Relieving pain with acupuncture

The ancient art of acupuncture has been used in Asia for centuries to treat many conditions and relieve pain. It's now being used in the United States and other Western countries to ease everything from low back pain, to nerve pain (such as painful shingles rashes), to headaches, fibromyalgia, and menstrual cramps — and more.

Traditional Chinese acupuncture involves the insertion of extremely fine needles into the skin at specific "acupoints." This may relieve pain by releasing endorphins, the body's natural pain-killing chemicals, and by affecting the part of the brain that governs serotonin, a brain chemical involved with mood.

In Chinese acupuncture, the acupuncturist may turn or twirl the needles slightly or apply heat or electrical stimulation to enhance the effects. He or she may also burn a therapeutic herb near the skin; this is called moxibustion.

A Japanese form of acupuncture involves more shallow needle insertion than in Chinese acupuncture, and the needles aren't usually manipulated. Korean acupuncture focuses on applying needles to points in just the hands and feet.

The acupuncturist typically inserts four to 10 needles and leaves them in place for 10 to 30 minutes while you rest. A usual course of treatment includes six to 12 sessions over a three-month period.

(Acupressure, a similar technique to acupuncture, does not use needles. Instead, the practitioner uses his or her hands to apply deep pressure at acupressure points.)

Acupuncture is generally quite safe, and the complication rate appears to be quite low. A review of acupuncture-related complications reported in medical journals found that the most serious problem was accidental insertion of a needle into the pleural space between the lungs and the chest wall (but this is rare). The advent of single-use, sealed needle packages has all but eliminated the risks of blood-borne infections such as hepatitis B or HIV.

Does acupuncture really work to quell pain? The evidence is mixed, with some studies showing that acupuncture relieves pain and others showing that it works no better than "sham" acupuncture (procedures designed to mimic acupuncture but to have no real effect, much like a placebo, or "sugar pill," used in medication studies). One of the problems with deciphering these results is that most acupuncture studies have been small. The design of "sham" acupuncture techniques has also varied widely, which complicates any comparison. It's also possible that acupuncture works for some people and not others.

If you decide to try acupuncture, seek out an experienced acupuncturist. Licensing requirements vary from state to state. In states with no licensing requirements, your best bet is to find an acupuncturist with certification from the National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org).

For more on treating common pain conditions and learning about other mind-body solutions to relieve pain, buy Pain Relief, a Special Health Report from Harvard Medical School.