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Acupuncture boosts effects of painkillers, natural or prescription

August 10, 2009 |  4:30 pm

High-tech images of the brains of chronic pain sufferers have found that the ancient practice of acupuncture fights pain by making key brain cells more sensitive to the pain-dampening effects of opioid chemicals. The study, published online in the August issue of the journal NeuroImage, comes less than a year after the publication of a controversial study that concluded acupuncture was no more effective than sham treatment at reducing pain.

Researchers at the University of Michigan's Chronic Pain and Fatigue Research Center used a positron emission tomography (PET) scanner to view the brains of 20 women diagnosed with fibromyalgia who reported suffering nerve and muscle pain at least 50% of the time. The PET scans were conducted during each woman's first acupuncture session and, a month later, her eighth.

In the regions of the brain that process and dampen pain signals -- the amygdala, caudate, cingula, thalamus and insula -- the PET scans showed an increase in the receptivity -- and possibly the number -- of brain cells to which opioid substances bind. Study author Richard E. Harris said that suggests that acupuncture appears to make the body more responsive to opioid painkillers.

But the mainstay of traditional Chinese medicine also appears to enhance the body's ability to regulate pain naturally, Harris said. Many of the analgesic chemicals the body produces, including endorphins (the source of what endurance athletes call "the runner's high") and enkephalins (which act to tamp down the sensation of pain), also bind to the opioid receptors. So if acupuncture treatments enhance those chemicals' ability to find a receptor to bind to, these natural painkillers work better as well.

Harris, a molecular and cell biologist at the University of Michigan and a licensed acupuncturist, said the group's findings are consistent with research that has found patients treated with acupuncture before surgery often need less post-operative medication to manage their pain. The acupuncture in these cases may have the effect of sensitizing the brain's opioid receptors to medication, making it work better.

The study may even support the controversial earlier finding that sham acupuncture works as well as real acupuncture to reduce pain, but that the two work in to reduce pain in different ways. In that experiment, patients seemed to gain considerable pain relief merely by a procedure that inserted needles into the body randomly, as oppose to following the paths of energy meridians that guide needle placement in acupuncture.

The random sinking of needles through the skin may prompt the body to increase its production of pain-dampening endorphins and enkephalins, Harris surmised. True acupuncture may work differently: Its painkilling effect may come not from boosting the supply of circulating natural analgesics, but by improving the ability of those chemicals to dock at a brain cell and exert their painkilling effects.

While many patients may turn to acupuncture as an alternative to conventional medication, Harris said his group's study suggests that the two means of pain relief can complement each other.

"I don't see them as mutually exclusive, and in some cases, they may work synergistically," Harris said.

-- Melissa Healy

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Comments (5)

"The PET scans were conducted during each woman's first acupuncture session and, a month later, her eighth."

Who the hell has time or money for 8 sessions a month??!! What value is there in this? Let's admit that puritanical attitudes toward opioids drive dead-end research for alternatives, to say nothing of big pharmas getting in on the act with side-effect ridden dicey meds like Lyrica that earn them for more $$$ than cheap effective morphine.

I agree that the massive use of pain-killlers has created a larger need for alternatives, but I don't see our system and lobbist dollars stopping the way that it does business. I am an acupuncturist an I have 8-10 patients currently that I see twice a week to help them with their problems. The pain levels that people deal with can be greater than you would every think possible, I know that I have been suprised. We are a relatively low cost, non-invasive form of treatment and the efficacy of acupuncture is continually growing thanks to newer research.

Hi Julie,

At first, it would appear that it might be cost prohibitive to have 8 acupuncture sessions in a month. That would typically run about 500-600 dollars depending on the going rate in your area. But acupuncture isn't a modality that requires continuous treatment to maintain effects. The study shows that the acupuncture actually changed the participants bodies on a cellular level. It changed the way their bodies functioned. Once the acupuncture has reached a point that improvement has come to a plateau, the patient may require no more treatment or treatment only occasionally to maintain the benefits of treatment. From that point on, the patient will actually be saving money by not needing as much prescription medication or possibly none at all. Not to mention the benefit that comes from decreasing dependency on addictive medications that have other unwanted side effects as well. If more studies like this were done, you might also find that insurance coverage will increase. In large towns and cities you may find a communal acupuncture clinic that treats patients in a group setting at hugely discounted rates or as donation only. So stick in there, if you are suffering it may be worth it.

I am a family practice doctor of 25 years and have been using acupuncture in my practice for 10 years. I have found that it is the most effective tool in medicine. It is both a diagnostic and therapeutic tool and it cost only 2 pennies!!! Because it is so easy and cheap, I will pit a 2 cent needle against the best orthopedic surgeons with a wealth of MRI’s, tests and surgical suites. The acupuncture/needle tool will win 9 to 1! With a needle you can detect changes in the tissue density to determine where to best treat. No other tool in medicine can do that and at the same time treat the diseased tissue. This tool could save the healthcare system billions and relieve a lot of suffering and misery.

Janet G Travell, MD, JFK’s doctor and the matriarch of pain therapy and proved beyond a doubt that needle therapy is better than open surgery. She realized that it is not about the ancient discipline but about a technique of using a needle to effect a cure. Most pain emanates from muscle defects called triggers and once treated pain is cured!!! The curing effect is caused by two simple and documented ways. One by micro injury which begins the healing cascade and the other by neuro-mechanical repolarizing the muscle to release tightness, restriction and pinching. It is that simple! You can delve further into the micro-bio-hormonal chemistry but it is not necessary. Do we question how a cut or incision repairs itself??

If you like to know more on acupuncture check out American Academy of Medical Acupuncture a site dedicated to doctors who have incorporated it into there practice.

(See the Q and A section of my website for more information on my thoughts)

Stephen S. Rodrigues, MD, Dallas, Texas

Important!! Any chronic pain therapy does not work as well in isolation, it must be paired with a wellness package of exercise, stretching, diet, sleep and minerals particularly magnesium.

Stephen S. Rodrigues, MD, Dallas, Texas



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