Scientists Find How Acupuncture Deactivates Pain (well, one of the ways)
February 7th, 2010
4 comments
… but are a bit lacking in their conclusion. Let me explain.
Their headline is “Acupuncture ‘lessens pain in brain not body’, scientists discover”.
Acupuncture works by making the brain, rather than the body, no longer experience pain, according to new research.
by Andrew Hough (http://www.telegraph.co.uk/health/healthnews/7167362/Acupuncture-lessens-pain-in-brain-not-body-scientists-discover.html)
Scientists who scanned the brains of volunteers as they were given the Chinese therapy found it deactivated pathways that govern pain.Complementary medicine expert Dr Hugh MacPherson, of the University of York, said: “These results provide objective scientific evidence that acupuncture has specific effects within the brain which hopefully will lead to a better understanding of how acupuncture works.”
A commenter earlier hinted that I am not being objective while citing evidence in this blog. Fine. I’m not objective. I’m biased because I use acupuncture myself and can see the effects on patients firsthand. I cannot help but acknowledge it works. I myself am a “victim” of being “duped” as my headaches were gone for four years. So don’t take my word for it. Take the scientists’ word for it. Oh wait, another commenter said that these studies that promote acupuncture are funded by companies that make money of it. Let’s ignore the fact that most if not all western medicine studies on drugs are also funded by the drugs’ manufacturers. I’m just saying let’s be consistent. If we’re going to accuse acupuncture research of being biased because of who funds it, let’s distrust western medicine also!
Anyway, if I’m not being objective, let’s take Dr. MacPherson’s word for it. Or are we to think that the University of York makes money by selling acupuncture needles?
The findings, published in Brain Research, suggest acupuncture has a significant effect on specific nerve structures.Dr MacPherson and colleagues explained when a patient receives acupuncture treatment a sensation called deqi can be obtained. Scientific analysis showed this switches off areas within the brain that are associated with the processing of pain.
After reading this, I came to the realization that one reason that people do not understand that it is quite difficult to conduct double blind studies with acupuncture is the fact that they fail to see that acupuncture is more than just sticking needles into points. The manipulation of the aforementioned needles is important, as they lead to the deqi sensation. The feeling of deqi (“acquiring qi”) or “needling sensation” can be present upon inserting the needles alone (if done right), or through a bit of manipulation. These manipulations are very dependent on the manual skill of the practitioner. Hence, acupuncture should be treated as a PROCEDURE and not a pill.
Electroacupuncture is a supplement to enhance the "de qi"
You can insert the needles on the same points and not have the same effect if one acupuncturist just pricks the skin and the other manipulates them properly according to the specific needs of the patient. For example I know that some patients are sensitive at LI 4 and only insertion is needed. At the same time others may need a bit of stroking at the handle of the needle to obtain the deqi. This knowledge comes from experience both with the points themselves in general and from knowing patients personally.
Dr MacPherson said: “We carried out two tests of acupuncture on our participants, one where the needles are inserted at a shallow depth which is the practise in Japan and the other where they went in much deeper which is the Chinese tradition.“We found 10 out of the 17 experienced ‘deqi’ while the others didn’t, and this appeared to help in deactivating areas in the brain that are associated with pain.“The Chinese have been using acupuncture for 2,000 years for wide ranging illnesses but we have only touched the surface at the moment.“We believe it can help relieve a number of conditions, including depression which we have recruited 640 people for another study where half will receive acupuncture and the others counselling.”
Note the sequence of events: those who experienced “de qi” deactivated pain centers in the brain. Those who did not… well. I recall the words of the Yellow Emperor’s medical classic, and I paraphrase: for acupuncture to work, you need to obtain de qi. Once de qi is obtained, there is no further need for manipulation.
It's not enough to stick it in. The needles may have to be manipulated to obtain the qi sensation or "de qi"
As for that depression study, I am looking forward to it. Then again the skeptics will just say that a sample size of 640 is too small. Then 1000 will be too small… then 10,000… sigh.
Last summer acupuncture was recommended for the first time by the drugs watchdog NICE (National Institute for Health and Clinical Excellence) as a treatment option for NHS patients with lower back pain.Guidelines now state that GPs should “consider offering a course of acupuncture comprising a maximum of ten sessions over a period of up to twelve weeks” for patients with this common condition.
Nice of NICE to say so.
Co researcher Dr Aziz Asghar, a neuroscientist at Hull York Medical School, added: “The results are fascinating. Whether such brain deactivations constitute a mechanism which underlies or contributes to the therapeutic effect of acupuncture is an intriguing possibility which requires further research.”The team is currently researching if acupuncture has the ability to successfully treat irritable bowel syndrome and depression. Previous studies have indicated the holistic treatment works on knee pain and migraines.Dr MacPherson and colleagues say their research could help to clear the way for acupuncture to be more broadly accepted as a treatment option on the NHS for a number of medical conditions.
But it’ll never be good enough for the “skeptics”.
Oh and my beef about the article title? It shows the linear method of thinking. The scientists found that acupuncture “defuses” pain sensations in the brain – so they conclude that that’s ALL it does. Previous studies have shown acupuncture mediates pain in the spinal level and local level through various mechanisms (google the research of Bruce Pomeranz and Gabriel Stux). It is multifactorial.
For reference, here is the abstract of the article (http://tinyurl.com/yb5p452)
Research ReportAcupuncture needling sensation: The neural correlates of deqi using fMRIAziz UR Asghara, b, Gary Greena, Mark F. Lythgoec, George Lewithd and Hugh MacPhersone, Corresponding Author Contact Information, E-mail The Corresponding Authora York Neuroimaging Centre, University of York, Y10 5DG, UKb Hull York Medical School and Department of Biological Sciences, University of Hull, Hull, HU6 7RX, UKc RCS Unit of Biophysics, UCL Institute of Child Health, University College London, WC1N 3JH, UKd Complementary Medicine Research Unit, University of Southampton, SO17 1BJ, UKe Department of Health Sciences, University of York, YO10 5DD, UKAccepted 7 December 2009.Available online 16 December 2009.AbstractThe needling sensation of deqi is considered by most acupuncturists to be an important component of acupuncture, yet neuroimaging research that investigates this needle sensation has been limited. In this study we have investigated the effect of deqi and acute pain needling sensations upon brain fMRI blood oxygen level-dependent (BOLD) signals. Seventeen right-handed participants who received acupuncture at the right LI-4 (Hegu) acupoint were imaged in a 3T MRI scanner. fMRI datasets were classified, on the basis of psychophysical participants’ reports of needling scores, into those that were associated with predominantly deqi sensations versus those with predominantly acute pain sensations. Brain areas showing changes in BOLD signal increases (activations) and decreases (deactivations) were identified. Differences were demonstrated in the pattern of activations and deactivations between groupings of scans associated with deqi versus pain sensations. For the deqi grouping, significant deactivations occurred, whereas significant activations did not. In contrast, the predominantly acute pain grouping was associated with a mixture of activations and deactivations. For the comparison between the predominately deqi sensation grouping and the acute pain sensation grouping (deqi > pain contrast), only negative Z value voxels resulted (mainly from deactivations in the deqi grouping and activations in the pain grouping) in the limbic/sub-cortical structures and the cerebellum regions of interest. Our results show the importance of collecting and accounting for needle sensation data in neuroimaging studies of acupuncture.Keywords: Functional magnetic resonance imaging; Acupuncture; Needling sensationCorresponding author. Senior Research Fellow, Department of Health Sciences, Area 3, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK. Fax: +1904 321388.Brain ResearchVolume 1315, 22 February 2010, Pages 111-118
Categories: Acupuncture, Research Acupuncture, arrival of qi, bias, Bruce Pomeranz, de qi, depression, Gabriel Stux, irritable bowel syndrome, MRI, needling sensation, neuroimaging, pain, Qi, Research, skeptics
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