Acupuncture

Acupuncture is one of the most ancient healing modalities, dating back to 6000 b.c.e. It has roots in China but is practiced worldwide today, both within and without the framework of traditional Chinese medicine (TCM). Until recently, there were few randomized trials proving the efficacy of acupuncture, but research now demonstrates success for many different conditions.

The Yellow Emperor's Classic of Internal Medicine was the first document to depict acupuncture. During the 6th century, Korea and Japan began integrating forms of TCM, such as acupuncture and herbals, into their medical traditions. Acupuncture first entered the Western world in France, when Jesuit missionaries returned with accounts of this technique in the 16th century. French clinicians took quickly to the practice; however, it was not until the early 1800s that America and Britain showed interest in acupuncture.

The goal of acupuncture is to remove obstructions or rebalance the flow of qi (also spelled ch'i), the vital life force that pulses through the body. Disease results from an imbalance in the forces of yin and yang. Yin, often thought of as the feminine form, is linked with cold, stasis, and tranquility. The masculine counterpart, yang, represents stimulation, assertiveness, and heat. Through the balanced interplay of these forces, well-being is achieved. In the [Page 13]absence of this, disease has the potential to surface and obstruct the movement of qi.

Qi flows throughout the body in a series of meridians (paths) set within the musculature. Needles (usually stainless steel) are placed at specific points to release the obstruction, both to treat illness and promote health. Over 365 documented acupuncture points exist on the human body. Some of these points correspond to organs and organ systems, much in the way that Chapman's points are described in osteopathic medicine—as a manifestation of the viscerosomatic reflex.

Many specialized forms of acupuncture exist, such as ear, scalp, and hand treatment. The auricular micro-system is one of the most commonly used, with over 200 points on the outer ear corresponding to other body regions. When these points are treated, a stimulus is felt to be sent through the brain to a respective location on the body via an electrical impulse. Hand acupuncture began in Korea when acupuncturists noticed patients experienced relief from other body aches following a hand treatment.

Modern scalp acupuncture differs from traditional body acupuncture in three ways. Rather than following the typical channels of the body, scalp points are mapped out in zones correlating to various regions and differing functions. There is also variance in the depth and angle of needle placement. Finally, scalp acupuncture employs rapid stimulation of needles, unlike the low-pulsing technique of traditional therapy.

After thousands of years in practice, acupuncture entered the research arena in the 1950s throughout China. During this time, the medical community sought evidence-based explanations for the benefits patients had been experiencing for millennia. J.S. Han of Beijing heralded these efforts, as he studied the neurotransmitter release accompanied by acupuncture.

Practitioners develop individualized treatments for each patient, which leads to barriers when one tries to standardize care in order to study efficacy for a specific condition. Many studies are inconclusive, primarily due to poor methodology, and most trials are small with insufficient power. Improper blinding raises doubts on reliability and most acupuncture studies do not resemble clinical practice. Collaboration between experienced acupuncturists and investigators is necessary to accurately apply methodology, while preserving the essence of the practice.

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