Acupuncture Side Effects

Why Needles Have To Be Sterilized

Why Needles Have To Be Sterilized
Following an epidemic of hepatitis B and hepatitisC (and HIV as discovered later) among injecting drug users (IDUs) in Edinburgh, Scotland between 1982 and 1984, a pharmacist decided to provide sterile injecting equipment, a decision that was soon set aside  by superior authorities .After an outbreak of hepatitisB(inflammation of the liver) among IDUs in Amsterdam in 1983, an organization of IDUs asked municipal health authorities to provide sterile injection equipment .This request was initially rejected but the decision was soon reversed, allowing for the establishment of the first official needle syringe programme in the world. The HIV/AIDS was widespread soon became the fundamental reason for this programme and similar programmes were rapidly established in many other parts of the world. Needle syringe programmes now operate officially in over 40 countries. Evaluation of the effectiveness and safety of these programmes began soon after they were first established and a vast literature was rapidly generated.

The general brief for this report was to evaluate the evidence on the effectiveness of sterile needle and syringe programming (including other injecting paraphernalia)for HIV prevention among IDUs in different settings and parts that surround a word or passage, and to recommend how the evidence can guide public health policy-makers in programming for HIV prevention among IDUs.
The report was to include all of the following subcategories: needle and syringe decontamination strategies; needle and syringe exchange; pharmacy, vending(slot-machine selling small items) and other distribution programmes; needle and syringe disposal; and
injecting paraphernalia laws collectively.
Additional feasibility an dimplementation criteria :
Cost effectiveness:

Although estimated in a number of different ways, authorities pay increasing
attention these days to the magnitude of benefit achieved from assigning or devoting of scarce public resources. Is the introduction of NSPs and other interventions cost-effective in all parts of the world and at different stages of an HIV epidemic?

Absence of negative consequences:

Consideration of possible uni-intentional and in-attentive adverse consequences is an important part of evaluating clinical and public health interventions. The presence of unintended negative consequences has a major impact on adoption or expansion of interventions. Fear that increased availability of sterile needle syringe programmes might make worse unlawful or forbidden drug use has been a major factor delaying adoption and expansion of these programmes.

The effectiveness of needle syringe programmes :

Strength of association
There were 48 studies dating from 1989 to 2002 that were identified with NSP implementation as an intervention and HIV super conversion, HIV seroprevalence or HIV risk behaviours among IDUs examined as outcome variables. Some studies assessed multiple outcomes. Out of 11 studies that evaluated HIV superconversion or seropositivity as outcomes  found that NSP use was protective; outcomes in 3 studies were negatively associated with NSP use and 2 studies showed no effect HIV risk behaviour outcomes were examined in 33studies (with some authors reporting on more than one study or outcome). The majority focused on syringe sharing, borrowing, lending or reuse 1 negative and  not fixed in extent while 6 studies examined diverse outcomes including ‘injection frequency’ ,‘proportion of syringes exchanged’ ,‘syringe return rate or exchange rate’ and ‘mortality among NSP users versus non-users’.

Different Tools Used in Acupunture

Tools used in acupuncture:

There are various tools that can be used in acupuncture treatment. Acupuncture needles are the main tool that is used. These needles are placed at various points to improve the function of the affected organs. Acupuncture involves the use of very fine needles inserted into the skin at certain points of the body which are believed to be situated on energy channels called meridians. Acupuncture needles come in different gauges (diameter) and lengths to be used on the different areas of the body where they are to be inserted. Historically, Chinese acupuncture needles have tended to be tapered and thicker than Japanese needles, however, the needles used nowadays are mostly very fine — they vary from 0.12 mm to 0.35 mm in diameter — that’s about a third of a millimeter in diameter for the thickest one. There are several types of acupuncture needles. In ancient China 9 different types of acupuncture needle were used.

Today, the most commonly used needle is the metal filiform (thread-like) needle that is made from stainless steel but can also be made of silver, gold, copper etc. The sizes vary from a 3mm stud used on the earlobe, to 15cm long needles used in deep muscles. The insertion of a needle should not be painful, apart from the initial prick; this is followed by a deeper “needling sensation”, which is similar to the sensation experienced when bumping a “funny bone”. This indicates that the Qi has been successfully stimulated. The majority of needles used today in Australia are pre-sterilized, single use, disposable types. They are manufactured and packed under sterile conditions into foil-backed blister packs with guide tubes on the end. Acupuncture needles are commonly left in for any length of time between a few seconds and half an hour or so. The acupuncturist may tweak the needles during this time. Some specialized very small, short needles are left in for a few days. Electro-acupuncture is another type of acupuncture in which electricity is used as a tool. In certain circumstances it may be necessary to attach electrical clips to some of the needles so that they can be electrically stimulated with an almost imperceptible current. Certain conditions such as osteo-arthritis may require heat, which can be applied by burning the herb Artemisia vulgaris [Mugwort] on the needles or near the acupuncture points.

This painless but very effective treatment is also called “moxa”. Laser acupuncture is latest type in acupuncture. It is done with the help of laser. If all this talk about needles is making you squirm, there is an alternative; acupuncture points can also be effectively stimulated with a low energy laser beam, which is harmless and painless. Many clinical acupuncturists use a laser, which is a modern Western modification. Laser has the distinct advantage of being able to treat children, and those with a needle phobia. They have several other advantages. Some of them are speeding up the healing of injured tissues e.g. ulcers and fever blisters, following injury or surgery, stimulating circulation, reducing inflammation, stimulating new cell growth, reducing fibrous tissue formation e.g. following burns and surgery.

Scientific Researches on Acupunture

Scientific Validation :
There has been a lot of scientific research into acupuncture over the last 20 years. This is really contrary to the popular belief of acupuncture. The ancient principles which were hard to understand in those days have now been largely validated by scientific methods. Some of the scientific methods that validate acupuncture are Bio-energetic, Neurological, Chemical, Placebo effect. Bio-energetic is the method in which there is much evidence to show that the nature of Qi is electro-magnetic. Acupuncture points have a lower electro-magnetic potential, which can easily be demonstrated with a sensitive ohmmeter. Disturbances in bio-energy cause biochemical changes, which in turn cause anatomical changes in the body. Neurological method deals with nerves. Although meridians do not correlate with nerve or circulatory pathways, it has been shown that acupuncture has an inhibitory effect on nerve pain transmission. It also has a direct effect on parts of the brain by increasing the blood flow to the medulla, which relays pain message. Chemical method deals with various chemical reactions taking place inside the body. The body, in response to acupuncture stimulation, releases various chemical substances.

These include endorphins, bradykinins and prostaglandins. Endorphins are pain relieving and mood elevating and are probably responsible for the euphoria that is often experienced after a treatment. Bradykinins are also pain relieving, and prostaglandins have anti-inflammatory effects. Placebo effect is efficient method of scientific validation. Placebo effects are beneficial health outcomes not related to the relatively direct biological effects of an intervention and can be elicited by an agent that, by itself, is inert. Understanding these placebo effects will help to improve clinical trial design, especially for interventions such as surgery, CNS-active drugs and behavioral interventions which are often non-blinded. A literature review was performed to retrieve articles discussing placebo implications of clinical trials, the neurobiology of placebo effects and the implications of placebo effect for several disorders of neurological relevance. Recent research in placebo analgesia and other conditions has demonstrated that several neurotransmitter systems, such as opiate and dopamine, are involved with the placebo effect. Brain regions including anterior cingulated cortex, dorsolateral prefrontal cortex and basal ganglia have been activated following administration of placebo. A patient’s expectancy of improvement may influence outcomes as much as some active interventions and this effect may be greater for novel interventions and for procedures. Maximizing this expectancy effect is important for clinicians to optimize the health of their patient. There have been many relatively acute placebo studies that are now being extended into clinically relevant models of placebo effect. Proponents of acupuncture often argue that the benefits are all in the mind. The scientific term for this concept is the “placebo effect”. It is generally accepted that in any healing, the placebo or psychological effect accounts for about 30% of the benefit, and that one’s state of mind can affect the outcome of any treatment. Despite this benefit, one does not have to believe in acupuncture for it to work; notably, acupuncture works in children and animals, which are not subject to the preconceptions of the placebo effect. Acupuncture does not work any more effectively in one racial group compared to others, nor does it form part of any religion, Eastern or otherwise.

Non-acupuncture points

Non-acupuncture points
Non-acupuncture points were differentiated by their connection to different pathways in the central nervous system. We have found that the pathway connected to the acupuncture point is different from the pathway connected to the non-acupuncture point. In addition, pathway connected to the non-acupuncture point is restrained or prevented within the lateral periaqueductal gray when the analgesia inhibitory system (AIS) is activated. We have explored these pathways by means of selective damage or injury of discrete brain regions, selective stimulation of brain regions, as well as by recording inspiring potentials arising from stimulation of non-acupuncture points. It was found that the lateral centromedian nucleus of the thalamus and the posterior hypothalamus are parts of the AIS. The non-acupuncture (abdominal muscle) points are both connected to the AIS. Analgesia caused by stimulation of the acupuncture point is naloxone reversible, while that caused by stimulation of the non-acupuncture point after injury of AIS is dexamethasone reversible. Stress-induced analgesia caused by low frequency electrical shock is naloxone as well as dexamethasone reversible. All three kinds of analgesia were abolished by hypophysectomy. The features and the degree of analgesia caused by intraperitoneal(within) 0.5 mg/kg morphine were similar to analgesia caused by acupuncture point stimulation. D-phenylalanine acts like a lesion of AIS in analgesia caused by stimulation of non-acupuncture points, and enhances naloxone reversible analgesia. The descending pain inhibitory system plays a role as the common pathway to produce these three kinds of analgesia. This pathway is found in the arcuate nucleus (dopaminergic), ventromedian nucleus of the hypothalamus, raphe nucleus (serotonergic), reticular gigantocellular nucleus (noradrenergic) and reticular paragigantocellular nucleus.
Acupuncture analgesia (AA), caused by low-frequency stimulation of an acupuncture point (AP)–in this case the tibial muscle–was augmented. Nonacupuncture analgesia (NAA), caused under certain circumstances by stimulation of a nonacupuncture point (NAP)–in this case the abdominal muscle–was unmasked by danger in the lateral centromedian nucleus of the thalamus (L-CM) or part of the posterior hypothalamus (I-PH). Stimulation in these regions suppressed the augmented part of the AA and blocked the NAA. These regions were, collectively, given the name analgesia inhibitory system. NAA was abolished, the same as AA, by hypophysectomy. The pathways from the AP and NAP to the pituitary gland were different. AA was naloxone reversible, and NAA was dexamethasone reversible. The analgesia inhibitory system is activated nonspecifically by stimulation of either an AP or NAP. It ascends to the I-PH, literary from the place to the L-CM, and ultimately inhibits the pathway nonspecifically connected to the NAP and AP in the lateral part of the periaqueductal central gray (PAG), without affecting the pathway specifically connected to the AP. Thus, only stimulation of an AP will produce analgesia, whereas stimulation of an NAP will not normally produce analgesia. Stress-induced analgesia (SIA) is produced in a different way than AA or NAA.
In this study, we used the 3 phases of SC-RNV to evaluate the absorption of Tc-99m pertechnetate injected subcutaneously in the acupuncture point SP-10 (Xuehai) and in a non-acupuncture point near SP-10. The results revealed that the absorption of Tc-99m pertechnetate via SP-10 was significantly greater than that of non-acupuncture point, evidenced by shorter phase 1, higher peak activity and greater accelerating rate of phase 2. This suggests that the absorption of radioisotopes from acupuncture point is faster and greater than that of non-acupuncture point.

How does Acupuncture Works

Working of acupuncture?
Acupuncture works on the principle of energy transfer. The human body consists of channels of energy that run in a regular pattern through the body and over its surface. These channels are referred as meridians. These channels are compared to rivers that are flowing through the body to irrigate and nourish the tissues. These meridians may have obstacles in their path which can be compared to a dam that back up. There are many ways to affects these meridians. The effective way to influence these points is needling the acupuncture points in these meridians. Acupuncture needles unblock the obstructions at the dams, and reestablish the regular flow through the meridians. Acupuncture treatments can therefore help the body’s internal organs to correct imbalances in their digestion, absorption, and energy production activities, and in the circulation of their energy through the meridians.

The modern scientific explanation is that needling the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain. These chemicals will either change the experience of pain, or they will trigger the release of other chemicals and hormones which influence the body’s own internal regulating system. The improved energy and biochemical balance produced by acupuncture results in stimulating the body’s natural healing abilities, and in promoting physical and emotional well-being. Research has found that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain. Western scientists have found evidence that acupuncture points are strategic conductors of electromagnetic signals. Stimulating points along these pathways through acupuncture enables electromagnetic signals to be relayed at a greater rate than under normal conditions. These signals may start the flow of pain-killing biochemicals, such as endorphins, and of immune system cells to specific sites in the body that are injured or vulnerable to disease. Studies have shown that acupuncture may alter brain chemistry by changing the release of neurotransmitters and neurohormones. Acupuncture also has been documented to affect the parts of the central nervous system related to sensation and involuntary body functions, such as immune reactions and processes whereby a person’s blood pressure, blood flow, and body temperature are regulated.
Preclinical studies have documented acupuncture’s effects, but they have not been able to fully explain how acupuncture works within the framework of the Western system of medicine. Acupuncture also has been documented to affect functions such as immune reactions and processes whereby a person’s blood pressure, blood flow, and body temperature are regulated. A person will lie on a comfortable surface before the needles are placed, where the position (side, face up or face down) will depend on where the needles should go. Although the procedure of inserting the needles in the body isn’t painful, a sharp sensation may be felt when the needle is inserted first. When the needle reaches the correct depth a deep aching sensation or acupuncture pain is common. Sometimes after the placement, needles are moved or stimulated by heat or electricity. Even though the powerful technologies are available today, the modern physicists cannot explain exactly how this ancient healing therapy works. Perhaps in the near future, the actual chemical and electromagnetic events that occur during acupuncture will be explained.