Acupuncture is the gentle insertion of thin needles into specifically targeted areas of the body. Its origin extends 2500 years as an integral tenant of Traditional Chinese Medicine (TCM). Today, however, its theory and practice have evolved beyond classical application towards effective pain management.
Under the TCM umbrella, needle locations are selected based on meridians, each corresponding to a specific organ system. Every point has a theoretical indication and effect. Current theories and supportive research step away from organ pairings and energetic meridians, especially when it comes to the art of pain management. Under this scope, acupuncture points are selected and targeted according to anatomical locations, affected nerve roots and trigger point palpation. In other words, acupuncture is used to target the physical root and origin of pain. For example, in the treatment of Sciatica, acupuncture would target the low back as a means of stimulating the L4-S3 nerve roots from which the Sciatic nerve is formed.
Techniques of needle insertion have evolved as well. Effective approaches include rapid needling and electro acupuncture (Chou et al, 2014). With rapid needling, the practitioner continually manipulates the needle by moving it in and out of the targeted area at a relatively quick pace (Chou et al, 2014). Electro acupuncture involves the addition of a light electrical impulse at the needle insertion. This technique elicits a pain inhibition response by stimulating vibration sensory nerve fibers (Zing et al, 2014).
So how does it work? To answer this question, we must first briefly discuss pain and what causes the feeling of pain. When a painful stimulus is encountered, it activates nociceptors (aka pain receptors), which send information along the spinal cord to the brain, where the feeling of pain is identified and perceived (Zeng et al, 2014). Additionally, pain is caused by chemicals of the immune system that initiate the process of inflammation and more specifically, swelling. Believe it or not, pain is meant to be a protective mechanism. When chronically experienced, however, it can be a danger and extremely impactful on quality of life.
The theory of acupuncture is an extremely complex and multi faceted topic. At a basic level, acupuncture works via two main systems; chemical reactions involving naturally produced opiates and sensory nerve pathways signaling pain inhibition.
Natural, endogenous opiates are chemicals produced in the body that have a potent analgesic effect (reduce pain perception). They include hormones and neurotransmitters like endorphins, serotonin and epinephrine (Baeumler et al, 2014). Acupuncture insertion stimulates the release of these chemicals in the central nervous system, which results in a decreased perception of pain. Similarly, endogenous opiates have anti-inflammatory effects, thereby reducing both chronic and acute swelling (Zing et al, 2014). This chemical-mediated process has a relatively longer onset and longer lasting effects. Electro acupuncture, on the other hand, elicits immediate pain relief by acting on sensory nerve pathways (Zing et al, 2014). Vibration information stimulates nociceptors, which initiate an inhibitory pathway from the brain to the affected area. Essentially, pain from sensitized nociceptors (in pain) differs from the stimulus of normal nociceptors (no pain) by acupuncture. This difference in brain processing is what triggers an inhibitory nerve pathway (Zing et al, 2014).
Acupuncture is an effective tool to manage chronic and acute pain. Specifically, it is indicated for any of the following conditions:
•Myofascial Pain Syndrome (chronic muscle pain from trigger points)
•Chronic neck and back pain
•Fibromyalgia
•Osteoarthritis
•Joint Pain
•Tension headaches
•Sciatica
•Plantar Fasciitis
•Post-operative pain
•Diabetes related peripheral-neuropathy
Other pain treatments include pharmaceutical opioid management (e.g. Percocet, Naproxen, Ibuprofen, etc.), inject able uploads (e.g. morphine) and corrective surgery. As a minimally invasive technique, acupuncture should be considered as first-line treatment prior to implementing higher risk procedures. Furthermore, if extensive therapy is indicated (e.g. surgery), acupuncture should be used to compliment recovery. Additional benefits include decreased cost, avoidance of opiate-induced side effects and avoidance of analgesic tolerance (when the same dose of a medication is no longer effective) (Zing et al, 2014).
Practitioners qualified to practice Acupuncture Toronto include Naturopathic Doctors, TCM certified practitioners and some Chiropractors and Physiotherapists. However, Naturopathic Doctors uniquely receive 4 years of intense training in the practice itself. Furthermore, they have the anatomy and clinical background to couple traditional acupuncture with more advanced and current theories.
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