Acupuncture as a primary therapy in treating musculoskeletal pain

From the American Academy of Medical Acupuncture

NCCAM Information and Resources Package

http://www.medicalacupuncture.org/acu_info/articles/nccaminfo.html

Most Useful as Primary Therapy: Musculoskeletal Pain

• In the United States, acupuncture has found its greatest acceptance and success in the management of musculoskeletal pain. Acute musculoskeletal lesions such as soft tissue contusions, acute muscle spasms, musculotendinous sprains and strains, and the pain of acute nerve entrapments are among the problems most frequently and successfully addressed with acupuncture. In such cases, acupuncture can legitimately serve as the initiating therapy.

• Chronic musculoskeletal pain problems are also commonly and appropriately treated with acupuncture, although not usually as the only approach. Those problems likely to be responsive to acupuncture intervention include repetitive strain disorders (eg, carpal tunnel syndrome, tennis elbow, plantar fascutis), myofascial pain patterns (eg, temporomandibular joint pain, muscle tension headaches, cervical and thoracic soft tissue pain, regional shoulder pain), arthralgias (particularly osteoarthritic in nature), degenerative disc disease with or without radicular pain, and pain following surgical intervention (both musculoskeletal and visceral). In the management of chronic musculoskeletal pain, acupuncture offers a broad range of potential value between the conventional therapy poles of pharmaceuticals and invasive procedures. Other chronic pain problems commonly responsive to acupuncture include postherpetic neuralgia, peripheral neuropathic pain, and headaches from other causes.

The Western theory behind acupuncture relates more to the effect that needles and stimulation of known points on the skin may have on the nervous and hormonal systems. The neurological theory behind acupuncture is called the counter-irritation theory of pain management. It is believed that the insertion of needles into the skin irritates the nerves and causes the nervous system to decrease its sensitivity to pain. An example of that theory would be rubbing a fresh injury immediately after it happens to make the pain go away. The hormonal explanation for acupuncture is called endorphin/enkelphin theory. These two hormones are known to be secreted during acupuncture. They are manufactured by the body and both have the same analgesic qualities as the drug opium.

Several processes have been proposed to explain acupuncture's effects, primarily those on pain. Acupuncture points are believed to stimulate the central nervous system (the brain and spinal cord) to release chemicals into the muscles, spinal cord, and brain. These chemicals either change the experience of pain or release other chemicals, such as hormones, that influence the body's self-regulating systems. The biochemical changes may stimulate the body's natural healing abilities and promote physical and emotional well-being.13 There are three main mechanisms:

• Conduction of electromagnetic signals: Western scientists have found evidence that acupuncture points an strategic conductors of electromagnetic signals. Stimulating points along these pathways through acupuncture enables electromagnetic signals to be relayed at it greater rate than under normal conditions. These signals may start the flow of pain-killing biochemicals such as endorphins and of immune system cells to specific sites that are injured or vulnerable to disease.14,15

• Activation of opioid systems: research has found that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain.16

• Changes in brain chemistry sensation, and Involuntary body functions: studies have shown that acupuncture may alter brain chemistry by changing the release of neurotransmitters and neurohormones in a good way. Acupuncture also has been documented to affect the parts of the central nervous system related to sensation and involuntary body functions, such as immune reactions and processes whereby a person's blood pressure, blood flow, and body temperature are regulated

Acupuncture as a primary therapy in treating musculoskeletal pain.pdf