How does Acupuncture work to Relieve Pain?

Acupuncture is a therapeutic procedure known for many thousands of years since the Han Dynasty in the Chinese history. It is a traditional Chinese medicine method used to promote natural healing of the body and improve health in a holistic way. It is done by puncturing the skin at different points using very small needles (thinner than hair strands), and sometimes applying heat, or electrical stimulation to these needles.

But, how does it work to relieve pain?

Acupuncture basics

The trigger points in acupuncture are known as acupuncture/acupressure points. Meridians are the pathways between the acupuncture points, which are connected by the flow of energy, called ‘qi’ (pronounced as chee or chi). These points also connect to the internal organs through different meridians.

Acupuncture is now a very well-known procedure, not only in China but also in the Western world. During the current era of scientific knowledge, research, and experimentation has led to the widespread use of acupuncture for different diseases. Its general uses include improving general health, alleviating pain, management of chronic illnesses, cancer, headache and migraines, arthritis, stress, anxiety, depressive disorder, and to improve menstrual health in women.

How does acupuncture work?

Needles are inserted at the acupuncture points. These points contain higher concentration of cutaneous nerves, blood vessels, and neuromuscular attachments. This puncturing produces a stimulus in the form of signaling cascades which leads to local effects at the local point of puncture, and central effects in the brain and spinal cord.

The ultimate result of acupuncture, as explained by Chinese medicine masters, is an enhanced homeostasis and self-healing. This is done by increasing the blood flow locally, favoring a correct distribution of nutrients and hormones through the blood, removing waste products more efficiently, and strengthening the immunity of the patients.

Central effects of acupuncture include improvement in the Hypothalamus Pituitary Adrenal Axis, activation of the endogenous analgesic system, and augmented stress and emergency response.

Does it work for joint pain?

Arthralgia is the medical term used to describe joint pain. It can occur due to varying number of conditions, including infection of the joints, crystal deposition, as a consequence of aging or as a part of a degeneration process or trauma. The source of pain can be the joint capsule, periosteum, subchondral bone, ligaments, and synovium. Pathology of the structures around the articulations may also produce pain, including the bursa, tendon sheath, tendons, and the insertion point of tendons and ligaments, called enthesis.

According to studies, joint pain patients can find significant relief in acupuncture. The results are varied, but even patients with inflammatory and auto-immune joint pain report feeling relaxed and improve their quality of life with acupuncture. That’s why most Western doctors are not against this technique and will be open to try it as an option if the patient is willing to.

Acupuncture for Chronic Pain

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Role of acupuncture in analgesia

Pain is an unpleasant feeling that results from the activation of certain sensory neurons in the skin. These neurons transfer pain signals to the central nervous system, especially the cerebral cortex through multiple synapses. The cause of pain is primarily an inflammatory process, resulting from trauma, infection, or a deviation from normal homeostasis.

There are many explanations that help us understand how acupuncture helps reduce the symptoms of pain. One of the possible mechanisms is through the activation of touch sensory system by inserting needles. In response to these sensory signals, our central nervous system is instructed to release certain chemical substances such as endorphins and enkephalins. These chemical substances are also known as natural/endogenous opioids and they form the endogenous analgesic system of our body. These mediators work as neurotransmitters and stop the pain pathway by inhibiting the synaptic transmission of those neurons which are responsible for carrying pain signals.

Acupuncture applied over the articulations can increase the blood supply to the joints. Increased blood flow provides better nutrition, supplies more oxygen, and leads to early healing in the case of fracture and prevention of degenerative process in other forms of joint pain. Another advantage of increased blood flow is a subsequent improvement in the removal of waste products from the tissues.

Acupuncture enhances the hypothalamus pituitary adrenal axis, leading to improved cortisol levels in the blood. This allows an improved adaptation of patient to the fight and flight situation during stressful conditions.  Cortisol is an anti-inflammatory hormone and its increased levels affects immune system of our body. Overactivated immune system causes damage to our body, as we can see in autoimmune diseases. A temporary rise of cortisol decreases the inflammatory response of our immune system, and the damage caused by a hyperactive immunity is prevented, promoting recovery and analgesia.

The Remarkable Way Acupuncture Can Relieve Pelvic Pain

Acupuncture and joint pain

Acupuncture can work for many causes of joint pain. For example:

  • Rheumatoid arthritis: Acupuncture helps relieve pain in RA by decreasing the inflammatory process. Other factors include improved blood supply, stabilized/inhibited hyperactive immune system, and endogenous analgesic system.
  • Osteoarthritis: Better blood supply relieves stiffness in the joints and decreases pain. The increased supply of nutrients through the blood aids in the delay and prevention of the degenerative processes in the joints. Pain is also reduced as a result of an improvement in the inflammation process.
  • Gouty arthritis: Increased blood flow might assist in the increased removal of waste products and decrease inflammation. Endorphins released in acupuncture sessions may also help to decrease pain.
  • Traumatic/mechanical joint diseases: Acupuncture improves healing through increased blood flow in patient with fractures. Other advantages of acupuncture in trauma patients include prevention of post traumatic arthralgia and stiffness.
  • Backache: Back pain of joint origin may be due to Enthesitis, and muscular pain of the back muscles. Analgesia provided by acupuncture in these patients is also because of anti-inflammatory function of acupuncture and better nutrient supply through the blood.
  • Infectious arthritis: Improved immunity, good response to stress situations, and endorphins help alleviate pain due to infectious arthritis.

Modern acupuncture has taken this millenary approach and studied its effectivity through clinical trials. Instead of reducing the weight of acupuncture, the evidence so far supports this technique, especially for patients with chronic health issues that include joint pain, hypertension, anxiety, and cancer. Now, it is easier than ever to find truly skilled acupuncturists who are licensed to work as such and provide an effective and safe treatment for patients with joint pain and other pathologies. If you are interested in taking Acupuncture treatment in the UK click here.

References:

Manheimer, E., Cheng, K., Linde, K., Lao, L., Yoo, J., Wieland, S., … & Bouter, L. M. (2010). Acupuncture for peripheral joint osteoarthritis. Cochrane database of systematic reviews, (1).

Manyanga, T., Froese, M., Zarychanski, R., Abou-Setta, A., Friesen, C., Tennenhouse, M., & Shay, B. L. (2014). Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC complementary and alternative medicine14(1), 312.

Lee, M. S., & Ernst, E. (2011). Acupuncture for pain: an overview of Cochrane reviews. Chinese Journal of Integrative Medicine17(3), 187-189.

Wang, C., De Pablo, P., Chen, X., Schmid, C., & McAlindon, T. (2008). Acupuncture for pain relief in patients with rheumatoid arthritis: a systematic review. Arthritis Care & Research: Official Journal of the American College of Rheumatology59(9), 1249-1256.

White, A., Foster, N. E., Cummings, M., & Barlas, P. (2007). Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology46(3), 384-390.

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