Acupuncture: Mechanism of Action, What Happens During Acupuncture Treatment & Its Efficacy

The millions of patients visiting hospitals and private clinics for the treatment of pain in chronic diseases found the results unsatisfactory. The drug regimes taken by them in the condition of migraine and severe headaches do not provide permanent cure from the pain. This realization has changed the mind of the population for the non-pharmacological treatments. Several scientific studies have already suggested acupuncture as an effective treatment option for the management of pain in chronic disorders such as migraine and muscle tension headaches. Few such study representing the effectiveness of acupuncture in the treatment of migraines, muscle tension headaches, primary dysmenorrhea, and postoperative auricular pain have been discussed below.^[1]

Acupuncture therapy is considered as a prophylactic course for the migraines and headaches. Therefore, acupuncture is used to reduce the number and severity of the migraines and not to treat the pain when it occurs.^[1]

Objective- To compare the effectiveness of prophylactic acupuncture course and medical treatment in the condition of chronic migraine and muscle tension headaches.^[1]

Patients and Methods- 48 patients suffering from the migraine and muscle tension headaches were recruited for the study. Patients were recommended to follow three months with both forms of the treatments.^[1]

Results- Out of them, 19 were unwilling to change from one therapy to another. Further, the results conveyed that 24 patients out of 41 showed improvements with the acupuncture. They reported reduced frequency and severity of the headaches. Whereas, the medical treatment improved the condition for only a quarter of the patients, i.e., 9 out of 36. Moreover, patients with depressive symptomatology improved only with acupuncture. When the patients were reviewed for their preferences of treatment after the completion of the study, a larger proportion preferred acupuncture. The benefits listed by the patients for the adoption of acupuncture were:

• A reduced dose of medication for controlling the pain
• Increased response of pain stimulus towards analgesics.
• No more consumption of prophylactic pills to prevent pain
• Removal of symptoms of feeling ‘headachy’ all the time^[1]

Discussion- The major perk of using acupuncture therapy other than negligible side effects is that the length of time of the headache or migraine does not affect its results. Additionally, it can be used for patients who are suffering from depression due to the pain. However, the therapy is not suggested for the population undergoing mild pain and responding to analgesic medications. Another difficulty faced by patients in the adoption of acupuncture is that it requires repetitive visits to the clinics.^[1]

Acupuncture is a technique of inserting needles at special points called acupoints of the body. The therapy has its roots in Chinese medicines. The Chinese principles claim the efficacy of acupuncture by controlling the flow of ”Qi”, the vital forces or energies which circulate between the organs. The circulation of energies among the different organs of the body is maintained by channels called meridians. 12 meridians correspond to 12 major organs of the body. The Chinese theory says that Qi energy must flow in the optimum strength and appropriate quality through each of these meridians and organs for the quality of health. The acupoints are located on the meridians which provide alternative means to the flow of Qi.^[2]

On average three million American adults adopt acupuncture therapy for the management of chronic pain every year.

The complementary and alternative medicine, i.e., acupuncture or electroacupuncture works by increasing the release of endogenous opioid peptides in the central nervous system. These peptides play an essential role in mediating the analgesic effect by releasing different kinds of neuropeptides at different frequencies of EA. EA of 2 Hz promotes the release of enkephalin, 𝝱- endorphin, and endorphin while at 100 Hz it releases dynorphins. The combined frequencies produce a simultaneous release of four peptides, and hence, maximized recovery from pain. The proposed theory verify the management of pain in several chronic conditions such as low back pain and diabetic neuropathic pain.

Acupuncture therapy is performed by inserting four to ten needles at specific acupoints. The time of insertion generally varies from 10-30 minutes. Needles are further stimulated by manual twirling or a small electric current. The new technology has replaced the needles with lasers in a few clinics.

The fine quality of needles does not hurt upon insertion like an injection. Some acupuncturists practice producing a sensation called “deQi”- a feeling of heaviness, numbness, or soreness at the skin area where the needle is to be inserted. Many patients during their therapy sessions reported relaxing and sedating experiences.

The adjunctive therapies recommended along with acupuncture are moxibustion(burning of herbs above the skin surface), massage, cupping, herbal preparations, exercises, and lifestyle modifications including dietary modifications.

Generally, six to twelve sessions are prescribed for a chronic condition in the course of acupuncture. The acupuncture treatment time may extend up to three months.^[2]

Acupuncture has a broad scope in the treatment of disorders. The most common diseases treated by acupuncture are back pain, arthritis, headache, asthma, hay fever, anxiety, fatigue, menstrual disorders, and digestive disorders. In the United States, acupuncture is also used for drug and alcohol rehabilitation.^[2]

The efficacy of acupuncture in controlling the pain during menstrual disorders particularly primary dysmenorrhea was measured in a clinical study. Forty-three women suffering from the disorder were recruited for the study. One year of therapy course was their duration of treatment. The subjects were divided into the following four groups:

Real acupuncture group in which patients were prescribed acupuncture therapy

Placebo acupuncture group in which subjects were given acupuncture at random points (far from acupoints) every week for three menstrual cycles

The standard control group in which no medical therapy (also acupuncture) was provided to the subjects

From the real acupuncture group, 10 out of 11 women, i.e., 90.9% showed improvements; 4 out of 11, i.e., 36.4% showed improvements from the placebo control group; in the standard control group 2 out of 11, i.e., 10% showed improvements.

Also, the subjects from the real acupuncture group reported a 41% reduction in the consumption of analgesic medications while no change or increased use of medications was reported by other groups.^[3]

The clinical studies have reported the superior efficacy of acupuncture for each pain condition over sham acupuncture and no acupuncture. Patients taking acupuncture sessions reported less pain.^[4]

Acupuncture is an umbrella term that covers many types of therapies under it. Auricular acupuncture or auriculotherapy is one such therapy that is used for many conditions such as drug dependence, pain, and anxiety. Under this therapy, needles are inserted at specific locations of the ear. Treatment of postoperative pain by auricular acupuncture has been confirmed by several clinical studies. The primary outcome measures used to measure the intensity of pain in such studies are pain intensity and analgesic requirements. The outcomes are measured on the Jadad scale.^[5]

Method- The patients (who have undergone thoracotomy) recruited for the study were divided into two groups randomly: experimental group (n=19) and control group (n=17). The patients from the experimental group received electro auricular acupuncture at two points on each side (2-20 Hz) for 10 minutes. It was followed by injecting vitamin B complex into these points. The treatment regimen continued for 7 days in which acupuncture sessions were provided after every 12 hours.^[5]

Results- The results conveyed the superiority of auricular acupuncture over other forms of treatment. However, the studies could score only up to the three points on the jadad scale. Therefore, the evidence stating the efficacy of auricular acupuncture in the management of postoperative pain is promising but not compelling.^[5]

The resistance caused by the allopathic medicines in the management of pain has shifted the choice of patients towards acutherapy. It is a process in which needles are inserted on to the surface of the skin at specific acupoints. The stimulation is increased by connecting the needles to the electric current. Acupuncture has spread its roots in several areas of pain such as headaches or migraine, low back pain, primary dysmenorrhea, postoperative auricular pain. Other than the pain, it is also used for asthma, hay fever, anxiety, fatigue, and digestive disorders. The effectiveness of acupuncture has been compared with the medical treatments by several clinical studies. Such studies had shown the improvement in the condition of patients due to the acupuncture in the following terms: reduced severity of pain, decreased consumption of medications, and reduced frequency of pain episodes. Hence, acupuncture therapy is considered superior over the medical regimen treatment. The better outcomes have resulted in the higher adoption of acupuncture over drugs in the United States and many other countries.

References: