What is Medical Acupuncture?
“The word acupuncture meaning ‘to prick with a needle’ was coined by Willem ten Rhyne. ”
The earliest detailed report on Chinese and Japanese medicine to be written by a European was by Willem ten Rhyne, a Dutch physician who published Dissertatio de arthritide in 1683 (Bivins 2001).
Following this lineage, the concept of medical acupuncture was pioneered by Felix Mann who began to view acupuncture as a form of peripheral nerve stimulation technique. In this approach needles are inserted into anatomically defined sites, and stimulated manually or with electricity.
Preferential sites for acupuncture stimulation are associated with areas rich in specialized sensory receptors such as muscle spindles, Golgi tendon organs, ligament receptors, Paciniform and Ruffini’s receptors (joint capsules), deep pressure endings (within muscle belly), and free nerve endings (muscle and fascia). All of these areas are highly innervated and as a result there are a number of physiological responses that help modulate the experience of pain.
Acupuncture Research Has Matured
In terms of complementary treatments more clinical practice guidelines, randomized controlled trials and systematic reviews now support the use of acupuncture as part of a multi-modal approach for patients suffering from common musculoskeletal symptoms including:
• Chronic pain (MacPherson et al. 2017, Vickers et al. 2017)
• Acute pain (Cohen et al. 2017, Jan et al. 2017, Murakami et al. 2017)
• Low back pain (Traeger et al. 2017, Wegner et al. 2017)
• Neck pain (Blanpied et al. 2017, Kjaer et al. 2017)
• Tension-type headaches (Busse et al. 2017, Linde et al. 2016)
• Migraines (Busse et al. 2017, Linde et al. 2016, Yang et al. 2016)
• Osteoarthritis (Busse et al. 2017, Lin et al. 2016, Woods et al. 2017)
• Postoperative Pain (Tedesco et al. 2017)
Mechanism of Action: Many clinicians explain the mechanism of action in neurophysiological terms.
If you use Occam's razor, the insertion of an acupuncture needle is a form of novel stimuli, that functions by sending anti-nociceptive input to the neuroimmune system. This contributes to a number of physiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brainstem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas (Chen et al. 2017).
More to Explore
Andronis L, Kinghorn P, Qiao S, Whitehurst DG, Durrell S, McLeod H. (2017). Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review. Appl Health Econ Health Policy.
Bivins, R. (2001). The needle and the lancet: Acupuncture in Britain, 1683-2000. Acupuncture in Medicine.
Blanpied, P.R., Gross, A.R., Elliott, J.M., Devaney, L.L., Clewley, D., Walton, D.M., Sparks, C., Robertson, E.K. (2017). Neck Pain: Revision 2017. J Orthop Sports Phys Ther
Busse, J.W., Craigie, S., Juurlink, D.N, ... Guyatt GH. (2017). Guideline for opioid therapy and chronic noncancer pain. CMAJ.
Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.
Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., ... Brodt, E.D. (2017). Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med.
Cohen, M.M., Smit, V., ... Cameron, P.A. (2017). Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Med J Aust.
Jan, A.L., Aldridge, E.S., Rogers, I.R., Visser, E.J., Bulsara, M.K., Niemtzow, R.C. (2017). Review article: Does acupuncture have a role in providing analgesia in the emergency setting? A systematic review and meta-analysis. Emerg Med Australas.
Kjaer, P., Kongsted, A., Hartvigsen, J., ... Povlsen, T.M. (2017). National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy. Eur Spine J.
Lin, X., Huang, K., Zhu, G., Huang, Z., Qin, A., & Fan, S. (2016). The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A Meta-Analysis. The Journal of Bone & Joint Surgery.
Lin, Y-C., Wan, L., Jamison, R.N. (2017). Using integrative medicine in pain management: an evaluation of current evidence. Anesth Analg.
Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Shin, B., . . . White, A. R. (2016). Acupuncture for the prevention of tension-type headache. Cochrane Database of Systematic Reviews.
Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Vertosick, E. A., . . . White, A. R. (2016). Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews.
MacPherson, H., Vickers, A., Bland, M., Torgerson, D., Corbett, M., Spackman, E., ..., Watt, I. (2017). Acupuncture for chronic pain and depression in primary care: a programme of research. Southampton (UK): NIHR Journals Library.
Millstine, D., Chen, C., Bauer, B. (2017). Complementary and integrative medicine in the management of headache. BMJ.
Murakami, M., Fox, L., Dijkers, M.P. (2017). Ear Acupuncture for Immediate Pain Relief-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Med.
Qaseem, A., Wilt, T.J., McLean, R.M., Forciea, M.A. (2017). Clinical Guidelines Committee of the American College of Physicians.. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med.
Robinson, N.G. (2016). Why We Need Minimum Basic Requirements in Science for Acupuncture Education. Medicines (Basel). (OPEN ACCESS)
Tedesco, D., Gori, D., Hernandez-Boussard, T. (2017). Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. JAMA Surg.
Traeger, A., Buchbinder, R., Harris, I., Maher, C. (2017). Diagnosis and management of low-back pain in primary care. CMAJ.
Vickers, A.J., Vertosick, E.A., Lewith, G., ... Linde, K. (2017). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain.
Wenger, H.C., Cifu, A.S. (2017). Treatment of Low Back Pain. JAMA.
Woods, B., Manca, A., ... Sculpher, M. (2017). Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLoS One.
Yang, Y., Que, Q., Ye, X., Zheng, G.h. (2016). Verum versus sham manual acupuncture for migraine: a systematic review of randomised controlled trials. Acupunct Med.
Yin, C., Buchheit, T.E., Park, J.J. (2017). Acupuncture for chronic pain: an update and critical overview. Curr Opin Anaesthesiol.
Zhao et al. (2017). The Long-term Effect of Acupuncture for Migraine Prophylaxis A Randomized Clinical Trial. JAMA Intern Med.