Carolyn Vachani, RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 27, 2007
Traditional Chinese Medicine (TCM), which includes the therapies of acupuncture, herbal medicine, and qigong (type of exercise), has been practiced in the Eastern world for thousands of years. The philosophy of TCM is based on the theory of yin and yang, opposing yet complementary phenomena, existing in a state of balance. Yin can be described as cold, slow, feminine, dark, and still; whereas yang is described as hot, fast, masculine, light, and moving. TCM views this as a process in constant motion, with yin and yang waxing and waning, but remaining in balance or equilibrium. When this balance or equilibrium is not present, pain and/or illness can occur.
Qi (pronounced “chee”) is a vital energy that results from the interaction of yin and yang. Qi flows throughout the body in a system of channels called meridians, maintaining equilibrium of bodily functions and delivering nourishing energy to our cells. When this flow is strong, balanced and unobstructed, the person is in a state of health. However, when the flow of qi is interrupted, illness or pain can occur. This can be due to emotional or physical trauma, prolonged stress, imbalanced mental or emotional state, unbalanced diet, exposure to the elements and so on. Acupuncture treats illness by connecting with these meridians, restoring the flow of qi.
TCM is just one type of acupuncture practiced today. Other types of acupuncture include five element, Japanese, Korean, auricular (uses points in the ear), French energetics, and acupressure (where pressure is used at points instead of needles). While each type of acupuncture has a different primary focus or philosophy, they all aim to restore the flow of qi.
Acupuncture techniques are used to redirect or restore the flow of qi by accessing one or more of the 12 primary meridians (and 8 additional meridians) by means of more than 360 acupuncture points, which lie along the meridians. Each meridian is connected to an organ system. The acupuncture points affect the quality and quantity of the flow of qi, in different ways, to support the functioning of the underlying organ system. For example, points along the liver meridian affect the function of the liver through the body, mind, and spirit. The acupuncture practitioner determines what points should be used based on a discussion with the patient about their health concerns, personal behavior and preferences, an examination of their pulses and tongue (color, texture).
As you can imagine, western medicine has had some difficulty grasping the concepts of yin, yang and qi. Researchers have attempted to explain how acupuncture works, but have not been very successful. Acupuncture is thought to work by affecting the nervous system, and by improving the activity of endorphins (natural pain relievers) and/or immune function (by enhancing activity of natural killer cells and lymphocytes). Evidence also suggests affects on neurotransmitters, cytokines, and neuropeptides.
The use of acupuncture in China has been traced back 50,000 BC by archaeology.
It has also been used in other Asian countries, including Japan and Korea, for centuries. Acupuncture has been used in Europe for over 500 years, but despite use in Chinatowns across the United States, it was not widely practiced in the U.S. until the 1970s. In 1976, the U.S. Food and Drug Administration classified acupuncture needles as medical devices, but it was the mid 1990’s before the National Institutes of Health held workshops and conferences related to acupuncture use. A study in 2002 reported that 8.2 million U.S. adults had received acupuncture at some time and 2.1 million had done so in the past year. The National Center for Complementary and Alternative Medicine now funds numerous studies on acupuncture to better define its role and effectiveness.
The acupuncture practitioner inserts very thin needles, ranging in length from 1/2 to 5 inches (although much thinner than a typical needle), into the predetermined acupuncture points. The needles may be stimulated with energy from the practitioner, electrical stimulation or heat (also called moxibustion). The practitioner may also manipulate them by rotating, inserting the needle further or removing it part way. All of this manipulation is an attempt to obtain the flow of qi at the site. The arrival of qi may be felt by the practitioner or reported by the patient as a symptom of temperature change, numbness, itching, dull ache, grabbing or pinching feeling. The needles are left in until this occurs, which generally takes 5-30 minutes, but in some techniques, shorter needles may be left in for several days.
Patients should be sure that the practitioner uses pre-packaged, sterile, one time use needles. Failure to do so can result in infection and the possible transmission of disease from the other patients the needles were used on. The practitioner should discuss the treatment protocol (number and spacing of sessions) prior to beginning therapy.