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Acupuncture

This article was prepared in consultation with Dr Ruth Livingstone. Dr Livingstone is a practising GP, a member of the British Medical Acupuncture Society, and her acupuncture work is accredited by the medical insurers, PPP.

What's the origin of acupuncture?

Acupuncture was originally part of traditional Chinese and Eastern medicine, and has been practised for thousands of years to cure all kinds of ills. Archaeologists have found stone acupuncture needles dating back five thousand years.

Doctors and missionaries brought acupuncture to Europe in the 17th century. However, it didn’t become well known until 1972 when an American journalist, James Reston, had acupuncture to ease the pain of an emergency appendectomy while working in China. He wrote about his experience in the New York Times, and the publicity began to spread. Acupuncture has now become a common and widely accepted form of complementary medicine, particularly for pain relief.

There are now two forms of acupuncture practised in the UK:
The first is the Chinese form, a part of traditional Chinese medicine. Practitioners of Chinese acupuncture believe illness arises from an imbalance in ‘life forces’ within us known as yin and yang. They insert needles at lots of different points on the body to try to redress the balance.

The second form of acupuncture is western or medical acupuncture, which focuses on the physical effects a needle might have on the body. This type generally uses the scientific principles of western medicine for diagnosis of disease rather than the concept of yin and yang. Many conventional doctors practise this form of acupuncture. Members of the British Medical Acupuncture Society are usually doctors but there are vets and dentists who are members too.

How does acupuncture work?

At the heart of traditional Chinese acupuncture is the idea of Qi (pronounced ‘chee’). Qi is described by practitioners as a form of energy formed by the union of yin and yang in the body. Chinese acupuncturists say that yin and yang must be balanced for us to be well and free from ill health. Qi is said to flow through channels, known as meridians, that run from our hands and feet to the body and head. There are 14 major meridians and when they become blocked, say acupuncturists, disease is the result. Qi is said to enter and leave the body at special points along the meridians and it is these points into which needles are inserted to free the flow of Qi.

In the Western medical form of acupuncture, practitioners tend not to subscribe to the theory of Qi. They prefer to consider the physical and chemical effects the insertion of needles may have on 'trigger' points (also known as acupoints). Trigger points are sensitive spots, often where nerves leave or enter muscles or tissues, for instance. By inserting a needle at these points, it’s thought that the body’s natural painkillers (known as endorphins) may be released into the bloodstream. There is also some evidence that acupuncture may trigger the release of natural anti-inflammatory compounds in the body, which help healing and recovery.

What happens during a treatment?

The practitioner will usually do a full assessment of you and your symptoms to make sure that acupuncture is the right treatment for you. They may spot a problem that requires another form of treatment, or suggest you visit a GP.
The practitioner may then use several small (a couple of centimetres long) sterile needles, which are very thin. The needles are much thinner than the more familiar needles used for injections, and pass easily through tissue. Patients usually only feel a slight prick when the needle enters the skin, and most people find the slightly 'heavy' warm feeling of the needle inside quite pleasant.

The acupuncturist may manipulate the needles and may pass a small electric current across them to increase their effects. Others may use moxa treatment, in which a herb is burnt on the needles to warm them up.

Some acupuncturists may not use needles at all, using other methods to stimulate the acupoints. Using one type, small conical moxa burners or moxa sticks are placed on the sensitive 'acupoints' and left to burn until the heat becomes uncomfortable. Another needle-free type of acupuncture is called 'cupping'. A small glass cup is placed on the acupoint. A small piece of cotton wool soaked in alcohol is burnt inside the cup and, as the oxygen is burnt inside the cup, the patient's skin is sucked up by the falling pressure inside.

After your first treatment you may notice a little bruising where the needles were inserted, but generally patients feel relaxed after treatment and often sleep. You will usually need a several sessions, maybe three to eight, before symptoms begin to improve.

What can acupuncture help with

Acupuncture is said to help with –
 Abdominal and bowel problems 
 Allergic reactions, like hay fever 
 Anxiety 
 Arthritis 
 Back pain 
 Depression 
 High blood pressure 
 Kidney disorders 
 Knee pain 
 Labour pain 
 Migraine 
 Pain relief 
 Period pains 
 Pre-menstrual syndrome 
 Rheumatism 
 Sciatica 
 Shingles pain 
 Sinus problems 
 Skin conditions 
 Toothache.

Remember to tell your acupuncturist if you’re pregnant, even if you’re seeing them for something else, because certain acupoints should not be touched during pregnancy.

Where's the evidence?

Many acupuncturists point to success with animals and small children to demonstrate that acupuncture is not 'all in the mind'.

Scientific evidence in humans is not clear cut. A study published in 1988 in the Journal of the Royal Society of Medicine showed that stimulating an acupuncture point about five centimetres above the wrist relieved and even eliminated nausea in pregnancy. There have been several similar reports published since. Other studies have shown that acupuncture can reduce pain and sickness following surgery.

Acupuncture has been shown to help the symptoms of asthma, although practitioners will usually warn patients not to stop taking their regular medication without first talking to their doctor. On the other hand, a study in 1997 showed that, for people who wanted to quit smoking, acupuncture acted only as a placebo. So overall, the evidence is unclear at the present time. Surgery Door will continue to keep you up to date with the latest findings.

What do doctors think of acupuncture?

The general view of mainstream medicine is that acupuncture works by making certain nerves in the body work better by stimulating them. These nerves often coincide with the traditional meridians of Chinese acupuncture.

While most Western doctors are sceptical of the concepts of Qi and meridians because they have not been observed by scientists, many accept  the mounting evidence that acupuncture points exist. The points appear to coincide with sensitive areas of the body, often found to be tender to touch when people are ill or in pain. These points have been recognised by many doctors and physiotherapists and usually occur where nerves enter or leave muscle tissue, for example.

What should I look for in a practitioner?

Advice and more information can be obtained from your GP or the acupuncture associations described below. They should also be able to help you find a registered practitioner in your area. It is also worth considering that some acupuncturists specialise in certain conditions and patients, like  women's health or back problems. You should always check the qualifications of your chosen acupuncturist with either the British Acupuncture Council or the British Medical Acupuncture Society. If after your initial consultation you are not happy for any reason, just don't make another appointment.

The British Acupuncture Council can be contacted on 0181 964 0222 or through its web site at http://www.demon.co.uk/acupuncture/bacc.html. The Council works to maintain standards for acupuncturists through a Code of Practice.

The British Medical Acupuncture Society (BMAS) is at 01925 730727 and their web site is at http://www.medical-acupuncture.co.uk. The web site can help you find a fully accredited member through a clickable image map of the UK. Not all accredited members have chosen to be listed, however, so a phone call to the BMAS may be worthwhile.