The Association between Acupuncture and Chronic Pain
According to Ji-Sheng Han, the scientific interest in acupuncture has been gaining popularity over the decades; especially within the World Health Organization (WHO) who has identified more than 40 disorders that benefit directly from acupuncture1. Specifically, in a recent meta-analysis with 17,922 participants, their study provided evidence that acupuncture is effective for treatment chronic pain2. Due to the longevity that chronic pain can have on an individual’s body, it is vital to understand the effectiveness of hormone release, anti-inflammatory actions of the muscles, and specific symptom locations that acupuncture treats in those with chronic pain. Acupuncture research is important to public health due to being a positive alternative treatment to addictive painkillers, therefore, contributing to the opioid epidemic; another public health issue. Throughout this literature review, I outline pain associations and symptom-specific acupoints throughout published studies in individuals with chronic pain. In addition, within this literature review I also aim to find whether certain characteristics of acupuncture are associated with better or worse outcomes of chronic pain.
I conducted this literature review on two research engine websites. My first research engine used was the University of Washington Libraries website on October 3rd, 2018. My second research engine used was the PubMed database on October 4th, 2018. On both of these websites, by following MeSH methods, I used the research terms: acupuncture areas of pain, acupuncture AND treatment, association, AND study. On my first website, there were 715 results excluding all non-English, non-peer reviewed, duplicates, and articles that were posted more than 10 years ago. On my second engine site, there were 5 results excluding all non-English, non-peer reviewed, duplicates, and articles that were posted more than 10 years ago to keep consistency across search engines. Through these engines sites I retrieved three primary research articles, and one peer-reviewed review paper directly related to my topic.
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In result, multiple studies found evidence showing that when using acupuncture related techniques to treat chronic pain, the practices were most effective when used for long spans of time; as well as across multiple sessions1,3. In addition, utilizing multiple sessions allowed for precision on symptom-specific acupoints to treat patterns of pain presented in patients4. These acupoints are described as specific regions of the body, where the needle is inserted to release hormones, specially endorphins to relax the muscles and reduce inflammation4. However, in one study when testing for pain threshold with pain-inducing tests for areas such as shoulder, back, and lower body pain; acupuncture showed no effect to subsiding pain more effectively than placebo needle treatments3. With this, studies are beginning to analyze different acupuncture techniques in different regions of the world, most commonly Westernized acupuncture methods versus Traditional Chinese acupuncture (TCM).
One study found that chronic shoulder pain was best treated using the TCM acupuncture, in addition to another study confirming that TCM methods improved chronic pain better than westernized acupuncture practices1,4. Across all studies, there was a lack of information in what would make the presence of chronic pain worse when comparing needle treatments with physical therapy, whereas the studies decided to compare needle treatment to no treatment whatsoever1,3,4. Studies did also not specify the differences between westernized and TCM acupuncture; so the logic behind what made certain practices unique in unclear1,3,4. In addition, there were notes of specific body areas responding better to acupuncture than other areas, leaving investigations only able to test certain regions associated to chronic pain4. Another limitation when comparing studies, was that the causes of the chronic pain were not specified, as well as not defining what chronic pain is compared to other kinds of pain one can experience, like acute pain2,3,4. Therefore, this limits the knowledge of how well acupuncture practices accurately treated the cases of chronic pain.
In conclusion, due to the variety of acupuncture practices and types, the success of the treatments can affect individuals in different ways. Therefore, it is vital to be able to understand the effects of acupuncture associated with chronic pain, and how it can be treated effectively without the use of pain killers. Specifically, it is important for acupuncturists to understand the certain symptomatic acupoints that are associated with treating pain points in the body. In order for acupuncturists and patients to accurately treat their chronic pain, research studies in public health need to analyze which methods are most effective; as well as craft educational interventions on the benefits and risks of acupuncture on the body compared to other forms of treatment.