By Rachele Kanigel
1 A year and a half after a car accident twisted her back and neck, Catherine Leary was living in
constant pain, unable to sit on stool, lie on her stomach, or stand for longer than five minutes at a time. Her days as an active horsewoman were over. The pain pills her doctors prescribed left her dizzy, nauseated, reeling with headaches. A physical therapist’s traction treatments only increased the throbbing in her neck.
2 When first her family doctor and then her daughter’s tai chi instructor suggested acupuncture, Leary2 panicked. Having needles stuck into her body seemed to her the worst kind of torture. And who
was to say it would work?3 The neurologist, the bone specialist, and the pain specialist she consulted all thought it was a ridiculous idea. But worn down by relentless pain, she was desperate enough to try anything.
3 In the past 25 years millions of Americans have traveled the same path, exhausting conventional Western treatments for their pain and them tentatively venturing into the world of traditional Chinese medicine. Because few health insurers cover acupuncture, most patients, like Leary, have paid the ＄95-to-＄125-per-session charges out of their own pockets. Sometimes they’ve even hidden their trips to the acupuncturist from their doctors, fearful of being ridiculed.
4 But the curtain of doubt over the 5,000-year-old practice is rising. Last fall, after poring over studies and interviewing leading researchers, a panel of experts assembled by the National Institutes of Health4 concluded that acupuncture works. Specifically, the group declared, acupuncture effectively stops the nausea that often accompanies anesthesia, preg- nancy, or chemotherapy, and it shows promise in the treatment of stroke, addiction, and asthma. In addition, the panel reported, patients battling pain—be it headaches, menstrual cramps, or bone disorders5—may find acupuncture a worthy alternative to drugs and surgery.
5 What has convinced a group of doctors and scientists that this needlework is legitimate? Although much of the research is inconclusive ( funding for large controlled studies6 has been scant), several reputable researchers have demonstrated that acupuncture works better than a placebo—and sometimes better than drugs—at relieving a variety of aches. Considering acupuncture has virtually no side effects, the findings are impressive. “I can’t think of a pain-related condition for which I wouldn’t at least try acupuncture,” says Gary Kaplan, a family physician and pain specialist who practices acupuncture at a clin- ic in Arlington, Virginia. “It may not take away all the pain, but if it offers relief or allows patients to use less medication, that’s wonderful.”
6 The pain studies that most impressed the NIH panel were those addressing the dis- confort that follows dental surgery. In one study of 94 patients who had acupuncture imme- diately after having a tooth pulled, 86 percent reported no pain and 10 percent noted slight pain. Only 3 percent said the acupuncture provided no relief.
7 The research on chronic pain is less conclusive but nonetheless persuasive. In a Dan- ish study 29arthritis patients awaiting knee surgery were treated with a acupuncture. Eighty percent said the treatments significantly reduced their suffering; seven were so satisfied that they canceled their operations.
8 Most of us would choose to avoid the knife and day, but what actually happens when the practitioner puts those needles in your skin? That question has been like a wall dividing Eastern and Western doctors to most U.S. physicians, the Chinese explanation lacks credibility because it implies belief in systems that are not mentioned in any conventional Western medical textbook. A vital7 energy called qi, the theory goes, moves through our bodies along invisible pathways called meridians. Good health depends on the proper flow of this energy; disease and pain are the result of qi out of balance. Acupuncturists contend that by inserting needles into particular points on the meridians they can bring a person’s life forces back into balance.
9 In recent years researchers have come up with explanations more acceptable to the Western scientific mind. The prevailing theory is that the needles stimulate the nervous system to release endorphins, the body’s own painkilling chemicals.
10 That idea hasn’t been confirmed, but studies have documented other biological changes that take place during acupuncture. In one that particularly impressed the NIH pan- el, researcher Abass Alavi showed that applying acupuncture needles alters blood flow in the brain. Alavi, chief of nuclear medicine8 at the University of Pennsylvania Medical Center,
was a skeptic when he started looking at acupuncture’s effect on brain function. Like many doctors, he suspected acupuncture acted as a placebo, tricking patients into feeling better because something was being done to them.
11 But then Alavi used an imaging technique to view the brains of nine patients, four pain sufferers and five healthy controls.9 After acupuncturists inserted needles in the pa- tients’ skin, the researchers could see blood flow increase in the thalamus, a rely station10 for pain messages and other sensory information. Changes were also seen in the cortex and brain stem11. these observations don’t reveal how acupuncture blocks pain, but the fact that physiological changes were evident even in the pain- free subjects indicates that forces other than psychological ones were at work. “This brings us a step closer to saying that12 acupuncture is not some form of magic,” Alavi says. “There’s really something to it.”
12 Catherine Leary was almost as skeptical as Alavi when she went to her first appoint- ment with Bradley Williams, a family doctor in Phoenix who has woven acupuncture into his practice for the past 15years. After a nurse took Leary’s blood pressure, Williams came in and began to ask detailed question. Where did she hurt most? What aggravated her discom- fort? How far could she bend over? How would she rate her pain on a scale of one to ten? They talked for a few more minutes; then Williams studied her pulse and tongue, two diag- nostic keys in traditional Chinese medicine.
13 Finally it was time for the needles. As Williams pressed the skin on the back of her neck to find the right point, Leary stiffened in anticipation. She squeezed her eyes tight, waiting for a flash of pain. But when the needle went in, she felt less than a pinprick, a sensation that lasted only an instant. As he inserted more needles in her back, stomach, and feet, some as little as one-sixteenth of an inch deep, other as much as two inches deep, other as much as two inches, she began to feel calm, even sleepy.
14 Half an hour later Williams came back to remove the needles and ask Leary how she was feeling. “My pain was down from about a ten to a four or a five,”13 she recalls. During the next few months, she had nine more treatments and left all but on of them feeling bet- ter.
15 More than two and a half years after the car accident, Leary still isn’t completely healed. She feels some pressure in her back when her horse moves into a trot, and a long afternoon of sitting at one of her daughter’s horse shows14 will leave her sore for a couple of days. But acupuncture has done what the drugs and physical therapy couldn’t: It’s restored her life. ”I figure15 my back will never be like it was before,” she says, “but I’m not in pain. It’s more like an ache or discomfort. I can pick up a bag of groceries or walk my horse now.”
16 Last fall, shortly after telling her State Farm16 claims adjuster how much better she felt, Leary received a surprise in the mail: a check for ＄1,450, the full cost of the treat- ments. Just a few months before, the insurer had said it wouldn’t pay a penny. Apparently Leary and the NIH panelists aren’t the only new believers. (1,272 words)
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Proper Names
Abass Alavi /（男子名）阿巴斯•阿位维
Arlington / 阿灵顿，位于美国弗吉尼亚州东北部
Bradley Williams / （男子名）布位德利•威廉姆斯
Danish / 丹麦的
Gary Kaplan / （男子名）加里•卡普兰
Catherine Leary / （女子名）凯瑟琳•利尔雷
The National Institutes of Health (NIH) 全美医学研究院