A look at acupuncture and how it works

1. ACUPUNCTURE
AN ANCIENT SCIENCE WITH MODERN IMPLICATIONS
Dr. Linda Lucienne Ehlers
Chiropractic Physician
8700 West 95th Street
Hickory Hills, Illinois 60457
1.708.598.9010

2. IS THE WORLD FLAT?


7. Does Acupuncture Work?
PAIN, International Association for the Study of Pain, November 1996, Volume IV, Issue 6
 Perception of non-European medical practice as empiric or "folk" medicine ignores
the history of science.
 During Europe’s "Dark Ages" of restricted scientific activity, the East witnessed
intense scientific development.
 Written records of Traditional Chinese Medicine (TCM) on systems of acupuncture
and moxibustion provide ample evidence for a science based on centuries of
inductive logic, observation, and painstaking classification 1,2.
 TCM poses insights but not in biomedical terms.
 Both the self-contained logic of TCM and Western medical establishment attitudes
about "alternative" or "complementary" medicine have insulated acupuncture from
developments in biomedicine3.
 Recent biomedical research on the neural modulation of pain rekindled interest in
acupuncture as a mode of peripheral sensory stimulation (PSS)4,5.
 The potential of TCM and the effectiveness of acupuncture are now being defined
biomedically.

9. Traditional Chinese Explanation of How
Acupuncture Works
 The human body has thousands of
nerve points or pressure points
that control different parts of the
body.
 Points located along 14 major
meridians or power lines inside the
body.
 These power lines carry energy or
Qi, Chi or …which is distributed
evenly in cases of a healthy body.
 However in cases of sickness or
disease, an obstruction at a
particular point affects the rest of
the body.
 Needles clean out the obstruction
and redirect energy into these
affected parts. This will cure the
problem over a period of time.

10. WHAT IS THE SCOPE OF
ACUPUNCTURE?
 Acupuncture is a system which can influence three areas of
health care:
promotion of health and well-being,
prevention of illness,
treatment of various medical conditions.
 Often associated with pain control it has much broader
applications.
 Effective as the only treatment used, or as the support or
adjunct to other medial treatment forms in many medical and
surgical disorders.

11. THE WORLD HEALTH ORGANIZATION
Recognizes the use of acupuncture in the treatment of a
wide range of medical problems
 Digestive disorders:  Neurological and muscular
gastritis & hyperacidity, disorders: headaches, facial
spastic colon, tics, neck pain, rib neuritis,
constipation, frozen shoulder, tennis elbow,
various forms of tendonitis,
diarrhea.
low back pain, sciatica,
osteoarthritis.
 Respiratory disorders:
sinusitis,  Urinary, menstrual, and
sore throat, reproductive problems.
bronchitis,
 Particularly useful in resolving
asthma, physical problems related to
recurrent chest tension, stress & emotional
infections. conditions.

14. From: A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic
Obstructive Pulmonary Disease (COPD): Title and subTitle BreakThe COPD-Acupuncture
Trial (CAT)Acupuncture in Patients With COPD
Arch Intern Med. 2012;():1-9. doi:10.1001/archinternmed.2012.1233
Figure Legend :
Figure 1. Acupuncture points used. The acupuncture points were selected according to traditional
Chinese medicine theory: (1) LU1 (Zhongfu) and (2) LU9 (Taiyuan) in the lung meridian; (3) LI18
(Futu) in the large intestine meridian; (4) CV4 (Guanyuan) and (5) CV12 (Zhongwan) in the
conception vessel; (6) ST36 (Zusanli) in the stomach meridian; (7) KI3 (Taixi) in the kidney
meridian; (8) GB12 (Wangu) in the gallbladder meridian; and (9) BL13 (Feishu), (10) BL20 (Pishu),
and (11) BL23 (Shenshu) in the bladder meridian.
Copyright © 2012 American Medical
Date of download: 5/15/2012
Association. All rights reserved.

15. Pain = Protective Mechanism
warns of impending or actual damage,
3 types of pain receptors:
-mechanical,
-heat
-other noxious stimuli
Sends the pain impulse to the CNS through afferent nerve fibers.
Abn px states = damage w/in px pathway

16. Pain Recognition
Unlike other sensory input
◦ Subjective,
◦ Previous experiences can influence one's
perception of px.
◦ True of dogs also; some breeds generally are
more stoic than others.
◦ A function of sex as females have shown a
much higher pain threshold

17. Pain Control & Acupuncture
A
Two Possibilities
◦ instigates the production endogenous opiates
(Ant. Pituitary)
 Or
◦ blocks pain transmission.

18. SIGNAL TRANSMISSION
Melzak-Wall Gate Control Theory of Pain Control
 3 types of pain receptors.
 Stimuli received from the mechanical and thermal pain receptors & transmitted
over large myelinated A-delta fibers -- close to 30 meters per second.
 Impulses received by the other type of receptors travel much more slowly on the C
fibers at the rate of 12 meters per second.
 A-alpha fibers, necessary for the proper perception of where we are in three-
dimensional space, found in muscles and joints.
 A-beta neurons are involved in feeling light touch and the bending of hairs.
 A-alpha and A-beta fibers transmit nerve impulses many times faster than A-delta or
C fibers .
 Pressure/mechanical stimulation produces non-painful sensory information that
travels along A-beta fibers. When the information reaches the inhibitory
interneurons, it shuts a nerve transmission "gate" that blocks the conduction of the
slower traveling A-delta and C fibers .
 Does not explain the delayed effects of treatment or the results of cross-circulation
studies ( blood circulation of two animals were connected, and the procedure
performed on one produced results in both).

20. SIGNAL TRANSMISSION
Humoral Theory
Vasodilation Theory
Autonomic Theory
BioelectricTheory
Non-synaptic diffusion
neurotransmission (NDN)

21. Humoral Theory
 Acupuncture instigates release
of endogenous (developed from
within) opiates that produce a
self-induced analgesia.
 Stimulates specific afferent
nerves, that in turn activate a
spinal cord center, a mid-brain
center and the hypothalamus/
anterior pituitary.
 All three of these have been
shown to block pain transmission
by means of endorphins and/or
other analgesic
neurotransmitters.
 Some believe that acupuncture's
pain relief derives from a
combination of the neurological
and humoral explanations.


22. Vasodilatation Effects
Localized vasodilatation effects,
Dilated blood vessels are better able to
eliminate pain-producing substances such
as bradykinin, prostaglandins and other
inflammatory products.
Explains procedure's benefits specific to
musculoskeletal disorders.

23. Autonomic Theory
Internal organs can be stimulated by
external acupuncture points.
Selectively
excite parasympathetic and
sympathetic nerves regulating the
autonomic nervous system.

24. Bioelectric Theory
Acupuncture meridians are like direct
current pathways
Acupuncture points function as amplifiers &
rectifiers.

25. Dr. Paul Bach-y-Rita
1934 - 2006
 American neuroscientist
 One of first to seriously
study the idea of
neuroplasticity
 Introduced sensory
substitution as a tool to
treat patients suffering
from neurological
disorders.

26. Non-synaptic diffusion neurotransmission
(NDN)
Discovered in 1962 by Bach-y-Rita
A complementary mechanism of information
transmission
May play multiple roles in the brain,
including in normal and abnormal activity,
brain plasticity and drug actions

27. Non-synaptic diffusion neurotransmission
(NDN)
 Diffusion of neurotransmitters and other neuroactive substances
through the extracellular fluid to reach extrasynaptic receptors, &
 Diffusion of substances such as nitric oxide through both the
extracellular fluid and cellular membranes to act w/in the cell.
 The possible roles of NDN in mass, sustained functions such as
mood, sleep and brain “tone”, as well as in various other functions,
e.g., in long term potentiation, at the retinal, lateral geniculate
nucleus and visual cortex levels of the visual system, in recovery
from brain damage and in neuropharmacology,

28. What these theories have in common is the stimulation of
acupuncture points
 insertion of small needles,
 application of pressure,
 cupping (suction) and
 application of heat through
moxibustion (which can be
used to raise the
temperature of the
needles), or
 infrared, laser or electrical
stimulation

30. Myofascial Chains
 Alternative therapists disagree with the neurological explanation.
 According to them acu works by stimulating nerve points to send extra messages over
the fascia to the covering tissue of muscle bundles.
 The messaged travel via specially made myofascial chains that are geared to carry
messages.
 The exact message will vary according to the neurological point that is stimulated.
◦ For example, stimulating a point in the forehead may help to sooth sinus pains and encourage
draining. These neurological or electrical points are said to have a lower electrical resistance and
they work like switches to control pain and healing in different parts of the body.

31. Nerve Complex Explanation
of How Does Acupuncture Work
 Some neurologists believe it is possible that acupuncture points
contain deep seated nerve complexes.
 Pressing down on these nerve complexes does cause a dull ache in
the affected area/body part.
 Inserting needles into these nerve points could result in a stimulation
of the brain and the spinal cord encouraging the release of natural
painkillers or endorphins.
 These chemicals can then block the sensation of pain and help the
area heal itself.