Living With Chronic Pain

Can Acupuncture Help Decrease Pain?

Living with chronic pain can make life miserable. It impacts every aspect. Standard treatments like ice and heat, anti-inflammatories and other medications, physical therapy, appropriate exercises, and topicals can often ease the pain. But what about alternatives like acupuncture? 

Over the years, there has been substantial debate about whether acupuncture really works for chronic pain. The evidence has been mixed, with some studies showing that acupuncture relieves pain and others showing that it works no better than “sham” acupuncture (procedures designed to mimic acupuncture but to have no real effect, much like a placebo, or “sugar pill,” used in medication studies). One of the problems with deciphering these results is that most acupuncture studies have been small. The design of “sham” acupuncture techniques has also varied widely, which complicates any comparison. It’s also possible that acupuncture works for some people and not others.

But new research from an international team of experts adds weight that it may actually provide real relief from common forms of pain. The team pooled the results of 29 studies involving nearly 18,000 participants. Some had acupuncture, some had “sham” acupuncture, and some didn’t have acupuncture at all. Overall, the results published in the Archives of Internal Medicine showed acupuncture relieved pain by about 50%. 

How Does It Work?

Acupuncturists insert hair-thin needles into the skin at specific points around the body. It is virtually painless when done by an experienced practitioner. Inserting the needles is thought to correct imbalances in the flow of energy in the body, called qi (pronounced “chee”). In Western scientific terms, acupuncture is thought to ease pain by affecting neurotransmitters, hormone levels, or the immune system.

The ancient art of acupuncture has been used in Asia for centuries to treat many conditions and relieve pain. It’s now being used in the United States and other Western countries to ease everything from low back pain, to nerve pain (such as painful shingles rashes), to headaches, fibromyalgia, menstrual cramps, and more.

Traditional Chinese acupuncture involves the insertion of extremely fine needles into the skin at specific “acupoints.” This may relieve pain by releasing endorphins, the body’s natural pain-killing chemicals, and by affecting the part of the brain that governs serotonin, a brain chemical involved with mood. The acupuncturist may turn or twirl the needles slightly, apply heat or electrical stimulation to enhance the effect or burn a therapeutic herb near the skin; this is called moxibustion.

A Japanese form of acupuncture involves more shallow needle insertion than in Chinese acupuncture, and the needles aren’t usually manipulated. Korean acupuncture focuses on applying needles to points in just the hands and feet.

The acupuncturist typically inserts four to 10 needles and leaves them in place for 10 to 30 minutes while you rest. A usual course of treatment includes six to 12 sessions over a three-month period.

Acupressure, a similar technique to acupuncture, does not use needles. Instead, the practitioner uses his or her hands to apply deep pressure at acupressure points.

Is It Safe?

Acupuncture is generally quite safe, and the complication rate appears to be quite low. A review of acupuncture-related complications reported in medical journals found that the most serious problem was accidental insertion of a needle into the pleural space between the lungs and the chest wall (but this is rare). The advent of single-use, sealed needle packages has all but eliminated the risks of blood-borne infections such as hepatitis B or HIV.

“It is unlikely that you will get harmed if it’s done by an experienced acupuncturist,” according to Dr. Lucy Chen, a board-certified anesthesiologist, specialist in pain medicine, and practicing acupuncturist at Harvard-affiliated Massachusetts General Hospital. “The infrequently reported risks include being infected by inadequately sterilized needles or contact with the acupuncturist’s hands. An incompetent acupuncturist could insert the needle too deeply. But If you research the literature on the harms of acupuncture, they are remarkably infrequent.” 

Acupuncture User Tips

How often do you need it? Dr. Chen recommends that new acupuncture seekers plan on weekly treatments until they start to see a benefit, then gradually lengthen the time until the next visit. Many people choose monthly treatment.

What does it cost? The typical cost of acupuncture ranges from $65 to $125 per session. Private insurers usually don’t pay for it, nor do Medicare or Medicaid. A handful of plans may reimburse for physician-acupuncturists.

Where do you get it?  Licensing requirements vary from state to state. In states with no licensing requirements, your best bet is to find an acupuncturist with certification from the National Certification Commission for Acupuncture and Oriental Medicine. If your healthcare provider doesn’t know of a practitioner you can search for a trained acupuncturist here or call (904) 598-1005.

For new pain, an acupuncturist should not be your first stop. Always seek out a healthcare provider and investigate what is causing the pain to rule out serious medical conditions that should be treated immediately or in other ways. When that’s been done, and the issue persists, acupuncture may be a safe alternative.



Sources:

-ncbi.nlm.nih.gov/pmc/articles/PMC1924617/

-jamanetwork.com/journals/jamainternalmedicine/fullarticle/1357513

-aafp.org/news/health-of-the-public/20180521acupuncture.html

-health.harvard.edu/healthbeat/relieving-pain-with-acupuncture

-health.harvard.edu/pain/is-acupuncture-for-you

-bmj.com/content/360/bmj.k970

-jpain.org/article/S1526-5900(17)30780-0/fulltext

-ncbi.nlm.nih.gov/pmc/articles/PMC3658605/

-woninstitute.edu/acupuncture-points/

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