As this ancient form of alternative medicine grows in popularity, it is being considered as a viable treatment for a range of conditions, especially pain management.
According to Mayo Clinic, “traditional Chinese medicine explains acupuncture as a technique for balancing the flow of energy or life force—known as chi or qi (chee)—believed to flow through pathways (meridians) in your body. By inserting needles into specific points along these meridians, acupuncture practitioners believe that your energy flow will re-balance. In contrast, many Western practitioners view the acupuncture points as places to stimulate nerves, muscles and connective tissue. Some believe that this stimulation boosts your body's natural painkillers.”
While the scientific evidence of acupuncture’s benefits is still widely debated, there seems to be agreement with research from key western studies that suggest acupuncture can be used to manage certain pain conditions, especially back pain, neck pain, headaches, osteoarthritis and knee pain.
There are many documented cases of the successful application of acupuncture as an alternative treatment for pain. Heidi Boyson had suffered from chronic low-back pain for a decade when she tried acupuncture for the first time..
She’d already tried chiropractors, physical therapy, and medication. “Nothing worked.” “The acupuncturist put needles in my head, and I fell asleep, which was great. When I woke up, I was much more relaxed.”
After just one visit, Boyson says her pain became manageable. Acupuncture has a long history of relieving many forms of pain. However, many of acupuncture's mechanisms are still unknown and/or misunderstood.
The Western explanation: The needle stimulates a nerve, which sends a signal to the brain to release beta-endorphins. These chemicals work as the body’s own opioids, lowering pain thresholds.
One widely quoted study focused upon the importance of connective-tissue planes in and around acupuncture points. By cellular reorganization - changing cells in connective tissue around the pressure points in lasting ways - it leads to less pain.
There is also evidence, according to a study that investigated the functional involvement of acupuncture stimulation (AS) in the regulation of inflammatory responses, that stimulating the vagus nerve, which runs from the brain stem to the colon, may lower inflammation throughout the body. Inflammation is closely tied to chronic pain.
States are desperately looking to cut opioid prescriptions. As the opioid crisis grows, states are opening Medicaid to alternative medicine. Under intense pressure to combat the problem, states across the country are expanding their Medicaid coverage for acupuncture as another option for pain treatment.
When Vermont commissioned a small pilot study on acupuncture for chronic pain in its Medicaid population, it concluded that 32 percent of people taking opioids for pain cut back. They were eligible for up to 12 treatments over two months.
The Centers for Medicare & Medicaid Services (CMS) has announced that Medicare will now cover acupuncture for patients with chronic low back pain in part because of the widespread abuse of opioids in America. Medicare will now cover up to 12 sessions in 90 days with an additional 8 sessions for those patients with chronic low back pain who demonstrate improvement. Until now, acupuncture was not covered by Medicare.
“Expanding options for pain treatment is a key piece of the Trump Administration’s strategy for defeating our country’s opioid crisis,” US Department of Health and Human Services (HHS) Secretary Alex Azar said in a statement.
“While a small number of adults 65 years of age or older have been enrolled in published acupuncture studies, patients with chronic low back pain in these studies showed improvements in function and pain. The evidence reviewed for this decision supports clinical strategies that include non-pharmacologic therapies for chronic low back pain,” CMS reported.
Pain medications, including opioids, often have limited efficacy and may impose unwanted adverse effects. These limits explain the Department of Defense and the Veterans Administration's interest in nonpharmacologic interventions including acupuncture.
The U.S. Department of Veterans Affairs has trained more than 2,800 providers of “battlefield acupuncture,” a protocol that involves the ear to relieve pain. According to Dr. Charles Levy at the Gainesville VA center in Florida, the protocol has helped with headaches, acute and chronic back and musculoskeletal pain, and neuropathic pain.
Chronic pain is a serious problem for combat veterans and soldiers. In a sample of 2597 soldiers who had served in Afghanistan and Iraq, 44% reported pain lasting for more than 3 months, half of whom reported pain for 1 year or more.
Pain medications, including opioids, often have limited efficacy and may impose unwanted adverse effects. These limits explain the Department of Defense and the Veterans Administration's interest in nonpharmacologic interventions including acupuncture. As traditionally practiced, acupuncture involves a complex assessment and individualized treatment by trained providers (300 hrs required for physicians), which are barriers to widespread implementation in military and veteran settings.
Besides obvious questions regarding the mechanisms of action, the comparative efficacy, and duration of effects, Acupuncture presents an opportunity to study the adaption and implementation of this most fascinating complementary technique into traditional western practice. If the promise of acupuncture holds true, it will add an important treatment option in western medicine’s arsenal to treat acute and chronic pain.