Brief Research Notes: Medical Acupuncture

Medical Acupuncture

Medical Acupuncture

Brief Research Notes

People often assume that acupuncture is synonymous with Traditional Chinese Medicine and that anyone who uses acupuncture does so based on 'qi' or 'meridians'. This is a misconception. Regardless of its theoretical basis, based on the traditional and official definition, the term acupuncture refers to the actual insertion of a needle into the body (Fan et al. 2016).

Acknowledging that traditional narratives outdated, medical acupuncture is an approach that is based upon a theory that is inline current scientific understanding of how the body works. Reframing acupuncture form of peripheral nerve stimulation technique in which acupuncture needles are inserted into anatomically defined sites, and stimulated manually or with electricity (White 2009).

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.

Is Acupuncture a Placebo?

The way we present ourselves and present our techniques is tied to clinical outcomes, the magnitude of a response may be influenced by mood, expectation, and conditioning. In any discussion on therapeutic effect it is important to acknowledge the placebo response (Kong et al. 2013).

It is also a within the realm of possibility that when acupuncture needles are inserted into anatomically defined sites, and stimulated manually or with electricity patients have a complex biopsychosocial response that INCLUDES but is not LIMITED to placebo. Several plausible theories attempt to explain how acupuncture works, this includes but is not limited to:
• The Gate Control Theory of Pain (Melzack & Wall 1984)
• The Release of Endogenous Opioids (Chen et al. 2017Yin et al. 2017 )
• The Release of Endogenous Cannabinoids (Gao et al. 2017McPartland et al. 2014Hu et al. 2017)
• Purinergic Signaling (Sawynok 2016Tang et al. 2016)
• Interactions Between Non-Neuronal Cells and Neurons (Ji et al. 2016Zhang et al. 2014)
• The Inflammatory Reflex (Chavan et al. 2014Lim et al. 2016Pavlov et al. 2017)
• Neuroplastic Changes Across Different Areas of the Peripheral and Central Nervous System (Maeda et al. 2017)
• Sensory-Discriminative and Affective-Social Touch (Chae et al. 2017)
• Mesenchymal Stem Cells (Salazar et al. 2017
• Downregulation of Pronociceptive Mediators (Qiao et al. 2017)
• Polarisation of M2 Macrophages (da Silva et al. 2015Zhao et al. 2017)
• Local Nitric Oxide Release (Ma et al. 2017)

More to Explore

Chae, Y., Olausson, H. (2017). The role of touch in acupuncture treatment. Acupunct Med.

Chavan, S. S., & Tracey, K. J. (2014). Regulating innate immunity with dopamine and electroacupuncture. Nature Medicine.

Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.

da Silva, M.D., Bobinski, F., Sato, K.L., Kolker, S.J., Sluka, K.A., Santos, A.R. (2015). IL-10 cytokine released from M2 macrophages is crucial for analgesic and anti-inflammatory effects of acupuncture in a model of inflammatory muscle pain. Mol Neurobiol.

Fan, A.Y., He, H. (2016). Dry needling is acupuncture. Acupunct Med.

Gao, F., Xiang, H.C., ... Li, M. (2017). Electroacupuncture Inhibits NLRP3 Inflammasome Activation through CB2 Receptors in Inflammatory Pain. Brain Behav Immun.

Hu, B., Bai, F., Xiong, L., Wang, Q. (2017). The endocannabinoid system, a novel and key participant in acupuncture's multiple beneficial effects. Neurosci Biobehav Rev.

Ji, R.R., Chamessian, A., Zhang, Y.Q. (2016). Pain regulation by non-neuronal cells and inflammation. Science.

Kong, J., Spaeth, R., ... Kaptchuk, T.J. (2013). Are all placebo effects equal? Placebo pills, sham acupuncture, cue conditioning and their association. PLoS One.

Lim, H., Kim, M., Lee, C., & Namgung, U. (2016). Anti-Inflammatory Effects of Acupuncture Stimulation via the Vagus Nerve. PLoS ONE

Ma, S.X., Lee, P.C., Anderson, T.L., Li, X.Y., Jiang, I.Z. (2017). Response of Local Nitric Oxide Release to Manual Acupuncture and Electrical Heat in Humans: Effects of Reinforcement Methods. Evid Based Complement Alternat Med.

Maeda, Y., Kim, H., Kettner, N., Kim, J., Cina, S., .... Napadow, V. (2017). Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain.

Mcpartland, J. M., Guy, G. W., & Marzo, V. D. (2014). Care and Feeding of the Endocannabinoid System: A Systematic Review of Potential Clinical Interventions that Upregulate the Endocannabinoid System. PLoS ONE.

Melzack, R., Wall, P.D. (1984). Acupuncture and transcutaneous electrical nerve stimulation. Postgrad Med J.

Pavlov, V.A., Tracey, K.J. (2017). Neural regulation of immunity: molecular mechanisms and clinical translation. Nat Neurosci.

Qiao, L.N., Liu, J.L., Tan, L.H., Yang, H.L., Zhai, X., Yang, Y.S. (2017). Effect of electroacupuncture on thermal pain threshold and expression of calcitonin-gene related peptide, substance P and γ-aminobutyric acid in the cervical dorsal root  ganglion of rats with incisional neck pain. Acupunct Med.

Salazar, T.E., Richardson, M.R., Beli, E., ... Grant, M.B. (2017). Electroacupuncture Promotes CNS-Dependent Release of Mesenchymal Stem Cells. Stem Cells.

Sawynok, J. (2016). Adenosine receptor targets for pain. Neuroscience.

Tang, Y., Yin, H., Rubini, P., & Illes, P. (2016). Acupuncture-Induced Analgesia: A Neurobiological Basis in Purinergic Signaling. The Neuroscientist.

White, A. (2009). Western medical acupuncture: a definition. Acupunct Med.

Yin, C., Buchheit, T.E., Park, J.J. (2017). Acupuncture for chronic pain: an update and critical overview. Curr Opin Anaesthesiol.

Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014). Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain. Anesthesiology. (OPEN ACCESS) 

Zhao, J., Wang, L., Li, Y. (2017). Electroacupuncture alleviates the inflammatory response via effects on M1 and M2 macrophages after spinal cord injury. Acupunct Med.