In an October 2012 article in the Journal of the American Medical Association entitled “Acupuncture for Chronic Pain,” researchers conducted a meta-analysis of almost 18,000 patients from other randomized controlled trials to determine acupuncture’s efficacy in treating four chronic pain conditions: back and neck pain, osteoarthritis, chronic headache and shoulder pain. The researchers found that “acupuncture was superior to both sham and no-acupuncture control for each pain condition,” meaning that “acupuncture is more than a placebo.”
In addition, the World Health Organization has published a list of 28 “diseases, symptoms or conditions for which acupuncture has been proved — through controlled trials — to be an effective treatment.” These include headaches, knee pain, low back pain, neck pain, periarthritis of shoulder, sciatica, sprains and tennis elbow. The list also includes 63 additional conditions for which “the therapeutic effect of acupuncture has been shown but for which further proof is needed.”
“Where There Is Pain There Is No Flow”
Chinese medicine is based on encouraging the unhindered flow of qi (energy, pronounced “chee”) through channels in the body known as meridians. A blockage in flow can cause pain, disease and emotional distress. To understand better, I turned to an expert in acupuncture for pain, Deborah Stotzky, M.S., L.Ac. of Acupuncture + Hot Stones Meridian Therapy.
When she meets with clients, Stotsky first addresses the pain. “I do back pain 70 percent of my day,” she notes. Other common complaints are iliotibial (IT) band pain (common with runners), sciatica and tennis elbow.
While Stotzky focuses on alleviating pain, she knows that other issues could be behind why one person ends up with back pain while another suffers from headaches. “When the musculature is tight and compressing the organs that lay beneath them,” she explains, “it affects the functioning of those organs.”
“Everything manifests itself in the fabric of the body, this musculature,” she says, which is why she uses acupuncture to treat both the symptoms and possible underlying root causes.
For example, with low back pain, she would use acupuncture needles to release the musculature in the lower back, including the quadratus lumborum and paraspinal muscles. She would also choose distal (further away) acupuncture points that might help release the back.
But she would not stop there. Perhaps she learned during the intake that her patient is utterly exhausted, burning the candle at both ends. She would then try to treat the kidney energetic (not the western kidney organ, but the energy channel that corresponds to the kidney in Traditional Chinese Medicine), because a blocked kidney meridian could manifest itself both as low back pain and exhaustion.
Trigger Points and Acupuncture
Dr. Janet G. Travell (1901-1997) literally wrote the book – Myofascial Pain and Dysfunction: The Trigger Point Manual – on trigger points as a cause of musculoskeletal referred pain. The manual compiled the most common muscular trigger points, or “the tightest fiber in an already tight line of muscle fiber,” as Stotzky puts it. Some acupuncturists use trigger points in addition to acupuncture points (sometimes they overlap) to alleviate pain.
The practitioner inserts a thin needle at the site of the trigger point (also called “dry needling), which stimulates a “fasciculation,” an involuntary twitch that causes the muscle to contract for a moment before it completely releases. Sometimes the pain is gone immediately, but for chronic or long-standing problems, you often need a few treatments.
The twitch can be intense and uncomfortable, but it only lasts a few seconds. Because some people arrive at acupuncture after a long time of trying other options, the brief twitch pales in comparison to their chronic pain.
“For some people it’s just a ‘hallelujah’ moment, because with the twitch comes a release of a tight rubber band,” Stotzky says. “It’s really affirming of their pain that has not been affirmed anywhere else.”
You can get trigger point therapy for musculoskeletal pain elsewhere. A good masseuse or acupressurist can do wonders, but it takes a lot longer than dry needling. In addition, if the masseuse does not fully release the trigger point, it can get aggravated and actually feel worse. You can also see a physician for injections of an local anesthetic like Novocaine. In this case the gauge of the hypodermic needle is 22-27, far larger than an acupuncture needle’s fine gauge of 34-36.
An Empowering Treatment
Stotzky enjoys working with people on their treatment. Because every day your body is in a different place, she must locate the trigger points anew each time. Clients tell her where it hurts and how much, so they become part of the solution.
“Acupuncture can be so mysterious,” says Stotzky. With trigger point acupuncture, “people have a palpable experience and release. They are leaving with something tangible. And we’re treating something deeper at the end of the day.”