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Covered
in this chapter:
What
is acupuncture?
Acupuncture is a system of healing which has been practised in China
and other Eastern countries for thousands of years. Although often
described as a means of pain relief, it is in fact used to treat
people with a wide range of illnesses. These might include anxiety
states, arthritis, asthma, back pain, cancer, chronic fatigue syndrome,
circulatory problems, coughs, colds, depression, digestive disorders,
facial paralysis, fibrositis, high blood pressure, HIV and HepB+C,
indeterminate aches and pains, infertility, menstrual problems,
migraines, rheumatism, sciatica, sleep problems, skin conditions
or ulcers.
Acupuncture
is a safe treatment for all. It has proved to be effective in pregnancy
management and for the relief of pain in childbirth. Acupuncture
is also helpful for people trying to overcome addictions such as
those related to smoking, alcohol, food or drugs.
Some
people may have acupuncture as a preventive measure to strengthen
their constitution, or because they feel unwell in themselves without
being “ill” in a Western sense. It can also be used
alongside conventional medicine in the treatment of both acute and
chronic diseases.
However,
it is important for me to point out that the above said is not a proven
fact and not a claim I am making, but rather my opinion, since neither
the CAP (Committee of Advertising Practice) nor the ASA (Advertising
Standards Authority) have so far accepted that there is sufficient
evidence that acupuncture works in such situations.
A
few words about its traditional roots:
According to traditional Chinese philosophy, our health is dependent
on the body’s motivating life force energy, known as Qi, which
moves in a smooth and balanced way through a series of channels
beneath the skin, and deeper inside the body. Health is the state
of perfect harmony of the Qi, and when Qi becomes unbalanced, illness
results. The flow of Qi can be disturbed by many factors. These
include emotional states such as anxiety, stress, anger, fear or
grief, hereditary factors, poor diet, weather conditions, infections,
toxic substances and traumas.
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Description
of the treatment?
There
are well over 500 recognised acupuncture points on the body, of
which I use about 100 on a regular basis. For the first consultation
I often choose only a small number of needles, like 2 or 4, which
will help you to get used to the acupuncture and show me how you
respond to the treatment. On subsequent treatments I more commonly
choose between 6 and 12 points.
The
majority of needles will be placed in the arms or legs, below the
elbows or knees. This is where the channels have influential points
known as the command points. Needles are also placed around the
local area of the problem. Another area where needles can be applied
is the ear, which is known as auricular acupuncture. You will usually
remain dressed during the treatment, with the clothing only removed
to reveal the site of the needling. If needles are placed on the
back, chest, abdomen, head or neck, it is usually sufficient to
just open a few buttons, or slightly lower the shirt, skirt or trousers.
Most
patients hardly feel the initial insertion of the needle. Acupuncture
needles are many times finer than injection needles, or those used
in blood tests, and bear little resemblance to the latter. Once
a needle is in place, it should be gently manipulated, usually rotated
or softly moved in and out (“lift and thrust”), in order
to obtain the correct therapeutic effect. This is known as “obtaining
deqi (arrival of Qi)”, and should be felt as a spreading sensation.
It can be very subtle, like a tingling, or the sensation of a magnetic
field, or it can be stronger, like a mild toothache. Occasionally
it is quite powerful, like an electric current. If the spreading
is felt along the pathway of the channel, this can be a very good
indication that the point has been chosen and needled well, and
the response might be favourable.
When
there is coldness, and the aim is to warm the acupuncture channel,
I may use Moxa, which can be used without needles. Moxa is a dried
herb, which gets burnt over the point without burning you. This
is generally very popular and well tolerated. Some patients are
troubled by its smell, which is the reason why I now mainly use
Japanese smokeless Moxa.
Occasionally
I apply a minute, battery-generated electric current (1mVolt, 1
mAmp) to the needles, which you will feel as a gentle tapping or
fluttering. This is used in inflammatory conditions, where the electro-acupuncture
is often better tolerated than strong hand manipulation.
I usually
accompany the acupuncture with a form of healing, which I like to
call ‘qi healing’. My hands are placed several inches
above the needles. In the manner of performing Qi Gong I allow the
energy (the qi) to flow through my left hand into a particular point
and along the channel, to be received out of another point through
my right hand. This you often feel as a warmth and heaviness, which
is usually very relaxing.
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How
does acupuncture work?
There has been a vast body of clinical studies and a plethora of
research trying to explain how acupuncture works. The answer to
this question still largely depends on the paradigm in which we
think.
Acupuncture has been shown in research to be effective in many clinical
conditions. Examples are respiratory disorders like asthma, chronic
obstructive pulmonary disease and chronic bronchitis, obstetrics
(labour pain and delivery time) and with infertility. Also in a
wide variety of digestive disorders including hypoactive gastric
function, hyperacidity, stomach ulcers, constipation, diarrhoea,
nausea and vomiting.
Acupuncture improves the microcirculation and the blood flow velocity,
lowers blood pressure, regulates the heartbeat and is thought to
help with angina and improve the coronary blood flow (oxygen supply
to the heart muscle). It regulates blood platelets and coagulant
factors, the prothrombin index and the blood sedimentation rate.
Acupuncture has a variety of metabolic effects including regulating
blood sugar levels (non-insulin dependent diabetes), improving the
adrenal and pituitary functions, regulating thyroxin levels and
helping with the concentration of the blood fats, the triglycerides,
lipids and cholesterol.
Acupuncture
has an anti allergic effect, which helps with hay fever and allergic
shock (anaphylaxis). I could list many more effects, which have
been documented, but I hope that the above helps to illustrate the
point that acupuncture is a useful tool to help the body to heal
itself.
There
have been many reports of acupuncture being effective in enhancing
the body’s immune response. I have personal experience with
successfully using acupuncture and moxibustion in raising the level
of the red and white blood cells (bone marrow function) during chemotherapy.
The Western scientific model: The list of documented effects
of acupuncture and moxibustion is longer than I could possibly present
in this context, the above merely describe some of the most important
examples. Modern science has come up with a number of hypotheses
explaining how acupuncture works.
The most popular models are:
- Neural
model: It is now known that pain is regulated via so-called
synapses on which both excitatory and inhibitory neurotransmitters
are active. Under normal circumstances they operate in a balance
meaning that we feel touch and pressure, but not pain since the
stimulation acts below the pain threshold. When the tissue becomes
disturbed through undue force, injury or inflammation, the excitatory
neurotransmitters get the upper hand and we feel pain as a result.
It has been shown in research that acupuncture can release inhibitory
neurotransmitters like beta-endorphin, met-enkephalin and dynorphin
A+B. This effect can also be used as anaesthesia, which has caught
the eye of the scientific community since the 1970’s. This
has contributed to the widespread belief that acupuncture is a
treatment for pain relief.
- Humoral
model: This model takes into account that many more substances,
including hormones have been found to play a role in the acupuncture
effect. These include serotonin, oxytocin, histamine, ACTH (adrenocorticoptrophic
hormone), prostaglandins and quite a few others. There are many
complaints like skin diseases, menstrual disorders and infections,
which respond to acupuncture treatment, where postulating the
humoral model makes a lot of sense.
- Bioelectric
model: It has been shown in research that acupuncture points
are areas of relatively high electro-conductivity (electrical
permeability), which can be demonstrated with a simple instrument
called a point locator. This has been used to confirm the exact
location of the traditionally described acupuncture points.
The fact that the body has an interconnecting system of collagen
fibres called the fascia, which together with the so-called interstitial
fluid facilitates the flowing of minute bioelectric currents,
may be the explanation for the workings of this interesting model.
Furthermore it has been shown that the electro-conductivity increases
or decreases in certain acupuncture points when there is an imbalance
or a diseased state in the body. This seems to corroborate some,
if not much of the traditional acupuncture theory.
Alan Bensoussan, in his book “The Vital Meridian”,
sums up the essence of this last model in three aspects. A) Points
and channels exhibit an electromagnetic nature. B) Needling induces
alterations in the electromagnetic properties of the channels
and tissues. C) Electromagnetic fields significantly influence
biological matter and physiological functions.
The jury is still out, and it is probably right to say at this stage
that we do not fully understand how acupuncture works. However, there
is now a lot of known data, which can go a long way to explain how
acupuncture works according to the western model.
The
Traditional model: Fundamental to understanding health
and illness in traditional Chinese medicine is the concept of a
life force, called Qi (as in Tai Qi, Qi Gong and Reiki). This is
rather similar to the concept of atoms, where the balance of electro-magnetic
forces determines the density, temperature and function of matter.
All manifestations of matter, not just human beings, have a life
force. To give an example: Stone has a very tightly packed density
of atoms, it holds plenty of potential energy with relatively little
movement (kinetic energy), hence it is hard, immobile and by nature
cold. In Chinese medicine the Qi of a stone would be called extreme
Yin.
On
the other hand a gas, like helium, contains very few atoms, which
are moving extremely fast. It is the opposite of dense by nature,
quick moving, volatile, and tends to be hot. The Qi of helium is
therefore extremely Yang.
Our body is likewise made up of matter, which operates in-between
these two extremes of Yin and Yang. Every body structure, organ
function, body fluid, etc. can be understood in terms of a manifestation
of Qi, as well as described in terms of Yin and Yang
In
Chinese medicine health is seen as a continuously maintained equilibrium
of the various manifestations of Qi, which for practical purposes
are subdivided into the ‘five substances’, essence,
Qi, blood, body fluids and spirit.
Acupuncture
is the thousands of years old practice of sticking pins into specific
points, which are known to tonify, move, reinforce, reduce, harmonise
or regulate the Qi, depending on which action is required according
to the principles of a traditional diagnosis. The latter is a lengthy,
complicated subject in it’s own right. Suffice it to say that
tongue and pulse diagnosis form an important part of it.
So
if the body shows signs of heat and excess, like this is the case
in an overactive thyroid, we aim to find appropriate points that
can help to reduce the Yang, clear excess, calm overactivity and
cool the body. This action, called reducing or sedating, is enhanced
by a specific way of manipulating the needle, in this case forceful
anti-clockwise lifting and gentle clockwise thrusting, with a large
amplitude.
If
the body shows signs of tiredness, underactivity, coldness, etc.
our action should be reinforcing, tonifying and warming. Now the
needle action tends to be gentle clockwise thrusting followed by
gentle and slow anticlockwise lifting, with small amplitude. We
also often use a herb called moxa which gets burned on or near the
needle (moxibustion).
The
examples above are just two of a variety of permutations, and the
process of diagnosing and treating can be quite complicated in some
cases. What points to choose and which action to perform on them
was, I presume, empirically found and passed on over many thousands
of years. Much of what we practice as traditional acupuncture today
was formulated from around 200 BC (Yellow Emperors Classic) through
to the Ming dynasty (1368 – 1644) and beyond. Even the last
100 years have seen plenty of revisions and new concepts of ‘traditional’
acupuncture.
How the needles and the described needling techniques actually achieve
these effects has never been specifically explained in the traditional
literature. Wanting to know how it works seems to me to be a desire
of our modern western culture. The traditional Chinese practitioners,
as far as I can see, were happy with observing that it works, rather
than wanting to explain exactly how it works.
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Are
there any side effects or risks involved with acupuncture?
Acupuncture is a remarkably safe treatment. Since
we nowadays only use pre-sterilised, disposable needles, the transmission
of infectious diseases is not an issue.
Some acupuncture points are over areas of the body, where too deep
or in-expert needling could cause problems, like in the case of
needling over the chest and upper back. Here great care has to be
taken not to puncture the lung and cause a pneumothorax.
Occasionally
an acupuncture needle can hit a blood vessel and leave a bruise.
This happens especially when the point is ‘congested’,
as may be the case on the temples during a headache, for example.
I try my utmost to anticipate these bruises, by pressing on the
point with a cotton swab, after the needle has been removed.
Very occasionally a patient feels faint during the treatment, which
means I take out the needles immediately and place the legs higher
than the head.
Acupuncture,
being a system of regulating the body’s energy flow rather
than the application of an external substance, has no side effects
as such. However, it is possible for symptoms to get slightly worse
before they get better, which usually only happens in the beginning
of treatment. This phenomenon, more common in chronic conditions
and well known in other naturopathic systems of healing, is the
consequence of adjustments made by the body during the process of
rebalancing
Most
patients feel very relaxed after a treatment. In some cases you
can feel tired or a little spaced out afterwards. This may affect
your ability to drive a car, or going to work immediately after
the treatment.
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When
should acupuncture not be used?
There are very few contraindications to acupuncture. If
you are needle phobic or tend to faint with a treatment, acupuncture
clearly is not for you. If you are on blood thinning medication
(Warfarin, Persantin, etc.) it is important that you tell me about
that. Some consider endocarditis (an inflammatory condition causing
damaged heart valves) to be a contraindication for acupuncture.
Being on steroid medication is not a contraindication, but it will
lessen your ability to respond to the acupuncture treatment.
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Can
acupuncture be used while I am on medication?
You should always tell me about any medication you
are taking, as this is part of your condition and may affect your
response to the acupuncture treatment.
Being on medication is no contraindication to having acupuncture.
The acupuncture treatment may enable you to reduce or even stop
taking some forms of medication, but I recommend that you should
not change your prescription without consulting with the doctor
who prescribed it.
I think it is a good idea if you inform your doctor about having
acupuncture, and if at any point you would like me to communicate
with your doctor, I am happy to write to him or her.
It is my policy, however, to always respect your choices. In other
words, recommending a certain strategy will not mean that I demand
that you carry it out as a precondition for my treating you.
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Can
I have acupuncture without needles?
If
you cannot tolerate needles, or the thought puts you off too much,
I can apply pointed magnets, which are able to influence the Qi
flow in the meridian. They adhere to acupuncture points with the
help of small suction cups.
I may also choose to massage over selected acupuncture points, or
apply Qi healing, a technique I have borrowed from the ancient practice
of Qi Gong, where the desired Qi flow is imagined and projected
into the acupuncture point through the middle finger.
When there is coldness, and the aim is to warm the acupuncture channel,
I may use moxa, which can be used without needles. Moxa is a dried
herb, which gets burnt over the point without burning you. This
is generally very popular and well tolerated. The trouble with non-smokeless
moxa is its smell, which is the reason why I don’t use it
when working at The Body Conditioning Studio.
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