Acupuncture to Treat Anxiety Disorders

According to the National Institute of Health, “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older.” In addition, according to the same source, women are 60% more likely to experience anxiety and the average onset of an anxiety disorder is age 11. However, only 42.2% of those with anxiety seek any kind of treatment, and of that only 33.8% are receiving minimally adequate treatment. The take away is that anxiety is something we all experience at some level and we are not doing enough to treat it.

Anxiety can be caused by many factors. From a specific event like an upcoming test, to an uncomfortable conformation with a loved one, to a more serious trauma, anxiety has many roots. Although the roots of the anxiety vary from person to person and must be identified and treated, the anxiety one experiences needs to be managed. Below are some of the bodily responses of anxiety:

•Physical symptoms such as an irregular heartbeat.
•Cognitive symptoms, which can cause negative thoughts.
•Behavioral symptoms, which may include uncharacteristic aggression or restlessness.
•Emotional symptoms, such as fear.

Acupuncture can be a good way to treat anxiety. According to Psychology Central, “In a comprehensive literature review appearing in a recent edition of CNS Neuroscience and Therapeutics, it was proved that acupuncture is comparable to cognitive-behavioral therapy (CBT), which psychologists commonly use to treat anxiety (Errington-Evans, 2011). Another study published in the Journal of Endocrinology in March 2013 discovered stress hormones were lower in rats after receiving electric acupuncture (Eshkevari, Permaul and Mulroney, 2013).” Science clearly agrees that acupuncture is a more than adequate way to help manage anxiety.

To understand how acupuncture helps relieve anxiety is to understand the thoughts behind Traditional Chinese Medicine (TCM). TCM believes in a force called QI that regulates the body’s overall health. QI, like blood, moves through the body via pathways called meridians. When factors like stress or changes in environment disrupt the flow of QI, health issues follow, according to the University of Miami Health System. When an acupuncturist inserts needles at a specific point in the body, balance is restored to the QI and the body’s overall health, the University of Chicago Medicine states. This might seem hard to grasp, but if you consider that QI is just another way of describing chemical reactions taking place in the body, it makes more sense.

Acupuncture needles can affect the body’s chemicals reactions. For example, needles placed in the correct acupuncture point can cause the nervous system to produce painkilling chemicals. It can also jump start the body’s natural healing process or stimulate the part of the brain that controls emotions, including anxiety, according to Dr. Daniel Hsu, a Doctor of Acupuncture and Eastern Medicine. Specifically referring to how acupuncture helps with anxiety, researchers at Georgetown University led by Eshkevari used lab studies to demonstrate that acupuncture slows the body’s production of stress hormones.

One study, published online in the Journal of Acupuncture and Meridian Studies showed that participants who underwent acupuncture for anxiety saw improvements after just one 20-minute session. This means that after just one session, patients could feel relief from their anxiety, and because acupuncture changes the chemical balance in the brain, which makes the patient feel better, it may mean less medication is needed. As the chemicals in the brain are altered, medication, which does the same thing, may no longer have a role to play.

It is important to note that any acupuncture session comes with general, normal side effects. They include minor bruising and dizziness, both of which are minimal as opposed to psychotherapy drugs, which can have more serious side effects. In this sense, acupuncture is much safer for treating anxiety. Plus, unlike drugs that can lead to dependency, acupuncture is not likely to have the same addictive effect.

When it comes to trying acupuncture for anxiety, you have nothing to lose. With a licensed acupuncturist, the risks are almost non-existent and are outweighed by the potential benefits. After just a few sessions, you may even find yourself sleeping better and enjoying other health benefits. If already on treatment for anxiety, acupuncture can make a good addition to your regimen. If it works, you can speak to your doctor about limiting or reducing medication. It is a win-win situation for your health. Even just trying a treatment will make you feel better because you are taking action to alleviate the anxiety instead of worrying and increasing your anxiety level.

Like many medical diagnoses, there is not always a one-size fits all solution. Depending on the person and the individual diagnosis, treatment may vary. For some people, acupuncture alone may work. For others, a combination of therapy, medication, and acupuncture may be best. Consult with your doctor before starting any treatment and discuss a treatment plan that will work for you.

This article originally appeared on Above & Beyond Acupuncture.

It’s Official: Acupuncture Doctor Approved

The American College of Physicians formally recommends acupuncture for the treatment of back pain. Published in the prestigious Annals of Internal Medicine, clinical guidelines were developed by the American College of Physicians (ACP) to present recommendations based on evidence. Citing quality evidence in modern research, the ACP notes that nonpharmacologic treatment with acupuncture for the treatment of chronic low back pain is recommended. The official grade by the ACP is a “strong recommendation.” [1]

A major goal of the recommendation is for acupuncture and other nonpharmacological therapies to replace drug therapy as a primary source of pain relief. Treatment with opioids is only recommended, with an official “weak recommendation,” when other modalities do not provide adequate relief. A strong recommendation is also made by the American College of Physicians for the treatment of both acute and subacute lower back pain with heat, massage, acupuncture, and spinal manipulation. [2] The recommendations were approved by the ACP Board of Regents and involves evidence based recommendations from doctors at the Penn Health System (Philadelphia, Pennsylvania), Minneapolis Veterans Affairs Medical Center (Minnesota), and the Yale School of Medicine (New Haven, Connecticut). 

The American College of Physicians notes that approximately 25% of USA adults have had, at the very minimum, a one day lower back pain episode within the past three months. The socioeconomic impact of lower back pain in the USA was approximately $100 billion in the year 2006 . The costs include medical care and indirect costs due to lost wages and declines in productivity. [3] Recommendations for treatment options, including those for the use of acupuncture, include considerations of positive medical patient outcomes, the total number of back pain episodes, duration between episodes, alleviation of lower back pain, improvement in function of the back, and work disability reductions. Recommendations are for both radicular and nonradicular lower back pain.

The target audience for the American College of Physicians recommendations includes all doctors, other clinicians, and the adult population with lower back pain. The ACP notes, “Moderate-quality evidence showed that acupuncture was associated with moderately lower pain intensity and improved function compared with no acupuncture at the end of treatment .” [4] In agreement, the National Institute of Neurological Disorders and Stroke (National Institutes of Health) notes that acupuncture is an effective treatment modality for the relief of chronic lower back pain. [5]

These findings are consistent with those published in Mayo Clinic proceedings finding that acupuncture is effective for the treatment of lower back pain. The same Mayo Clinic report notes that acupuncture does not cause any significant adverse effects. [6] The Mayo Clinic findings apply to both nociceptive and non-nociceptive pain. Nociceptive back pain includes musculoskeletal inflammation and pain involving nerve cells wherein nociceptors are activated. Nociceptors are afferent neurons in the skin, muscles, joints, and other areas. For example, nerve impingement (often referred to as a “pinched nerve”) produces one type of nociceptive pain.

Non-nociceptive pain does not involve inflammation and is more relevant to pain processing in the central nervous system. One type of non-nociceptive pain condition is fibromyalgia and acupuncture has been confirmed as an effective treatment modality for this condition. The Mayo Clinic proceedings note, “Martin et al. found a significant improvement between electroacupuncture vs sham electroacupuncture. Differences were seen on the Fibromyalgia Impact Questionnaire (FIQ) scores for fatigue and anxiety.” [7]

Learn more about how to alleviate fibromyalgia related pain in the acupuncture continuing education course entitled Fibromyalgia Syndrome Treatments. Click the following to learn more:

Fibromyalgia Online Course >
 

The Mayo Clinic and American College of Physicians findings are consistent with additional quality research. Memorial Sloan Kettering Cancer Center (New York) and University of York (United Kingdom) researchers note “We have provided the most robust evidence from high-quality trials on acupuncture for chronic pain. The synthesis of high-quality IPD found that acupuncture was more effective than both usual care and sham acupuncture. Acupuncture is one of the more clinically effective physical therapies for osteoarthritis and is also cost-effective if only high-quality trials are analysed.” [8]

Doctors understand the true need for effective pain management. Nonpharmacological solutions are important for a variety of reasons including prevention of addiction, effective relief of pain, and prevention of adverse effects. This is often of heightened concern during pregnancy and for children. As a result, university hospitals integrate acupuncture into usual care settings to improve patient outcomes. For example, pediatric doctors at the UCSF Benioff Children’s Hospital San Francisco provide acupuncture to children, including non-needle laser acupuncture. At the University of California hospital, acupuncture is made available for both inpatients and outpatients. Dr. Kim notes that acupuncture reduces nausea up to 70%. She adds that acupuncture is also effective for significant reductions in post-surgical pain and chronic headaches. [9]

Recently, researchers have discovered how acupuncture stops pain and provides other forms of relief for patients. Breakthrough research conducted by University of South Florida (Tampa) and Fujian University of Traditional Chinese Medicine (Fuzhou) researchers documents how acupuncture stops pain. The researchers note, “acupuncture exerts a remarkable analgesic effect on SCI [spinal cord injury] by also inhibiting production of microglial cells through attenuation of p38MAPK and ERK activation.” [10]

Microglia are central nervous system immunity cells that secrete proinflammatory and neurotoxic mediators. Acupuncture reduces pain by attenuating this response. The researchers also document that acupuncture provides neuroprotection. The researchers note that acupuncture prevents brain damage in the hippocampus by “preventing microglial activation.” The University of South Florida members of the research team were from the Department of Neurosurgery and Brain Repair and the Department of Pharmaceutical Sciences. Funding was provided by the United States Department of Defense, University of South Florida Neurosurgery and Brain Repair, and the James and Esther King Biomedical Research Foundation.

The aforementioned research reveals an important biochemical mechanism involved in acupuncture’s ability to alleviate pain and reduce harmful inflammation. Researchers focus on other mechanisms activated by administration of acupuncture treatments. For example, laboratory investigations reveal how acupuncture regulates blood pressure.

University of California (Irvine) researchers find acupuncture effective for the treatment of high blood pressure. In a controlled laboratory study, University of California researchers have proven that electroacupuncture at acupoint ST36 (Zusanli) promotes enkephalin production, which dampens proinflammatory excitatory responses from the sympathetic nervous system that cause hypertension. Specifically, electroacupuncture regulates preproenkephalin gene expression, a precursor substance that encodes proenkephalin, which then stimulates the production of enkephalin. [11]

The formal recommendation for the use of acupuncture in cases of lower back pain by the American College of Physicians is based on modern research. Mayo Clinic findings and research from the Memorial Sloan Kettering Cancer Center (New York) and the University of York support this recommendation. In response to the needs of patients, doctors have already implemented acupuncture into several hospitals throughout the USA and both inpatient and outpatient acupuncture treatments are available.

Now, modern scientific investigations reveal how acupuncture works. University of South Florida and Fujian University of Traditional Chinese Medicine researchers confirm acupuncture’s ability to attenuate microglial activation. University of California researchers have quantified acupuncture’s ability to control inflammation by regulating enkephalins. In addition, the NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) provides professional certification for acupuncturists, which ensures standards of excellence for licensed acupuncturists. Given the large body of supportive research and the administrative support for providing safe and effective acupuncture to the general public, expect to see greater implementation of acupuncture into usual care settings.

Accessibility to care is dependent upon both availability and financial capabilities. Insurance companies have been providing health insurance coverage for acupuncture for decades. Cigna, Blue Cross, Blue Shield, AETNA, United Healthcare, and many other insurance companies provide reimbursement to patients for use of services by licensed acupuncturists. The level of coverage varies, largely dependent upon individual health insurance policy provisions. Licensed acupuncturists can learn more about providing coverage for their patients in the continuing education course entitled Acupuncture Insurance Billing #1. This basic introductory course covers diagnostic requirements, including ICD-10 coding, and other important procedural requirements necessary to obtain reimbursements for patient care.
 

References
1. Qaseem, Amir, Timothy J. Wilt, Robert M. McLean, and Mary Ann Forciea. "Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of PhysiciansNoninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain." Annals of Internal Medicine (2017).
2. Qaseem, et al. Annals of Internal Medicine (2017).

3. Katz J.N. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences.J Bone Joint Surg Am200688 Suppl 2214.
4. Lam M. Galvin R. Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis.Spine (Philadelphia, Pennsylvania 1976) 201338212438.
5. ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet. Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health.
6. Nahin, Richard L., Robin Boineau, Partap S. Khalsa, Barbara J. Stussman, and Wendy J. Weber. "Evidence-based evaluation of complementary health approaches for pain management in the United States." In Mayo Clinic Proceedings, vol. 91, no. 9, pp. 1292-1306. Elsevier, 2016.
7. Martin DP, Sletten CD, Williams BA, Berger IH. Improvement
in fibromyalgia symptoms with acupuncture: results of a randomized
controlled trial. Mayo Clin Proc. 2006;81(6):749-757.
8. MacPherson, H., A. Vickers, M. Bland, D. Torgerson, M. Corbett, E. Spackman, P. Saramago et al. "Acupuncture for chronic pain and depression in primary care: a programme of research." (2017).

9. Leslie Lingaas. ucsf.edu/news/2014/04/113966/acupuncture-helps-young-patients-manage-pain. Acupuncture Helps Pediatric Patients Manage Pain and Nausea, 2014.
10. Lin, Lili, Nikola Skakavac, Xiaoyang Lin, Dong Lin, Mia C. Borlongan, Cesar V. Borlongan, and Chuanhai Cao. "Acupuncture-induced analgesia: the role of microglial inhibition." Cell transplantation 25, no. 4 (2016): 621-628.
11. Cevic, C and Iseri, SO. The effect of acupuncture on high blood pressure of patients using antihypertensive drugs. Acupuncture & electro-therapeutics research 2013; 38(1-2): 1-15. ncbi.nlm.nih.gov/pubmed/23724695.

This article originally appeared on http://www.healthcmi.com

Here's What Just 3 Weeks Of Acupuncture Did For My Digestion, Sleep & Energy Levels

Acupuncture always seemed like a voodoo-type practice to me, so I never considered it an option. However, I recently experienced about two months of consistent bloating to the point that I looked three months pregnant in a swimsuit. I tweaked my diet, cut out coffee, started meditating more, but still the bloating remained. So, I decided to finally give acupuncture a try. What could happen? After all, I have been battling ulcerative colitis for nine years now and have become open to just about anything that will alleviate my symptoms.

I saw an acupuncturist twice a week for one month. He applied traditional acupuncture techniques while incorporating craniosacral work. Here's what happened:

Week 1:

After my first week of treatment, my bloating decreased significantly to where I no longer felt discomfort. Unexpectedly, I also noticed fewer chronic fatigue symptoms. I often get body aches but those were gone and I felt like I had quite a bit more energy.

Week 2:

I told the acupuncturist that I was having a hard time sleeping so he adjusted his needle points accordingly and began performing craniosacral work on my head and neck. Without realizing it, I fell asleep on the table almost immediately and had the most restful sleep I'd had in a while. Even more, I've been able to sleep well and wake up feeling rested ever since this treatment.

In addition, I usually know when my period is about to start by the severe back pain and discomfort in the day and hours leading up to it. The first day of my period is always the worst—and I mean the absolute worst. Painful cramps normally plague me on the first and second day. This time around? I had NONE—I couldn't believe it. The second day showed very slight discomfort but was the easiest period I’ve had in a long time. To me, this meant that the acupuncture was lowering my inflammation levels and helping ease my hormonal changes throughout the month.

Week 3:

I didn’t fall asleep this time, but that is likely because I was already getting great sleep at night and was feeling very alert. I mentioned to the acupuncturist that I was having exams in grad school and that I was stressed about them. Again, he adjusted the location of the needles and let me rest on the table, listening to Bob Marley. Maybe it was the needles, maybe it was Bob—or probably a combination of the two—but I felt like I had just had a massage as I walked out of the office. I also started feeling more alert and energized during the day, without the help of coffee, and was able to focus in classes better than before.

The take-home message? Acupuncture is the bee’s knees! I am officially a skeptic turned believer in just three short weeks. Will the effects keep on lasting? It's hard to say, but so far so good. My health condition is not an easy one to manage, so knowing that this is a viable option for me to help keep my symptoms at bay is absolutely priceless.

This article originally appeared on MindBodyGreen & was written by Holly Campbell.