain. This 'endorphin effect' accounts for some of acupuncture's ability to give pain relief. Researcher Prof Bruce Pommeranz said: "we now have 17 seperate lines of evidence supporting acupuncture's endorphin effects, this is much more than we have for the majority of drug medicines so, in many ways, our understanding of acupuncture in pain is better than that for most drugs". Endorphins are also believed to account for some other effects of acupuncture; anxiety, depression, some addictions and also in seemingly unrelated areas such as fertility. Endorphins are not the only explanation for acupuncture's effects as the pain relief lasts much longer than if only endorphins are involved. Also, we find that repeated acupuncture produces stronger and more lasting effects whereas endorphin pain relief wears off after a few hours.

Natural Steroid Hormones

acupuncture increases the secretion of ACTH from the pituitary which makes the adrenals produce more natural steroid hormones that have anti-inflammatory and pain relieving effects. This contributes to the acupuncture effect.

Increased blood flow

Studies have shown acupuncture that acupuncture increases blood flow. For example, fertility researcher Dr Elsbeth Stenner-Vitorin has used ultrasound to measure increased pelvic blood flow in response to acupuncture, in women attending a Swedish fertility clinic. Her work showed the effect sustained for many weeks after the end of the acupuncture course. Also, MRI scans have shown clear increases in blood flow in the brain following acupuncture to the hand or foot. Moxabustion heat treatment also causes blood vessels to dilate and so to increase blood flow.

Immune responses

Many studies have shown that this treatment is able to improve immune function. White blood cell counts have been found to increase, including rises in NK Cells which form part of our defenses against cancer. Acupuncture cannot cure cancer but it can relieve some symptoms and counter some adverse effects of medical treatment.

Current of injury

The micro trauma caused by acupuncture triggers beneficial healing responses. First by causing what is known as current of injury - the"on switch" for tissue repair. This then triggers improved local blood circulation and the release of epidermal growth factors (EGFs) - very potent local hormones that repair tissues. In one study (published in a leading Opthalmology journal in 2002) such local damage was found to increase the degree and rate of healing by about 100 times - that is quite a lot! moxabustion This heat treatment also has beneficial effects, for example by improving local blood flow. Other effects may involve release of Nitric Oxide (NO) a powerful local communicating chemical - the one targeted by Viagra - and a powerful set of repair substances called HSPs (heat shock proteins).

Other effects

Other mechanisms of acupuncture remain to be fully explored. For example, it has been well established by clinical research that moxabustion can help foetuses move into the correct position for safe delivery but we have no idea what makes this happens in practice. One study found that acupuncture was effective in delivering placentas retained after childbirth. Ear acupuncture has been shown to stop the gagging reflex in dentistry and even better evidence supports the value of the acupoint P6 in stopping nausea and vomiting. Currently there is much interest in exploring the way that the autonomic nervous system is involved in some effects of acupuncture

What can it treat?

....Will it work for me?

No medicine in the world is 100% effective all the time, for everyone, but surveys have found that the majority of patients who have acupuncture benefit from it. For some conditions acupuncture has strong research support in the form of metanalyses of randomised controlled trials, examples include: nausea and vomiting, chronic back pain, migraine, neck pain, post-operative pain, knee osteoathritis, fertility and IVF support.

The WHO lists* "things acupuncture has been proved through clinical trials to be an effective treatment…." depression, hay fever, rhinitis, bowel disorders, menstrual pain, effects of cancer treatment, stomach pain, headaches, migraines, hypertension, knee pain induction of labour, foetal malposition, low back pain, morning sickness, nausea & sickness, neck pain, shoulder pain, post-op pain, arthritis, sciatica, sprain, stroke, tennis elbow

… and for which "acupuncture has been shown to work but where further proof is needed…" acne, asthma, cancer pain, infertility, earache, gall stones/inflammation, facial spasm, gout, urethral syndrome, fibromyaligia, insomnia, labour pain , herpes zoster, neuralgia, male infertility/impotence, prostatitis, addictions, polycystic ovaries, PMS, recurrent cystitis, ulcerative colitis, TMJ pain, stiff neck

These are things that have been researched - many other problems not on this list may be helped.

Although the WHO have given us a useful guide in most cases better evidence would give even more certainty about acupuncture's value in specific conditions.

When we allow for the fact that people with these conditions are often quite poorly-served by modern medicine acupuncture offers perhaps the most evidence-based alternative available.

Context - Evidence in modern medicine 

Virtually no medicine or medical test is 100% effective, reliable or proven. Many commonly accepted types of modern medicine have only a weak evidence base - surgery and physiotherapy are good examples. Most drug medicines are not, on close examination of the evidence, quite as good as you might expect and some common licenced medicines frankly do no good at all. For example, major recent evidence summaries have concluded that beta-blocker drugs, when added to a regime for blood pressure, actually increase the rate of death from cardiovasular disease and so are worse than useless.

The BMJ’s Clinical Evidence website, “one of the world’s most authoritative medical resources”, in summarising data on about 2,500 conventional treatments used in the UK's National health Service, tells us that:

13% are “proven to be beneficial”
23% are “likely to be beneficial”
8% represent “a trade-off between benefits and harms”
6% are “unlikely to be beneficial”
4% are “probably ineffective or harmful”
46% are of “unknown effectiveness” 

* Acupuncture: Review & Analysis of Reports on Controlled Trials. World Health Org. 2002