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Pinpointing pain

Western medicine is learning how acupuncture works. The answer may lie with the body's natural painkillers and responses deep in the brain.

October 24, 2005|Elena Conis | Special to The Times

WHEN Melanie Burke's infertility treatments went awry a few years back, she came down with constant throbbing muscle aches, searing back pain, insomnia and migraines so severe they affected her vision.

Burke's doctors wrote off the symptoms as a reaction to the hormones she was taking to help her get pregnant. But the pain persisted long after Burke stopped those treatments. "I saw an orthopedic doctor, a neurologist, two endocrinologists and a physical therapist," says the 47-year-old Santa Monica psychotherapist. "Nothing helped -- I was beginning to think I had something very serious."

Finally, after six straight months of pain-racked days and sleepless nights, Burke turned to acupuncture -- and found relief within two treatments. Her pain subsided so quickly that "within five minutes, I was so relaxed I was on the verge of sleep," she says.

From the traditional Chinese medicine point of view, Burke's qi, or energy flow, had been out of balance. Needles inserted at specific points in her body redirected the flow of her qi and restored her to good health.

For The Record
Los Angeles Times Thursday November 03, 2005 Home Edition Main News Part A Page 2 National Desk 1 inches; 36 words Type of Material: Correction
Acupuncture -- An Oct. 24 Health section article about acupuncture said psychologist Terry Oleson was a director at Emperor's College of Traditional Oriental Medicine in Santa Monica. Oleson is no longer a director at the college.
For The Record
Los Angeles Times Monday November 07, 2005 Home Edition Health Part F Page 8 Features Desk 1 inches; 34 words Type of Material: Correction
Acupuncture -- An Oct. 24 article on acupuncture said psychologist Terry Oleson was a director at Emperor's College of Traditional Oriental Medicine in Santa Monica. Oleson is no longer a director at the college.

From the modern medicine point of view, Burke may have had an endocrine imbalance caused by fertility treatment. The needles helped her through a combination of hormone production, cell changes, neurons firing -- and possibly a bit of mind over matter.

Hundreds of thousands of Americans attain pain relief through acupuncture each year, according to a recent national survey conducted by the Centers for Disease Control and Prevention -- and many, these days, seek the treatment at their doctor's suggestion. Mainstream medical interest in acupuncture has grown as the studies pile up: A National Institutes of Health statement, published in 1997, concluded that the procedure appeared most promising in treating nausea, then pain.

Yet despite this growing Western faith in an ancient Chinese practice, scientists and doctors understand remarkably little, in modern medical terms, about how the procedure works to provide lasting pain relief.

In recent years scientists have begun studying the body's biological responses to the treatment in hopes of shedding light on how a handful of needles and some heat lamps can perform as well as, or better than, Western medicine's strongest pain-killing drugs. They have come up with an array of theories to explain the technique's effectiveness, some of them widely accepted, others too new to assess.

"We're still in the early stages of understanding how it works," said Dr. Ka-Kit Hui, founder and director of the Center for East-West Medicine at UCLA. Already, he adds, studies on the topic are raising interesting questions about the body's physical and emotional responses to pain -- and might someday force Western medicine to reassess its understanding of the nauseous sensation.

A philosophical approach

IN traditional Chinese medicine terms, good health depends upon two things: an unobstructed flow through the body of energy, or qi, along 12 major channels, or meridians, and a balance between the two life forces -- cool, passive yin and warm, active yang. Illness or pain occurs when the flow of qi is blocked, or when one life force dominates the other.

Acupuncture is thought to act on meridians. In the form of the treatment most widely practiced in the U.S., hair-thin needles are inserted into the skin at specific points along the meridians to redirect or unblock stagnant qi. (Other types of acupuncture apply pressure, smoldering herbs or electrical currents at the points.) These so-called acupoints correspond (in traditional theory, at least) to different organs or systems in the body.

For example, inserting a needle at a point inside the forearm known as P6 is intended to treat nausea; needling Liv3, on top of the foot, is meant to help with motor function.

Studies suggest that inserting needles into acupoints does affect the body, and in potentially meaningful ways. In a study of 37 subjects published this year in the journal Neuroscience Letters, inserting a needle into acupoint L14 on the hand -- traditionally used to treat pain -- was shown to deactivate parts of the brain that are involved in processing pain.

Indeed, a decade of acupuncture imaging research has shown that "people who get better with acupuncture have clear changes in their brain function," says Dr. John Farrar, a pain researcher at the University of Pennsylvania School of Medicine. Changes are seen in the thalamus, a brain region that processes information from the senses, including touch and also pain.

But acupuncture also affects activity in the brain region called the cingulate gyrus as well as other brain structures that make up the limbic system, which processes the range of human emotions and memory.

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