Acupuncture is an ancient form of Chinese medicine involving the insertion of solid filiform acupuncture needles into the skin at specific points on the body to achieve a therapeutic effect. No drug is injected. The needles alone create the beneficial effects of acupuncture.
Acupuncture is used to encourage natural healing, improve mood and energy, reduce or relieve pain and improve function of affected areas of the body. It is safe and effective and is often successfully used as an alternative to medications or even surgery. Relief is often obtained with acupuncture when traditional medical therapy has failed.
Acupuncture needles are solid, usually stainless steel (they may also be gold or silver), and measure from 13-70 mm, although longer reusable ones up to about 150 mm in length can be purchased. The needles are very fine, flexible and rounded but sharp at the tip. They are ‘atraumatic’, meaning that they do not have a cutting edge like a hypodermic needle, which slices through tissue. Their design allows acupuncture needles to slide smoothly through tissues and makes them unlikely to cause bleeding or damage to underlying structures.
Acupuncture points (also referred to as ‘acupoints’) are places on the skin that have a lower resistance to the passage of electricity than the surrounding skin and are part of a network of points that were mapped centuries ago by the Chinese. Most are found along ‘meridians’ or ‘channels’ that are believed to be the pathways by which energy or Qi (pronounced ‘Chee’) flows through the body. Acupoints are located either by identifying anatomical landmarks or by the classical method (for example: “the point where the middle finger touches the thigh when standing at attention”).
A dull, heavy, or aching feeling often occurs when the needle is correctly placed. This is referred to as ‘de Qi’ and is considered by some traditional acupuncturists to be necessary for acupuncture to be effective. The experience of AFCI is that relief of pain can often be obtained without provoking the de Qi response. Recent fMRI studies indicate that there is a difference in the response of the brain to needling with and without the de Qi sensation1.
The needles are left in place for 15-30 minutes, and the practitioner may manipulate the needles to strengthen or reduce the flow of Qi. Lifting, twisting, and rotating are some of the needling techniques a practitioner may use.
Other related techniques:
• Electro-acupuncture: needles are electrically stimulated by various frequencies and voltages by attachment to a battery-powered machine using wires with small clips on the ends. Low frequency stimulation (2-4 Hz) results in a slow onset of pain relief that outlasts the treatment for hours to days and is often cumulative by repeating treatments. High frequency stimulation (80-200 Hz) results in a pain-blocking effect that is fast in onset but does not usually outlast the stimulation.
• Moxibustion: Sometimes the needles are heated by attaching and burning a piece of rolled up Artemisia Vulgaris (mugwort) on the needle handle or by holding a cigar-shaped piece of tightly-packed ‘smokeless’ moxa near the handles of the needles. This technique is known as moxibustion or ‘moxa’. In traditional acupuncture there are indications for the use of moxa when there is a ‘cold syndrome’ or for moving energy.
• Auricular acupuncture: the ear is a ‘micro system’, meaning that there is a point on the ear that represents every part of the body 2. The development of a topographical approach to the use of ear points for treating systemically began with Dr. Paul Nogier in Lyon, France in the 1950s. His interest began with the observation of several individuals from Africa who had scars on their external ears in the same location, an area that was used to treat sciatic pain. For more information about this phenomenon, see http://www.sedatelec.com/english/acupauri.htm
• Acupressure: a technique involving pressure on acupuncture points using the thumbs or fingers, capable of giving relief of symptoms in responsive individuals3.
• Shiatsu: a Japanese massage technique that employs points that fairly closely correspond to the Chinese acupoints. For more information, click on these links: http://www.shiatsuassociation.com/site.asp? PageID=10 , http://www.shiatsutherapy.ca/ .
• Electricity-conducting electrodes or moistened cotton-tipped applicators can be used to deliver electrical stimulation to acupuncture points (transcutaneous electrical nerve stimulation or TENS). Low power laser may also be used instead of needles to stimulate appropriate points.
History
Acupuncture originated in China at least 2500 years ago and spread to neighbouring Asian countries including Japan, Vietnam, and Korea by about 500 CE, and finally to Europe in the 16th century. Acupuncture has been practised in France for at least 200 years. Early French practitioners included Sarlandière, probably the first individual to apply electric currents to the needles. He reported having success treating asthma, migraines, rheumatism and various forms of paralysis4.
Acupuncture in the Modern Era:
In spite of its spread to Europe so long ago, most North Americans were unaware of acupuncture until President Richard Nixon made his famous trip to China in 1971. James Reston of the New York Times, a reporter on Nixon’s trip, had the misfortune to develop appendicitis while there. After the surgery he developed ‘paralytic ileus’, meaning that his small bowel stopped functioning and he became bloated with gas. Instead of putting a tube down through his nose to let the gas escape from his stomach, an acupuncture needle was inserted, possibly in his leg. Reston passed his gas and the rest is history. The whole world heard about this amazing phenomenon and before long westerners were being shown operations done without anaesthetic. With a few acupuncture needles in place, the pain of surgery was tolerable and patients were sometimes able to get off the operating table and walk away.
A former heart surgeon from China, now living in Toronto, recounted how he operated on children using acupuncture for pain control and had been asked more than once “Doctor, when will you start?” when he already had the child’s heart in his hand. The lack of after-effects of anesthesia made their post-operative recovery much easier with acupuncture.
History of Medical Acupuncture in Canada:
Acupuncture, no doubt, has been used in Canada since the first Chinese immigrants came to our shores in the 19th century. After Reston’s revelation, interest in acupuncture became intense and Canadians were among the earliest visitors to the People’s Republic of China to observe and study it. In 1974 10 professors of anaesthesia from universities across Canada went to China for an extended visit to learn acupuncture. Three of them set up acupuncture clinics in teaching hospitals in Vancouver, London Ontario and Halifax that functioned for many years.
The forward-looking, open-minded physicians who founded these clinics were:
• Dr. Wolfgang Spoerel, Professor/Chair of Anaesthesia, University of Western Ontario, 1958-1983, a wonderful man who had the courage of his convictions and an insatiable curiosity. He chaired the Acupuncture Committee of the Ontario Medical Association from 1981-84 after a failed attempt to create a clinical Section on Acupuncture in the OMA that he lead, beginning in the mid-1970s. Resistance to acupuncture was high then but Wolf Spoerel just carried on in his quiet, strong and dignified way. It was a great loss when he died in 1989. Those of us who were fortunate enough to have known him and worked with him remember him fondly. Unfortunately, the clinic in London, established in 1974, did not last much beyond 1989. See Dr. Spoerel’s bio at http://anesthesialondon.ca/about-his-chairs.html
• Dr. Ian Purkis, another pioneering Canadian physician, established the acupuncture clinic at Dalhousie University in 1974/75 following his experience in China. He was instrumental in assisting the Acupuncture Foundation of Canada in holding its first course for physicians at Dalhousie in 1981. The pain clinic at ‘Dal’ was a leader in offering acupuncture as part of a more comprehensive approach to pain. In 1976 Dr. Purkis joined the Division of Continuing Medical Education at Dalhousie as an Assistant Director and developed programs which required a commitment for change from the participating physicians, a goal of this quiet but influential Scotsman.
• Dr. Len Jenkins, Professor of Anaesthesia at the University of British Columbia, returned from China and established the Acupuncture Clinic at the Vancouver General Hospital that existed for years. Because acupuncture was not paid for by provincial health care, the VGH clinic was the only place to get acupuncture free of charge and there was a two year wait-list almost from the start.
• The Certificate Program in Medical Acupuncture at the University of Alberta Faculty of Extension was founded in 1991 under the leadership of Dr. Steven Aung. Dr. Aung is Clinical Associate Professor, Faculty of Medicine and Dentistry;
Adjunct Professor, Faculty of Extension and Faculty of Rehabilitation Medicine, University of Alberta. This program has been successful in providing a broad education in acupuncture to licensed practitioners of medicine, dentistry and physiotherapy. http://www.extension.ualberta.ca/acupuncture/index.aspx
The history of the Acupuncture Foundation of Canada and its sister organization the Acupuncture Foundation of Canada Institute can be found in About AFCI History click here.