Acupuncture

Acupuncture is an important aspect of traditional Chinese medicine. While some consider it to be pseudoscience (a practice lacking scientific basis), many clinically evident benefits have been noted as well. The original philosophy behind acupuncture in the olden times was based on the principle of “Qi'' (pronounced as “chee”), which was believed to be a fluid, animated life energy source present inside a human. Well functioning, or well flowing, Qi was believed to be needed for mental and physical well being; any obstruction to said the flow was thought to result in ailments. By inserting special needles in meridians, or pathways of the flow, the “Qi” was believed to be brought into balance. The modern-day practice of acupuncture can be described as the stimulation of nerve-rich areas of the skin to influence the underlying tissues, glands, organs and overall functioning of the body, in a minimally invasive manner, by strategic placement of special acupuncture needles. Scientifically, modern-day acupuncture practice can be theorised to rely on the infliction of small needle injuries (not enough to produce pain or discomfort) that elicit an immune reaction from the body in the targeted area to stimulate healing.

Although scientific evidence and research on acupuncture therapies in different conditions is limited, some conditions have been found to respond to it and clinical improvement noted. However, it must be remembered while opting for acupuncture therapy that while some improvement of symptoms may be possible in select cases, it is not a miracle cure-all or suitable replacement for allopathic medical therapy. Some conditions with claims to respond to acupuncture therapy include, but may not be limited to:

• Allergies
• Anxiety and depression
• Osteoarthritis
• Chronic pain (especially of the neck, back, knees and head)
• Hypertension (high blood pressure)
• Insomnia
• Menstrual cramps and symptoms of premenstrual syndrome (PMS)
• Headaches (including tension headaches and migraine)
• Morning sickness
• Sprains
• Strokes
• Lower backache
• Neck pain

A few other conditions, with limited evidence and research, are said to benefit from acupuncture. Currently, research is ongoing for the potential benefits of acupuncture therapy in the following:

• Acne
• Abdominal pain
• Cancer pain
• Obesity
• Infertility
• Diabetes
• Schizophrenia
• Stiff neck
• Alcohol dependence

Following are some of the effects that occur following acupuncture therapy:

• Analgesic effect or pain relief
• Sedative effect
• Homeostatic effect
• Effects on the brain and spinal cord (central nervous system)
• Motor recovery
• Enhancement of immunity
• Effects on blood vessels and blood
• Effects on the digestive system
• Effects on the respiratory system

Although acupuncture therapy does not require patients to undergo specific preparations, some advisable measures to take to enhance the treatment experience include:

• Reach early: Arriving 15 minutes before session time to avoid being stressed or uneasy when the treatment begins. This helps avoid dizzy spells during acupuncture.
• Eat an appropriate amount before the session: Avoiding eating too much or too little is recommended to help patients remain comfortable throughout the session and to not feel faint or dizzy.
• Avoid caffeine: Caffeinated beverages, or caffeine in other forms, should be avoided before the acupuncture session as the stimulant action of caffeine can aggravate dizziness and cause heart palpitations in susceptible patients.
• Wear loose comfortable clothing: Not only does this help the patient feel more relaxed but also helps the acupuncturist manoeuvre and place the needles correctly.

After finding a trained and licensed acupuncture therapist, an appointment is booked for the first session. During the first session, the acupuncture specialist evaluates the individual seeking therapy. This is usually done by asking about symptoms of the problem that needs to be addressed, lifestyle practices, behaviour, pre-existing conditions (with a special emphasis on contraindications) and so on. An examination may be conducted, which may be somewhat different from a medical doctor’s examination. The initial assessment can last up to an hour, however, the subsequent sessions are shorter, lasting around thirty minutes or so. Usually, two sessions per week are needed to adequately address a single complaint with acupuncture therapy and on average most individuals receive acupuncture treatments for 6 to 8 weeks. The following may be assessed by the acupuncture therapist:

• The parts of your body that are painful
• The shape, coating and colour of your tongue
• The colour of your face
• The strength, rhythm and quality of the pulse in your wrist

Most acupuncture therapists have their own unique approach to therapy that combines original eastern practices as well as newer methods developed over the years. A personalised treatment plan is created and shared with the individual after the initial assessment.

The therapist identifies the acupuncture points of the individual’s body. Some of these acupuncture points may be far removed from the site of reported pain or symptoms. The acupuncturist will inform the patient about the proposed plan of treatment and the general area in which the work will be carried out. Depending on this, the patient may have to remove clothing or other articles to better expose their skin for the acupuncturist to work. Towels, gowns, sheets or other coverings will be provided to the patient to safeguard their privacy and make them feel more comfortable. The patient is then made to lie on a comfortable padded table and the procedure is carried out using special acupuncture needles. The process can be summarised in the following three steps:

• Needle insertion: Specialised acupuncture needles that are exceptionally thin are inserted through the skin to varying depths in strategic points in the body (acupuncture points) to address the underlying cause of pain or symptoms. As these needles are very fine and thin, the patients do not perceive pain on their application. A dull aching sensation may be felt when the needle reaches the correct depth of insertion. Five to twenty acupuncture needles may be inserted in a single area of treatment.
• Needle manipulation: After the needle is inserted through the skin into an acupuncture point, the acupuncturist may gently move or twirl the needles, or apply heat or mild electrical pulses to them till the desired positioning and effect is achieved.
• Needle removal: Generally, the needles are left in place for 10 to 20 minutes while the patient is made to lie still and relax on the padded table. Usually, no discomfort is experienced while the needles are inside and no pain is felt on the removal of needles.

Most people feel relaxed and energised after an acupuncture therapy session. However, not everyone perceives the difference and responds to treatment. If after a few weeks of acupuncture therapy an individual does not seem to benefit, it is best to consider other options as acupuncture therapy may not be helpful for them.

Although acupuncture, when performed correctly by a certified practitioner, can be beneficial in many conditions, some patients with certain factors should not get acupuncture therapy.

Absolute contraindications to acupuncture therapy

The presence of any of the following factors makes the patient entirely unsuitable and ineligible for acupuncture therapy.

• Pregnancy: The application of acupuncture therapy to certain lumbar and sacral points in the body while pregnant can stimulate labour pains and labour. This can even result in premature labour, delivery or other adverse events.
• Patients with uncontrollable body movements: Patients suffering from ailments that can produce uncontrolled jerking or other movements in the body are unsuitable to receive acupuncture therapy. Acupuncture needles may be misplaced while being applied, can produce unwanted effects and even hurt the patient or the practitioner.
• Edematous limbs or limbs at the risk of developing lymphoedema: By erroneous injury to lymph vessels, edema can set in or exacerbate.
• In areas of spinal instability: Due to the muscle relaxing effect that will be produced by insertion of acupuncture needles in the area of spinal instability, spinal cord compression can arise.
• Skin with sensory deficits, recent incisional wounds, scars and keloids: Needling of these sensitive tissues should not be carried out.
• Bleeding disorders (like a patient on anticoagulant therapy, on blood thinners or suffering from hemophilia): Acupuncture needling can result in blood loss and haemorrhage in individuals with impaired blood clotting. Acupuncture therapy of intrascapular points should especially be avoided as the shoulder blades (scapulae) have a rich network of blood vessels surrounding them.

Relative contraindications to acupuncture therapy

Presence of some factors may need further investigations, consultations with physicians or specialist doctors and consideration of other factors before proceeding with acupuncture therapy. Some such factors include, but are not limited to:

• Acute stroke
• Patients with cancer
• Areas of poor skin condition
• Diabetes
• Patients with epilepsy
• Hemophilia or other blood clotting disorders

Following can be some side effects of acupuncture therapy:

• Needle related complications of acupuncture therapy: 
  • Needle dystocia or misplaced needle
  • Bent needle 
  • Broken needle
  • Forgotten needle
• Dizziness due to acupuncture needling
• Fainting due to acupuncture needling (Some individuals may feel dizzy or faint during needle application in acupuncture therapy due to vasovagal syncope)
• Pain at the acupuncture needle site
• Bleeding at the acupuncture needle site
• Infection at the acupuncture needle site

In order to get the most of the treatment, it is advisable to:

• Avoid exercising after treatment
• Avoid caffeine after therapy session
• Avoid alcohol after therapy session
• Eat healthy food but avoid large meals after the session