Acupuncture Gains Acceptance in Western Health Care

From the WebMD Archives

Oct. 3, 2000 -- It happened in a split second at the wholesale tree nursery where Mark Scheller works. He was loading a customer's tree into the back of a truck when the tree slipped and hit him in the head. The aftereffects? "A couple of screwed-up disks; horrible, debilitating headaches, plus my left shoulder felt like a rock," Scheller tells WebMD. "I couldn't work. I was sitting in a chair for 12 hours at a time. I just couldn't do anything."

In the two years that followed, he saw seven doctors. "I was going anywhere to find relief," he says. Then a homeopathic physician insisted that Scheller see Ian Cyrus, an acupuncturist at the Center for Integrative Medicine at Thomas Jefferson University Hospital in Philadelphia. The weekly treatment involves 15 or 20 needles inserted at various points on Scheller's ankles, knees, and the left side of his back.

"It's pretty unpleasant what he's doing," Scheller says. "He inserts the needles several times. It doesn't go into the muscle, but it's pretty uncomfortable." But the results, he tells WebMD, are "definitely dramatic. ... I was able to do my job ... not feeling 100%, but I could deal with that. It's been a real long time since I've gotten the massive headaches. ... I definitely feel like I'm making progress."

Acupuncture would never have been his first choice of treatment, Scheller says. "For those of us in the Western world, it's a pretty far-out thing. But I wouldn't put up with it if it didn't work."

Since it surfaced in the U.S. in the 1970s, acupuncture has gained acceptance as an alternative to traditional Western medicine, for pain relief and for treating a variety of other health conditions. Millions of American patients are seeking acupuncture treatments, performed by physicians, dentists, acupuncturists, and other practitioners.

One of the eight branches of traditional Chinese medicine, acupuncture has been traced back at least 2,500 years. "Archaeologists have uncovered ancient stone needles dating back 5,000 years, evidence that primitive treatments were used -- perhaps to treat wounds in time of war," says Lixing Lao, PhD, who heads a National Institutes of Health-funded study looking at acupuncture's effectiveness in relieving postoperative dental pain.

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The ancient theory, Lao explains, is that patterns of energy, or Qi, flowing through the body are essential for health. Disease occurs when there are disruptions in this flow. Acupuncture involves placing needles to stimulate certain points close to the skin, which is believed to correct these energy-flow imbalances.

At his Philadelphia clinic, Cyrus treats about 60 patients a week. "These people are on several [medications]; they have a range of problems, from clinical depression to anxiety to a myriad of [muscle and bone pain syndromes] ... carpal tunnel syndrome, back pain," he says. "They're being managed by medication, but they don't want to be medicated anymore. They've tried everything under the sun, and nothing's worked. So they seek out people like me."

But how much is really known about acupuncture?

Over the years, the NIH has funded a variety of research projects on the procedure, says Brian Berman, MD, director of complementary medicine at the University of Maryland. "There was a flurry of research in the 1970s, after a New York Times reporter had acupuncture anesthesia during surgery while he was following [former President] Nixon in China," Berman says. "There were a lot of very small, not really well-done, studies. Then interest sort of died off."

But the last seven years have brought renewed interest in acupuncture research. Once on the FDA's "experimental devices" list, acupuncture needles are now regulated with the same standards as surgical scalpels and other medical devices. Larger studies have been funded, and groups like Berman's have studied the worldwide scientific literature on acupuncture, he tells WebMD.

At a 1997 consensus conference, the NIH announced that "the strongest evidence for acupuncture was in prevention of nausea and vomiting and for postoperative oral surgery pain," Berman tells WebMD. Other areas that look promising include stroke rehabilitation, as well as treatment of addictions, headache, menstrual cramps, tennis elbow, osteoarthritis, low-back pain, carpal tunnel syndrome, asthma, and fibromyalgia, a disease that causes widespread muscle pain.

Berman is a principal researcher in a study on osteoarthritis of the knees being conducted on nearly 600 elderly patients. More than 200 studies have been performed on acupuncture, and most have shown favorable effects from the treatment, he tells WebMD.

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But how can the ancient Chinese concept of Qi translate into Western medical terms?

"There's a lot of basic science work that's been going on for many years to understand the mechanism of acupuncture," Berman tells WebMD. "They feel that when you put the needle into acupuncture points, you are stimulating different [chemicals] in the brain. When different [chemicals] are stimulated, they have different effects in the body."

In addition to the traditional Chinese explanation of energy imbalances, there's another theory, Berman says. "A form of 'gate control' operates within the body, regulating pain. When you put a counter-stimulation in a different spot -- not at the pain site -- you send a signal that stops the sensation." Some argue that the placebo effect, as well as the synergy between patient and practitioner, may be at work, Berman tells WebMD, "But that's part of all medicine," he says. "So placebo effect may be part of the mechanism, but I think there's probably an effect beyond that."

Acupuncture is part of many drug treatment programs, says Janet Konefal, PhD, a certified acupuncturist and chief of complementary medicine at the University of Miami School of Medicine. Studies have shown acupuncture is "helpful in getting cleaner faster," she says. "It reduces craving, improves sleep, helps people think clearer if they get enough treatments. The result is that people stay in treatment. [The] biggest problem with substance abuse treatment is dropout." At last count, she says, 600 substance-abuse clinics -- many of them government-funded -- were using acupuncture.

Cancer seems to be among acupuncture's few therapeutic limitations, says Cyrus: "We don't treat cancer. ... Once someone has cancer, there's very little someone like me can do except to treat quality of life. We manage side effects of chemotherapy or radiation therapy quite well. And that goes a long way in terms of the patient's quality of life. Also, [acupuncture] can help keep white blood-cell count elevated."

In fact, every patient's acupuncture experience seems to be different. "No two patients react the same way to this in terms of number of visits, in terms of reaction to treatment," Cyrus tells WebMD. "Sometimes we see miraculous changes. I've had patients who in one visit, it took care of their problem. I've had some come every week for two years."

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Certain people should not have acupuncture, including those who are pregnant; who have heart-valve diseases, bleeding disorders, pacemakers, irregular heartbeats, or epilepsy; or who use blood-thinning medication.

And there's a slight chance of side effects: "Some first-time patients may experience what we call needle shock. ... They get dizzy, may get somewhat nauseous," Cyrus says. But this rarely happens, he says, and when it does, it's mainly just a reaction to the needles. "Basically, it's anxiety," he says.

During treatments, he tells WebMD, "you'll feel something, but I wouldn't describe it as pain. ... You do get certain sensations, like an electrical-type sensation shooting through the body, the area may become warm." It's those sensations that tell acupuncturists whether what they're doing is effective, Cyrus says. "We have this concept of 'deqi' -- the arrival of chi at the acupuncture point. It's a very definite sensation that both the patient and I feel as I hold the acupuncture needle."

But how do the patients know that what the practitioners are doing is effective -- can you trust every chiropractor, every physician, who hangs out an acupuncture shingle?

While acupuncture generally won't hurt you, if you head to the acupuncturist without first seeing a Western-trained physician, you miss the Western diagnosis, says C. James Dowden, executive administrator of the American Academy of Medical Acupuncture. "The problem is, the patient has done the diagnosis and come up with treatment," he says. "And the question is, whether the patient was correct. The appropriate treatment [method] may or may not be acupuncture.

"Acupuncture is an option to the physician, but not the only option. We believe in combining the best of both Eastern and Western worlds of medicine. And clearly that would not be true of someone licensed in only acupuncture. That doesn't mean they are not well trained," he says.

Doctors can get an acupuncture license after 200 hours of training. Accredited schools also offer 2,500-hour training programs in acupuncture for non-physician students as a master's level program. All physician and non-physician practitioners must meet their state 's licensing or registration requirements.

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But Cyrus, who is vice president of the American Association of Oriental Medicine, worries that physicians, chiropractors, and others who take these 200-hour acupuncture courses may have too superficial of an understanding of the process to do patients much good.

"If someone comes in with a headache, that headache can have 15 different etiologies, or causes," he says. "It doesn't mean that any one certain point is going to be appropriate. You can use a few needles to treat it, but there's so much more to it than that. They can't hurt patients, except maybe their pocketbooks. But it's an art and a medicine and takes a lifetime to really understand."

Cyrus' advice to consumers: "Verify credentials of the person providing treatment. Get references. Ask the practitioner if you can speak to a few other patients. Don't be afraid to verify license and education, and whether they have passed the national board exam. These are critical things."

Here are some other tips to help you find a qualified acupuncturist:

  • To find doctors who are licensed acupuncturists, you can check the web site of the American Academy of Medical Acupuncture, a professional society composed of more than 1,800 physicians who have incorporated acupuncture into their medical practices.
  • The American Association of Oriental Medicine also has a referral section on its web site.

For more information from WebMD, visit our Living Better page on Alternative Medicine.

WebMD Health News Reviewed by Annie Finnegan
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