OWhen the opioid addiction crisis began to erupt in the United States a decade ago, Dr. Medhat Mikhael spent a lot of time talking to his patients about other ways to cure pain in addition to opioids, other types of drugs to alternative treatments.
As a pain management specialist at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., he didn’t plan to completely give up short-term use of opioids because they work so well for post pain. -surgical. But he wanted to recommend a safer and still effective remedy.
It turned out to be acupuncture.
“Like any treatment, acupuncture doesn’t work for everyone, but the majority of my patients who have tried it have found relief,” he says. “When I started looking into the studies, I discovered how much evidence there was behind this treatment, and it made me feel comfortable suggesting it as an alternative or adjunct to painkillers and other treatments. .”
This mix of anecdotal successes, research-backed results, and a growing level of openness from the medical community is what has driven acupuncture’s popularity as a therapy. According to a 2021 World Health Organization report, acupuncture is the most widely used traditional medicine practice in the world, and it is gaining traction in the United States. In 2020, the Centers for Medicare & Medicaid services began covering acupuncture for chronic low back pain.
Although scientists don’t yet understand all the nuances of how it works, research indicates that it can have a significant effect on some conditions and shows promise for others.
What is acupuncture ?
The goal of acupuncture is the same today as it was thousands of years ago when it was first developed in China: to restore balance to the body, says Kevin Menard, a medical acupuncturist. sportswoman and traditional Chinese medicine practitioner in Sag Harbor, New York.
The practice is based on how the energy, or Qicirculates through the body along a series of channels called meridians, in the same way that nerves and vessels carry messages and blood in all systems.
“According to Chinese medicine theory, each meridian is related to a specific organ, and placing fine needles at certain points along these meridians can effect certain changes in the body to restore homeostasis,” Menard explains. The needles are not the type you would use to draw blood; they are very thin and flexible, almost like pieces of wire.
Placement along meridians is thought to cause reactions such as sending more blood or lymphatic fluid to specific organs or releasing muscles in a way that reduces stress on joints and bones.. The needles can also stimulate nerves and change the regulation of the nervous system to induce a relaxation response, which relieves pain, Mikhael says.
Acupuncture is also thought to boost the immune system and control inflammation, Menard says, two effects that can provide benefits throughout the body. Depending on the condition or injury, relief may occur with a single treatment, but it usually takes a series of sessions, Menard says, especially if a problem is complex or chronic.
What the research says
Research on acupuncture has been extensive, and so far strong evidence supports its effectiveness for some, but not all, conditions. According to an analysis published in February 2022 in the BMJ who analyzed over 2,000 scientific reviews of acupuncture therapies, the science is the strongest behind the effectiveness of acupuncture for post-stroke aphasia; neck, shoulder and muscle pain; fibromyalgia pain; lactation problems after childbirth; lower back pain; symptoms of vascular dementia; and allergy symptoms.
The National Institutes of Health (NIH) find that acupuncture for pain relief tends to have the most evidence, especially for conditions that have become chronic like osteoarthritis and lower back pain, as well as tension headaches. . A review of 11 clinical trials also suggests that acupuncture may help relieve symptoms associated with cancer treatment, notes the NIH.
This has been a burgeoning area of focus for the field, says Sarah Weaver, an acupuncturist and massage therapist at Northwestern Health Sciences University in Minnesota, who focuses on integrative health professions, such as acupuncture, chiropractic and traditional Chinese medicine. For cancer patients, sessions can focus on reducing nausea, numbness and tingling (called neuropathy), brain fog, lack of appetite, acute and chronic pain, and mood issues that support cancer care.
“Often people with cancer want to add a complementary treatment that doesn’t affect their chemotherapy or radiation therapy, and that’s where an option like acupuncture can be helpful,” she says. “That’s why more and more healthcare systems are integrating this treatment into their integrative care options.”
What’s next on the pitch
Acupuncture is far from a proven and accepted therapy for most conditions, even those that seem promising. This is partly because the studies supporting it are sometimes not of high quality and the field lacks standardized protocols that would better allow it to be scientifically assessed, according to the recent WHO report.
For example, a 2016 research review analyzed studies looking at acupuncture for substance abuse and addiction. Among the 83 research papers included in the review, researchers found substantial variation in the quality of studies, frequency of acupuncture, length of time needles were left in the body during treatment, points along meridians used and other potentially important factors. It was therefore difficult to assess the real effectiveness of acupuncture. The field also lacks clear terminology and universally accepted agreement on the location of acupuncture points, researchers say.
Issues like these will need to be addressed to gain more clarity and to gain recommendations from reputable organizations in the future. International experts in the field are pushing for more rigorous clinical trials to prove acupuncture’s usefulness for patient care and to help providers adopt best practices as new benefits become apparent.
Some potential directions for future studies include investigating how acupuncture may affect hormone regulation, such as alleviating hot flashes in menopause or treating menstrual irregularities. Research indicates the practice can boost estrogen and other hormones, and acupuncture for gynecological issues is becoming increasingly popular, Menard says. Some researchers also focus on studying the impact of acupuncture on fertility; some small preliminary studies indicate that its use may be linked to earlier pregnancy and better results from IVF treatments.
Acupuncture for mental health issues like depression and anxiety is another major direction of research, particularly regarding how these issues affect overall health. For example, chronic pain has often been linked to depressive symptoms. Researchers are therefore investigating whether acupuncture can treat both: a person’s pain and depression. Researchers are hopeful. A study published in 2020 in the journal Frontiers in Neurology found that migraine sufferers who received acupuncture treatments had a lower risk of depression and anxiety and tended to use medical services less often, compared to migraine patients who did not practice acupuncture.
As the evidence base expands, acupuncture will likely continue to grow in popularity. Although acupuncture has been used for centuries, it’s only in the past decade that there’s been a seismic shift in acceptance by both Western physicians and patients, Menard says. Ongoing research efforts and increased interest from health systems mean the treatment could be part of more conversations like the ones Mikhael had with his patients.
“Ultimately, physicians want their patients to feel better, and many people are looking for non-pharmaceutical avenues of wellness,” Menard says. “Depending on the condition, these little needles can have a huge impact.”
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