How does Acupuncture actually work?
By Henry McGrath, Acupuncture Course Director at CNM (College of Naturopathic Medicine)
Acupuncture is the insertion of tiny needles into certain points on the body, for the treatment of illness. It has been practised for over 2000 years in China, and it is becoming ever more popular in the West. It is estimated that over one million treatments are given per year in the UK.
There is increasingly good evidence that acupuncture can treat a wide range of conditions successfully. The World Health Organisation website lists 28 conditions for which acupuncture has been “proved through controlled trials to be an effective treatment”, including rhinitis, headache, high blood pressure, lowered immunity, rheumatoid arthritis, sciatica, back pain, and knee pain. It lists another 60 conditions for which some “therapeutic effect has been shown”, including asthma, infertility, insomnia, and pre -menstrual syndrome. Thousands of western doctors and physiotherapists have undergone some training in acupuncture. Despite this, many people are still sceptical about acupuncture because it seems to make no sense that the insertion of tiny needles can treat disease. So how does acupuncture actually work?
Part of the answer is that the insertion of acupuncture needles causes the release of chemicals called “endorphins”. (This word is short for “endogenous morphine”. Endogenous means it is produced inside the body, and the word morphine comes from the Greek God of sleep, Morpheus.) There are many kinds of endorphins in the human body, each with a different function. Some reduce pain, some promote the healing of damaged tissue, some promote good sleep, some calm anxiety, and some play a role in hormone production. So, we can see how acupuncture can be used to treat many conditions.
Recent scientific investigations have given us more clues. Using an MRI scanner, it has been shown that the shallow insertion of needles at specific points causes increased activity in the pain control centres of the brain. However, what the neuroscientists found really interesting and surprising, was that if the needles are inserted deeper into the skin, and manipulated until the patient feels a tingling around the needle, the pain control areas become less active (you can see this remarkable experiment on You Tube). This would explain why experienced practitioners get better results than novices, as getting the tingling sensation is an acquired skill.
One study showed that acupuncture caused changes in the brain which promoted to stroke recovery. In this experiment, normal acupuncture was compared to “sham” acupuncture, where needles are deliberately inserted in the wrong points. Only the correct acupuncture had the desired effect.
According to Chinese medicine, energy, or “qi”, gathers in certain points near the surface of the body, and flows along channels called “meridians”. It has been speculated that this “qi” is a very low level of electrical impulse, and indeed acupuncture points and channels have been found to be areas of low electrical resistance. When a person is ill, the electrical activity at the acupuncture points changes from what it normally is. The insertion of needles helps to return the electrical activity of the acupuncture point to its normal level. Experiments have been done where substances have been injected into acupuncture points, and have been observed to move along the acupuncture channels.
So, there is mounting evidence that acupuncture has real health benefits, and that it has a scientific basis of action.
About the writer
Henry McGrath MA MBAcC MRCHM is Academic Director and Acupuncture Course Director at CNM (College of Naturopathic Medicine).
Henry has been practicing Acupuncture since the mid 1990s. He trained for nine years in shiatsu, acupuncture and herbal medicine, in the UK and in China. He is the author of numerous publications, including “Traditional Chinese Medicine Approaches to Cancer” (Jessica Kingsley Publishers). He runs a clinic in Bristol, and lectures at CNM colleges in London, Bristol, and Dublin, as these are the CNM locations which offer a diploma in Naturopathic Acupuncture.
There are CNM colleges nationwide. For information on CNM’s full range of diploma, postgraduate or short courses in a range of natural therapies, please call 01342 410 505 or visit www.naturopathy-uk.com.
Ahhh my aching back! We all know someone with back pain; have probably experienced it ourselves at some point; and our clinics are filled with patients seeking relief from longstanding and chronic back conditions. Indeed the statistics on the personal and societal cost of low back pain are shocking. According to the British Occupational Health Research Foundation back pain:
o Affects 40% of the population
o Causes the loss of 50 million working days
o Costs about £5 billion (or £200 for every employee) in sickness absence costs
Source: Clinical Standards Advisory Group
Being able to treat low back pain effectively is a must for any practitioner who wants to do their best for their clients and have a full and thriving practice. At Jing we have pioneered a method of combined soft tissue techniques using trigger point, myofascial release and advanced stretching that works effectively alongside your existing bodywork skills to reduce client pain in 1-6 weekly treatments.
Causes of low back pain
A big factor in most cases of back pain is soft tissue damage. The muscles, ligaments and fascia can be adversely affected by sudden injury or trauma, chronic repetitive misuse or habitual poor posture. As these more subtle “soft tissue issues” cannot be diagnosed via X rays or MRI’s they often escape the medics’ attention leading to unnecessary long standing pain that can in most cases easily be resolved.
The role of trigger points
Studies suggest that trigger points (contraction “knots” in soft tissue) are a component of up to 93% of the pain seen in pain clinics and the sole cause of such pain as much as 85% of the time. (Gershwin; Fishbain quoted in Travell and Simons: Myofascial Pain and Dysfunction: The trigger point manual Volume 1)
Trigger points are known to cause or contribute to low back pain, carpal tunnel symptoms, tennnis elbow, neck pain, migraines, jaw pain, and many kinds of joint pain mistakenly attributed to arthritis. They can cause sinus pain and congestion, nausea, chronic dry cough and are thought to contribute to fibromyalgia.
The key factor about trigger points is that they typically cause pain in a site distant to where the trigger point is located.
Pain in the low back can come from trigger points in unusual places such as the buttocks, stomach muscles or even the calves! If you don’t know where to look for the source of the pain your ability to help your client is severely limited.
The muscles most often riddled with trigger points in low back cases are:
o Erector Spinae,
o Piriformis – which when tight can often mimic “sciatica”.
o Psoas- an anterior deep muscle
o The Gluteus group
o Quadratus Lumborum – According to Travell and Simons “ The Quadratus Lumborum muscle is one of the most overlooked muscular sources of low back pain and is often responsible, through satellite gluteus minimus trigger points for ‘pseudo disc syndrome’ and the ‘failed’ surgical disc syndrome’.”
The fascia is connective tissue that encases every structure of the body like a 3- dimensional body stocking. If there is a pull or a snare somewhere in this powerful fabric, it causes greater tightening in other areas causing pain and decreased mobility.
Recent research has pointed to the role of the lumbar fascia previously almost unregarded in back pain research. The lumbar fascia is densely innervated by potential pain receptors. During inflammatory processes in the lower back area, the sensitivity is considerably enhanced . Histological studies suggest that micro injuries within the lumbar fascia are a frequent cause for back pain . These and similar studies could “disburden” the intervertebral discs as a cause for back pain in several cases .
How to Treat Low Back Pain – The Jing Method of Combined Soft tissue technique
At the Jing Institute of Advanced Massage training we have pioneered a simple yet highly effective approach to treating common pain conditions. We know this approach works as we have been using it ourselves in our own practices over the past 20 years with thousands of clients with pain conditions. This approach looks at using a tried and tested combination of the best advanced soft tissue techniques available to enable the therapist to gain maximum results quickly and easily. In our experience, using a creative combination of techniques is the best way to achieve effective results; for example trigger point therapy is a fantastic technique, but will gain even better results if combined with fascial release and stretching in a treatment. The concept of a Gestalt – “the whole is greater than the sum of it’s parts” nicely illustrates our philosophy – the combined effect of these skills is magically greater than would be gained through the individual sum of these techniques alone.
Acute and chronic pain and the appropriate use of hot and cold.
The use of hot and cold is a vital tool in the treatment of pain. It should be our first step in treatment. Basically speaking, cold therapy such as ice packs, ice massage or cold stones are applied in the acute stages of pain. And heat, such as warm moist packs or hot stones for chronic pain conditions.
Fascia – Fascial techniques are used first to release restrictions in the fascial system
Muscles – All the muscles around the affected joint are treated for trigger points
Acupressure – at Jing we believe in an integration of Eastern and Western techniques and in our protocols we incorporate local acupressure points that help reduce pain in specific areas
Stretching – Advanced stretching techniques such as PNF, active isolated stretching or soft tissue release are used to integrate the work
Self care – Self- care suggestions are given to enable the client to feel in control of their own health. These may include stretching, strengthening, self trigger point work etc.
There is nothing more rewarding and powerful than to feel that you are truly helping people out of pain. This will have a huge effect on you and your clients. Your business will naturally grow and so will your confidence in your profession. Just this week, a client who had been coming to me for low back pain that he had been suffering with for 10 years said the most profound thing to me. After his 5th session, he said, “I never came here looking for a cure, only some relief, and now I am at the stage that I have forgotten I was ever in pain. My life is completely different.” I cannot put into words how that made me feel.
1. Tesarz J, Tachuchi T, Mense S. Die Fascia thoracolumbalis als potentielle Ursache für Rückenschmerzen. Manuelle Medizin 2008; 46: 259
2. Schleip R et al. Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi). European Spine Journal 2007; 16: 1733-1735 Article (PubMed)
3. Interview mit Schleip R. Rückenschmerzen, Faszien und Rolfing. BR2, Wissensredaktion. ARD Mediathek. (Interview beginnt nach ca. 3/4 des Podcasts) Interview – in German (ARD Mediathek)
About Rachel Fairweather and the Jing Institute of Advanced Massage
Rachel Fairweather is co-founder and director of the Jing Institute of Advanced Massage. Based In Brighton, London and Edinburgh we run a variety of courses in advanced techniques to help you build the career you desire.
Our short CPD courses include excellent hands on learning in a variety of techniques including trigger point therapy, myofascial release and stretching. For the first time you are now able to learn these techniques at your own time and pace with our revolutionary online low back pain course aimed at giving qualified bodyworkers the skills they desire.
For the therapist who wants to be the best they can possibly be, we offer a BTEC level 6 (degree level) in advanced clinical and sports massage – the highest level of massage training in the UK.
Tel: 01273 628942
Email: [email protected]
Copyright Jing Advanced Massage November 2013. Text: Rachel Fairweather. Photos: Meghan Mari.
Cardiovascular disease is the No1 killer, yet it is also preventable and can be reversed. Benjamin Brown’s session at camexpo in October covered research into wholefood traditional dietary patterns, clinical interventions shown to reverse heart disease, foods for heart health and topics that are the cutting edge of nutrition including the role of advanced glycation end products (AGEs), and the emerging benefits of dietary nitrate.
About Benjamin Brown
Ben is a naturopath, science writer and speaker. He lectures internationally and contributes regularly to industry magazines and scientific journals. Ben also works in nutraceutical research and is Technical Director at Viridian Nutrition. He is contributing author of forthcoming textbook on nutrition and cardiovascular medicine.