By Higgy Lerner
Acupuncture is the insertion of very fine-gauge stainless steel needles into points on the skin. It originated in ancient China thousands of years ago and spread throughout Asia and to Europe and the Americas. The many styles of acupuncture vary from those that barely touch the skin with the point of the needle to more assertive styles designed to elicit strong responses. Sometimes magnets are used instead of needles, or electrical stimulation is applied through needles or directly to the points on the skin.
Acupuncture is grounded in the philosophies of ancient China, including Taoism and the I Ching, or Book of Changes. These philosophies developed from observations of the natural order of nature and the ebb and flow of natural processes. All peoples around the world have developed ways to deal with illness and trauma. Traditional Chinese medicine (TCM) came into being grounded in the context of these philosophies. Acupuncture is one of the methods of TCM, along with the use of moxabustion, herbal medicine, tui na massage, cupping, dietary therapy, and in Asia, bonesetting.
Restoring Your Qi/Energy
We can say that the goal of acupuncture therapy is to help restore the natural flow of Qi ,or energy, and the free circulation of blood in the human body. When the Qi and blood flow harmoniously the body and mind tend toward homeostasis. The majority of patients find acupuncture treatment a relaxing experience, at least in part from this restoration of the natural uninhibited flow of Qi and blood. Moxabustion is the burning of mugwort, dried Artemesia vulgaris, which grows locally in Northern California, on or over acupuncture points. The Chinese word for acupuncture is really two words, for needle and moxa.
Many patients ask, “How does acupuncture work?” While there has been a tremendous amount of research on the subject, and thousands of years of traditional theory to explain it, this is not a simple question to answer. Like so many things, it depends in part on perspective. When the body relaxes, the circulation improves, and greater healing can take place. Improved blood flow is in itself healing and anti-inflammatory. A variety of chemicals are released both locally and systemically during an acupuncture treatment. Some of these are local chemicals responding to the minute tissue damage from the needle, stimulating a healing response. Others come from various organs stimulated somehow by the insertion of acupuncture needles. Functional MRI of the brain shows us that areas of the brain “light up” in response to needling. Sometimes needling causes muscles to twitch and then relax, or it leads to lessening of trigger-point activity in muscles or fascial tissue. Acupuncture obviously is mediated largely via the nervous system. Yet none of these facts adequately explains why we can needle the foot to stop a headache. Or needle the top of the head to help with a prolapsing organ. Or for that matter, why the application of moxabustion, the burning of a herb over or on a point near the tip of the little toe, will turn a breech-presentation fetus.
Traditional explanations for how acupuncture works have to do with the aforementioned flow of Qi and blood. It has to do with the meridians, or channels, that connect the points in lines over the body. While no one has been able to find these meridians by dissection, they have been traced electrically. The points are situated over common trigger points in muscles, and they are close to nerve endings and lymphatic structures as well. Traditional Chinese medical theory provides a framework for the acupuncturist to view the body, organize and categorize a person’s symptoms, and act upon the body to affect the symptoms and move the person toward a more positive state of health.
My view is that all these explanations provide pieces of the puzzle as to how acupuncture works, but no single explanation is adequate.
Some of the earliest Chinese medical writings date from the 3rd century B.C. Through the centuries thousands of works were written and compiled in China, with different theories and schools of thought adding to the knowledge. Around the year A.D. 800, Chinese medicine went to Japan with Buddhist monks who traveled there. Both acupuncture and herbal medicine grew and thrived in Japan, with the Japanese developing their own approach to both. Even before reaching Japan, Chinese medicine had spread to Korea, where today, as in Japan, there is a great deal of research into the effects of acupuncture and herbal medicine. Hundreds of herbal formulas have been approved for medicinal use by the Japanese government. It is also practiced in Vietnam and other countries of Asia. Early European missionaries and explorers brought knowledge of Chinese medicine back to Europe and then to America. There was some use of it in the United States as far back as the early 1800s. Today, acupuncture is widely practiced and well researched in Germany and England and other European countries. Studies from Germany and England, where there has been national health insurance for some time, have found acupuncture to be a cost-effective treatment for conditions such as headache and back pain. Because of the national health-insurance systems, these countries have been able to conduct studies with thousands of patients to find these positive and cost-saving effects.
In the United States there has been tremendous growth in the practice of acupuncture. California has the most acupuncturists, but almost all states now have acupuncture licensure. Hospitals are now adding acupuncture clinics and sometimes even inpatient treatment. Here in Chico, at Enloe Medical Center, I was involved in setting up inpatient treatment for cardiac surgery patients eight years ago, and an outpatient, low-cost clinic at the Enloe Cancer Center. This was Chico’s first “community-style” acupuncture clinic. Grant funding for the inpatient treatments ran out, but the low-cost clinic is ongoing. During my thirty-plus–year career as a licensed acupuncturist, I have seen the growing acceptance of acupuncture firsthand. When I practiced in Berkeley, California, 25 years ago, the hospital there would not even answer an inquiry from me about any form of privileges there. Now Enloe Medical Center offers acupuncture! The famous Cleveland Clinic now has a Chinese herbal clinic. And even more dramatically, the general public has come to accept acupuncture as a valuable tool for both health maintenance and treatment of disease.
Integrative medicine aims to incorporate the best of a number of medical practices, allowing use of and access to a variety of beneficial treatments. A great example of this is the use of acupuncture to help alleviate the side effects of modern medical treatments for cancer. Many, if not most, conditions might benefit from combining different types of treatments. But it is important that both practitioners and patients use critical thinking. In other words, the treatments used should have evidence of efficacy. Some in the field of integrative medicine would say that the lower the risk from a treatment, the less rigorous the evidence of efficacy needs to be. This is part of weighing the cost/benefit ratio of an intervention. Critical thinking is important because we are all constantly inundated with claims and recommendations, many of which contradict each other, and many of which are profit driven and simply too good to be true.
Not that many years ago, when I would read letters to medical journals after an article about acupuncture that would call it only a placebo response, or a hypnotic effect, I would have to chuckle at the hubris of those letter writers. Traditional Chinese medicine has withstood the test of time, having been practiced continuously for thousands of years. The aim and effect of restoring the healthy flow of Qi in the human body/mind continues to resonate with many people. We also see this in the growing numbers of people practicing yoga, tai ji quan, and qi gong, all of which are ways to achieve this harmonious flow of Qi and blood.
In the next issue of Lotus Guide I will discuss Chinese herbal medicine.
Higgy Lerner is a licensed acupuncturist, herbalist, and teacher of tai ji quan and qi gong. For more information visit www.higgylerneracupuncture.com.