Is acupuncture effective for chronic pain? Here’s what the science says.

The data is so promising that in 2020 the Centers for Medicare and Medicaid Services began covering acupuncture therapy for chronic low back pain. Clinical trials over the past several decades have suggested that acupuncture may be a beneficial treatment for other conditions, such as chronic obstructive pulmonary disease And constipation.

To determine if acupuncture really works, researchers compared it to “dummy” acupuncture.

Acupuncture is a treatment consisting of activating specific locations – or acupuncture points – on the body, usually with fine needles. In traditional East Asian medicine, it is believed that the activation of acupuncture points help restore the flow of chithe vital energy of the body.

In sham acupuncture, the acupuncturist inserts needles, but deliberately avoids established acupuncture points. It is not a perfect double-blind system, as trained acupuncturists know they are administering a sham.

From the patient’s perspective, however, the experience is essentially the same. And if the benefits of acupuncture were entirely due to a placebo effect, the fake and the real would produce similar results.

In some cases, they don’t.

A 2018 meta-analysis of over 20,000 patients in 39 high-quality randomized controlled trials found acupuncture to be superior to both sham acupuncture and no acupuncture for back or neck pain, osteoarthritis, headache, and shoulder pain. These results generally persisted over time, even after 12 months of treatment.

But it is not a magic panacea. Like any treatment, it may not be suitable for everyone. Although it is popular among people undergoing in vitro fertilization treatments, for example, research has shown that it does not improve fertility.

The science of acupuncture

Some skepticism persists about the lack of explanation from Western medicine’s perspective on how acupuncture works. But scientists have begun to discover the answer: the brain.

“People talk about psychedelics that reshape the nervous system. Acupuncture kind of does the same thing,” said Richard Harris, Professor and University of California, Irvine Susan Samueli Integrative Health Institute Chair.

His group conducted a series of analyzes on acupuncture in patients with chronic pain. They found that acupuncture – but not sham – altered brain activity in terms of activate opioid-binding receptors, which help control pain in the body. Electroacupuncture, in which needles are stimulated with minor electrical currents, also impacted how the different areas of the brain were connectedessentially rewiring the pain network of the brain.

Consider This: In a 2017 study of 80 patients with carpal tunnel syndromescientists found that electroacupuncture of the affected wrist was as effective in relieving symptoms as acupuncture of the opposite ankle.

Aside from subjective recovery, both groups saw an improvement in the ability of the median nerve in the wrist to transmit electrical signals, which did not happen to those who underwent sham acupuncture. This would suggest that acupuncture may act locally where the needle is placed, but may also have the ability to act on parts of the body far from that location.

This could happen via the central nervous system. The scientists therefore examined the subjects’ brains using functional MRI imaging. They found that wrist and ankle needling caused significant changes in how finger stimulation was mapped to the cerebral cortex.

More research is needed to uncover more of the ways acupuncture influences the body, but studies have provided compelling evidence that it’s more than just a placebo effect.

The consensus of the World Health Organization recognizes 361 standardized acupuncture points on the human body. Acupuncture points seem to respond to various stimulations, such as pressure, heat, and electricity.

There’s still a lot we don’t know about how acupuncture points work. Some studies have shown that traditional acupuncture points may have a high density of nerve endings and mast cells. Stimulation of these areas can cause chemicals to be released in the body (such as hormones) and ultimately impact the brain.

Bringing together what defines an acupuncture point, how they relate to each other, and their physiological importance is a critical area of ​​research funded by the National Institutes of Health.

If you’re considering acupuncture, talk to your doctor about your options and ask them to find a qualified acupuncturist in your area.

Acupuncture is generally considered safe when performed by a well-trained practitioner. Serious complications and related deaths are extremely rare. Fainting or pain at the needle insertion site is also uncommon.

The risks are not zero, but they may be lower than those associated with some painkillers.

What I want my patients to know

Some people in the United States are prejudiced against treatments that are not based on Western medicine. But when doctors like me suggest acupuncture to their patients – which I often do for pain or constipation – it’s not because we’re out of ideas, or grabbing a last resort. We recommend it precisely because of the strength of the data.

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