Which Diseases Can be Helped by Acupuncture?
Diseases of the Muscles, Bones and Joints
Diseases of the Nervous System
Anxiety, Depression and Other Nervous Disorders
Other Nervous Diseases
Diseases of the Respiratory System
Diseases of the Heart and Blood Vessels
The Correction of Abnormal Heart Rhythms
Raised Blood Pressure
The Use of Acupuncture in Addiction and Obesity
Hard Drug Addiction
The Use of Acupuncture in Obstetrics
The Use of Anaesthesia for Labour and Delivery
Which Diseases Can be Helped by Acupuncture?
In the field of acupuncture few good clinical research trials have been completed, and there has also been very poor follow-up assessment of many of the conditions that have been treated by acupuncturists. It is therefore impossible to give a clear idea of the success of acupuncture in some of the conditions which will be mentioned in the following sections.
It is also essential for the reader to recognize two important facts—firstly that acupuncture, like any treatment, is not a guaranteed cure for disease. Some diseases are more successfully treated (by acupuncture), whilst others are less successful, but no disease responds 100 per cent of the time to any form of treatment. Secondly, some of the suggestions that will be made to illustrate the effectiveness of acupuncture, in particular conditions, are no more than educated guesses. Information about the success rate of acupuncture is not available in some areas, and there the only advice that can be given is based on the clinical experience of individual practitioners.
Before embarking on a course of acupuncture, whatever the condition being treated, it is wise to allow a clear diagnosis to be made. This puts both the patient and the acupuncturist in the position where the complaint can be treated properly, and the results of treatment can be assessed objectively. It may be that Western medicine offers an excellent form of therapy for a particular condition, and in that instance it would be wrong to advise the patient to have acupuncture.
Many of the facts and figures quoted in the following sections are the results of clinical trials carried out in China, so it is worth while mentioning several facts about these 'Chinese trials'. They involve the assessment of a huge number of patients, sometimes up to 10,000, but the published assessments of success and failure are often unclear, and the research is poorly designed. The Chinese also treat their patients for long periods and a stroke patient may receive one hundred or two hundred acupuncture treatments before being declared a success or a failure.
All these factors create difficulties when discussing specific diseases but, in spite of this, I have made an attempt to provide an objective assessment of the effects of acupuncture in some common diseases. It is impossible to cover the whole range of medicine in so short a chapter, so some complaints have been excluded.
It is my hope that future research work will provide information about the effects of acupuncture in a wide variety of diseases, as only with this information will acupuncture make any progress as a recognized form of therapy.
Diseases of the Muscles, Bones and Joints
The muscles, bones and joints are usually called collectively the musculo-skeletal system. When disease or damage occurs to this system it nearly always results in pain, and most people use words such as rheumatism or arthritis to describe this type of pain. Before discussing the effects of acupuncture on such pain, it is important to clarify the conditions that are collectively called 'rheumatic' as some rheumatic diseases respond well to acupuncture whilst others seem to respond less well.
There are three main types of damage that occur to the musculo-skeletal system; the first is a sudden injury or sprain which might be a domestic injury, or might be incurred during a sporting activity or in a car accident. This usually causes local pain and bruising lasting for a few days, or even a few weeks. The other main group is arthritis and this can be divided into two important types, Osteoarthritis and rheumatoid arthritis.
Osteoarthritis is by far the commoner type of arthritis and can be thought of as 'wear and tear' damage to a joint. It usually occurs in older people and tends to affect the spine (both neck and lower-back), the hips, knees, elbows and shoulders. Nobody is clear about the exact cause of Osteoarthritis; it can sometimes run in families or it may result from severe localized damage in earlier life, such as a broken bone. Osteoarthritis tends to develop in one or two of the main weight-bearing joints of the body, but it does not usually affect all the joints of the body. The pain caused by osteoarthritis fluctuates; if a person suffers from osteoarthritis of the knee there will be periods when the knee is painful, and other times when the pain is less severe.
The X-ray of an osteoarthritis joint looks ragged and shows some joint destruction, but such X-ray findings do not correlate with the pain suffered. If joint destruction is demonstrable on the X-ray the patient may not have severe pain, and conversely the patient may have severe pain with few X-ray findings. The main problem with osteoarthritis is pain, which in turn causes a general lack of mobility and limited joint movement.
Rheumatoid arthritis is far less common than osteoarthritis and represents a completely different disease process. The small, non-weight-bearing joints in the hands and feet are affected by an active destructive process. This process is poorly understood and can occasionally result in joint deformity.
Sudden injury or sprains usually respond well to acupuncture. The pain resulting from a sprained shoulder will often continue for some days or weeks after the initial injury. Once a clear diagnosis has been made acupuncture can usually be used to relieve this type of pain. Many of these 'acute pains' represent a self-limiting disease process; for instance a small burn is usually excruciatingly painful for a few days and then settles. If acupuncture is used as a form of pain relief for burns then its 'pain relieving' effect is only required for a few days. Because of the natural history of the pain it is therefore difficult to produce a clear picture of the effect of acupuncture on this type of 'short-lived pain'. In China, acupuncture is usually given for acute pain, but in the West acupuncture is not generally available for 'short-lived pain' as there are not enough acupuncturists to provide this service.
The experience of a variety of acupuncturists, myself included, shows that, of the people treated for differing acutely painful conditions, about 70 per cent obtain swift and significant pain relief. If a fracture of the bone is present then the pain relief gained from acupuncture is less effective than if the injury is due to a strain or tear of the muscles, tendons or ligaments. The main advantage of treating these acute pains with acupuncture is that chronic pain can be avoided. A sudden shoulder injury may produce pain and immobility for many months, sometimes years, but if acupuncture is used when the pain occurs then it seems that chronic pain may be avoided. These 'impressions' about the use of acupuncture in acute pain are consistently quoted, both in the West and China, but until adequate statistical research is completed the effectiveness of acupuncture in 'acute pain' will remain no more than a clinical impression.
Osteoarthritis and the rheumatic pains that result from this type of joint damage, are quite a common problem. People frequently complain that their arthritic knee pain is worse in cold or damp weather and this demonstrates quite clearly the origin of the concept of pathogens in traditional Chinese medicine. The pathogen in osteoarthritis is almost always cold or damp and therefore these pains should be treated by the use of localized heat.
A great deal of research work has been done to investigate the effects of acupuncture on the pain caused by osteoarthritis. Some of this work is excellent but, for a variety of technical reasons, some is poor. Clinical trials have been completed on knee, hip, elbow, neck and lower back pain, and the information from these trials shows that significant pain relief can be achieved in about 70 per cent of those who receive acupuncture. Some work suggests that only 50 per cent of people benefit from acupuncture while other trials show 95 per cent of the patients benefiting.
The effect of acupuncture in osteoarthritis pain does not last for ever, the available research showing that its effects gradually diminish after about six to nine months. Some people may have significant pain relief for up to two years, but the majority of people who gain relief from acupuncture will require further treatment after about six months. Treatment is usually just as effective on the second or third occasion as it was initially.
Osteoarthritis is a condition that naturally causes intermittent pain and discomfort. Patients may find that their osteoarthritis knee is relatively painless for nine months and then goes through a painful period for a further six months. For this reason the effects of any treatment must be compared to the natural history of the disease process and this can cause difficulty in interpreting the results of individual treatments. Acupuncture also has a 'magical quality' that pills do not have, so it is difficult to sort out the effects of the 'magic' as compared to the real effects of acupuncture. In spite of these problems, acupuncture is a safe and effective form of treatment for osteoarthritis.
The effects of acupuncture on rheumatoid arthritis are not so clear cut. During the early, acute, inflammatory stage of rheumatoid arthritis there is some evidence to suggest that acupuncture might worsen the pain and therefore many acupuncturists do not treat acute rheumatoid arthritis. After some months the acute inflammatory stage subsides and the residual joint destruction may then lead to the development of a secondary osteoarthritis. This type of pain is amenable to acupuncture and responds in the same way as other osteoarthritic aches and pains.
Chronic pain, due to disease of the musculo-skeletal system, is frequently amenable to acupuncture treatment. The published research shows that pain which has been present for many years can respond as well as pain that has been present for only a few months; therefore, from the available information, it is fair to say that acupuncture is 'always worth a try' in this type of condition.