Alternative medical practices seem to be gaining speed as they maneuver into our collective health consciousness, but it is often hard for the public to know what to make of them. More major medical centers are offering non-conventional therapies to their patients. But many people may still be wondering, how effective are they?
The confusion about alternative practices is understandable. From acupuncture to yoga, there are a wide variety of methods available and the medical conditions that drive people to seek alternative medical practices are equally varied.
Whatever your reason for considering complementary and alternative medicine, you want to be somewhat skeptical, both because you should be interested in knowing what has been proven to work and because you need to know what is safe.
In addition, research into how these practices actually work on our bodies physiologically is still in its infancy – and the findings we do have are not always conclusive.
The NIH’s National Center for Complementary and Alternative Medicine (NCCAM), favors the term “CAM,” which includes both complementary and alternative medicine. There are four main divisions of CAM: Mind-Body medicine, including acupuncture, meditation, and yoga; Natural Products, which includes herbs and nutritional supplements; Manipulative and Body-Based Practices like massage and spinal manipulation; and “Other Practices” like Reiki, magnet therapy, and Ayurvedic medicine.
Because pain is both physical and mental, it is an excellent candidate to address with mind-body practice.
People turn to CAM for a variety of reasons. Some may be eager to try alternative techniques either because conventional medicine has not worked for a specific condition, or because they wish to avoid medication. Some simply use alternative methods in hopes of improving health and staving off disease.
But whatever your reason for considering complementary and alternative medicine, you want to be somewhat skeptical, both because you should be interested in knowing what has been proven to work and because you need to know what is safe.
This ancient practice is one of the most popular, but one of the most elusive. Dating back 5,000 years, acupuncture is still an important part of medical practice in China where it originated, and in the West, which has adopted it. Surveys have shown, for example that in 2007, approximately 3.1 million Americans had acupuncture in the previous year – this number had tripled from 1997.
According to the director of NCCAM, Josephine M. Briggs, MD, the most promising applications of acupuncture are in pain management, and much research has been devoted to understanding if and when it is effective. Because pain is both physical and mental, it is an excellent candidate to address with mind-body practice.
In the brains of people who had undergone actual acupuncture, there were increased connections between the brain’s resting state network (default mode network, or DMN) and the areas that govern pain and handle memory.
Some have suggested that acupuncture’s effects are actually more pronounced not during, but following treatment. To address this possibility, another team looked at the brains of people who had undergone either actual or sham acupuncture five minutes prior to MRI scanning. They found that that in the brains of people who had undergone actual acupuncture, there were increased connections between the brain’s resting state network (default mode network, or DMN) and the areas that govern pain and handle memory. These results may suggest that the resting network of the brain (and its connection to other areas) continues to be effected after acupuncture ends.
There has been other evidence suggesting that acupuncture works on the brain’s opioid system, which is a large component of the brain’s pain response. Morphine, a potent painkiller, is a type of opioid. A study showing that patients receiving acupuncture were over twice as likely to successfully stop using morphine may support that idea.
Another large review study found that while acupuncture had significant benefits on low back pain compared to Placebo immediately following the treatment. The effects did not last after that. In the same study, acupuncture and sham treatment (skin pricks with toothpicks, but no needles inserted subcutaneously) did not differ in helping neck pain, but they were better than no treatment at all. Acupuncture's effect on migraine pain has been similarly mixed, with some studies finding that acupuncture does seem to have an effect on migraine treatment and even prevention, but that it does not appear to be greater than sham.
'Our minds and bodies are intimately connected, so there’s reason to think that if you’re reassured that you’ll feel better, this will change your perception of pain.'
Dr. Briggs says that part of acupuncture’s effectiveness may have to do with simply being distracted from one’s pain and being reassured by another that we’ll feel better. “Our minds and bodies are intimately connected,” she says, “so there’s reason to think that if you’re reassured that you’ll feel better, this will change your perception of pain.”
The bottom line seems to be that acupuncture may have some effect in reducing pain, but the mechanisms aren’t well demonstrated, and much of it may have to do with alleviating our perception of pain.
Still, says Dr. Briggs, “We’re learning more and more about acupuncture and the central nervous system, and there is a lot of excitement surrounding the use of neuro-imaging studies, like fMRI... We are also interested in real world effectiveness: does it help the healthcare system deal with tough problems like pain conditions that result in prescription abuse?” If acupuncture has even the slightest chance of reducing reliance on medication, this could save money, resources, and the risk of addiction.
Since acupuncture is typically safe and there’s little evidence that acupuncture can hurt you, says Dr. Briggs, it might be worth a try. If you do decide to try the practice, make sure you go to a trained professional who uses aseptic practices (for example, using disposable needles rather than reusable ones). See the NCCAM website for more information on choosing a practitioner.