BETHESDA (Reuters) -- A 12-member Consensus panel convened by the National Institutes of Health (NIH) concluded that acupuncture treatment is effective for postoperative pain, chemotherapy-induced nausea and vomiting, nausea of pregnancy,
and postoperative dental pain.
There are a number of other pain-related conditions in which acupuncture could be considered an effective adjunct therapy, an acceptable alternative or part of a comprehensive treatment program, the experts said.
The panel found that the rate of adverse effects associated with acupuncture is low and often less than side effects associated with conventional treatments for these painful conditions.
...acupuncture may be effective in smoking cessation if combined with a comprehensive medical program that involves behavioral modification techniques, panel member Dr. Leonard A. Wisneski of NIH said.
Evidence supports the claim that opioid peptides are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by these actions. The finding that opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis, Wisneski said.
Stimulation by acupuncture could also activate the hypothalamus and the pituitary gland and result in a broad spectrum of systemic effects.
The experts presented data suggesting that acupuncture alters the secretion of neurotransmitters and neurohormones and regulation of blood flow, both centrally and peripherally. There is also evidence of immune function alterations associated with acupuncture. It is presently unclear which of these and other physiological changes mediate clinical effects, the panelists noted.
The panel concluded that there is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage study designs that can withstand rigorous scientific scrutiny.
The panel issued their consensus statement following an extensive review of the existing medical literature and a series of presentations by acupuncture research experts at a three-day NIH Consensus Development Conference on Acupuncture.
Acupuncture is a health care system which is used to treat disease, prevent illness and improve well-being. It is effective for physical, psychological and emotional problems. Acupuncture originated in China more than 5,000 years ago and due to its proven effectiveness has been embraced throughout the world. Hair-thin sterile needles are placed into the skin. The art and science of acupuncture involves the choice of points, the direction and depth of insertion, and the subtle manipulation of the needle in the patient's body. All of these factors determine the stimulus the patient will feel.
WHAT IS ACUPUNCTURE?
Acupuncture, simply stated, is a health science which is used to successfully treat both pain and dysfunction in the body.
Acupuncture has its roots deeply planted in China. In fact, authorities agree the science is between 5,000 and 7,000 years old. Its use spread throughout ancient Egypt, the Middle East, the Roman Empire and later into Western Europe as merchants and missionaries to China told of the amazing discoveries the people of the Orient had developed. Acupuncture did not become known on a national level in the U.S. until 1971 when diplomatic relations between China and America were relaxed.
At first glimpse, acupuncture appears strange, as its primary notoriety is the utilization of needles placed in the skin at various locations to relieve pain or affect a body part.
Chinese physicians theorize there is an energy network traversing just below the surface of the skin which communicates from the exterior to the internal organs and structures at over 1,000 "Acupoints" on the body. They believe this energy works in harmony with the body's circulatory, nervous, muscular, digestive, genitourinary and all other systems of the body. These physicians also believe that when this vital energy becomes blocked or weakened, an effect in a body system or anatomic location becomes evident. Stimulation of one or a combination of key "Acupoints" on the body is said to restore harmony to the affected area.
Historians have stated, "More people have benefited from acupuncture over the course of fifty centuries than the combined total of all other healing sciences, both ancient and modern."
HOW DOES ACUPUNCTURE WORK?
In recent years, science has determined that human beings are complex bioelectric systems. This understanding has been the foundation of acupuncture practice for several thousand years.
Classic acupuncture states that energy circulates throughout the body along well-defined pathways, called meridians. Points on the skin, along these pathways, are energetically connected to specific organs, body structures, and systems. If this energy circulation is disrupted, optimum function is affected and this results in pain or illness. Acupuncture points are stimulated to balance the circulation of energy, which influences the health of the entire being.
The modern theory of acupuncture is that there is a connection via the central nervous system that induces the production or secretion of chemicals in the body such as endorphins, neurotransmitters, hormones, lymphokines, etc. Though most of these chemicals are used fairly quickly, clinical experience indicates that acupuncture generally has cumulative effects. Thus, acupuncture must provide some training of the autonomic mechanisms that control the patient's pattern of physiological function.
In short, acupuncture works with a person's internal pharmacy, rather than putting in chemicals from the outside. This approach has several advantages over pharmaceutical medicine.
Far too often in the medical professions, a patient is told after extensive examination, "There is nothing wrong." "It is all in your head," or "Sorry, you'll have to learn to live with it." The examining doctor unable to find the cause of the problem has little else to tell the patient. Fortunately, many medical physicians are now referring their patients for an acupuncture evaluation as a last resort.
Medical research continues in this country and others to attempt to explain in western scientific terms what the ancient Chinese many centuries earlier described. Today, many theories have been postulated as to why acupuncture is so effective in pain control. However, as more discoveries are made, more research is indicated.
HOW DOES ACUPUNCTURE FEEL?
Prior to their first treatment, many people do not believe that acupuncture can be painless. Different sensations, such a warmth or pressure, may be felt but the energetic sensation differs from pain. People often comment that the feeling is unfamiliar but pleasant and relaxing.
Acupuncture needles are very, very fine, about the size of a thick hair, and honed to a gently tapered tip. The needles are solid and nothing is injected through them. Over the centuries, very refined needle insertion techniques have been developed which enable the skilled acupuncture practitioner to place a needle with little or no sensation. Modern technology has brought the availability of disposable needles. Those are the only type we use in our office.
In some cases it is not necessary to use needles at all. For example, when treating young children, infants, or sensitive adults, there are other techniques which are equally as effective. The most common alternative technique we use is electroacupuncture.
While not always completely painless, insertion of acupuncture needles is often less painful than stimulating points with finger pressure. Most patients state they can't feel the insertion of the needles. After inserting the needle, its subtle manipulation may cause a feeling of fullness, warmth, pressure, or a propagating "electrical" sensation. These sensations may be surprising or strange, but are not painful. Most patients find acupuncture treatment very relaxing.
One would assume inserting a needle into the skin would be painful since most of us can relate to being stuck with a pin or receiving a hypodermic injection. However, four to ten acupuncture needles can easily be inserted into the hollow tube of a hypodermic needle. Because of the extreme slenderness of the needle, most people don't even feel its insertion into the skin. A phenomena referred to as "De Qi", pronounced "Day Chee", often occurs when the needle reaches a certain depth. This sensation is felt as a mild to moderate heaviness or tingling.
Needles obviously still have their place in a clinical practice. However, many physicians certified in acupuncture and licensed acupuncturists are employing electronic stimulation to the acupoint with equal effectiveness as the needle. Both of these procedures are relatively painless and are quickly becoming standard worldwide. We often use electroacupuncture in lieu of needles in the office.
Perhaps the cornerstone of acupuncture examination is pulse diagnosis whereby the trained practitioner, by feeling a pulse, is able to determine the balance of the (12) meridians. This ancient method of diagnosis is giving way to modern electronic evaluation referred to as "Ryodoraku" or "electro meridian imaging" (EMI). This is the type of diagnostic imaging we use at Simone Physical Medicine. A small painless electronic pen is placed on the skin over specific Acupoints. By way of a sensitive metering device, the electro potential of the point is measured. This examination is extremely reliable and is quickly becoming the standard method of diagnosis internationally.
BENEFITS OF ACUPUNCTURE
Since acupuncture promotes the body's natural healing ability, most conditions can be corrected or improved. The effectiveness of acupuncture is well documented and extends far beyond the conception that it is only useful for chronic pain management or as an analgesic. Many athletes have discovered that acupuncture treatment helps them to achieve optimum performance levels. Also, throughout its long history, acupuncture has established a solid reputation as a system of preventative health care that works.
ACUPUNCTURE IS USEFUL FOR:
Body Aches and Pains
Allergies, Sinus Problems and Headaches
Chronic Fatigue & Insomnia
Joint Pain & Sport Injuries
Back and Neck Pain/Stiffness
Stress & Anxiety Related Disorders
Digestive Disorders (Acidity, Constipation, Gas, Bloating)
WHAT CONDITIONS ARE ACCEPTED?
Acupuncture textbooks list well over one hundred different conditions that respond well to acupuncture. The World Health Organization, working in close harmony with the International Acupuncture training center of the Shanghai College of Traditional Chinese Medicine, has indicated acupuncture is effective in the following conditions.
Acute and chronic pain relief
Tension, cluster and sinus headaches
Cervical (neck) pain
Low back pain
Post-operative pain relief
Abnormal blood pressure
Chronic fatigue syndrome
This is only a partial list of the numerous conditions acupuncture has been credited with helping. At Simone Physical Medicine, we treat only those conditions that have scientific research to support the use of acupuncture. Ask Dr. Simone if your disorder may be helped with acupuncture. You may e-mail him at the bottom of this page.
HOW MANY TREATMENTS ARE USUAL?
Obviously the number of treatments vary with different conditions and individuals. Chronic problems generally require more treatment than acute ones. Some patients notice an immediate improvement after the first treatment, whereas others may not notice any effect until the fourth or fifth visit. It's been shown that a certain percentage of patients receive maximum benefit from six months to a year or more following a course of therapy.
WHAT CAN I EXPECT AFTER AN ACUPUNCTURE TREATMENT?
A common sequence of events is that after the initial acupuncture treatment there is a fairly transient improvement, lasting perhaps 2 or 3 days. Subsequent treatments tend to give longer relief, which may also be more nearly complete. Ideally patients become symptom free after perhaps four to six treaments. A small number of patients will initially experience a worsening of symptoms. This is not unusual and is no need for alarm. Another common "side effect" of acupuncture is the feeling of drowsiness or euphoria following a treatment. You should have someone with you on your first visit to drive you home if you experience this reaction. If not, you will be asked to stay in the office until the sensations wear off.
HOW MANY TREATMENTS WILL I NEED?
Researchers internationally agree the usual number of treatments per condition is between six and twelve. You should feel some relief by the third or fourth treatment. If some relief isn't felt by that time, Dr. Simone will discuss other alternatives with you. The usual frequency is about two treatments per week.
Patients are urged not to enter an acupuncture program with the thought of "taking a few" to see what will happen. Even though is possible to achieve success after one treatment, a program of six to twelve visits would have a better chance for success. Patients are encouraged to be patient with the healing process.
IS ACUPUNCTURE EXPENSIVE?
The cost of Acupuncture treatment varies in different parts of the country. However, the average appears to be between $45.00 and $100.00 per treatment. Most treatments in our office average between $45.00 and $80.00 per treatment. We offer special programs for smoking cessation and weight loss. Call the office or leave an e-mail message for more information about these programs or to see if your insurance company covers acupuncture treatment.
ARE RESULTS PERMANENT?
For acute problems where there has been little or no organ system or tissue damage, results are often permanent. For chronic conditions, symptoms may recur from time to time. Generally a few additional treatments are sufficient to obtain relief. It's suggested that patients with severe or chronic conditions return for an additional treatment two or three times a year.
Acupuncture has been used quite successful in place of chemical anesthesia for a variety of surgeries within the last twenty years. At the Beijing Obstetrics and Gynecology hospital it is used routinely on all cases of Cesarean section. At the Long Hua Hospital in Shanghai it's used routinely on cases of thyroidectomy. It has been shown effective in gastric surgeries and brain operations.
During the procedure the patient remains alert communicating with the surgeon. The patient does not feel pain, only pulling, tugging, etc. that may be employed in surgery.
It is unlikely that acupuncture will replace chemical anesthesia in the U.S. However, it is a favorable possibility for those patients unable to tolerate regular anesthesia. The application in dentistry are extremely significant.
The first U.S. national media coverage concerning Acupuncture was in 1971 during President Nixon's visit to China. There, visiting columnist James Reston told of his emergency appendectomy performed under acupuncture anesthesia.
Acupuncture has gained a great deal of notoriety in recent years concerning its considerable success with addiction control. It has been shown that acupuncture has a very positive effect in the area of both drug and alcohol addiction. This procedure, in conjunction with professional counseling, has been proven extremely effective.
One of the most noteworthy addictions acupuncture helps is smoking. The average patient will reduce their intake by at least one half within a week of the first treatment. Additional treatments generally allow the patient to stop without experiencing the negative effects of quitting. Acupuncture also has a favorable effect in weight control. Currently there are several clinics in the U.S. devoted solely to drug and alcohol rehabilitation. Dr. Simone will not accept you as a patient for weight loss or smoking cessation unless he is convinced you are serious about your desire to stop smoking or lose weight.
Asian Physicians have historically recognized the importance of herbs in healing for centuries. Herbs are utilized either alone, or in combination for specific maladies, with astounding success. Many, if not most, drugs used in the West are derived from actions observed from specific herbs used for generations. Dr. Simone only recommends herbs whose use is supported by scientific research.
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