Acupuncture

An article in the journal Mediators of Inflammation, “Anti-inflammatory actions of acupuncture” [1] outlines various ways one essential mechanism of acupuncture may stimulate the body’s inflammatory and anti-inflammatory activities.

Puncture by an acupuncture needle mobilizes the body’s own defenses, improves blood flow to organs, activates cell growth, and influences the movement of substances in and out of cells. Among the chemicals stimulated by the insertion of an acupuncture needle are neuropeptides such as calcitonine gene-related peptide (CGRP), which is a substance that both prevents and promotes some forms of inflammation. Another neuropeptide known as, Substance P, works in conjunction with CGRP to create edema and inflammation, both of which are important in containing an injury and bringing red and white blood cells and nutrition to the site of injury.

Acupuncture stimulates or otherwise influences the production of other substances involved in inflammation. Beta-endorphins, another group of neuropeptides, promote the analgesic (pain-reducing) effects of acupuncture. Cytokines, produced by white blood cells, “provide signals to regulate immunological aspects of cell growth and specific immune response” mostly local to their production but sometimes systemically.

[2] Nitric oxide (NO), used by the body to expand the size of blood vessels (vasodilatation), is another component of the inflammatory process that brings blood where it is needed. Acupuncture’s initial effect is thus to engage the body’s own defenses.

While “high levels of CGRP have been shown to be pro-inflammatory , . . . CGRP in low concentrations exerts potent anti-inflammatory actions . . . . Therefore, a well-performed and frequently applied ‘low-dose’ treatment of acupuncture could provoke a sustained release of CGRP with anti-inflammatory activity, without stimulation of pro-inflammatory cells.” This dual action, inflammatory and anti-inflammatory, may explain why acupuncture is effective in the short term for acute disorders and is also effective in the long term for chronic illness.

Notes:
1. Anti-inflammatory actions of acupuncture. Mediators of Inflammation, 12(2), 59-69 (April 2003). Freek J. Zijlstra, Ineke van den Berg-de Lange,Frank J. P. M. Huygen1 and Jan Klein.
2. Tabor’s Medical Dictionary, 18th Edition.

Can acupuncture treatments relieve back pain?
Answer
from J. D. Bartleson, M.D.

When performed properly by trained practitioners, acupuncture has proved to be an effective therapy for back pain. Several studies have found that acupuncture can help reduce chronic back pain and improve daily function.

Acupuncture for back pain involves inserting very thin needles to various depths into strategic points on your body. This is thought to balance the flow of energy or life force — known as qi or chi (pronounced chee) — believed to flow through pathways (meridians) in your body.

Scientists don’t fully understand how or why acupuncture affects the amount of pain you feel. Several studies have found that acupuncture causes the same effects as sham (minimal or simulated) acupuncture used in some studies for comparison. Sham acupuncture involves tapping the skin with a toothpick at the same strategic points used in acupuncture to simulate the insertion of a needle. Sham acupuncture may not be an accurate way of studying the benefits of acupuncture, however, because it’s possible that acupuncture points can be stimulated by even surface pressure. Both acupuncture and sham acupuncture showed improvement over usual medical treatments.

Acupuncture is generally recognized as safe if done by a competent, certified acupuncture practitioner. Possible side effects and complications can occur, which include soreness, bleeding, infection or bruising at the needle sites.

Acupuncture isn’t a cure and not everyone responds to acupuncture for back pain. If your back pain doesn’t begin to improve within a few weeks, acupuncture may not be the right treatment for you. If you’re considering acupuncture for back pain, talk with your doctor, who can refer you to an acupuncturist.