Demystifying Acupuncture and Chinese Medicine (Part 6)

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***This is a series of articles written by Chris Kresser, I’m posting them here because I have yet to find a better commentary on the modern understanding of acupuncture and Chinese medicine. If you enjoy his writing, you can visit him at chriskresser.com.***

Most people in the US don’t know much about acupuncture. They might have heard it’s good for pain, that it can treat infertility, or that it can help you relax. What most people don’t realise is that acupuncture is a more complete and effective method of healthcare than western medicine.

Here’s why.

#1: Acupuncture treats your whole body

Acupuncture isn’t directed toward a particular disease or condition. It works instead by activating the body’s self-healing ability. This is why acupuncture can address everything from irritable bowel syndrome to back pain to the side effects of chemotherapy.

When you get an acupuncture treatment for elbow pain, your elbow pain will go away but it’s also likely that you’ll see improvements in other areas. The headaches you’ve had for ten years will get better, you’ll have more energy, you’ll be better able to handle stress, and you’ll sleep better.

The reason acupuncture can do this is that it focuses on treating the root cause of your health problems. The ancient Chinese knew that symptoms don’t arise out of nowhere. Symptoms are manifestations of an underlying malfunction and disease process. The progression from malfunction > disease process > symptom can take many years. If you just address the symptom without addressing the malfunction or disease process, healing doesn’t occur.

The Chinese also knew that a malfunction or disease process can give rise to many different symptoms that may seem unrelated. For example, headaches, heartburn and skin rashes may all be expressions of the same underlying problem.

Western medicine, on the other hand, often mistakes symptoms for disease. Treatment is almost always directed at the symptom, not the disease. Western medicine is based on the Cartesian paradigm that has dominated both scientific and philosophical views of the body for the past three hundred years. This philosophy created the notion that the body is a machine composed of many separate parts, and that health can be achieved by simply addressing each part in isolation. There is no consideration for how the parts are connected and related.

This is why in western medicine we have doctors for every different part of our body. We’ve got cardiologists for our hearts, gastroenterologists for our guts, podiatrists for our feet, gynecologist for female reproductive organs, neurologists for our brains, etcetera. We’ve carved our body up into various parts and put different doctors in charge of taking care of each part. In a perfect medical system these doctors would be communicating frequently and sharing ideas about their patients. While this does happen in some cases, all too often it doesn’t. I don’t believe this is the fault of the doctors themselves. They are as much victims of the deficiencies of our healthcare system as patients are.

Acupuncturists have a different perspective, because Chinese medicine is based not on Cartesian dualism but on Chinese philosophy, which is inherently holistic. Acupuncturists look at the body as one interconnected whole. From this viewpoint it is impossible to consider a specific part (like the knee, or the heart) without considering it in relation to the whole. This is of course much more consistent with what we know about how ecological and biological systems (which the body is an example of) operate. And it explains why a single therapy like acupuncture can treat your entire body at the same time.

#2: Acupuncture cures disease

What is a cure? One definition is that a cure has been achieved when the treatment is removed and the dysfunction or illness doesn’t come back.

With the exception of antibiotics, chemotherapy and selective surgery, western medicine does not cure disease. It suppresses symptoms.

How do we know this? If you take a drug for a problem you generally have to take it for the rest of your life. The problem doesn’t go away – it’s being suppressed by the drug. The drug has just replaced a certain function of your body. But as soon as you stop taking that drug, the problem will come back. And often it will be worse than before.

Blood pressure medication is the perfect example of this. It will certainly lower your blood pressure, but it doesn’t do anything to fix whatever was causing your high blood pressure in the first place. People find this out the hard way when they try to stop taking their medication, and their blood pressure skyrockets to a level higher than it was before they started taking the drug.

Why does the problem get worse after taking a drug? Because drugs don’t only suppress symptoms. Drugs also suppress functions. Though drugs provide symptom relief in the short term, over time they may worsen the underlying condition because they interfere with our body’s self-healing mechanisms.

For example, many people take ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) to cope with arthritis and inflammatory conditions. While NSAIDs are effective in reducing pain and inflammation in the short-term, they are also known to reduce blood flow to cartilage. Since blood carries all of the nutrients and immune substance necessary for tissue repair, NSAIDs can actually worsen the original problem when taken chronically.

Drugs also have side effects. Drugs may correct a specific imbalance, but in the process they cause at least one other and often several other imbalances. When this happens in western medicine, other drugs are prescribed to address the side effects caused by the first drug – and so on until the patient ends up on a cocktail of drugs treating the side effects of drugs. (See my article Problem With Your Pill? Take Another Pill! for more on this phenomenon.)

There’s nothing wrong with symptom relief. Anyone who has suffered from a debilitating health condition can tell you that. I believe that symptom suppression with medication is necessary, and even life saving, in certain cases. The problem occurs when symptom suppression with drugs takes the place of other approaches (such as nutritional and lifestyle changes) that address the root of the condition.

Acupuncture, unlike most drugs, has the potential to cure disease. Why? Because as I mentioned above, acupuncture stimulates the body’s self-healing mechanisms. And the body’s ability to heal itself far surpasses anything western medicine has to offer.

The discovery of antibiotics is certainly one of the greatest achievements of medicine (though not without problems, as the recent phenomenon of antibiotic resistance indicates). However, these medications are like children’s toys compared with the extraordinary complexity of the immune system’s ability to heal disease.

The body is capable of spontaneously healing wounds, regenerating tissue, neutralizing toxins, and keeping cancer cells at bay – all while we catch the latest episode of Lost on TV or pick up the kids from soccer practice.

As evolutionary biologist Paul Ewald puts it:

Put bluntly, medicine’s success at vaccination and antibiotic treatment are trivial accomplishments relative to natural selection’s success at generating the immune system… We will probably obtain much better disease control by figuring out how to further tweak the immune system and capitalize on its vastly superior abilities than by relying on some human invention such as new antimicrobials (antibiotics, antivirals or antiprotozoal agents).

Acupuncture does just that: it “tweaks” the immune system and capitalizes on the body’s vastly superior ability to heal itself. That is the strength of acupuncture. However, this strength can also be a limitation. Since acupuncture works by stimulating the body’s built-in healing capacity, if that capacity is impaired or damaged (by poor nutrition, excessive stress, etc.) then the healing power of acupuncture will be limited.

#3: Acupuncture prevents disease

The superior physician makes it his prerogative to treat disease when it has not yet structurally manifested, and prevents being in the position of having to treat disorders that have already progressed to the realm of the physical. The low level physician finds himself salvaging what has already manifested in physical form, and treating what is already ruined.

Amazingly enough, this quote comes from a medical text in China written 2,500 years ago! The idea of “preventative medicine” has received a lot of attention in the west during the past decade. But as the quote above indicates, the Chinese have been aware of the importance of preventative medicine for thousands of years.

Acupuncture and the other branches of Chinese medicine (nutrition, herbal medicine, tai qi, qi gong) restore homeostasis and keep the body functioning at an optimal level. When the body is functioning at an optimal level, we’re far less likely to get sick, and far more likely to recover quickly when we do get sick.

Another way to put it: acupuncture is an effective method of healthcare.

Healthcare, which may be defined as a method of promoting and maintaining health, is not the focus of our current medical system. A more accurate term for the focus of Western medicine would be disease management.

Disease management is important and we certainly need it in the modern world. Yet it’s a mistake to confuse disease management with healthcare. They aren’t the same thing at all.

Western medicine is focused on the treatment of serious disease. Many of the tests, for example, performed in western medicine will not be triggered as abnormal unless the person being tested is already very sick. If a person goes to see a doctor complaining of headaches, digestive problems, fatigue and insomnia, the doctor will run some tests. If the tests come back “normal”, the patient is told that there’s nothing wrong with them! But of course the patient knows that’s not true. They know it’s not normal to have all those problems, and they know that something is wrong.

In fact, until recently doctors thought serious health conditions such as irritable bowel syndrome and fibromyalgia, and physiological changes related to normal life stages like menopause, were “all in the patient’s head”.

Why is western medicine so oriented towards serious disease? Part of the reason is that there is no concept of health in western medicine. If you look in the index of any western medical textbook, you’re not going to find a definition of health. Doctors don’t study health, and what it takes to be healthy, in medical school. They study diseases and the drugs that are used to treat those diseases. This puts western medicine at a serious disadvantage when it comes to promoting health.

I want to emphasize that I am making generalizations here. There are surely many doctors (and I have seen quite a few of them myself) that are deeply committed to the health and well-being of their patients, recognize the interconnectedness of the body and mind, emphasize the importance of preventative care, and prescribe nutritional and lifestyle changes to their patients. In particular I see this with many younger doctors who have graduated from medical school in the past ten to fifteen years. They tend to be much more open-minded to alternatives to drugs and surgery, and more inclined to recommend these alternatives when appropriate. This is an encouraging trend in medicine.

#4: Acupuncture makes your life better

The goal of Chinese medicine is to improve your quality of life and keep you healthy right up until the end. This means you’re rock climbing, snowboarding, playing with your grandchildren, or doing whatever else you enjoy until you pass away in your sleep at a ripe old age.

Western medicine, on the other hand, is focused on the treatment of serious, life-threatening conditions. It is an unsurpassed intervention for trauma and acute emergencies. Doctors can achieve almost miraculous feats to keep people alive, including reattaching severed limbs and literally bringing people back from the dead. It’s also true that antibiotics have nearly eliminated the risk of dying from the infections that were the primary cause of death all the way up until the mid-20th century, and that medications like insulin for Type 1 Diabetes have made a normal life possible for people who otherwise would have died at an early age. These interventions have extended our average lifespan considerably, and their contributions to our quality of life shouldn’t be underestimated.

So I’m certainly not “against” Western medicine. Believe me, if I get in a car accident or someday have a heart attack, I’ll go straight to the hospital. However, if I were to develop type 2 diabetes, I would begin by changing my diet because in many cases type 2 diabetes can be completely controlled with diet alone. (Of course it’s very unlikely that I will ever get diabetes, because my diet and lifestyle make it virtually impossible for that kind of blood sugar dysregulation to occur.) These examples explain my guiding principle in making decisions about my health care: for any given condition, I will choose the treatment that does the most good and causes the least harm. In my experience, acupuncture and Chinese medicine fits this guiding principle far more often than drugs and surgery.

#5: Acupuncture won’t kill you or make you sick

Primum non nocere, or “first, do no harm” is one of the principal precepts of medical ethics that students are taught in medical school. Another way to state this principle is, “given an existing problem, it may be better to do nothing than to do something that risks causing more harm than good.”

Somewhere along the line this important precept got swept under the rug. While western medicine has made tremendous contributions to disease management, it has also proven to be dangerous to our health.

We may have the most advanced disease management system in the world, but the US is far behind most other industrialised countries when it comes to health. The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators.

Even worse, a recent study (PDF) by Dr. Barbara Starfield published in 2000 in the prestigious Journal of the American Medical Association demonstrated that medical care is the 3rd leading cause of death in this country, causing more than 250,000 deaths per year. Only heart disease and cancer kill more people. Although this study was published in one of the most reputable medical journals in the world, it received little media attention and my guess is that few doctors have heard of it.

Dr. Starfield estimates that, each year, medical errors and adverse effects of the health care system are responsible for:

  • 116 million extra physician visits
  • 77 million extra prescriptions
  • 17 million emergency department visits
  • 8 million hospitalizations
  • 3 million long-term admissions
  • 199,000 additional deaths
  • $77 billion in extra costs

As grim as they are, these statistics are likely to be seriously underestimated as only about 5 to 20% of medical-care related incidents are even recorded. Analyses which have taken these oversights into consideration estimate that medical care is in fact the leading cause of death in the U.S. each year.

I ask you this: can a medical system that potentially kills more people each year than any other cause of death else be considered “healthcare”?

In contrast to western medicine, acupuncture is extremely safe and well-tolerated. A recent cumulative review published in the British Medical Journal examined the incidence of adverse effects with acupuncture in more than one million treatments.

According to the evidence from these studies, the risk of a serious adverse event with acupuncture is estimated to be 0.0005% per 10,000 treatments, and 0.0055% per 10,000 individual patients.

The authors conclude:

The risk of serious events occurring in association with acupuncture is very low, below that of many common medical treatments. The range of adverse events reported is wide and some events, specifically trauma and some episodes of infection, are likely to be avoidable.

The incidence of milder side effects during acupuncture is also relatively low. In a study of 230,000 patients who received an average of 10 treatments each, 8.6% reported experiencing at least one adverse effect and 2.2% reported one which required treatment. Common adverse effects were bleedings or hematoma (6.1% of patients, 58% of all adverse effects), pain (1.7%) and drowsiness (0.7%).

To put that in perspective, a review of more than a hundred phase I double-blind, placebo-controlled trials reported that 19% of those receiving placebo experienced side effects, with higher rates following repeated dosing and in the elderly.

This suggests that placebos (sugar pills) may cause more side effects than acupuncture.

I hope this article has helped you to understand the power of acupuncture and Chinese medicine and its relevance as a genuine system of healthcare. And I hope this series of articles has made clear that acupuncture is not a “woo-woo” energy therapy, but a complete system of medicine based on known anatomical and physiological principles.

I would love to hear your feedback on how these articles have affected your perception and understanding of acupuncture. Please leave a comment!

If you’d like to refer people to this series of posts in the future, I’ve created a special “acupuncture” page on the blog with an index of all of the articles in the series. It’s listed on the right hand side of the page, in the sidebar, under “Health Reports”.

  1. Ewald, P. Plague Time. p.64
  2. See chapter 2 of the Suwen, in Nanjing Zhongyi Xueyuan, ed., Huangdi neijing suwen yishi (An Annotated Text With Translation of the Yellow Emperor’s Classic of Medicine: Plain Questions) (Shanghai: Shanghai Kexue Jishu Chubanshe, 1991), p. 16;
  3. Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press; 1998.
  4. General Accounting Office study sheds light on nursing home abuse. July 17, 2003 . Available at: http://www.injuryboard.com/view.cfm/Article=3005. Accessed December 17, 2003
  5. Rosenzweig P, Brohier S, Zipfel A. The placebo effect in healthy volunteers: influence of experimental conditions on the adverse events profile during phase I studies. Clin Pharmacol Ther 1993;54:578-83.

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