New York — Many different approaches are used to manage pain in medicine, and most therapies are pharmacologically based. Acupuncture is one therapeutic modality that can be used as a viable treatment option for painful diseases and conditions (including those seen in dermatology) without the occurrence of the adverse events that can take place with topical, oral or intravenous drug therapies.
Acupuncture has truly stood the test of time and has been used in traditional Chinese medicine for more than 2,500 years. Today, acupuncture is used for a mosaic of conditions encompassing the musculoskeletal system and for headaches and migraines.
At first glance, perhaps the idea of sticking needles into a patient with real medical issues seems like voodoo medicine. However, this notion is far from the truth. The fact is, acupuncture works.
"For more orthodox-thinking people, acupuncture is sometimes looked upon as a mysterious, esoteric practice with only anecdotal effectiveness. The truth is, acupuncture works and has a scientifically recognized efficacy for a variety of conditions, including acute and chronic pain issues," says Michael Bennett, M.S., L.Ac., Dipl.O.M., director of Metropolitan Acupuncture & Herbal Medicine, New York.
The American Academy of Medical Acupuncture has outlined certain conditions for which acupuncture is indicated, some of which include both acute and chronic dermatologic diseases/conditions such as herpes zoster and post-herpetic pain, pruritis, eczema, urticaria and psoriasis. Severe pruritus can be disfiguring and painful and a source of great frustration and anxiety to the affected patient. Mr. Bennett says he has used acupuncture in some of these cases, and has achieved meaningful results in his patients.
In some patients who need to take high doses of pain medication for their medical condition or disease, increasing this dose to quell their pain symptoms may not be the best option. Such cases beg for alternate avenues of therapy. Here, acupuncture could be useful.
Mechanism of action
Acupuncture analgesia is initiated by the stimulation of the sensory nerves in the muscle tissue and epidermal tissues. There are pain gateways that lead from the peripheral areas of the body to the central nervous system.
These trajectories in the body are like channels, which form a series of acupuncture points. When acupuncture needles are placed at these specific cutaneous points, they stimulate the various nerve centers in the body (specifically the spinal cord, the mid-brain and the pituitary) to elicit an analgesic response.
Next, these nerve centers start to release neurochemicals such as endorphins, serotonin, cephalins and norepinephrine, which begin to block the pain signals that the patient may be feeling. Electrical acupuncture is one variant of the art in which an electrical stimulation unit is attached to the stainless steel acupuncture needles, and after their placement, a continuous electrical current is applied at different frequencies to manage pain by the elicitation of the body's natural opioids.
According to the World Health Organization, acupuncture is comparable to morphine preparations in its effectiveness against chronic pain. The major difference is that acupuncture does not cause any of the serious adverse events of morphine.
A typical acupuncture treatment session may last approximately 30 minutes, and, when possible and depending on the level of pain or severity of condition or disease, treatments should be repeated once or twice weekly. According to Mr. Bennett, the alleviation and improvement of pain perceived by the patient is almost immediate.
"My patients swear by the treatment, and many express a profound gratitude for the alleviation of their symptoms," he says. "Though patients know that acupuncture is not a cure for their ailment, they experience a significant improvement in their pain symptoms after a short, 30-minute session. Depending on the severity of their condition, the analgesia could last days to weeks.
"Moreover, all patients appreciate the fact that the treatment is natural and not pharmacologically based, which is often associated with compromised liver function, GI complaints and other adverse events," he says.