In a recent post, Trust Your Gut, we talked about the importance of gut health, and how a healthy gut is important to the immune system and balancing the gut-brain axis and nervous system. We have gotten so used to tummy troubles that a lot of people suffer daily, even without a diagnosed digestive disorder; at times, it can be hard to pinpoint the source of the discomfort. Americans are inundated with articles about food sensitivity, overconsumption, and other factors that lead to gastrointestinal problems. The good news is, acupuncture is a safe, effective approach to improving overall gut health, which has a positive impact throughout the body.
Acupuncture can help improve the performance of the different organs in the abdomen, as well as the nervous system, and balance hormonal imbalances – all of which impact gut health. An overactive nervous system alone decreases digestive function, which has a negative impact on how effectively our bodies absorb nutrients and process waste.
The Major Players
Generally, when we think about gut health, the stomach gets all of the attention. There’s more to how the digestive system works.
Chewing, beginning of food breakdown through saliva
Peristalsis – the movement of organ walls, allowing food and liquid to move through the GI tract
Where food and digestive juices meet
Produces digestive juices that help break down carbohydrates, fats, and proteins
Processes nutrients absorbed by the small intestine
Recent studies show that acupuncture can help promote or decrease peristalsis and reduce certain acid outputs.
Some of the areas acupuncture can impact:
Irritable Bowel Syndrome
Nashville’s Best Acupuncturist
Acupuncture has been effective in treating areas of digestive distress for thousands of years. Your acupuncturist will look at the body as a system, rather than a sum of individual parts, in developing a treatment plan specific to you and your needs.
Acupuncture is a relaxing experience. However, new patients might feel a little anxious before their first visit. There are a lot of unknowns and misconceptions about acupuncture. But going for acupuncture treatment in Nashville doesn’t need to make you nervous. Acupuncture is calming, relaxing, and can soothe many sources of aches and pains. Here is what you can expect on your first visit, so you’re anxiety over the treatment can be replaced with excitement.
There are a few things you can do to set your first acupuncture treatment up for success. This preparation starts hours before you even show up for your appointment. The first thing you can do is avoid coffee and alcohol. These stimulants can cloud your mind when one of the goals of acupuncture is awareness. This effectively walks the benefits backwards before you even start.
Be sure you wear loose and comfortable clothing. This makes it easier for the acupuncturist to place the needles where they need to go. Proper placement is essential to the success of treatment. You want to be able to relax and worrying about clothing will take your mind away from one of the major benefits of being there in the first place.
Don’t show up to your appointment with a full stomach. At the same time, don’t show up hungry. An empty stomach can leave patients feeling light-headed and dizzy after an appointment. You’ll want to eat some food before coming in, just don’t go overboard. Eat a meal maybe two hours before going in. But if you’re unsure, err on the side of eating as opposed to not eating.
Finally, you’ll want to show up at your appointment early. Give yourself at least fifteen minutes to fill out some paperwork.
Acupuncture treatment is like going to the doctor’s office, but more relaxing. It might help to frame your experience like this. Expect to be asked questions about your medical history and current symptoms of anything you’d like to be addressed. You should also expect the acupuncturist to give you a short examination and to assess your general health. This information will help the acupuncturist tailor your treatment to you specific needs.
After the initial examination and health assessment, you’ll be asked to lie down. Soft music might be played, the lights will be dimmed, the whole experience is curated to instill a calming mood in the room.
Many people are afraid of needles. Getting their blood drawn or receiving shots make them tense up and grow anxious. These people might be afraid of experiencing acupuncture because of this fear. But the needles used in a doctor’s office are much different from those used in acupuncture. For one thing, acupuncture needles are much smaller than those used for vaccines. These smaller needles make far less impact with the body while also remaining near the surface. They aren’t inserted as far as the needles you might be used to.
Another concern is that of hygiene. But again, this concern doesn’t need to exist. The needles used for acupuncture treatments are sterilized and disposable. This means they are discarded after they are used. The needles used in your first treatment with be the first treatment for the needles, as well.
The acupuncturist will ask you to lie down and get comfortable. They will then insert about ten needles in strategic spots. These needles will remain in place between twenty and thirty minutes. This process can be repeated at the acupuncturist’s discretion.
Much like before your acupuncture appointment, there are a few things you can do to get the most from your treatment. The session itself should have been relaxing and restful, and it’s recommended you try to elongate that feeling as much as possible. Following acupuncture with massage is a great way to give your body and mind the time to process the treatment. If that’s not possible, simply allowing yourself to relax for a couple hours after the appointment works as well.
As before the appointment, avoiding alcohol and caffeine afterwards is recommended. You want to remain mindful and present and these substances will only dull your awareness. Likewise, they will dehydrate you. Remaining hydrated, while good practice all the time, is important after an acupuncture treatment.
Maintain healthy eating practices to avoid introducing toxins to your body. Again, this is a good practice to maintain all the time. But this will help maximize the benefits of your acupuncture treatment.
As far as side effects from the treatments go, the most you can expect is some slight bruising. But if you have some soreness or pain from anything else you should avoid using ice packs and cold treatments. Instead, use heating packs to soothe any soreness.
Why Doctors Approve Acupuncture For Medical Ailments Treatment
The American College of Physicians formally recommends acupuncture for the treatment of back pain. Published in the prestigious Annals of Internal Medicine, clinical guidelines were developed by the American College of Physicians (ACP) to present recommendations based on evidence. Citing quality evidence in modern research, the ACP notes that nonpharmacologic treatment with acupuncture for the treatment of chronic low back pain is recommended. The official grade by the ACP is a “strong recommendation.” 
The Medical Goal of Acupuncture
A major goal of the recommendation is for acupuncture and other nonpharmacological therapies to replace drug therapy as a primary source of pain relief. Treatment with opioids is only recommended, with an official “weak recommendation,” when other modalities do not provide adequate relief. A strong recommendation is also made by the American College of Physicians for the treatment of both acute and subacute lower back pain with heat, massage, acupuncture, and spinal manipulation.  The recommendations were approved by the ACP Board of Regents and involves evidence based recommendations from doctors at the Penn Health System (Philadelphia, Pennsylvania), Minneapolis Veterans Affairs Medical Center (Minnesota), and the Yale School of Medicine (New Haven, Connecticut).
The American College of Physicians notes that approximately 25% of USA adults have had, at the very minimum, a one day lower back pain episode within the past three months. The socioeconomic impact of lower back pain in the USA was approximately $100 billion in the year 2006 . The costs include medical care and indirect costs due to lost wages and declines in productivity.  Recommendations for treatment options, including those for the use of acupuncture, include considerations of positive medical patient outcomes, the total number of back pain episodes, duration between episodes, alleviation of lower back pain, improvement in function of the back, and work disability reductions. Recommendations are for both radicular and nonradicular lower back pain.
The target audience for the American College of Physicians recommendations includes all doctors, other clinicians, and the adult population with lower back pain. The ACP notes, “Moderate-quality evidence showed that acupuncture was associated with moderately lower pain intensity and improved function compared with no acupuncture at the end of treatment .”  In agreement, the National Institute of Neurological Disorders and Stroke (National Institutes of Health) notes that acupuncture is an effective treatment modality for the relief of chronic lower back pain. 
These findings are consistent with those published in Mayo Clinic proceedings finding that acupuncture is effective for the treatment of lower back pain. The same Mayo Clinic report notes that acupuncture does not cause any significant adverse effects.  The Mayo Clinic findings apply to both nociceptive and non-nociceptive pain. Nociceptive back pain includes musculoskeletal inflammation and pain involving nerve cells wherein nociceptors are activated. Nociceptors are afferent neurons in the skin, muscles, joints, and other areas. For example, nerve impingement (often referred to as a “pinched nerve”) produces one type of nociceptive pain.
Non-nociceptive pain does not involve inflammation and is more relevant to pain processing in the central nervous system. One type of non-nociceptive pain condition is fibromyalgia and acupuncture has been confirmed as an effective treatment modality for this condition. The Mayo Clinic proceedings note, “Martin et al. found a significant improvement between electroacupuncture vs sham electroacupuncture. Differences were seen on the Fibromyalgia Impact Questionnaire (FIQ) scores for fatigue and anxiety.” 
The Mayo Clinic and American College of Physicians findings are consistent with additional quality research. Memorial Sloan Kettering Cancer Center (New York) and University of York (United Kingdom) researchers note “We have provided the most robust evidence from high-quality trials on acupuncture for chronic pain. The synthesis of high-quality IPD found that acupuncture was more effective than both usual care and sham acupuncture. Acupuncture is one of the more clinically effective physical therapies for osteoarthritis and is also cost-effective if only high-quality trials are analysed.” 
Doctors understand the true need for effective pain management. Nonpharmacological solutions are important for a variety of reasons including prevention of addiction, effective relief of pain, and prevention of adverse effects. This is often of heightened concern during pregnancy and for children. As a result, university hospitals integrate acupuncture into usual care settings to improve patient outcomes. For example, pediatric doctors at the UCSF Benioff Children’s Hospital San Francisco provide acupuncture to children, including non-needle laser acupuncture. At the University of California hospital, acupuncture is made available for both inpatients and outpatients. Dr. Kim notes that acupuncture reduces nausea up to 70%. She adds that acupuncture is also effective for significant reductions in post-surgical pain and chronic headaches. 
Recently, researchers have discovered how acupuncture stops pain and provides other forms of relief for patients. Breakthrough research conducted by University of South Florida (Tampa) and Fujian University of Traditional Chinese Medicine (Fuzhou) researchers documents how acupuncture stops pain. The researchers note, “acupuncture exerts a remarkable analgesic effect on SCI [spinal cord injury] by also inhibiting production of microglial cells through attenuation of p38MAPK and ERK activation.” 
Microglia are central nervous system immunity cells that secrete proinflammatory and neurotoxic mediators. Acupuncture reduces pain by attenuating this response. The researchers also document that acupuncture provides neuroprotection. The researchers note that acupuncture prevents brain damage in the hippocampus by “preventing microglial activation.” The University of South Florida members of the research team were from the Department of Neurosurgery and Brain Repair and the Department of Pharmaceutical Sciences. Funding was provided by the United States Department of Defense, University of South Florida Neurosurgery and Brain Repair, and the James and Esther King Biomedical Research Foundation.
The aforementioned research reveals an important biochemical mechanism involved in acupuncture’s ability to alleviate pain and reduce harmful inflammation. Researchers focus on other mechanisms activated by administration of acupuncture treatments. For example, laboratory investigations reveal how acupuncture regulates blood pressure.
University of California (Irvine) researchers find acupuncture effective for the treatment of high blood pressure. In a controlled laboratory study, University of California researchers have proven that electroacupuncture at acupoint ST36 (Zusanli) promotes enkephalin production, which dampens proinflammatory excitatory responses from the sympathetic nervous system that cause hypertension. Specifically, electroacupuncture regulates preproenkephalin gene expression, a precursor substance that encodes proenkephalin, which then stimulates the production of enkephalin. 
The formal recommendation for the use of acupuncture in cases of lower back pain by the American College of Physicians is based on modern research. Mayo Clinic findings and research from the Memorial Sloan Kettering Cancer Center (New York) and the University of York support this recommendation. In response to the needs of patients, doctors have already implemented acupuncture into several hospitals throughout the USA and both inpatient and outpatient acupuncture treatments are available.
Now, modern scientific investigations reveal how acupuncture works. University of South Florida and Fujian University of Traditional Chinese Medicine researchers confirm acupuncture’s ability to attenuate microglial activation. University of California researchers have quantified acupuncture’s ability to control inflammation by regulating enkephalins. In addition, the NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) provides professional certification for acupuncturists, which ensures standards of excellence for licensed acupuncturists. Given the large body of supportive research and the administrative support for providing safe and effective acupuncture to the general public, expect to see greater implementation of acupuncture into usual care settings.
References 1. Qaseem, Amir, Timothy J. Wilt, Robert M. McLean, and Mary Ann Forciea. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of PhysiciansNoninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain.” Annals of Internal Medicine (2017). 2. Qaseem, et al. Annals of Internal Medicine (2017).
3. Katz J.N. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences.J Bone Joint Surg Am200688 Suppl 2214. 4. Lam M. Galvin R. Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis.Spine (Philadelphia, Pennsylvania 1976) 201338212438. 5. ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet. Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health. 6. Nahin, Richard L., Robin Boineau, Partap S. Khalsa, Barbara J. Stussman, and Wendy J. Weber. “Evidence-based evaluation of complementary health approaches for pain management in the United States.” In Mayo Clinic Proceedings, vol. 91, no. 9, pp. 1292-1306. Elsevier, 2016. 7. Martin DP, Sletten CD, Williams BA, Berger IH. Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial. Mayo Clin Proc. 2006;81(6):749-757. 8. MacPherson, H., A. Vickers, M. Bland, D. Torgerson, M. Corbett, E. Spackman, P. Saramago et al. “Acupuncture for chronic pain and depression in primary care: a programme of research.” (2017).
9. Leslie Lingaas. ucsf.edu/news/2014/04/113966/acupuncture-helps-young-patients-manage-pain. Acupuncture Helps Pediatric Patients Manage Pain and Nausea, 2014. 10. Lin, Lili, Nikola Skakavac, Xiaoyang Lin, Dong Lin, Mia C. Borlongan, Cesar V. Borlongan, and Chuanhai Cao. “Acupuncture-induced analgesia: the role of microglial inhibition.” Cell transplantation 25, no. 4 (2016): 621-628. 11. Cevic, C and Iseri, SO. The effect of acupuncture on high blood pressure of patients using antihypertensive drugs. Acupuncture & electro-therapeutics research 2013; 38(1-2): 1-15. ncbi.nlm.nih.gov/pubmed/23724695.