Posts Tagged ‘brain’
Chronic Low Back Pain
Jan 9, 2012
Chronic low back pain is one of the most common reasons to go to the doctor as well as miss work. It decreases quality of life and causes people to avoid activities they would normally enjoy. Acupuncture is a very well accepted and safe method to treat chronic low back pain (1,2).
Acupuncture for Chronic Low Back Pain
Acupuncture is over 2000 years old, and has a long track record of treating back pain. Acupuncture needles are solid, there is no medication in or on the needle. It is not anesthesia that helps to reduce the pain. Acupuncture works by stimulating the body to heal itself. It does this through relaxing the back muscles, stimulating the release of anti-inflammatory chemicals, and regulating how the brain feels pain (3).
Chinese medicine and acupuncture theorize that there are underlying imbalances in the body which leads to chronic low back pain. A successful acupuncture treatment must be tailored specifically to what is going on with your back. Acupuncture needles are placed in specific points correct imbalances that can cause back pain.
Lower back pain treatment will most often be focused on the back. Needles will also be placed in other areas to stimulate movement of the energy and increase production of the energy.
What Causes Back Pain?
According to acupuncture and Chinese medicine, the two major imbalances which cause back pain are deficiency and stagnation.
An old acupuncture saying goes, “When there is no movement, there is pain. When there is movement, there is no pain.”
Stagnation is when there is not enough flow of energy through the back. Trauma, stress, or injury can cause the qi flow, or energy flow, in the body to slow down and gets stuck. When there is no flow, pain develops. Car accident, sports injury, and stress can lead to development of stagnation.
Deficiency is when there is not enough energy in body. The body needs qi, or energy, in order to function healthy. Gradual, slow, chronic onset of back pain can be a sign that there is not enough energy, or a qi deficiency.
Sometimes there is a combination of deficiency and stagnation. This can happen after a long period of time after an accident and not getting better.
Acupuncture therapy is individualized for each patient
During the initial acupuncture visit, there is generally an examination and assessment of the root cause of the back pain. The acupuncture treatment is individualized for your specific issues.
An effective acupuncture treatment may involve acupuncture and electro -acupuncture stimulation. Other therapies including acupressure or cupping are very helpful for chronic low back pain. For some people ear magnets or auricular acupuncture is very powerful for pain relief. The proper combination of these treatments leads to profound and long term pain relief.
Read More about Acupuncture for Chronic Lower Back Pain:
References:
1. Sherman KJ, Cherkin DC, Eisenberg DM, et.al. The Practice of Acupuncture: Who Are the Providers and What Do They Do? Ann Fam Med 2005;3:151-158.
2. Berman BM, Langevin HM, Witt CM, Dubner R. Acupuncture for Chronic Low Back Pain. N Engl J Med 2010; 363:454-461.
3. 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.
written by: Joseph Alban
Last Edited: 1/09/2012
Another Look at the Placebo Effect
Dec 12, 2011
For the last 50 years, the placebo effect has been a dirty word. Real interventions make a physiological change in the body. Placebos do nothing but convince the patient that something is different. Reality states otherwise. Ted Katpchuk, an acupuncturist and Chinese medicine doctor who focuses on the placebo effect in his research, wants to change all that.
In last week’s New Yorker, an article focuses on the placebo and the scholars who think about and examine the placebo.
What is a Placebo?
One of the difficult and fundamental questions is what is a placebo? We’ve come to believe a placebo is an inert intervention. A sugar pill.
In most clinical trials of medication, or even with some physical interventions, a group of people with a given condition are given active therapy or medication. The outcomes in this group are compared with a group of people who are given a placebo, but most often are not told which group they are in. Usually both groups improve, even people give the placebo. If the medication is successful, the people on active medication will improve more. The the placebo group improvement is called the placebo effect.
The placebo effect is thought to stem from a belief that a given intervention will help. People convince themselves that the medication is working, and miraculously it does. But the placebo does not change the body physiologically. Or so we thought.
Is the Placebo Inert?
One colossal challenge to the concept of a placebo, is that many studies have shown that a placebo is not inert. Meaning that your body has physiological reactions to taking a placebo. This could mean that belief in a specific drug or intervention actually stimulates your body to heal.
This is particularly true with chronic pain. Early placebo studies have shown that placebo intervention for pain relief actually influence the releases natural pain killers in your brain.
The All Encompassing Placebo
Many of the placebo researchers go further. A placebo is any aspect of a given intervention that may help you feel better, but without a specific physiological interaction with the body. This idea encompasses the whole experience of an individual. The environment of the office, the taste of the pill or tea, and how much the practitioner listens to you. The article even discusses how different colors and shapes of pills have various placebo effects.
A powerful concept in placebo research examines how a given intervention, be it medication, massage, or surgery, is more than simply the intervention itself. For example, my statistics professor at Mount Sinai would often discuss the fact that the clinical trial itself is a placebo. Patients in a clinical trial tend to do better on their medication than the general public. This could be because they feel special, receiving a new medication, being treated by expert doctors with a large staff at their disposal. Then, in the general public, the medications tend to work less well.
Doctor Patient relationship
Kaptchuk would like to explore how best to harness the power of placebos in the healing process. He has focused on the patient doctor interaction as placebo. He even ran a clinical trial of a placebo intervention on IBS where the patients were actually told they were taking a placebo, and that it had clinical efficacy in the past. And amazingly, it worked.
However, this dilemma brings a difficulty with the word placebo. Doctor patient relationship is a skill. A skill that many medical schools have begun to teach, as we loose this skill to technological advances.
Perhaps careful explanation, a caring tone, and an ear to listen can be called a placebo, as it is a non-specific intervention. It is not a chemical pill or an herbal remedy. However, it is also a skill, that can be developed and improved. Kaptchuk would certainly agree with teaching how to wield the healing power of the doctor patient relationship.
Yet, the placebo has a negative tone with the medical establishment, and also much of the population, because we are being fooled into getting better. Perhaps there needs to be a new name for a non-specific intervention.
Placebo: The Social Stigma
What is radical about the placebo idea is that nobody wants to believe that a placebo helps them. And its not just Western medical physicians. Acupuncturists, Chiropractors, and other modalities, as well as patients, fight against the idea that whatever intervention is helping, is a placebo. That means its all in your head.
Kaptchuk and others want to change this stigma. Even if the placebo is all in your head, so what. You feel better. You’re healthier and that’s what counts. But what’s interesting, in some cases, the placebo intervention can actually alter physiology of the body.
A Placebo or Common Sense
A comforting office environment has often be chalked up to placebo. But why would you not want to be comfortable in a doctor’s office with soothing colors and music? It is nerve wrecking enough to go to the doctor. And stress has a real effect on the body. It is just common sense to make the office nice.
I think there is a danger when discussing design of a pill and patient doctor interaction both as placebo because this could reduce the importance of the doctor patient relationship.
Acupuncture itself is an interesting question about the placebo effect. I have a hunch that Kaptchuk believes that acupuncture has a real physiological effect, as he has been involved in many studies comparing acupuncture physiology to placebo physiology, and there is often a difference. But it is not discussed in the article, because the point is that it helps people feel better.
Harnessing the Placebo
The field of studying the placebo itself is young. It questions central tenets to clinical research and shows that our bodies can physically heal ourselves of certain chronic conditions. We do not just react to medication, but also to caring, touch, and the environment.
Like much of good science, these studies bring up more questions than they answer. What is the most important aspect of placebo to focus on. Soft voice, listening to the patient, the examination. Or is it the office lighting, soft colors, and music. As the definition expands, the concept of the placebo can encompass almost anything.
Probably the best way to harness the power of many aspects of the placebo is by not calling it a placebo. Doctor patient relationship, a comforting healing environment, and physical touch are all words that don’t have the placebo stigma. These all help the patient get better, which is what is most important.
Lack of social acceptance in the public and medical community is a challenge that the research will not be able to overcome.
images: erix
Understanding Acupuncture
Feb 11, 2011
© Bob Stockfield Courtesy: National Center for Complementary and Alternative Medicine
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?
Acupuncture and Pain Relief
Nov 30, 2010
For many years now, researchers have been looking at how acupuncture works for pain relief. Often these acupuncture studies will use an fMRI scanner that tracks activity and blood flow in the brain.
A recent study coming out of Germany, which was presented yesterday at the Radiological Society of North America, at the showed that acupuncture regulates the pain mechanism in brain as well as the expectation of pain relief in the brain.
Normal people without pain received electric shocks on one of their feet. On the other foot, they used acupuncture to try to block this pain reaction. Looking at the scan of the brain, it showed that the acupuncture effectively blocked the sensation of the pain in the brain.
These results are exciting, further support acupuncture has a real physiological effect on the body for pain relief. I am very excited that many acupuncture researchers in the future are not only looking at the brain scan of acute pain, but also the long term changes that happen in the central nervous system and throughout the body from acupuncture treatment.
Relieve Back Pain with Acupuncture
Aug 30, 2010
Acupuncture for Back Pain
Back pain is one of the most common reasons to go to the doctor as well as miss work. It decreases quality of life and causes people to avoid activities they would normally enjoy. Acupuncture is a well accepted and safe method to treat back pain which uses no medication (1,2). Acupuncture works by stimulating natural healing mechanisms in your body.
Acupuncture is a Natural Choice for back pain treatment
Acupuncture is over 2000 years old and has a long track record of treating back pain. Acupuncture works by stimulating the body to heal itself. Acupuncture does this through relaxing the back muscles, stimulating the release of anti-inflammatory chemicals, and regulating how the brain feels pain. (3)
Chinese medicine and acupuncture theorize that there are underlying imbalances in the body which leads to chronic low back pain. A successful acupuncture treatment must be tailored specifically to what is going on with your back. Acupuncture needles are placed in specific points to correct imbalances that can cause back pain.
What Causes Back Pain?
An old acupuncture saying goes, “When there is no movement, there is pain. When there is movement, there is no pain.”
Stagnation is when there is not enough flow of energy through the back. Trauma, stress, or injury can cause the qi flow, or energy flow, in the body to slow down and gets stuck. When there is no flow, pain develops. Car accidents, sports injury, and stress can lead to development of stagnation.
Another imbalance is called deficiency. Deficiency is when there is not enough energy in body. The body needs qi, or energy, in order to function healthy. Gradual, slow, chronic onset of back pain can be a sign that there is not enough energy, or a qi deficiency.
Sometimes there is a combination of deficiency and stagnation. This can happen after a long period of time after an accident and not getting better.
Lower back pain treatment will most often be focused on the back. Needles will also be placed in other areas to stimulate movement of the energy and increase production of the energy.
Acupuncture Therapy is Individualized for Each patient
During the initial acupuncture visit, there is an examination and assessment of the root cause of the back pain. The acupuncture treatment is individualized for your specific issues.
Kidney 3
An effective acupuncture treatment may involve acupuncture and electro -acupuncture stimulation. Other therapies including acupressure or cupping are very helpful for chronic low back pain. For some people ear magnets or auricular acupuncture is very powerful for pain relief. The proper combination of these treatments leads to profound and long term pain relief.
Acupuncture needles, placed in specific points correct imbalances that can cause back pain.
Back pain treatment will most often be focused on the back. Needles will also be placed in other areas to stimulate movement of the energy and increase production of the energy. Two effective points for this could be inside the ankle on Kidney 3, or on the calf at UB 57.
Acupuncture Stimulates the Body to Heal Itself
Aug 24, 2009
Chinese medicine believes in the body’s power to heal itself. As clinicians, we remove the imbalances that are keeping you from being healthy.
Interestingly, modern acupuncture research is beginning to show how it actual does to stimulate the body’s own power to heal itself. The acupuncture needle does not inject any medicine, nor is it coated. It is simply reprogramming the body to be healthy again.
The research is still young and we don’t know everything. It is probably a complex series of events which occur in many systems across the body. But we do know that it works to regulate the nervous, endocrine, and the immune system. We also think that it works on a cellular level to influence intercellular communication and regeneration.
The brain and
nervous system
Using a type of brain scanner called an fMRI, scientists have shown that acupuncture regulates pain centers in the brain.1 When there is chronic pain, the brain can get stuck in an unhealthy pattern of pain and illness. For example in back pain, your back can be healed, but the brain remembers the pain and still feels it. The acupuncture helps to reset this pattern as a way of reteaching the body to be healthy.
Although not fully understood, acupuncture also has been shown to affect the release of many neurotransmitters such as opoids, endorphins, and endocannaboids that regulate pain, emotion, and possibly help with addiction.
Hormonal level
It has also been suggested that acupuncture can help regulate hormones. This is because we know it works great for conditions like PCOS, hot flashes, diabetes and infertility. In one study, electroacupuncture was shown to increase estradiol and other hormones in rats who had their ovaries removed.2 This suggests that electroacupuncture stimulates the hypothalamus to release the hormones that help to treat infertility.
Cellular level
Healing also occurs at the place where the needle is inserted, on a cellular level. The surrounding connective tissue cells actually grabs hold of the needle and expands.3 Some scientists believe this begins the replication and repair of the cells around the needle.
This needles grasp by the cells also represents the beginning of the communication within the acupuncture channels and may signal that the channels are alternative communication system through the connective tissue.
Immune System
The immune system is tricky. Without it, we could not live. But often it can overreact and attack ourselves, causing autoimmune conditions like asthma, allergies, and eczema. Acupuncture may help to down regulate the overactive immune system as well as give a boost to those with poor immune systems.
In one study, electroacupuncture was shown to lower the number of inflammatory cells in asthmatic rats compared to placebo acupuncture. It also lowered the number of cytokines, which are proteins that signal the inflammatory reaction.4 In another rat study, electroacupuncture to the point ST 36 showed to decrease inflammation through release of opioids.5
This shows that acupuncture has both a analgesic effect and an anti-inflammatory effect. This is good news, because so many disorders with pain also have significant inflammation.
A Glimpse into the Research
This is a glimpse of what modern research is explaining about acupuncture. There is still a lot more to learn, but what we know is really exciting.
In the next post I will explain acupuncture theory of channels and meridians.
Read more about acupuncture and…
Images: Wikipedia, Wikipedia, Wikipedia
References
¹ Napadow, V. Kettner N., Liu J. Et. al. Hypothalamus and Amygdala Response to Acupuncture Stimuli in Carpel Tunnel Syndrome. Pain. 2007; (130): 254-266.
2. Zhao H, Tian Z, Feng Y, Chen B. Circulating estradiol and hypothalamic corticotrophin releasing hormone enhances along with time after ovariectomy in rats: Effects of electroacupuncture. Neuropeptides. 2005; (39): 433–438.
3. Langevin HM, Churchill DL, Wu J. Et. al. Evidence of Connective Tissue Involvement in Acupuncture. FASEB Journal. April 10, 2002. Published Online.
4. Carneiro ER, Et. Al. Effect of Electroacupuncture on Bronchial Asthma Induced by Ovalbumin in Rats. JACM. Volume 11, Number 1, 2005, pp. 127–134.
5. Kim HW, Et. Al.The Anti-Inflammatory Effects of Low- and High-Frequency Electroacupuncture Are Mediated by Peripheral Opioids in a Mouse Air Pouch Inflammation Model. JACM. Volume 12, Number 1, 2006, pp. 39–44.
SEARCH
Sign up
GET RSS FEED
CATEGORIES
ARCHIVES
Like us on Facebook
RECENT BLOG POSTS
Recommended by
