May
16

Acupuncture for Pain Relief

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The ancient practice of acupuncture has become more widely accepted by Western medicine.

For people with chronic pain from arthritis and other conditions that affect joints, no magic bullet will take away pain. Getting relief from pain, and improving your ability to function, depends on a multipronged approach that many include physical therapy, weight loss, bracing, pain medications, supplements, and assistive devices and, increasingly, acupuncture.
Acupuncture and integral part of traditional Eastern medicine for centuries, is becoming more accepted in Western medical practice. “Many doctors refer patients for acupuncture, or even practice it themselves, because of the mounting evidence for its effectiveness and cost-effectiveness,” says Jamie Starkey, Traditional Chinese Medicine Program Manager and Lead Acupuncturist in Cleveland Clinic’s Center for Integrative Medicine.
A study published in Archives of International Medicine (September 2012) combined results from 29 studies that included nearly 18,000 people with back and neck pain, osteoarthritis, chronic headaches or shoulder pain. When compared with no acupuncture or a simulated procedure (in which needles touch but don’t pierce the skin), acupuncture provided the greatest pain relief. The differences between real and stimulated acupuncture suggest the improvement was more than just a placebo effect.

Chinese Medicine
Acupuncture is one modality that fall under the large umbrella of traditional Chinese medicine, which also includes Chinese herbal medicine. “What we do in Chinese medicine is try to get to the root cause of the problem by assessing the whole person,” says Starkey.
An acupuncturist will start by making a diagnosis made by a physician but will include other assessments. Chinese medicine practitioners consider physical symptoms, like pain, but also emotional, mental and spiritual aspects.
The goal is to treat not only the main complaint but the entire person. Based on the diagnosis, the acupuncturist will chose a combination of acupoints to insert the needles. The needles are very fine (about the diameter of a strand of hair) and rigid.
For most people, acupuncture does not have any side effects. There is a possible bruising where the needles were placed. Before beginning treatment, Starkey always discusses goals and expectations with patients. Some people turn to acupuncture to cut back on pain medications or to eliminate them altogether. While you can see an acupuncturist without a physicians referral, it is best to let your doctor know you’re having acupuncture. Even better, the physician and acupuncturist should consult with one another as part of a team approach to your care, especially if you are aiming to lower a medication dose. You and the acupuncturist must work with your physician to make sure of any dose adjustment is done safely.

How Effective Is It?
The effectiveness of acupuncture is measured subjectively (decrease in pain intensity, duration, and frequency) and objectively (ability to reduce medication use and engage in physical activity without pain). Responses vary from person to person. For some people, one course of acupuncture is all that’s needed. “Best case scenario is I never see them again”, says Starkey. “But many people with chronic pain must come in periodically on a maintenance schedule.”
Many people find that acupuncture has added benefits beyond its effects on pain, some secondary benefits may include improved sleep, improved mood, and for postmenopausal women, reduced hot flashes.

How does it Work?
How acupuncture works to relieve pain has been the subject of scientific investigation. Several possible mechanisms have emerged. For example, the insertion of needles may cause the brain to release endorphins, the body’s natural painkilling chemicals. Studies have found that acupuncture may also have an effect on certain chemicals in the brain that are involved in pain pathways.
An anti-inflammatory effect may also be at work. Some studies have found that acupuncture may counteract the effects of cells in the body that produce inflammation (called cytokines). Inflammation is a component of many arthritic pain conditions.
“Acupuncture is not taboo anymore,” says Starkey. “Don’t be shy about asking your physician whether it would be appropriate for you.” Of you decide to try it, be sure to see a licensed practitioner. You can find one on the web site of the National Certification Commission for Acupuncture and Oriental Medicine (nccaom.org).

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