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Complementary and Alternative Medicine: Fair and Balanced

Acupuncture: When is it likely to work for you?

The patient says "Doctor, it hurts when I do this."  "Then don't do that!" Henny Youngman

By John Russo Jr./Vicus.com

VICUS.COM (21 Aug. 2000) -- Are you in pain? There is a good chance the answer is yes, as more than 50 million Americans suffer from chronic pain (including more than 20% of Americans over age 60), and nearly 25 million more experience acute pain each year due to injuries or surgery. 

Headache and lower back pain are the most common types of pain in the United States. What's more, only an estimated one in four of those with pain receive proper treatment, according to the American Pain Foundation.

Never ignore pain

If your pain is persistent, don't let anyone convince you that your pain is trivial. Pain is the body's way of letting the brain know there is something wrong. Ignoring pain is like going through a red traffic light. There is trouble ahead if you ignore the signal.

The first step in managing pain is to identify the cause or the source of the pain. If the pain is persistent, visit a comprehensive pain management center for an evaluation. Most pain syndromes can be managed effectively at a good pain center, where they understand pain and how to manage it using an integrative approach to treatment.

For many people, acupuncture contributes to pain relief.

What should I expect from acupuncture as a treatment for pain? 

Most of the 15 million Americans who use acupuncture use it to achieve analgesia, or pain relief. And, since pain is the main complaint among people with arthritis, acupuncture has found a role in the management of a wide variety of arthritic conditions, including osteoarthritis, rheumatoid arthritis, fibromyalgia, gout and Raynaud's phenomenon.  

How does it work? 

Acupuncture appears to stimulate the release of endorphins and enkephalins, the body's natural painkillers. In fact, acupuncture seems to be able to influence the production and distribution of many neurotransmitters (substances that send nerve impulses to the brain) and neuromodulators (substances produced by nerves that influence the action of the neurotransmitters). All of this alters the perception of pain.  

When to consider acupuncture 

A comprehensive list of conditions in which acupuncture is considered one method of alternative treatment (based on available information) is presented in the table. Evidence for acupuncture's effectiveness in these conditions varies from good (morning sickness) to sketchy (TMJ pain) to poor (certain gastrointestinal disorders). 

The list below is based on recommendations from an expert panel that reviewed alternative therapies for more than 80 conditions. The panel's recommendations are not meant to suggest that acupuncture should be used in place of traditional medical treatment, or that it will be equally effective from one condition to another (Pelletier, 2000). Rather, acupuncture should be viewed as complementary to traditional medicine, as well as other alternative therapies. 

Henny Youngman had it half right 

It makes sense to follow Henny Youngman's advice. If it hurts when you do "this," then don't do it; but if your pain persists, take action. 

Find a reputable health-care practitioner to assess your condition. Some chronic pain sufferers may find help at a comprehensive pain management center. Remain involved and responsible in your care and work with appropriate health-care providers to identify the cause of your pain, and then to select and implement the prescribed treatment that will help you feel well again.

  

John Russo Jr., PharmD, is senior vice president of medical communications at Vicus.com. He is a pharmacist and medical writer with more than 20 years of experience in medical education.


References:

American Pain Foundation.
http://www.painfoundation.org/ 

Bratman S. The Alternative Medicine Ratings Guide: An Expert Panel Ranks the Best Treatments for Over 80 Conditions. Rocklin (CA): Prima Health; 1998. 

Ezzo J, Berman B, et al. Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain. 2000 Jun; 86(3):217-25. 

Horstman J. The Arthritis Foundation's Guide to Alternative Therapies. Atlanta (GA): Arthritis Foundation; 1999. 

Lee TL. Acupuncture and chronic pain management. Ann Acad Med Singapore. 2000 Jan; 29(1):17-21. 

Rusy LM, Weisman SJ. Complementary therapies for acute pediatric pain management. Pediatr Clin North Am. 2000 Jun; 47(3):589-99. 

The Burton Goldberg Group. Alternative Medicine: The Definitive Guide. Fife (WA): Future Medicine Publishing; 1994.