Does Acupuncture for Chronic Pain Work?
Acupuncture is the therapeutic use of very thin, hair-width needles to stimulate specific points on the body in order to reduce pain or disease and promote wellbeing. You may be thinking "But I hate needles; this sounds too painful!"
In my own experience with using acupuncture for chronic pain, the needle insertion feels like a slight pinch, which disappears in a few seconds. If there is any discomfort, the acupuncturist will remove the needle.
After insertion, you usually cannot feel the needles. Occasionally, there may be a sense of warmth or heaviness around the insertion point. The needles are typically left in for 15 to 30 minutes while you rest.
What is Acupuncture?
Acupuncture has been used for over 3,000 years and is an integral part of Traditional Chinese Medicine (TCM). In this medical system, health is understood as achieving a balance between opposing forces (yin and yang).
Traditionally, essential life energy, called qi (chee) is believed to flow along channels in the body called meridians, keeping yin and yang balanced. Acupuncture points are mapped along meridians — if the flow of qi is blocked, it causes pain and disease (imbalance).
Stimulating acupuncture points restores the flow of qi along the meridians, improving the health of the individual and restoring balance.
A Western Approach
Western medicine offers a different perspective on how acupuncture works. Scientific studies demonstrate that acupuncture points are often located on nerve bundles or muscle trigger points.
Acupuncture has been found to increase blood flow to tissues around the acupuncture point, promote healing of localized tissues and affect the central nervous system. Some of the nervous system effects include down-regulating pain sensation, encouraging a relaxed brain state and calming the autonomic nervous system.
However, some skeptics believe these findings only demonstrate a strong placebo response to acupuncture.
How Can Acupuncture Help Chronic Pain?
Dozens of studies have investigated whether acupuncture is an effective treatment for chronic pain. The National Centre for Complementary and Integrative Health (NCCIH) explains that "results from a number of studies suggest acupuncture may help... types of pain that are often chronic," including low-back pain, neck pain and osteoarthritis.
Acupuncture may also reduce the frequency of tension headaches and prevent migraines. A recent review of 150 studies conducted over the past 50 years concluded that acupuncture is a safe and effective treatment for back pain and osteoarthritis.
What the Research Says About Acupuncture for Chronic Pain
Researchers have been interested in the question of whether it matters if needles are inserted in Traditional Chinese Medicine (TCM) acupuncture points or at random points on the body (a placebo, or so-called sham acupuncture).
To answer this question, researchers analyzed 29 separate randomized controlled studies that included a total of 18,000 study participants with chronic pain. The researchers concluded that the effectiveness of acupuncture at TCM acupuncture points for pain reduction was statistically significant compared to sham acupuncture. They concluded that acupuncture was an effective treatment option for people with chronic pain conditions.
Another recent study investigated the effectiveness of individualized acupuncture treatment programs for patients with fibromyalgia (as opposed to most studies that use a standardized treatment program). Tailored treatments were compared to sham acupuncture treatments.
Researchers found that, after nine weeks of 20-minute treatment sessions, individuals who received the tailored acupuncture reported a 41% decrease in pain compared to 27% for the sham acupuncture group.
Interestingly, at a 12-month follow-up, the tailored treatment group still reported a 20% pain reduction from the study's beginning, as compared to 6% for the sham treatment group.
The NCCIH notes that one of the benefits of acupuncture is the low-side effect profile (when conducted by a credentialed acupuncturist using sterilized needles). Since medication for chronic pain often causes significant side effects, this makes acupuncture an attractive treatment option for people living with chronic pain.
Eastern vs. Western Acupuncture
If you are interested in trying to acupuncture for chronic pain, you should know that there are two broad types of practitioners.
First, they should be trained in Traditional Chinese Medicine Acupuncture and should have their certification accredited by a recognized professional body like the National Certification Commission for Acupuncture and Oriental Medicine.
Secondly, the school of acupuncturists practice Contemporary Medical Acupuncture based on western medical principles rather than balancing qi in the body. Often these practitioners are physiotherapists (physical therapists), naturopaths, or chiropractors who have received additional certification.
How Do You Decide Which Type of Practitioner to See?
TCM acupuncturists will treat from a whole-body perspective and may offer new insights or see connections other medical professionals have not. Contemporary medical acupuncturists are probably most effective at treating localized problems.
For example, my physiotherapy sessions have become more effective at relieving neck and low back muscles spasms since my therapist began incorporating acupuncture. My TCM acupuncturist has helped me reduce my overall pain and fatigue.
I have to add that TCM acupuncturists are much more adept at inserting needles painlessly — after all, this is their area of expertise!
In my own experience, there is a wide variation in the skill level and bedside manner of acupuncturists. For that reason, it is important to do your research and come prepared with a list of questions:
- Research the practitioner you are considering. Ensure they have a recognized certification.
- Ensure the clinic has a clean needle policy. All needles should be pre-packaged, sterilized and unused. (I have never come across a clinic that does not do this, but better to be safe than sorry!)
- Contact the clinic and ask whether they have experience treating clients who have similar chronic pain conditions. Do not go to a spa or aesthetician for pain treatment!
- Ask that they provide extra pillows to support your body while lying down. You’ll also need a treatment table with a head cradle (an oval opening for face support when you are lying on your stomach, so you do not need to turn your head to the side).
- Ensure they provide you with a way to call for assistance. It is uncomfortable to move while needles are inserted, so it is imperative that you can get help. The clinic should be able to provide you with a button to push to summon assistance or someone who can hear you easily.
- Tell the practitioner if this is your first time receiving acupuncture and ask that they only use 5 to 10 needles so you can test how your body will respond. There is no need to trigger a flare by starting with aggressive treatment.
- You may be offered additional treatments, like acupuncture with a mild electric current, cupping (using suction cups) or moxibustion. Make sure all your questions are answered before you start and always trial the treatment the first time. Once, I agreed to have my entire back suction cupped, and I had the pain and bruises for days afterward. If I had only allowed a small area to be cupped, I could have realized this treatment was not for me without the suffering!
- Just like with anyone who is a part of your treatment team, it is important to make sure you get along. Also, ensure they provide patient-centered care.