Should You Consider Acupuncture for Chronic Pain?
Acupuncture is a technique within Traditional Chinese Medicine (TCM) that utilizes fine metallic needles inserted through the skin for analgesia and pain control. In TCM, health is considered in terms of harmony between the body and nature (Berman et al., 2010). A vital force known as qi is thought to flow through the body. If the flow of qi is disrupted, the person experiences pain. Qi flows along a series of 20 meridians in the body, 12 of which are associated with primary organs such as your heart and lungs, urinary bladder, and gallbladder, and 8 secondary meridians. The acupuncturist restores the flow of qi by inserting needles at specific points along these meridians and manipulating them to stimulate a dull ache called de qi.
Just as there are different varieties of conventional medical treatments for pain, there are different types of acupuncture. Most people are familiar with the “classical” style which involves mechanical stimulation only. However, some acupuncturists also offer the newer electroacupuncture or EA, in which an electrical current is used to stimulate the needle insertion site. The practice of acupressure does not involve the use of needles, but rather using the fingers, palms, or elbows to apply pressure along the meridians. Transcutaneous Electrical Acupoint Stimulation or TEAS involves the placement of gel pads with electrodes along meridians at specific acupressure points. Each of these techniques is slightly different and may appeal to different types of patients.
Practitioners are required to be licensed by the National Certification Commission for Acupuncture and Oriental Medicine. TEAS practice requires special certification. Make sure to check with your practitioner to ensure that they have the proper credentials and that their training is up to date.
Practitioners of conventional Western medicine have attempted to find out if there are specific groups of patients who benefit more acupuncture. In a study of 638 patients who live with low back pain, researchers compared use of acupuncture to usual care (Sherman et al., 2009). For example, they wanted to find out if pre-existing beliefs about the efficacy of treatment would affect outcomes. It did not. In fact, the only outstanding characteristic was the level of baseline disability. The more your chronic back pain interferes with day-to-day activities, the more you stand to benefit from acupuncture.
What might you expect during an acupuncture treatment? Treatment time typically runs about an hour. The acupuncturist will begin with a physical exam that includes taking your pulse and examining your tongue, and any specific areas of your back in which you are experiencing pain. Wear comfortable and loose-fitting clothing so that the acupuncturist can easily reach the needle insertion points. For low back pain, you will typically lie prone (face down) on the treatment couch. After inserting and stimulating the needles, you will be asked to lie quietly for the needles in place: 15-30 minutes. During this time, the acupuncturist may leave, but will provide you with a way to call for help if necessary.
If you are considering acupuncture, there are medical conditions for which the practice is unsafe. These include bleeding disorders (hemophilia and advanced liver disease), anti-clotting medications (Warfarin), local skin infections or skin trauma and certain psychiatric conditions (psychosis). Electroacupuncture is contraindicated for patients with implanted medical devices such as pacemakers and ICDs. If you are pregnant or believe you may be pregnant, be sure to let the acupuncturist know since this requires avoiding certain needle insertion points.
Unlike oral medication, acupuncture takes time to be effective. Do not expect to see results after just one session. Most recommendations are for 12 sessions or more (Berman et al., 2010) over a period of weeks. According to some studies, patients will see increases in benefit up to about a month, with benefit after discontinuing treatment extending another six months or so.
While Western medicine practitioners may not endorse acupuncture as a stand-alone therapy for back pain, physicians recognize its value, particularly as adjunct to conventional treatments. Because it is relatively safe for all but the above-mentioned groups, it is certainly worth considering if you would like to improve the efficacy of your current pain management plan.