Mammoth Relief
Describing a cartoon is not as much fun as actually showing one, but I’m going to give it a go
Over a caption that reads “Early Acupuncture,” dozens of cavemen are throwing sharp spears at the rear of a giant wooly mammoth. The mammoth is munching on plants, oblivious to the spears that are stuck to his posterior, but he’s thinking to himself, “That’s oddmy neck suddenly feels better.”
Credit for this comic goes to cartoonist Mark Parisi who offers no clinical evidence that acupuncture might have been effective on wooly mammoths. But we do have some new research that indicates the effectiveness of acupuncture in relieving back pain in humans.
Meta-thinking
Researchers at the University of Maryland School of Medicine conducted a meta-analysis of 33 randomized, controlled trials that compared the effectiveness of acupuncture with sham acupuncture (placing needles at spots that generate no response), or no additional treatments, or other active therapies that treat lower back pain.
Data from the trials was grouped into categories such as acute pain relief, chronic pain relief and style of acupuncture. Each category was then analyzed to assess diverse outcomes of pain, including functional abilities, overall improvement, return to work and painkiller use.
Noting that the quality and quantities of the trials varied, researchers found acupuncture to be “significantly more effective than sham treatment or no additional treatment.” Furthermore, acupuncture was found to be just as effective as other active therapies (read: “pain killers”) in relieving chronic lower back pain.
In cases where lower back pain was acute the data was inconclusive.
All in the head
The University of Maryland researchers focused their trial on lower back pain studies, so the data didn’t include a remarkable acupuncture study from Harvard Medical School that I told you about in the e-Alert “Stuck on You” (4/7/04). In that study researchers investigated the body’s response to acupuncture with functional magnetic resonance imaging (fMRI), which reveals changes in blood flow, as well as fluctuations in blood oxygen.
Manipulation of needles was performed on a specific acupuncture point on the hand in 13 healthy subjects. When fMRI was used before, during and after acupuncture treatments, clear changes in the imaging occurred in several different areas of the brain in 11 of the subjects. These imaging changes indicated a decrease of blood flow, described by the researchers as a “quieting down” of the regions of the brain associated with pain, mood and cravings.
One of the researchers – Harvard Medical School radiologist Bruce Rosen – told the Associated Press (AP) that the regions of the brain affected in the test are particularly susceptible to a brain chemical called dopamine, which he describes as a reward chemical. Mr. Rosen speculates that when the blood flow is reduced, the resulting dopamine activity triggers the release of endorphins(chemicals that relieve pain).
As one neurobiologist pointed out to the AP, the next step should be a controlled study in which patients undergoing fMRI analysis would receive genuine acupuncture while another group of patients would receive stimulation of sham acupuncture points. Until then, this study provides an important step in understanding how the brain responds to acupuncture.
If you try, certify
A couple of years ago I was experiencing enough discomfort from chronic back and neck pain that I screwed up my courage, overcame my aversion to needles, and underwent acupuncture therapy.
To my great relief – literally – I felt at most a very mild sensation from the acupuncture needles, and sometimes felt nothing at all. But my pain pretty much disappeared. When it was over, I wondered why I had waited so long to try it. After all, acupuncture is an ancient healing method. Treatments that don’t work don’t last for millennia.
So I can enthusiastically vouch for the relief that acupuncture can bring to neck and back pain. And I have a friend who successfully
overcame insomnia through acupuncture. We’ve both found that it relieves stress as well.
If you’d like to try acupuncture for yourself, it’s very important to locate an experienced and board-certified acupuncture practitioner. You can find a listing of certified acupuncturists on the web site for the National Certification Commission for Acupuncture and Oriental Medicine (nccaom.org). Using your Zip Code, you can easily search for practitioners in your area who have national board certification.
Fortunately, many health insurance plans in the U.S. are starting to cover acupuncture treatments, so check your policy before you choose your practitioner.
I’d be very interested to hear from any HSI members who have tried acupuncture – no matter what your experience may have been, good or bad.
Sources:
“Early Acupuncture” cartoon, Mark Parisi, Off the Mark, offthemark.com
“Meta-Analysis: Acupuncture for Low Back Pain” Annals of Internal Medicine, Vol. 142, No. 8, 4/19/05, ncbi.nlm.nih.gov
“Acupuncture Modulates the Limbic System and Subcortical Gray Structures of the Human Brain: Evidence from fMRI Studies in Normal Subjects” Human Brain Mapping, Vol. 9, No. 1, ncbi.nlm.nih.gov
