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PHYSICAL METHODS TO TREAT MIGRAINE WITHOUT DRUGS: ACUPUNCTURE
In recent years the ancient Chinese technique of acupuncture has become increasingly used. Great claims have been made for the technique, particularly in the field of pain relief e.g. in patients undergoing major surgery with acupuncture anesthesia.
The old Chinese teachings stated that the body consists of a balance of positive and negative forces, the у in and the yang, which flow through the body through various channels, along which there are special points where flow can be influenced. Particular points were thought to relate to specific organs. The acupuncturist feels many acupuncture ‘pulses’ and, through abnormalities in these, arrives at a diagnosis. Insertion of sharp needles into the appropriate combination of points are claimed to produce cessation of pain, as well as healing, in a particular organ.
There is no doubt that this technique can work as far as pain relief is concerned, but the evidence that it influences healing of disease is doubtful. The theoretical basis has no scientific substantiation-no-one has demonstrated the system of channels and points which are meant to cover the body, although there are areas of the skin with a decrease in electrical resistance (corresponding to acupuncture points).
We are then left with the question as to how pain is relieved. Legend has it that acupuncture was evolved following the observation by a soldier that the pain of his wound was relieved when he had been pierced elsewhere in his body by an arrow. In the heat of battle, adrenalin, noradrenalin, and Cortisol are released into the blood stream; in addition, there is increased release of chemicals in the brain called peptides, particularly those involved in the appreciation of pain. This could explain how the body feels less pain when geared for a fight. The arrow wound could act, not only by its effect of further increasing the release of the pain-reducing substances, but also by another mechanism, by affecting the gating mechanism for pain. This theory explains how transmission of other sensations can block pain impulses, preventing them from ascending to consciousness. In effect, the pain gate can be shut by other sensations.
Acupuncture may work through similar mechanisms although the exact mode of action is unknown. Treatment by acupuncture sometimes needs to be fairly painful to be effective and, in some centers, a modified form of acupuncture is used passing a small electric current down the needles.
The usefulness of acupuncture in migraine has not yet been fully assessed. Theoretically the technique is useful for chronic pain but it is not so easy to see why it should be effective in a condition as episodic as migraine, although it has proved useful in the treatment of some cases of chronic migrainous neuralgia.
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