Lynnae Schwartz, M.D., M.Ac., FAAP
Many chronic pain patients, be they children, adolescents, or adults, find acupuncture treatment to be quite helpful in managing their pain. Based on that positive response, they and their other healthcare providers often ask “how does acupuncture work?” We are now a bit closer to answering that question. I’ve reviewed some of the recent research using tools that measure levels of activity in different brain regions. These studies offer some amazing insights into how acupuncture is helping our patients.
In order to understand this research, we have to first think of the brain and the entire nervous system as a network of communication that carries information from one area of the body to another. Sometimes certain areas of the brain are very active, for example when a person is performing a task, while other areas may be less so. Just like a computer circuit, more activity means more information is processing.
We can actually measure and map levels of activity in different areas of the brain under different conditions. Studies of this nature, e.g. functional MRIs, show that acupuncture causes some areas of the brain to be more active, and other areas to become relatively inactive, depending upon the activity we are performing. These studies have been done in healthy adults, as well as in chronic pain patients.
Therefore, one answer to the question of how acupuncture might “work” is, that when a needle is inserted into an acupuncture point, it changes the way different parts of the brain communicate with one another. In other words, acupuncture[CF1] affect how information is managed in the nervous system. Using this way of thinking, along with studies of brain activity, can help us understand why acupuncture treatment can be truly helpful in chronic painful conditions, such as migraine headache.
[CF2] Migraines are a common and often disabling painful condition. The prevalence of migraine increases with age. Migraines have been diagnosed in children as young as one 1-3 years of age. An estimated 8-23% of teenagers experience them. There is often a family history of migraine, and recent genetic studies have identified several “migraine genes” associated with this pain syndrome.
Interestingly, some pediatric and adolescent patients with migraine headache also have a history of infant colic, or recurrent episodes of a particular kind of muscle spasm called torticollis, or bouts of vertigo, cyclic vomiting, and/or severe abdominal pain. These conditions are now described as childhood periodic conditions. It may be that childhood periodic conditions are a sign that migraine genes are present, and that the child may develop migraines later in life. Further, these conditions may be due to a highly sensitive nervous system, wherein brain regions associated with pain are overactive. Inflammation may also play a role, especially in acute severe migraine attacks.
There have been many research studies in adult migraine patients. These show that acupuncture is indeed helpful, and may be at least as effective as prophylactic drug treatment in reducing the frequency and severity of migraine attacks . Studies of brain activity with acupuncture for pain are helping us understand why. The evidence for benefit in migraine syndromes with acupuncture treatment is now strong in adults because of the large numbers of research trials and study participants. There are far fewer studies of acupuncture in children with headaches; and the quality of those studies is not as good as for adults. But in general, they also indicate that acupuncture may be helpful .
I often treat teens and adults who suffer with migraine headache, and my experience treating these individuals is both positive and professionally gratifying
Throughout the history of Chinese medicine, meticulous observation of the patient and the effect of acupuncture has been the basis for our practice over three thousand years. We are now approaching an era where those observations can be explored and more deeply understood using the ideas and tools of modern neuroscience. Studies in acupuncture treatment of migraine headache show us that such efforts can help us understand how [CF3]
. Linde K et al. Acupuncture for Migraine Prophylaxis. Cochrane Database Systematic Reviews 2011 (1): CD001218.
. Schetzek S et al. Headache in Children: Update on Complementary Treatments. Neuropediatrics 2013; 44: 25-33.
Dr. Lynnae Schwartz is a board certified pediatrician and anesthesiologist with 35 years of clinical experience in academic medical centers. Her life’s work as a medical professional has been dedicated to the care of children and adolescents with complex medical conditions. With great enthusiasm, Dr. Schwartz has joined the Six Fishes team, where she will focus exclusively on providing acupuncture treatment to children, adolescents and other patients with neurological, musculoskeletal, and inflammatory disorders and other complex chronic pain. Read her full bio and schedule an appointment here.