Acupuncture - what is it?

Written by: 
Richard Thomas, medical writer

This page looks into the history and traditions of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points., along with its integration into Western medicine. See the page outlining its uses.

Acupuncture is the ancient Chinese art of healing by inserting very fine needles into the body at specific points and stimulating the needles to regulate the body's self-healing processes.

Stimulation involves gently moving the needles from side to side; applying a very mild electric current to them (electro-acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points.) or heating them by burning a special herb attached to them (moxibustion).

The origins of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. date back around 5000 years. Acupuncture is generally thought to have grown out of the older Chinese practice of acupressure. Both acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. and acupressureA complementary therapy derived from acupuncture, which uses finger pressure rather than the fine sterile needles used in acupuncture. are part of a therapeutic discipline known as Daoyin that also incorporates breathing exercises, stretching and massage.

If you are considering acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points., points of interest and concern include:

Acupuncture and Traditional Chinese Medicine

In the 6th century AD acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. was introduced from China into Japan. Documents from this period describe acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. as part of a comprehensive system of healing. This system is today known as Traditional Chinese Medicine (TCM).

TCM includes herbalism (treating ailments with plants and plant extracts), therapeutic bodywork, exercising, breathing techniques and dietary measures. The word acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. itself was invented in Europe in the late 17th century, and derives from Latin words meaning 'prick with a needle'.

Central to TCM, and therefore to acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points., is the belief that the human body has an innate ability to heal itself, coupled with a coherent pattern of subtle energy pathways ('meridians') said to distribute energy (in Chinese qi, pronounced 'chee') throughout the body.

The concept of qi, though unrecognised in modern scientific medicine, is fundamental in TCM. Qi energy is associated with 'life force'.

Related concepts include yin (the female principle associated with passivity and the earth) and yang (the male principle, associated with action and the heavens): yin and yang are the principles of balance and are said to act throughout the universe. When they are unbalanced in the body, this can cause disease or physical problems.

The connection of yin and yang with illness is closely related to qi. In TCM, illness may be caused by an imbalance of yin and yang or by a deficiency of qi or 'life force'.

Another key idea is that of the 'Five Elements' (of wind, water, earth, fire and metal) that are believed to make up the body and to be influenced by the same elements in the natural world.

The aim of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. in this complex ancient system is to trigger the body's self-healing processes by unblocking or re-balancing the perceived free flow of qi. Practitioners believe that only when qi flows freely and harmoniously around the body can the body fully function as it should, thus removing the causes of illness.

How a traditional Chinese acupuncturist works

The traditional Chinese acupuncturist conducts a comprehensive 'whole body' diagnosisThe process of determining which condition a patient may have. of an individual and then decides into which one or more of roughly 350-360 'acupoints' (tsubo in Chinese) to insert needles. Various sources list anything between 349 and 365 acupoints.

The practitioner will sometimes vary needling with techniques such as burning powdered mugwort over a point (moxibustion) or attaching a small jar to a point by creating a vacuum inside it (cupping). Another variation using points on the ear, known as 'auricular therapy', is said to be particularly effective in treating addictions.

Attitudes to acupuncture in Western medicine

Acupuncture has had a mixed reception among medical researchers. It was widely practised in the second half of the 20th century by many Western-trained doctors who developed what they called 'medical acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points.' - acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. without the Chinese philosophy.

Medical acupuncturists reject the idea of qi in favour of a variety of possible scientific explanations for the apparent effectiveness of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points.. One of these explanations suggests that needling blocks pain signals to the brain and triggers the release of the body's natural pain-killers; another proposes that needling creates a small electric current (known as a 'piezo current') in the body's connective tissue A group of cells with a similar structure and a specialised function.(fascia) and that this promotes the healing process.

Recent clinical trials of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. have often not been conclusive, although the therapy remains popular in Western countries-and is still widely practised in many eastern countries.

Use of acupuncture to treat conditions

Some practitioners claim that acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. is beneficial in treating ailments ranging from nausea, pain, fatigue and insomnia to addictions, asthma, osteoarthritisA disease mainly of the large joints of the body, as a result of wear and tear of the surface cartilage. and bowel problems. Medical research has yet to confirm many of these claims.

However, encouraging clinical trial results led the US National Institutes of Health (NIH) in 1997 to approve the use of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. for treating various types of pain, including long-term (chronicA disease of long duration generally involving slow changes.) pain and osteoarthritisA disease mainly of the large joints of the body, as a result of wear and tear of the surface cartilage., and for nausea and vomiting, including that caused by cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. treatments.1

In May 2009 the British National Institute for Health and Clinical Excellence (NICE) announced that it supported acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points., among other complementary therapies such as chiropractic, over drugs for the treatment of back pain.2

The World Health Organization (WHO) has not officially sanctioned the use of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points., calling for more research into it. Its 2008 Beijing Declaration, however, placed traditional medicine at the centre of its new global strategy on public health, and cited acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. as an example of a traditional therapy that has a potentially major part to play in future world healthcare.3

Not all trials, however, have shown clear benefits. For example, the official view of the NIH is that research on the effectiveness of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. for treating conditions such as ulcerative colitis and Crohn's disease has been 'promising but not conclusive'.

Find out more about the uses of acupuncture.

Safety, side-effects and cautions

There is generally regarded to be little danger in acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. when it is performed by a properly trained practitioner using good-quality, sterile needles.

Acupuncture needles are extremely fine and specially made of stainless steel or a sterile alloy. They should always be discarded after one use to avoid the risk of infectionInvasion by organisms that may be harmful, for example bacteria or parasites..

Practitioners who re-use needles risk transmitting serious infections, including HIV and hepatitis, even if the needles have been sterilised between uses.

The insertion of the needles is quick and rarely causes discomfort. Most people describe a sort of dull or slightly numb sensation at first, followed by a feeling of relaxation. The practitioner's quality of training and level of skill is of paramount importance.

Where pain or a problem such as bleeding, bruising or actual injury has occurred, this has tended to be because the acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. practitioner was not skilful enough.

Some people also have a natural sensitivity or aversion to needles that can cause nausea or fainting.

Selecting and seeing a practitioner

The practice of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. around the world varies enormously. In some countries, including most of those with a regulated medical profession, it is illegal to practice acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. without a medical or nursing qualification.

Unfortunately a medical qualification is no guarantee of skill or ability in acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points.. Likewise, non-medical practitioners operate unofficially in many countries, but there are few safeguards to protect against unsafe or unqualified practice.

Three important tips that are worth remembering when selecting an acupuncturist are:

  • Check that the practitioner is a member of a recognised professional body in the country you are in. This may not necessarily be a medical body.
  • Make sure that the practitioner uses disposable needles that are thrown away after a single use.
  • Ask around. Word-of-mouth recommendation is often a good guide.

The practice of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. has divided between the traditional Chinese way and the Westernised scientific version. The two approaches are so different that it is almost impossible to compare them.

The Chinese approach involves a system of individualised diagnosisThe process of determining which condition a patient may have. and treatment far removed from conventional Western medical practice.

It is possible to find practitioners trained in both traditional Chinese and Western methods of acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points. in China itself, but they are rare outside it.

In the end any choice between these systems has to be one of personal preference.

References: 
  1. 'Acupuncture.' NIH Consensus Statement. Anonymous. 11 March 1997; 15(5): 1-34.2.
  2. 'Low back pain: early management of persistent non-specificHaving a general effect. low back pain.' Full guideline. NHS National Insitute for Health and Clinical Excellence. May 2009. Link
  3. 'Address at the WHO Congress on Traditional Medicine.' Dr Margaret Chan, Director-General of the World Health Organization. 7 Nov 2008. Link