ACUPUNCTURE - Getting to the point,
by Dr Clare Thornley

Acupuncture is growing in popularity, with nearly one in ten people attending an acupuncturist at some time in their life. What is more, it is gradually gaining scientific and medical approval as we discover more about how it works. Some hospital pain clinics now include acupuncture in their range of treatments, and doctors and physiotherapists are increasingly being trained in this technique.
A large UK study showed that more than two-thirds of patients treated with acupuncture were very pleased with their results. Many were able to reduce or stop their usual medication and, of the remaining third, most experienced at least some benefit.
Of course, like every medical treatment, acupuncture has its strengths and weaknesses. It won’t work for everyone, and it isn’t a cure-all for every known disease. But when it does work – sometimes when everything else has failed - the results can be extraordinary.

So what happens and does it hurt?
After taking a medical history and conducting any physical examination that is needed, the acupuncturist will insert a number of very fine needles (bearing no resemblance in size or appearance to those used for taking blood or for giving injections – honestly!) into various areas of the body. Some may be around the problem area, while others may not.
Some people feel little or nothing when the needles are inserted. Others experience some mild discomfort when they enter the skin. But it is rare indeed for a patient to discontinue a course of treatment because they cannot tolerate it.
Once in place, the needles are left for anything from a few minutes to half and hour. The length of time depends on how sensitive the patient is, and the nature of the problem. So does the number of treatment sessions any individual requires, though the average is around five or six.
Treatments are usually given once, sometimes twice a week. Some people start to notice a change straight away, but most will take at least a couple of weeks. Some problems benefit from regular maintenance treatment, but most people who respond will find they only need a “top-up” from time to time, if at all.

How does acupuncture work?
There is no simple answer to this, because we are still learning. Traditional Chinese Medicine (TCM) sees the body as comprising a series of channels (meridians) of energy (known as qi – pronounced “chi”), which become interrupted by disease. There are various associated theories, but TCM aims to cure the underlying disease by relieving these blockages of energy.
Interestingly, it is now possible to explain many of the effects of acupuncture from a Western scientific standpoint, and much of the evidence points to acupuncture working principally via the nervous system.
For example, in 2006, a BBC2 television programme which involved scientists investigating different branches of complementary medicine, found that when volunteers had acupuncture needles deeply inserted, MRI brain scans showed definite changes in the area governing pain. The scientists were surprised to find that this area was deactivated by acupuncture.
In addition, there seems to be a second mechanism for the pain-relieving and relaxing properties of acupuncture. Research has shown that the insertion of the needles stimulates a release of the body’s own natural painkillers and tranquillisers – our own opium-like substances, called endorphin, encephalin, serotonin, and many others.

CASE STUDY A case of back pain Margaret, a 36 year-old civil servant, had had four years of constant back pain and sciatica. Although traction and physiotherapy had helped a little, pain had kept her out of work for 12 months. Unable to do housework, exercise, or get a decent night’s sleep, she was, understandably, worn down.
Margaret was worried at the prospect of needles, but was relieved to find that she could tolerate the treatment easily. A few days after the first session, her pain slowly started to improve. After four weeks she was back swimming and was sleeping through the night. She returned to work part-time a month later, and opted to continue her acupuncture once a month for the next six months. The following year, she returned and had successful treatment for her sinuses.

So what is it good for?
Unlike conventional medicines, it is difficult to conduct research into the success of acupuncture, but positive trials have now been published in well-respected medical journals like the British Medical Journal and The Lancet. These studies point to a significant benefit for people suffering from chronic back pain, headache, osteoarthritis of the knee, and infertility. Most acupuncturists will probably agree that these are the conditions that respond most rapidly and reliably to treatment.
Of course, there are many other health problems that seem to benefit from acupuncture. These include period pains, irritable bowel, overactive bladder, tennis elbow, neck and shoulder pain, sinus problems, hay fever, and post-shingles pain. Due to a lack of research, the scientific jury is still out on their effectiveness, but who knows - perhaps more positive studies are just around the corner?

What about safety?
In trained hands, acupuncture is very safe indeed, with the use of single-use disposable needles now almost universal in the West. Doctors and physiotherapists will normally be registered with their own regulatory bodies and must be properly trained in acupuncture before they practise it. There is, as yet, no statutory registration for non-medically qualified practitioners. However the HSE has encouraged the three largest acupuncture organisations in the country to form the Acupuncture Council of Ireland, which will regulate and supervise the training and standards of its members. As this is a work in progress, you may find other well-qualified practitioners who are registered with other organisations. If in any doubt, always ask about qualifications, registration and insurance.
I might add that anyone who, on a whim, wanders off a city street into an acupuncture practice, allows themselves to be talked into buying - in advance - 10 sessions of unspecified treatment, and ends up being sold an expensive pot of herbs into the bargain, clearly hasn’t been doing the required homework!

A lifetime of migraine
Siobhan, a 50-year old housewife and mother of four, could not remember when her migraines had started. Certainly by her midtwenties she was having around two or three every month, each lasting several days and interfering with her family and social life. Over the years, she had tried all the usual drug treatments, but none had worked for her for long. Siobhan attended for five sessions of acupuncture at weekly intervals, and one more a month later. Remarkably, she then suffered no migraine attacks at all for two years. When they returned following a sinus infection, another course of treatment put her back on track.

CASE STUDY
A stressful time
Jim, a 40-year-old teacher, hoped that acupuncture would help him cope with the stress and depression he had suffered for two years since his parents’ death. Unknown to his family, he was taking an antidepressant, but wasn’t sure it was helping. He felt tense and anxious all the time. Sometimes his body would shake and he was troubled by frequent muscle spasms.
Although not one of the minority who experiences instant relaxation from acupuncture, he nevertheless soon began to feel calmer, and the muscle spasms diminished. As he improved, he was able, with his GP’s agreement, to reduce and stop the antidepressant. After three months, and eight sessions of acupuncture, Jim felt like a new man.

Can you give blood after acupuncture?
That depends. If the acupuncturist is a registered medical doctor, a doctor’s nurse or a chartered physiotherapist, they can issue a signed certificate to confirm this, and you can donate blood straight away. Otherwise, the Blood Transfusion Service insists that you wait six months from the date of your last acupuncture treatment.

Common myths
You need to believe in it for it to work. Not true. Research trials have shown that neither the person administering the acupuncture, nor the one receiving it, has to be a “believer”. Of course, as with any treatment, having trust in one’s practitioner is vital. Acupuncture is just a placebo. Although there is a placebo element to every type of medical treatment (research has even confirmed that red pills work better than white ones), there is now ample evidence that acupuncture is more than just a placebo.

Four six-million-dollar questions...
Will it help me stop smoking?
Smokers often ask whether acupuncture can help them give up the dreaded weed. There is evidence that it might well be of benefit as part of a broader treatment programme, with several sessions being more effective than just one or two. As with any addiction, education, support and counselling are an essential component of the treatment - along with will power, of course!

So how does acupuncture help stop smoking?
It has been used experimentally in drug addiction treatment centres, and researchers think that it probably reduces withdrawal symptoms and cravings by stimulating feelings of relaxation and calm.
Will it help me lose weight?

If you want to slim down, you just can’t beat the combination of adopting a healthier, whole food diet, and taking more, regular exercise. If strapped for cash, your money might be better spent on a twiceweekly Weight Watchers-type programme and a subscription to the local gym. However, if you’re doing all that anyway, and getting stressed out about it, acupuncture might help you chill out and relax (before you head off back to the treadmill).

Will it help stress?
That rather depends. Obviously, acupuncture can’t give you a less pressured job, persuade your family to help out more round the house, or turn down the neighbours’ loud music. And if you’ve always been a tense sort of person, then it probably won’t change that either (although you might be amazed at what you can achieve with a daily relaxation or meditation technique).
But you’ve already read in this article about the calming, relaxing, sedative properties of acupuncture. Some people respond better than others, so if you’re one of these, you may well find a few sessions of acupuncture beneficial if you’re feeling strung out. Many people report improved sleep after acupuncture, so it makes sense that it can also be used to treat insomnia.

Can it give me a facelift?
So-called cosmetic acupuncture is certainly not a quick fix. Since it takes decades of stress, sun damage and exposure to environmental toxins - mainly from cigarette smoking - for your skin to reach a state of crisis, it makes sense that the damage will not be undone overnight. However, the American Cosmetic Acupuncture Association believes that cosmetic acupuncture may offer the reduction or erasure of fine lines and the softening of deeper ones, with some clients reporting enhanced skin tone. Those who offer this service - and I don’t - usually recommend a course of 10-12 treatments followed by long-term regular top-ups.


How can you be sure that acupuncture will work for you?
Well, you probably can’t until you’ve tried it, but an experienced practitioner should be able to give you an idea of their success rate for your type of problem. As they say: nothing ventured, nothing gained.

USEFUL CONTACTS
The British Medical Acupuncture Society
www.medical-acupuncture.co.uk
Acupuncture Council of Ireland (TCMCI)
www.tcmci.ie

Dr Clare Thornley, runs an acupuncture and homeopathy clinic on Forth Mountain, near Wexford town. Until recently a practising GP, her main areas of interest are women’s health, stress, and pain relief. She is a qualified member of the Faculty of Homeopathy (MFHom) and the British Medical Acupuncture Society (DipMedAc). Her CD “Relaxation Made Easy” is available from the clinic. dr.clare.thornley@gmail.com