Acupuncture

Until about 15 years ago, I had no experience with or real knowledge of acupuncture.  Now, after 17 years of reflex sympathetic dystrophy (RSD; a.k.a. CRPS), the primary symptom of which is pain so intense it's unimaginable, I've had hundreds of acupuncture treatments from about a half-dozen practitioners from Illinois to Hawaii.  I'm proof that acupuncture can stimulate accelerated healing, foster a great increase of energy, and relieve chronic (neuropathic) pain.

Note:  In the following section, ALL images are available as an expanded view by clicking the image.

Do you like the images associated with acupuncture? Do so I! Take a look at this page [Acupuncture Images; opens in a new tab/page], devoted purely to the beautiful graphics used to teach or refer to by acupuncture practitioners.

For the PowerPoint files, if you don't have Microsoft PowerPoint, a very good, free viewer is available here:


Backgroundold acu chart

There are written references to acupuncture in Chinese texts dating into antiquity.  The page to the right is from the Ming Dynasty, called "Expression of the Fourteen Meridians".  The study and application of acupuncture has continued, and huge amounts of data gathered, for thousands of years. During this period, the discipline diversified into several specialized schools which stress different aspects of Traditional Chinese Medicine (TCM).

A detailed treatment of the theory behind the practice of acupuncture is far beyond the scope of this short article and the knowledge of this author.  A very accurate, clear, and well-referenced source is the piece in Wikipedia; its articles on acupuncture points and meridians are similarly great. However, this is its mode of action as is currently understood by Western scientists, whose perception of the human body is so foreign to Eastern practitioners - and visa versa - that true understanding may be a long way off.

    Acupuncture is the practice of inserting and manipulating thin needles into certain points on the body to relieve pain, restore energy, or for other therapeutic purposes. The TCM model of the human body is that there are meridians, or channels. throughout the body; their main function is to provide a pathway for the circulation of qi, or life essence (). The practitioner determines where the flow of qi is restricted, and then stimulates its flow through the meridians by manipulating extremely thin needles in very specific points along the meridians.

Though numerous theories have been proposed, no Western research has established any consistent anatomical structure or function for either acupuncture points or meridians. It has been proposed that trigger points were related to acupuncture points, but the two are rarely consistently found together, identified trigger points are rarely used by acupuncturists and when they are used, they are not used for the same indications.*

For a long time, researchers have looked for a connection between meridians and acupuncture points and the nervous system (this would be a logical correlation to propose); however, none has ever been found. This says nothing about the validity of acupuncture, only that its foundations rest in concepts foreign to Western medicine. Whether or not its scientific basis is ever delineated, its efficacy is indisputable, and its ongoing use for 5000 years attests to its success.

A current theory about acupuncture's pain-relieving ability, diagrammed to the left, holds that needling an acupuncture point along the appropriate meridian stimulates the body's own production of endorphins - the body's endogenous opioids. However, since the bases for Eastern vs. Western medicine are so different, greater acceptance on both sides - especially Western, allopathic healthcare providers - will have to occur before true cross-fertilization enables patients to get the best of both worlds.

A site has recently appeared that features many excellent diagrams of the meridians used by acupuncture practitioners, called All About Acupuncture. Check it out!

Two very good, readable articles I found on acupuncture are the following (both pdf):

1. "Acupuncture: Theory, Efficacy, and Practice" by T.J. Kaptchuck, OMD; Ann Inter. Med. 2002, 136, 374.

2. "Acupuncture in Modern Society" by X. Yi et al.; J. Acupunct. Meridian Stud. 2009, 2, 26.

Additionally, there are two PowerPoint presentations available for download (a free viewer link is near the top of this page) that help clarify these concepts. One is called Pain Management by Acupuncture, which focuses on current theories of acupuncture's effect of blocking pain. The other, somewhat longer, presentation is on the principles of Traditional Chinese Medicine (TCM), and covers several other topics in Eastern medicine in addition to acupuncture. They're both easy to understand and really fascinating!


Articles from the Popular Medical Press

Acupuncture from Medline Plus

Acupuncture (from the National Cancer Institute) a clear summary of acupuncture applications, concentrating (not surprisingly) on pain relief.

Acupuncture: A Clinical Review from Medscape, a very complete, comprehensive discussion of acupuncture

Acupuncture: An Introduction from NCCAM (part of NIH), a concise discussion of acupuncture in general

Acupuncture Does Help For Chronic Pain from the very good MedpageToday.com, a careful meta-analysis of controlled trials

Acupuncture for Pain from NCCAM, a very objective look at the utility of acupuncture for treating pain

Acupuncture Overview from the National Cancer Institute

Acupuncture - Tests and Procedures from the Mayo Clinic, an authoritative and concise summary of acupuncture

Acupuncture - Topic Overview from WebMD - although presented under "Fibromyalgia", this is an excellent overview

Backgrounder - Acupuncture from NIH, a six-page pamphlet (pdf) that goes over the basics of acupuncture for those considering it

NCCAM Acupuncture Information and Resources Package from the American Academy of Medical Acupuncture - a very comprehensive, layperson-level discussion on acupuncture and how it integrates with Western medicine. Very good!

Slideshow: A Visual Guide to Acupuncture from WebMD, a 23-image slideshow that explains acupuncture photographically

Understanding Acupuncture - Time To Try It? from NIH's monthly newsletter called News In Health, this is a very good, short inroduction to acupuncture in lay person's language.


Yamamoto New Scalp Acupuncture (YNSA)

In the mid-1970's, Toshikatsu Yamamoto, M.D., Ph.D developed a new application of acupuncture, which he called a "microsystem" of acupuncture, where all therapeutic points are located above the neck. The best lay explanation is the short paper written by the originator. Another very good presentation is in this 2005 paper from Medical Acupuncture, as is this paper outlining the cortical activation caused by YNSA and the benefit to stroke patients.

Also, here are a couple of papers from J. Alt. Comp. Med., one documenting the benefit of YNSA to autistic children, the other the rehabilitation of stroke patients. Clearly, the potential of this new advance has yet to be fully realized.


Scientific Literature

The following articles, which were chosen for their background or currency and are in approximate reverse date order, can be downloaded as PDF files by clicking the citation in the left column.

Citation (& link) Title of Paper
Support Care Cancer 2012, 20, 1147
Acupuncture for the treatment of cancer pain: a systematic review of randomized clinical trials - REVIEW
Evidence-Based Compl. Alter. Med. 2011, 301767
Does Acupuncture Improve Quality of Life for Patients with Pain Associated with the Spine? A Systematic Review
Pain Med. 2011, 12, 268
The Effect of Brief Electrical and Manual Acupuncture Stimulation on Mechanical Experimental Pain
Arch. Intern. Med. 2012, 3654, online
Acupuncture For Chronic Pain - REVIEW
BMC Compl. Altern. Med. 2012, 12, 161
Efficacy of acupuncture for chronic knee pain: protocol for a randomized, controlled trial using a Zelen design
Costs and consequences of acupuncture as a treatment for chronic pain
Acupuncture Alters Pain Sensations in the Brain
Demonstrated the lack of adverse events during acupuncture
Acupuncture successfully treats persistent hiccups as suffered by cancer patients receiving certain types of chemotherapy
Survey shows that physicians who routinely send patients for acupuncture become much greater consumers themselves after a single acupuncture Tx.
New Bioimpedance Research Device (BIRD) for measuring the electrical impedance of acupuncture meridians
Acupuncture for Lower Back Pain - A Review
Efficacy of Acupuncture and Acupressure for Allergic Rhinitis
Acupuncture Analgesia: I. The Scientific Basis
Acupuncture Analgesia: II. Clinical Considerations
Acupuncture in Theory & Practice: Part 1 - Theoretical Basis and Physiological Effects
Acupuncture in Theory & Practice: Part 2 - Clinical Indications, Efficacy, and Safety
Clinical Research on Acupuncture, Part 2
Clinical Research on Acupuncture, Part 1
Acupuncture in pain and peripheral neuropathy in HIV patients
Editorial: Is "Energy Medicine" a good label for acupuncture?

   If you haven't tried at least a few sessions with the same practitioner, you aren't making an informed decision on whether it can help you, since acupuncturist skill is the #1 variable as to your satisfaction with your treatment.  Find a practitioner (see below) and commit to, say, three sessions, one per week.  Go into each session with no expectations except to feel much better when you leave.

There is a GREAT disparity in skill levels of acupuncturists, and there is no federal licensing body to try to assure a uniform skill level.; licensure requirements are set state-by-state.  As with many such things, the best recommendations are word-of-mouth, so ask your friends, people around a gym, etc., if they can recommend a great acupuncturist.  It won't take long before you keep hearing the same name or two.  Then it's your move.

The following is a fairly complete collection of associations, societies, etc., whose common purpose is to convince Westerners to consider acupuncture when looking into healthcare providers.  The URLs directly below the title of the organization (in white) are hyperlinked to their home page.

Please note: When researching an article on any subject with a long history, it is very common to encounter some of the most colorful, complex, and/or beautiful images around. This is especially true with Oriental history, as it is thousands of years old. I've collected several of these, which are displayed on a separate page, called Acupuncture Images. Enjoy!


red wedgeAccreditation Commission for Acupuncture and Oriental Medicine (ACAOM)
http://www.acaom.org/
1010 Wayne Avenue, Suite 1270
Silver Spring, MD 20910
Phone: (310) 608-9680

The ACAOM evaluates various programs at colleges of acupuncture and Oriental Medicine to establish and maintain high educational, performance and quality standards and establishes accreditation criteria. The ACAOM is the only accreditation agency that is recognized by the U.S. Department of Education and the Commission on Recognition of Post-Secondary Accreditation.

red wedgeAcupuncture and Oriental Medicine Alliance (AOMA)
www.AcupunctureAlliance.org
The AOMA is a professional membership association providing information to professionals and the public on acupuncture and Oriental Medicine. It maintains a patient referral service and provides general information on acupuncture and Oriental medicine; legislative issues; national professional issues, acupuncture and Oriental medicine treatment; conferences and workshops; information on publications of interest and information for potential students.

red wedgeAcupuncture.Com
http://www.acupuncture.com
With its subtitle "Gateway to Chinese Medicine, Health, and Wellness, this is THE web home for acupuncture and other facets of TCM. There are sections for patients, practitioners/students, employment, Chinese herbal medicine, recipes, and an "Ask the Doctor" section. They also sell various products associated with TCM, feature a "Recent Research" section with links to primary research literature, and have a feature called "Acufinder.com", claimed to be the world's largest acupuncturist referral service.

red wedgeAmerican Academy of Medical Acupuncture (AAMA) and Medical Acupuncture Research Foundation
www.medicalacupuncture.org
Physicians founded the American Academy of Medical Acupuncture in 1987 to promote the integration of concepts from traditional acupuncture and modern Western medical training. Their web sites covers the following areas: information on medical acupuncture; a nationwide medical acupuncturist search service; continuing medical education for CME credits; international symposia and educational tours; a list of all programs accredited by the ACAOM; research and case studies by disease with an extensive reference list; and acupuncture-related news. The journal Medical Acupuncture is available online and there is also a special section for members.

red wedgeAmerican Association of Acupuncture and Oriental Medicine (AAAOM)
http://www.aaaomonline.org/
433 Front Street
Catasauqua, PA 18032
Phone: (610) 266-1433
Fax: (610) 264-2768

This organization was established to unify American acupuncturists and to promote high ethical and educational standards in the field. The association acts as an umbrella organization that represents the profession in the U.S.

red wedgeAmerican Association of Oriental Medicine (AAOM)
www.aaom.org
The AAOM was formed in 1981 with the intention to act as a unifying force for American acupuncturists committed to high ethical and educational standards. The AAOM web site provides introductory information on the organization and on Oriental Medicine; membership information; a referral list which can be searched by state; an education section offering a list of schools for acupuncture and Oriental Medicine with advice to future students on how to compare and choose programs; legislative issues; a list of state acupuncture associations; a calendar of events; an article library available to members only; and books, tapes and other publications which can be ordered directly from the site.

red wedgeAmerican Oriental Bodywork Therapy Association (AOBTA)
www.aobta.org
The AOBTA was formed in 1989, joining together a number of associations representing the individual disciplines of Asian Bodywork Therapy. Their web site provides membership information, access to a member database, descriptions and general scope of practice of a number of bodywork therapies from Asia, and web resources listed by organizations, State Chapters, schools and other related references.

red wedgeCouncil of Colleges of Acupuncture and Oriental Medicine (CCAOM)
http://www.ccaom.org/
1010 Wayne Avenue, Suite 1270
Silver Spring, MD 20910
Phone: (301) 608-9175
Fax: (301) 608-9576

The CCAOM is a membership organization for schools and colleges of acupuncture and Oriental Medicine that are accredited by the Accreditation Commission of Acupuncture and Oriental Medicine. The CCAOM works to advance the status of acupuncture and Oriental Medicine through educational programs and the improvement of research and teaching methods. It also provides a list of member schools and will answer questions regarding educational matters.

red wedgeDiscoveries in Acupuncture
http://www.disability-resource.com/medical-health/alternative-medicine/acupuncture/
This series of articles about acupuncture, from the Disability Resource Directory, covers most of the problems for which someone might consider acupuncture. The pathologies covered by a dedicated article include infertility, headache, arthritis, eating disorders, nicotine addiction, Carpal Tunnel Syndrome, etc. This holistic site also features pieces on herbal remedies, reflexology, and spiritual healing.

red wedgeInternational Veterinary Acupuncture Society (IVAS)
www.ivas.org
IVAS promotes acupuncture as an integral part of the total veterinary health care delivery system. It offers educational programs and an accreditation examination. The web site provides general information on veterinary acupuncture; organization information; a discussion of how veterinary acupuncture works, how it differs from Western veterinary medicine, what types of conditions are responsive to veterinary acupuncture, and how Western medicine and acupuncture can be combined; questions on prophylactic care, safety issues, frequency and length of treatment; calendar of events; and course information on basic veterinary acupuncture, qualifying for approximately 100 hours of continuing education credits.

red wedgeNational Acupuncture and Oriental Medicine Alliance (NAOMA)
www.acuall.org
NAOMA is an alliance of practitioners and consumers working for the advancement of acupuncture and Oriental Medicine. The web site provides general information on acupuncture and Oriental Medicine; information on NAOMA; state and international legislative issues; discussion of a number of national professional issues; treatments for a number of specific diseases; and lists of national conferences and workshops as well as publications of interest.

red wedgeNational Acupuncture Detoxification Association (NADA)
http://www.acudetox.com/
P.O. Box 2271
Vancouver, WA 98668-1972
Tel: 1 (888) 765-NADA
Fax: (360) 260-8620

NADA promotes the use of acupuncture for the treatment of addictions. The association provides training and educational materials for health care professionals working in the field of addiction behavior and substance use.

red wedgeNational Acupuncture Foundation (NAF)
http://www.nationalacupuncturefoundation.org/
P.O. Box 2271
Gig Harbor, WA 98335-4271
Tel: (253) 851-6538
Fax: (253) 851-6883

The National Acupuncture Foundation was established in 1992 to facilitate the advancement of acupuncture, Chinese herbal medicine, and other aspects of Oriental medicine and their integration into the American health care system. The NAF publishes the Acupuncture and Oriental Medicine Laws, Clean Needle Technique Manual for Acupuncturists, and the Legislative Handbook for the Practice of Acupuncture and Oriental Medicine. The NAF also maintains a national database of acupuncture and Oriental medicine practitioners, state associations, colleges and state regulatory boards.

red wedgeNational Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)
www.nccaom.org
The NCCAOM was founded in 1982 to promote nationally recognized standards of competency and safety in acupuncture, Chinese herbal medicine and Oriental bodywork through a program of national certification. The NCCAOM is accredited by the National Commission for Certifying Agencies, representing the highest voluntary certification standards in the U.S. Information on their web site covers certification programs, eligibility and fee schedules; updated news on testing and exam locations; certification and state regulations; and re-certification.

red wedgeSociety for Acupuncture and Research (SAR)
www.acupunctureresearch.org
The mission of the Society for Acupuncture and Research is to promote scientifically sound inquiries into clinical efficacy, mechanisms of action, use and theory of acupuncture, herbal medicine, and other modalities of Oriental Medicine. The web site provides information on SAR activities as well as an opportunity to join in membership.

red wedgeTufts University: The Evidence-Based Complementary and Alternative Medicine Program - East Asian Medicine
www.tufts.edu/med/ebcam/
Covers Chinese herbal medicine, acupuncture, tai chi and qigong. Research evidence is detailed and the appropriateness of referral to a practitioner is evaluated. Focuses on East Asian Medicine in the treatment of cardiovascular health, smoking cessation and hypertension.