Does acupuncture work for chronic pain? Here’s what science says.

K: I have tried many medications for my chronic pain and nothing has worked. Should I try acupuncture?

A: Critics once dismissed the benefits of acupuncture as a placebo effect, which still persists among a segment of the public. But research has found a benefit for some conditions, including chronic pain.

The data is so promising that in 2020, centers for medical and clinical services were launched Includes acupuncture treatment For chronic low back pain. Clinical trials over the past several decades have suggested that acupuncture may be an effective treatment for other conditions. Chronic obstructive pulmonary disease And Constipation.

To determine whether acupuncture actually works, researchers compared it to “sham” acupuncture.

Acupuncture is a treatment that activates specific locations on the body – or acupoints – usually with fine needles. In traditional East Asian medicine, acupoints are thought to activate Helps restore the flow of ChiVital energy of the body.

In pseudo-acupuncture, the acupuncturist inserts needles but deliberately avoids established acupoints. This is not a perfect double-blind system, as trained acupuncturists know they are administering counterfeit drugs.

However, from the patient’s point of view, the experience is essentially the same. If the benefits of acupuncture were purely due to the placebo effect, then the fake and the real thing would produce identical results.

In some cases, they don’t.

A 2018 Over 20,000 meta-analyses Patients in 39 high-quality randomized controlled trials found that acupuncture was better for both back or neck pain, arthritis, headaches, and shoulder pain. These effects often persisted over time – even 12 months after treatment.

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But this is not a magic cure. As with any treatment, it’s not for everyone. Although it’s popular among people undergoing IVF, for example, research shows it doesn’t improve fertility.

Acupuncture is the science

Some skepticism persists due to a lack of explanation from a Western medical perspective as to how acupuncture works. But scientists are beginning to unlock the answer: the brain.

“People talk about psychedelics reshaping the nervous system. Acupuncture kind of does the same thing,” said Richard Harris, a professor at the University of California, Irvine, and president of the Susan Samueli Integrative Health Institute.

His group conducted a series of analyzes of acupuncture among chronic pain patients. They found that acupuncture – but not sham – modulated brain activity Activates receptors that bind opioids, helps control pain in the body. Acupuncture, in which needles are stimulated with a small current, also impact How different parts of the brain are connectedMainly modulating the brain’s pain network.

Consider this: In 2017 A study of 80 patients with carpal tunnel syndromeScientists have found that electroacupuncture of the affected wrist is as effective in relieving symptoms as acupuncture on the opposite ankle.

Subjective recovery aside, both groups had an improvement in how well the median nerve at the wrist could send electrical signals — something that didn’t happen to those who received sham acupuncture. This suggests that acupuncture can act locally at the injection site, but may also have the ability to act on parts of the body anywhere near that point.

One way this can happen is through the central nervous system. So the scientists looked at the subjects’ brains using functional MRI imaging. They found that injections into the wrist and ankle resulted in significant changes in how stimulation to the fingers was mapped in the cerebral cortex.

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More research is needed to determine exactly how acupuncture affects the body, but studies have provided strong evidence that it is more than just a placebo effect.

World Health Organization consensus 361 Recognize standardized acupoints in the human body. Acupoints respond to various stimuli such as pressure, heat and electricity.

There’s still a lot we don’t know about how acupoints work. Some studies show that traditional acupoints Nerve endings and mast cells may have a high density. Stimulating these areas can lead to the release of chemicals (such as hormones) in the body and can eventually affect the brain.

What defines an acupoint, how they relate to each other, and their physiological significance is an important 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 about finding a qualified acupuncturist in your area.

Acupuncture is generally considered safe when performed by a well-trained practitioner. Serious complications and deaths related to it are extremely rare. Numbness or pain at the injection site is also rare.

The risks are not zero, but they may be less than those associated with some pain medications.

What my patients need to know

Some people in the United States have a bias against non-Western medicine treatments. But when doctors like me recommend acupuncture to their patients—which I often do for pain or constipation—it’s not because we’ve run out of ideas or because we understand it as a last resort. We recommend the data precisely because of how compelling it is.

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