Posts Tagged ‘acupuncture research’
Sep 12, 2012
Acupuncture is famous for the treatment of chronic pain. Chronic pain is one of the most common health concerns I see in my NYC acupuncture clinic. Back pain, headaches, migraines, shoulder pain, knee pain, neuropathy, arthritis, and other chronic pain conditions. Patients can have profound results.
In the clinic we know acupuncture is effective for pain, but often skeptics are vocal opponents because they believe that there is not enough research.
Recently, a very large analysis of research trials, called a meta-analysis, was published focusing on acupuncture for pain. The meta-analysis shows that acupuncture is effective for the treatment of pain. This was across many pain conditions including back and neck pain, osteoarthritis, chronic headaches, and shoulder pain.
Andrew Vickers PhD, the head author, and his team painstakingly reviewed virtually all of the acupuncture research trials which have focused on pain. They had strict criteria for the quality of the studies to be included in their analysis. In the end, the group used 29 acupuncture studies which included 17922 total patients.
The results of the study showed that acupuncture was much better than no-acupuncture control groups across the studies. The acupuncture was also better than placebo acupuncture across the groups. The difference between real and placebo acupuncture was not as large as the difference between acupuncture and no acupuncture. However, the numbers are large enough to show a real difference between placebo and real acupuncture for pain reduction.
Oct 28, 2011
Chronic pain is mysterious. It can come and go. It can get worse, or get better. Often without explanation.
Chronic pain is serious. It interferes with work, school, and relationships. Chronic pain is the most common issue that comes into my acupuncture clinic. Pain can effect almost any place in the body: headaches, back pain, shoulder pain, neck pain, knee pain, and any other location.
Acupuncture for Chronic Pain
Acupuncture is a complex therapy and works in a combination of ways to reduce pain and inflammation.
Acupuncture works to reduce pain and inflammation through regulating neural pain pathways, stimulating the release of natural pain relieves in the body, such as opioids, as well as regulating pain relieving opioid receptors.
Many studies have also shown acupuncture to have a anti-inflammatory effect, reducing the circulating inflammatory hormones in the blood, such as cortisol. Interestingly, many of the hormonal and neural effects last long after the acupuncture treatment has finished, suggesting that acupuncture has both immediate and long term regulatory effective in reducing pain.
What is the acupuncture needle doing?
We also can think about what the acupuncture needle itself is doing. When inserting a needle, the muscles near the acupuncture needle or along the acupuncture channel will often twitch. Many scientists have looked at this “twitch response” which can change the inflammatory mediators in the area of the acupuncture point. This could point to a mechanism related to local pain reduction.
Connective tissue stimulation is another possible mechanisms for pain relief that the acupuncture needle site.
Acupuncturists will twirl the needle many times during the treatment. Researchers have shown that this stimulates subcutaneous loose connective tissue. Helene Langevin, the remarkable researcher who discovered this, writes, “Fibroblasts (the cells) within the loose connective tissue respond to the mechanical stimulation with active cytoskeletal remodeling that may have important downstream effects within connective tissue.”
We do not know the specific clinical effects of the connective tissue responses. But Langevin believes these results may eventually lead to an explanation of the acupuncture channel circulation and connecting the body.
The next steps in acupuncture research will look to understand how these complex mechanisms work together for long lasting pain relief.
Napadow V, Ahn A, Longhurst J, et.al. The Status and Future of Acupuncture Mechanism Research. J Altern Complement Med. 2008 September; 14(7): 861–869.
Langevin HM, Churchill DL, Wu J. Et. al. Evidence of Connective Tissue Involvement in Acupuncture. FASEB Journal. April 10, 2002. Published Online.
National Center for Complementary and Alternative Medicine Website. Acupuncture for Pain. Accessed 4/30/2013.
Feb 11, 2011
The National Institutes of Health just published a very good short article on acupuncture, acupuncture research, what we know and what we don’t.
It features a number of excellent acupuncture researchers discussing the positive work and challenges in acupuncture research.
One of my favorite researchers is Karen Sherman, who researches discusses the challenges of a placebo acupuncture needle and questions if it is possible to create a reliable placebo for acupuncture. Richard Harris also discusses the placebo needling and how placebo studies may reveal some mechanisms of acupuncture. His studies have looked at the physiology of acupuncture and placebo acupuncture in fibromyalgia patients. The clinical studies show that both acupuncture and placebo acupuncture work, but he shows that have very different mechanisms in the brain.
This returns us to the question… What are the theraputic mechanisms of any placebo?