Acupuncture, once a therapy foreign to western medicine, has grown in popularity and is now a common therapy practiced by manual therapy and sports medicine health care practitioners for the treatment of musculoskeletal injuries. Musculoskeletal injuries are any injuries that affect the muscles, joints, ligaments, and bones of the body. There is currently evidence that shows positive benefit for acupuncture for a variety of musculoskeletal injuries. While acupuncture research is advancing every day, many patients are left wondering: What is acupuncture? How does it work? What is it good for? How safe is it? Who should I see to determine if it is a reasonable treatment for me? This article will help guide patients in their understanding of acupuncture.
Acupuncture is the practice of inserting one or more needles into specific sites on the body surface for therapeutic purposes. The Traditional Chinese Medicine (TCM) theory of how acupuncture works is based on the concept of “energy” called “Qi” that flows through energy meridians in the body. According to TCM theory, disease is associated with an imbalance of the flow of “Qi” and acupuncture is utilized to correct this imbalance.1
While the TCM “Qi” theory has existed since the origin of acupuncture, it is a very difficult and counter-intuitive theory for western science to accept. How are acupuncture’s effects explained by western science? A large area of research points to a concept called neuromodulation.
To understand this concept, one must first recognize that the body is comprised of multiple transmission systems that send pain and inflammation signals to the brain and other areas of the body. Acupuncture has demonstrated, in animal and human studies, the ability to modulate these signalling systems in the body. Acupuncture has the ability to affect pain by stimulating reflex systems in the spinal cord, decrease activation in the pain centres of the brain, stimulate the secretion of endorphins and enkephalins (molecules that help modulate pain), and stimulate pain modulating hormones in the blood.1,2
What does all this scientific jargon mean? Acupuncture appears to have the ability to modulate the nervous system’s control over the signalling mechanisms in the body responsible for relaying signals for pain and inflammation. By modulating the nervous system, acupuncture has the ability to decrease pain, create an anti-inflammatory state in the body, and increase blood flow to injured areas to help stimulate the healing process. These effects have influence both locally at the injury site and systemically throughout the entire body.
With basic science research identifying these acupuncture-specific effects, it seems intuitive that these benefits should be seen clinically as well. Recently, there has been clinical research that has investigated the effects of acupuncture for a variety of medical conditions. In 1997 the National Institute of Health consensus conference stated acupuncture was supported by positive evidence for a range of conditions and the World Health Organization in 2003 concluded acupuncture has been proved for 28 medical conditions. By examining musculoskeletal injuries alone, there is currently evidence that has shown positive benefits for acupuncture for the treatment of shoulder, elbow, knee, low back, headache and neck pain.3-7
Acupuncture is a great therapy for chronic painful conditions like knee osteoarthritis where pain and inflammation has traditionally been treated with drugs that may exhibit unwanted side effects with long term use. Some clinical research has shown that acupuncture may help decrease dependency on drugs or is a great therapy to utilize in conjunction with pharmacological therapy.1
With acupuncture becoming increasingly popular, how safe is it and who should I consult to determine if it is a good therapy for me? Acupuncture has been described as a very safe therapy. However, as with all health care therapies, there are always risks in certain instances. Serious side effects are rare, but they can include injury to the lungs and organs if it is performed improperly around the thorax. A responsible and well-trained acupuncture professional is knowledgeable of these potential adverse effects, and in the hands of these well-trained individuals; side-effects are rare and acupuncture is a safe therapy.8
The importance of consulting a well-trained professional is important both for the effectiveness and safety of the therapy. In Ontario, a certified acupuncture practitioner must be a regulated health care professional who has completed post-graduate training in acupuncture methods. By consulting a regulated health care professional you ensure that they have sufficient knowledge to identify who is and who is not a candidate for acupuncture treatment and you ensure they have sufficient knowledge in human anatomy to perform acupuncture properly without side-effect. If anyone is interested in acupuncture as a potential therapy, the best thing to do is contact a registered health care professional who is a certified acupuncture practitioner. Prior to performing acupuncture, you – the patient – should have a discussion about your specific case and the role acupuncture can have in the treatment of your injury.
Acupuncture is no longer considered an alternative therapy. It is now common place in the field of manual therapy and sports medicine. Western science has identified pain modulating and anti-inflammatory effects with acupuncture treatment. Clinical research is mounting and there are positive research studies for a variety of musculoskeletal conditions. The responsible use of acupuncture in the hands of a competent health care practitioner can help expedite recovery and make life and sport more enjoyable for those suffering from musculoskeletal injuries.
Dr. Alex Lee
BSc (Hons), DC, D.Ac (cert)
Sports Performance Centres
1) Ernst E. Acupuncture – a critical analysis. Journal of Internal Medicine. 2006;259:125-137.
2) Cho ZH, Hwang SC, Wong EK, et al. Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms. Acta Neurologica Scandinavica. 2006;113:370-377.
3) Green S, Buchbinder R, Hetrick S. Acupuncture for shoulder pain (review). Cochrane Database of Systematic Reviews. 2005.
4) Green S, Buchbinder R, Barnsley L, Hall S, White M, et al. Acupuncture for lateral elbow pain (review). Cochrane Databse of Systematic Reviews. 2002.
5) Melchart D, Linde K, Berman B, White A, et al. Acupuncture for idiopathic headache (review). Cochrane Database of Systematic Reviews. 2001.
6) Furlan AD, Van Tulder MW, Cherkin DC, Tsukayama H et al. Acupuncture and dry-needling for low back pain (review). Cochrane Database of Systematic Reviews. 2005.
7) Trinh KV, Graham N, Gross AR, Goldsmith CH, et al. Acupuncture for neck disorders (review). Cochrane Database of Systematic Reviews. 2006.
8) Peuker ET, White A, Ernst E, Pera F, Filler TJ. Traumatic complications of acupuncture. Arch Fam Med. 1999;8:553-558.