Acupuncture Confirmed Helpful for Chronic Pain
September 29 2012
By Dr. Mercola
Chronic pain is an exceedingly common condition impacting an estimated 76.5 million Americans, one-third of whom describe their pain as severe and “disabling.” When it comes to treating ailments such as chronic pain, I definitely prefer non-toxic options to modern medicine’s poor excuses for “cures.”
One such option is acupuncture, which can be an effective option for a number of health problems, but pain in particular.
In a recent analysis published in the Archives of Internal Medicine,1 researchers concluded that acupuncture has a definite effect in reducing chronic pain, such as back pain and headaches – more so than standard pain treatment. Real acupuncture also produced slightly better results than using sham needles, which suggests the benefits of needling are due to more than the placebo effect.
“The findings counter those of the last large study on the subject, which found that the needle technique was no better than a fake acupuncture treatment – using random pricking with toothpicks – in reducing people’s pain. But Vickers says his meta-analysis of the data, in which researchers reviewed 29 previous studies involving 17,922 participants, does a few things the previous studies did not.
For one, he and his colleagues began by looking at only the most rigorous trials involving acupuncture and pain relief – those that directly compared acupuncture treatment with some type of sham needle therapy in which needles were either inserted only superficially or placed in locations that are not known by acupuncture standards to be key treatment points in the body.
The authors of the analysis contacted each of the researchers on the previous studies to discuss with them how they separated the two treatment groups. By limiting their review to the most robust studies published, the authors could assess with more confidence acupuncture’s true effect on participants’ reports of pain before and after treatment.”
Clear and Robust Effects of Acupuncture
The researchers also went the extra mile by retrieving the raw data on self-reported pain. By standardizing the various study participants’ responses, they were able to more accurately assess and compare them as a whole. The team discovered a “clear and robust” effect of acupuncture in the treatment of:
- Back pain
- Neck pain
- Shoulder pain
On a scale of 0 to 100, participants who started out with a pain rating of 60 experienced an average 30 point drop (a 50 percent reduction) in response to the real acupuncture treatments (using needles); a 25 point drop when receiving sham acupuncture; and a mere 17 point drop when receiving “standard pain care” that did not include acupuncture. According to the lead author:3
“The effects of acupuncture are statistically significant and different from those of sham or placebo treatments… So we conclude that the effects aren’t due merely to the placebo effect.”
“The authors stressed that although the superiority of true acupuncture over sham acupuncture appeared to be relatively small, the real-world choice patients face is not between acupuncture or fake acupuncture but rather between acupuncture or no acupuncture at all. And in that context they suggested that their findings are ‘of major importance for clinical practice.’
‘Basically what we see here is that the pain relief difference from acupuncture versus no acupuncture is notable, and important, and difficult to ignore,’ [lead author] Vickers said.”
What is Acupuncture?
Acupuncture is an ancient Chinese medical practice with roots that go back thousands of years. According to the Eastern mindset, your body is a cohesive unit, or whole – a complex system where everything within it is inter-connected, and where each part affects all other parts. A major component is the acceptance of an invisible flow of chi (or ki). This chi can be translated as “energy” or “life force,” which circulates through meridians in your body. When energetic blocks or deficiencies occur within a meridian, an imbalance is created that can cause a ripple effect of physical symptoms. Needles inserted into certain points along the meridians can stimulate sluggish chi, disperse blocks, or otherwise manipulate the flow of energy.
In essence, lack of balance within this bio-energetic system – which also includes blood flow and nutrients – is the precursor to all illness. Your body exhibits symptoms when suffering from inner disease and if it is not rebalanced, these symptoms may lead to acute or chronic illnesses of all kinds.
Chinese medicine, contrary to Western allopathic medicine, does not treat symptoms, but rather seeks to find the origin of the imbalance that produced the symptoms in the first place. Another major difference is that acupuncture, which is part of Traditional Chinese Medicine (TCM), is remarkably safe with few, if any, negative side effects, so it certainly doesn’t hurt to try.
Traditionally, acupuncture is used to treat all kinds of health problems. In many Asian cultures, you see an acupuncturist in the same way you’d see a primary care physician here in the West, and in some US states acupuncturists are in fact considered primary health care physicians. Still, many Westerners have been slow to grasp this type of holistic view, where your body is perceived as being perfectly capable of self-correction and healing without drug intervention. Scientists are still at a loss to explain why acupuncture works, but for those who get relief or healing, the mechanics may not be of great importance.
Other Alternative Pain Treatments
Besides acupuncture, there are a number of treatment modalities that can help ease pain, such as:
- Emotional Freedom Technique (EFT): Few people want to be told that their pain is psychological or emotional in origin, but there’s quite a bit of evidence that backs this up. Underlying emotional issues and unresolved trauma can have a massive influence on your health, particularly as it relates to physical pain. According to Dr. John Sarno, a psychiatrist who uses mind-body techniques to treat patients with severe low back pain, EFT has a greater than 80 percent success rate
- Chiropractic adjustments: According to a recent study published in the Annals of Internal Medicine5 and funded by the National Institutes of Health, patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain free in 12 weeks compared to those who took medication
- Massage: Massage releases endorphins, which help induce relaxation, relieve pain, and reduce levels of stress chemicals such as cortisol and noradrenaline – reversing the damaging effects of stress by slowing heart rate, respiration and metabolism and lowering raised blood pressure. It is a particularly effective therapy for stress-related tension, which experts believe accounts for as much as 80 to 90 percent of disease
- Neuro-Structural Integration Technique (NST): NST is a gentle, non-invasive technique that stimulates your body’s reflexes, which can provide relief for back pain. Simple movements are done across muscles, nerves and connective tissue, which helps your neuromuscular system to reset all related tension levels, promoting natural healing. The results can be both profound and lasting, and are usually apparent within two or three sessions.
More Natural Solutions for Pain
If you have chronic pain of any kind, please understand that there are many safe and effective alternatives to prescription and over-the-counter painkillers, though they may require some patience. Among the best are:
- Start taking a high-quality, animal-based omega-3 fat like krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they positively influence prostaglandins.) The omega-3 fats EPA and DHA contained in krill oil have also been found in many animal and clinical studies to have anti-inflammatory properties.
- Reduce your intake of most processed foods as not only do they contain sugar and additives but most are loaded with omega-6 fats that upset your delicate omega 3-6 ratio, which will contribute to inflammation.
- Eliminate or radically reduce most grains and sugars (especially fructose) from your diet. Avoiding grains and sugars will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production. That is why eliminating sugar and grains is so important to controlling your pain.
- Optimize your production of vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain.
In the meantime, you don’t need to suffer unnecessarily. Following are options that provide excellent pain relief without any of the health hazards that pain medications often carry.
- Astaxanthin: One of the most effective oil-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than NSAIDs. Higher doses are typically required and one may need 8 mg or more per day to achieve this benefit.
- Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
- Curcumin: Curcumin is the primary therapeutic compound identified in the spice turmeric. In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility. In fact, curcumin has been shown in over 50 clinical studies to have potent anti-inflammatory activity, as well as demonstrating the ability in four studies to reduce Tylenol-associated adverse health effects.
- Boswellia: Also known as boswellin or “Indian frankincense,” this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
- Bromelain: This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind that most of the bromelain is found within the core of the pineapple, so consider leaving a little of the pulpy core intact when you consume the fruit.
- Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a “joint lubricant” and an anti-inflammatory. I have used a topical preparation for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards.
- Evening Primrose, Black Currant and Borage Oils: These contain the fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
- Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body’s supply of substance P, a chemical component of nerve cells that transmit pain signals to your brain
Chinese Medicine Goes Under the Microscope
By Shirley S. Wang
There’s growing acceptance that herbal medicines could be effective for medical conditions, but the scientific evidence to vault such a treatment into an approved drug is often lacking. As Shirley Wang explains on Lunch Break, researchers are making progress on a cancer treatment based on a common herbal combination in Chinese medicine.
Scientists studying a four-herb combination discovered some 1,800 years ago by Chinese herbalists have found that the substance enhances the effectiveness of chemotherapy in patients with colon cancer.
The mixture, known in China as huang qin tang, has been shown in early trials to be effective at reducing some side effects of chemotherapy, including diarrhea, nausea and vomiting. The herbs also seem to bolster colon-cancer treatment: Tests on animals with tumors have shown that administering the herbs along with chemotherapy drugs restored intestinal cells faster than when chemo was used alone.
The herb combination, dubbed PHY906 by scientists, is a rare example of a plant-based product used in traditional folk medicine that could potentially jump the hurdle into mainstream American therapy. A scientific team led by Yung-Chi Cheng, an oncology researcher at Yale University, and funded in part by the National Cancer Institute, is planning to begin Phase II clinical trials to study PHY906’s effectiveness in people with colon cancer.
Many conventional medications are derived from individual chemical agents originally found in plants. In the case of huang qin tang, however, scientists so far have identified 62 active chemicals in the four-herb combination that apparently need to work together to be effective.
“What Dr. Cheng is doing is keeping [the herbal combination] as a complex entity and using that as an agent,” says Josephine Briggs, head of the federal National Center for Complementary and Alternative Medicine, which is helping fund some of the PHY906 research. “It’s polypharmacy,” or the equivalent of several drugs being administered at once.
Dr. Cheng began his research on huang qin tang about a dozen years ago when he sought a better way of dealing with the chemotherapy’s side effects. A variety of medications are currently used to treat these symptoms, but with varying success. A more effective technique could improve patients’ quality of life and possibly allow them to tolerate a larger dose of chemo, which might speed up their course of treatment, he says.
Dr. Cheng, who grew up in Taiwan, turned to Chinese traditional medicine, which often touts holistic treatments and multiple health claims for a single herb. In herbal literature he found mention of huang qin tang, a herbal combination traditionally used in China for gastrointestinal problems, and decided to test whether it could help cancer patients without compromising the effectiveness of the chemotherapy.
The research team began by giving mice with colon cancer high doses of irinotecan, a chemotherapy drug. Some of the mice also received varying doses of PHY906, the herbal combination. After four days, the animals that got the herbs seemed to experience fewer side effects. The herbs also appeared to improve the efficacy of the chemo, restoring damaged intestinal cells faster than with chemo alone and allowing the mice to tolerate doses of the drug that otherwise might have been lethal.
They followed with another experiment treating animals in four groups. One group received just the chemotherapy drug, another received just PHY906, a third group got both and the last group got nothing. The herb and drug combination worked the best at reducing side effects. As the researchers expected, PHY906 had no impact on the cancer when used by itself.
Further testing showed that PHY906’s effectiveness was diminished if any of the four herbs was eliminated, indicating that there is an apparent synergistic effect between them. This finding “got me serious about [PHY906],” says Dr. Cheng. The work was published in the journal Science and Translational Medicine in 2010. By submitting PHY906 to the scientific rigor of clinical trials, Dr. Cheng aims to win regulatory approval for the compound’s use in cancer treatment.
One challenge with using herbal medicines is that the ratio of the chemicals they contain isn’t consistent when plants are grown under different conditions. After testing various suppliers, Dr. Cheng ended up creating a biotechnology company sponsored by Yale called PhytoCeutica to carefully monitor growing conditions to ensure plants from different batches were pharmacologically consistent and to continue clinical development of the compound.
Why PHY906 works isn’t entirely clear, Dr. Cheng says. The herbal combination appears to have an anti-inflammatory effect on the gastrointestinal tract, according to work the group published in the journal BMC Medical Genomics last year. Dr. Cheng says he believes PHY906 works in at least three different ways in the body to control the side effects of chemotherapy, whereas conventional treatments work in just a single way.
So far, research data seem to support Dr. Cheng’s hunch about traditional medicine. “If it’s still in use after a thousand years there must be something right,” he says.
Write to Shirley S. Wang at email@example.com
Bucking the Mainstream to Focus on Healing Herbs
When cancer researcher Yung-Chi Cheng set out some 12 years ago to study a traditional Chinese medicine, the initial reaction from colleagues and other experts in the field was “pretty bad,” he says.
Colleagues worried that Yale University’s Dr. Cheng, a mainstream, respected professor of pharmacology, was taking a professional risk by delving into possible herbal treatments for cancer. It wasn’t possible to get separate batches of herbs containing chemical compounds that were consistent, they told him. And there wasn’t evidence to support the claim that the herbs had any benefit. “It was rejectionist and narrow-minded,” Dr. Cheng says.
Some herbs and plants with possible cancer-treatment benefits.
What it is being studied for: To reduce tumor growth and brain swelling in patients with gliomas
What it is being studied for: To use with chemotherapy drugs to treat advanced non-small-cell lung cancer
What it is being studied for: To improve sleep in cancer patients undergoing treatment
What it is being studied for: To reduce hot flashes in postmenopausal women with breast cancer
Source: National Cancer Institute
Born in Britain and raised in Taiwan, the 67-year-old Dr. Cheng mainly works at developing better cancer and antivirus compounds. He says he decided to move forward with the work on Chinese herbs on a part-time basis because he felt that whether the medical claims were true or not, they needed to be evaluated closely.
Over the years, the field’s view of this type of work has changed, says Dr. Cheng. With clinical evidence and data showing that the herbal product can be made to be consistent, he has experienced more acceptance from colleagues in the U.S. and internationally. In 2003, he started a global consortium of researchers and pharmaceutical companies studying traditional Chinese medicine.
Dr. Cheng, who earned his doctorate in biochemical pharmacology from Brown University in Rhode Island, has also found it easier over time to get published and to receive funding for the work with herbs, including as a potential treatment for the side effects induced by cancer chemotherapy.
Anticipating the skepticism he might face in developing a plant-based drug, Dr. Cheng didn’t publish his work in a journal until two years ago when he had consistent, clinical evidence and some understanding of the mechanism. “I might as well wait until the whole comprehensive story develops,” says Dr. Cheng. “Now I feel it’s about time.”
—Shirley S. WangCorrections & Amplifications
The common name of the plant Hypericum perforatum is St. John’s wort. In an earlier version of this article, a listing of herbs and plants with possible cancer-treatment benefits misspelled the name as St. John’s sort.
A version of this article appeared April 3, 2012, on page D4 in some U.S. editions of The Wall Street Journal, with the headline: Chinese Medicine Goes Under the Microscope.