| Acupuncture
Getting stuck
with needles sounds more like torture than a medical treatment.
But there's evidence that acupuncture – a standard health
practice in asia – helps relieve pain. Should you try
it for arthritis?
The Chinese therapy
of acupuncture has been used for millennia to treat a range
of ailments. Now it looks like Western medicine is getting
the point.
Acupuncture has
become one of the most popular – and accepted –
unconventional therapies within the United States. An estimated
15 million Americans have tried this needle therapy. It's
offered in many chronic pain clinics, and is covered by some
insurers and managed heath organizations. The World Health
Organization recommends it for more than 40 conditions as
diverse as asthma and chronic pain. The Food and Drug Administration
regulates acupuncture needles as medical devices, the same
as it does surgical tools. And in 1997, a National Institutes
of Health panel found acupuncture to be an acceptable treatment
for many pain conditions, including fibromyalgia and general
musculoskeletal pain. And, no, it usually doesn't hurt after
an initial "pinch" or sting. So it's no surprise
that some rheumatologists are suggesting acupuncture, along
with more conventional treatments, to their arthritis patients
– and a few even give acupuncture treatments themselves.
"It's really
almost mainstream now," says Stuart S. Kassan, MD, a
rheumatologist in private practice in Denver who became an
acupuncturist in 1996. "It's safe when done properly,
and can be very helpful for pain."
However, Dr. Kassan
says, many doctors do remain skeptical. "Some roll their
eyes and say they can't believe I'm doing acupuncture,"
he says. "But rheumatologists see a lot of patients with
problems we can't do anything about, especially chronic pain.
We all become very frustrated. And this is where acupuncture
makes its greatest impact: with patients who have failed conventional
treatment."
Don L. Goldenberg,
MD, chief of rheumatology at Newton-Wellesley Hospital and
professor of medicine at Tufts University School of Medicine
in Boston, agrees. A fibromyalgia specialist, he often works
in conjuction with a medical doctor trained in acupuncture,
which he finds often gives good results when used in addition
to more conventional treatments. "Acupuncture clearly
can help lots of chronic pain issues, including fibromyalgia,"
he says.
But it doesn't
work for everyone. "Some people respond spectacularly
– but not all," says Wendell Hatfield, MD, a Denver
rheumatologist who is also a trained acupuncturist. "And
as with all treatments for chronic conditions, it's not a
cure. It helps control the symptoms."
WHAT IS ACUPUNCTURE?
Acupuncture is the use of fine needles inserted into the skin
at precise points. It originated in China thousands of years
ago, and is based on the theory that an essential life energy
called qi (pronounced chee) flows through the body along invisible
channels, called meridians. When the flow of qi is blocked
or out of balance, illness or pain results. Stimulation of
specific points along the meridians can correct the flow of
qi to restore or optimize health, or to block pain, according
to Chinese theory.
The "acupoints"
can also be stimulated with heated herbs (called moxibustion),
magnets, mild electrical current (electroacupuncture), manual
pressure (acupressure), low-frequency lasers, or even bee
stings. A traditional Chinese medicine practitioner may also
offer herbs along with lifestyle advice.
Western scientists
don't know exactly how acupuncture works. However, some acupoints
correspond to areas, called trigger points, that are known
to be rich in nerve endings, and studies show stimulating
acupoints causes multiple biologic responses. Such stimulation
can prompt a cascade of chemicals in the muscles, spinal cord
and brain that releases the body's natural pain-killing endorphins,
and can also affect circulation and other bodily systems.
WHAT THE RESEARCH
SHOWS
Acupuncture has been described in thousands of writings throughout
the centuries. Among the many recent studies are several that
show it relieves osteoarthritis symptoms – so well in
one Scandinavian study that 25 percent of patients previously
scheduled for knee surgery canceled their plans. That same
study showed booster treatments once a month sustained the
pain relief.
Other studies
have shown that acupuncture helps relieve pain from fibromyalgia
and osteoarthritis; can decrease the number and severity of
Raynaud's phenomenon attacks; helps ease conditions that can
accompany arthritis such as depression and irritable bowel
syndrome; and enhance conventional treatments for gout, when
used in a combined therapy.
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