Perspectives on acupuncture

Dr Hugh MacPherson

There is growing scientific evidence that acupuncture can alleviate the symptoms of some physical and psychological conditions. It may also encourage a person’s body to heal itself, where such change is possible.

The stimulation of nerves in the skin and muscles by needling can produce a variety of physiological effects such as:

• increasing the body’s release of painkilling endorphins and the mood-altering chemical serotonin.

• deactivating parts of the brain associated with mediating our experience of pain, demonstrated in brain imaging studies.

In addition to these physiological effects, patients can often experience direct changes not only to symptoms but also to their mood and feelings of well-being.

Acupuncture includes a wide variety of healthcare practices developed in different countries. The common factor is the insertion and stimulation of needles at specific points on the body to stimulate nerves in the skin and muscle. Acupuncture points appear to correspond to physiological and anatomical features such as peripheral nerve junctions. Stimulation of an acupuncture point appears to affect both physiology (nerve conduction) and biochemistry (neurotransmitters).

In traditional Chinese medicine, acupuncture can also be described as a self-regulatory process, driven by a person’s underlying energy, called Chi, or Qi. Acupuncturists trained in this approach use needles to correct or direct this flow within the body.

 With the rise of evidence-based medicine, acupuncture has come under increasing scrutiny. In systematic reviews, the strongest evidence for acupuncture appears to be for the treatment of;

• low back pain

• chronic neck pain

• headache and migraine

• osteoarthritis of the knee

The unambiguous evidence from these large-scale trials, when the data is synthesised, is that acupuncture is more than a placebo effect.

The NICE guideline for back pain recommends a course of 10 weekly sessions of acupuncture as a referral option in primary care for patients with persistent low back pain. As well as symptoms of chronic pain, acupuncture also appears to help a range of other conditions such as depression, menstrual problems, fertility, nausea and vomiting. Acupuncture does not appear to be effective for stopping smoking or for losing weight. There is a continuing need to further develop the evidence base, clarifying for which conditions acupuncture is effective and cost-effective, and for which conditions it is not.

Further information

To find out more, contact:

• British Acupuncture Council – www.acupuncture.org.uk

• Acupuncture Association Chartered Physiotherapists - www.aacp.uk.com

• British Medical Acupuncture Society - www.medical-acupuncture.co.uk

• British Association Western Medical Acupuncturists - www.bawma.co.uk