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Acupuncture and MS the BASIC FACTS

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Acupuncture and MS the BASIC FACTS Acupuncture and MS THE BASIC FACTS MULTIPLE SCLEROSIS Acupuncture is one form of traditional Chinese medicine that is widely used The theory throughout the world. In the United There are major conceptual differences States, acupuncture was relatively rare between Western medicine and traditional until the early 1970s. Since then, it Chinese medicine. For example, Chinese has grown quickly in popularity, and medical theory does not include the today, possibly a million Americans use concept of a nervous system. In Western acupuncture yearly. The frequency of science and medicine, the nervous system acupuncture being used among people is seen as a critical component in with MS in the United States and Canada understanding and treating many diseases. is not known, but based on two large Furthermore, while “causality” (meaning surveys, it may be higher than in the that process “A” leads to process “B”) is general population. fundamental to many Western concepts, Chinese thought assumes that the world is a web-like array of many interrelated processes that cannot be viewed in isolation or in one-to-one relationships with each other. Acupuncture and MS | 1 Acupuncture, and traditional Chinese medicine generally, is based on a complex The procedure theory of body functioning that involves a flow of energy, or “qi,” through 14 main Acupuncture refers to a group of procedures pathways, or “meridians,” in the body. that involve stimulating specific locations on There is also a balance of opposites the skin. Most often, this involves the insertion known as “yin” and “yang.” According of thin, solid, metallic needles into points on to traditional Chinese medicine, disease the body’s “meridians”. It is believed that this states are thought to be a consequence of alters the flow of energy and thereby produces disrupted energy flow and/or imbalances. improvement. There are approximately 400 acupuncture points, but usually only four to Attempts have been made by scientists to twelve points are used in a single session. explain some of the pain-relieving effects of acupuncture in Western terms. It has Other methods for stimulating the skin are been hypothesized that acupuncture may also used. The acupuncture points can be work by altering the levels of chemical stimulated by: messengers in the body. Specifically, n fingerpressure,whichisknownasacupressure acupuncture may release “opioids” that or,inJapan,shiatsu decrease pain. Other hypotheses propose n smallheatedcupsplacedonthepoints that acupuncture decreases stress or acts as (“cupping”) a placebo. (Improvement occurs because n electroacupuncture,whichuseselectrically the patient strongly believes the treatment stimulatedneedles is beneficial.) n “moxibustion”inwhichsmolderingfibersof In one study using a special type of anherb(Asianmugwortor“moxa”)areplaced magnetic resonance imaging (MRI), onthepoints,orusedtoheatneedlesafter insertion acupuncture at certain sites produced changes in brain activity. These changes, some of which occurred in pain-relevant brain regions, were present during the Studies in MS time in which the pain-relieving effects Few clinical studies have been conducted were present. to assess acupuncture effectiveness in people In the end, it may be found that multiple with MS. One preliminary study conducted processes are involved in acupuncture’s in Canada evaluated whether acupuncture pain-relieving effects—or that current might improve bladder function in people Western biological concepts are with MS. This well designed but small study insufficient to explain the processes. (involving 41 people) suggested that bladder urgency and incontinence might be improved through the use of acupuncture. However, the effect varied depending on the particular acupuncturist performing the procedure. Acupuncture and MS | 2 Several other reported trials of acupuncturein were acupuncture-related improvements in MS involved very small numbers of people anxiety, depression, dizziness, and urinary and were not well designed. It is difficult to difficulties. draw any conclusions based on those studies. It is important to remember that people in Two large surveys—one in the United these studies did not have MS. It cannot be States and one in Canada—have been assumed that these same effects would be conducted involving people with MS experienced by people who do have MS. and acupuncture. Although the results of surveys are not as convincing as those from clinical trials, they are an important Effects on the method for generating ideas for further research. The preliminary findings of both immune system studies are similar. In each, 20–25% of the It is important for people with MS to ask respondents who said they have MS had if acupuncture has an effect on the immune tried acupuncture, and 10–15% of those system, since inflammation and MS attacks who tried it indicated that they planned to are associated with certain overactive immune continue using it. In both surveys, pain, functions. At this time, however, the issue spasticity, and numbness or tingling were is not well understood. Studies focusing on among the symptoms most frequently acupuncture’s effects on the immune system reported to be improved. Other symptoms have been done in people with several forms of that were frequently reported to be improved cancer and rheumatoid arthritis. Acupuncture by acupuncture included fatigue, depression, has been associated variously with stimulating, anxiety, and bowel or bladder function. inhibiting, and having no effect at all on the immune system. Due to these mixed results, Studies in people further studies are needed. without MS Risks and side effects A large number of studies have assessed acupuncture for other medical conditions. In general, acupuncture is a very well tolerated To evaluate these studies in an objective procedure, especially when performed by a manner, the National Institutes of Health well-trained acupuncturist. The NIH panel (NIH), created a 12-member panel in that evaluated acupuncture stated, “The 1997. Based on research data and clinical occurrence of adverse events … has been experience, the panel concluded that documented to be extremely low.” The panel acupuncture is a reasonable treatment option concluded that acupuncture was,“remarkably for stroke rehabilitation, headaches, and safe with fewer side effects than many well- pain (including facial pain, low back pain, established therapies.” and neck pain). Other studies suggested there Acupuncture and MS | 3 Over a 20-year time period, only 216 serious n AmericanAcademyofMedicalAcupuncture acupuncture complications have been reported www.medicalacupuncture.org; 310-364-0193 worldwide. Serious complications, such as n TheAmericanAcademyofAcupuncture puncturing a lung, were associated with andOrientalMedicinewww.aaaom.edu; 651-631-0204 acupuncturists who were poorly trained. n NationalCertificationCommissionfor There are other rare risks. To avoid hepatitis AcupunctureandOrientalMedicine or AIDS, sterile disposable needles should www.nccaom.org; 904-598-1005 be used. People with heart valves that are damaged or prosthetic should probably not be treated with acupuncture to avoid the risk Acupuncture of infection. People who take blood-thinning medication (warfarin or Coumadin®) may combined with occasionally experience bruising or, more rarely, bleeding complications. Electro-acupuncture other asian therapies may produce heart rhythm abnormalities in Traditional Chinese medicine includes Chinese people with pacemakers, and the fumes from herbal medicine, qi gong, lifestyle advice, t’ai moxibustion may worsen breathing in people chi and exercise, as well as acupuncture. with asthma. There are several important considerations regarding Chinese herbal medicine or, indeed, Practical information any type of herbal therapy. Chinese herbal medicine involves treatment with complex Acupuncture is usually done once or twice mixtures of many different herbs. There may be significant variability in the quality and weekly. Sessions typically cost $45–$100. composition of these preparations. Some The length of time required for a course chemical compounds in the herbs may be toxic of treatment varies. If a beneficial response or may interact with prescription medications. occurs, it should usually be noted after six The safety of these herbal preparations in to ten sessions. The length of a complete people with MS has never been extensively course of treatment depends on the specific studied. symptoms and the underlying disease. For MS and other chronic diseases, a longer It is known that some of the herbs used treatment course may be necessary. in herbal medicine stimulate the immune system, which, theoretically, may be harmful In the United States, there are approximately to people with MS. Some of these potentially 30,000 licensed acupuncturists. There are harmful, immune-stimulating herbs include: 3,000 acupuncturists who have M.D. or D.O. Asian ginseng (Panax ginseng), dong quai training. Organizations that can be helpful (Angelica sinensis), astragalus (Astragalus in obtaining information about acupuncture membranaceus), coix, Epimedium sagittatum, and locating a trained acupuncturist include: Acupuncture and MS | 4 reishi mushroom (Ganoderma lucidum), If acupuncture is used, it should only shiitake mushroom (Lentinus edodes), be used in addition to conventional Acanthopanax obovatus, Artemisia myriantha, medicine, in consultation with your Artemisia annua, Salvia Miltiorrhiza, Sophora physician or other licensed health-care
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