After three 20-minute sessions, each
covered by his medical plan, his blood pressure plunged 20 points.
"Every time I left I was so relaxed;
it was like euphoria," said Mr. Szymanski, 61, who lives in New York. "My
blood pressure stayed down for quite a while."
Acupuncture, long shunned by
mainstream medicine but for centuries considered the crown jewel of
alternative therapy, is slowly gaining ground in doctors' offices around
the country. While some experts still question its effectiveness, studies
in recent years - including one at Duke last week - have thrown scientific
weight behind its benefits, supporting its usefulness in alleviating
conditions from morning sickness to carpal tunnel syndrome.
In the past few years, the number
of hospitals offering acupuncture and other alternative therapies has
doubled. At the same time, postgraduate training programs in alternative
medicine have sprung up at universities around the country, most recently
at Harvard and the University of San Francisco.
"There's a greater demand for
these programs now because so many physicians are interested in learning
acupuncture," said Dr. Nader E. Soliman, an anesthesiologist in Rockville,
Md., and president of the American Academy of Medical Acupuncture. "A lot
of physicians who used to be extremely reluctant to refer patients for the
treatment are now doing it regularly."
Patients curious about
alternative medicine and increasingly skeptical of the drug industry are
also seeking out the procedure, experts say.
A visit to an acupuncturist can
cost $50 to $100. For people working at the right companies, however, it
runs a lot less. More and more employers looking for low-cost additions to
medical plans are embracing the treatment. Nearly 50 percent of workers
with benefits received coverage for it in 2004, compared with just over 30
percent two years ago, according to a survey this month by the Kaiser
Family Foundation and Health Research and Educational Trust.
The trend, it seems, is not
limited to humans. In a society of people attached to their pets, it may
be no surprise that veterinarians around the country say they are also
seeing a greater demand for the service. Dr. Barbara Royal, a vet in
private practice in Chicago, says she has been fully booked virtually
since the day she received her acupuncture license eight years ago.
"People were desperate for it," she said.
Dr. Royal uses the technique
mostly on cats and dogs hobbled by arthritis, but recently she has been
summoned to treat more exotic animals. At Brookfield Zoo in Chicago, she
regularly uses acupuncture to alleviate arthritis in a 1,600-pound
Bactrian camel, now able to run again for the first time in years.
"I think the trend in animals is
correlating with what's happening in humans," she said. "There's a
holistic movement out there, and if people have found something that works
for them, they want it for their pets, too."
But as acupuncture slowly blends
into the mainstream, some experts are calling for tighter regulation. Dr.
Joseph J. Fins, a member of the White House Commission on Complementary
and Alternative Medicine Policy two years ago, said that while acupuncture
was relatively safe and effective, there was no system for tracking
harmful side effects. Without closer monitoring, he said, a careless
acupuncturist who reuses needles that become infected with hepatitis, for
example, might easily go unnoticed.
"Because of how many people are
using it, it's important that we have some kind of surveillance system in
place," said Dr. Fins, who is chief of the division of medical ethics at
Weill Medical College of Cornell University in New York City. "There's no
real mechanism to collect information about the safety and efficacy of
these treatments. It's the same problem with over-the-counter
Experts say that a vast number of
alternative therapies, like oil drips and aromatherapy, have little
scientific base or have yet to be studied properly. But government
financed research on acupuncture dates from the 1970's, about the time the
treatment first started gaining popularity in the United States. It
originated in China over 2,000 years ago.
"Of the many different
alternative therapies, this was really the first one to be studied
seriously by the National Institutes of Health," said Dr. Richard Nahin,
senior adviser for scientific coordination and outreach at the National
Center for Complementary and Alternative Medicine in Bethesda, Md.
Some of the results of the
decades of research on acupuncture have been ambiguous. Because it
involves inserting needles into the skin, creating the equivalent of
placebo pills for control groups in some studies can be complicated,
experts say. And, in some cases, acupuncture has been shown to help ease
certain conditions - like drug addiction - when combined with other
treatments, but not necessarily when used alone.
For other ailments, however,
acupuncture has been found to work better than standard medications - and
without side effects. It has been widely used for years to ease chronic
pain conditions, and studies have repeatedly endorsed its usefulness.
Last week, researchers at Duke
showed that it was far more effective for postoperative sickness and
vomiting in a group of subjects than Zofran, a widely used antinausea
drug. Roughly a quarter of all people who undergo major surgery in the
United States experience retching and illness afterward, usually brought
on by anesthesia. Antinausea medications offer relief, but because they
sometimes cause severe headaches and cramps a number of patients are
reluctant to take them, said Dr. Tong J. Gan, an author of the new study,
published in the journal Anesthesia & Analgesia.
Dr. Gan's study looked at a group
of 75 women who were either given Zofran before major breast surgery or
hooked up to an electroacupuncture machine that delivered low doses of
current during the operation. The high-tech acupuncture technique
prevented illness in all but 27 percent of those who received it, while
about half of the women given the antinausea drug complained of sickness
the next day. The rate of sickness in a control group that received
neither treatment was about 60 percent.
"This is sort of an interesting
time right now," Dr. Gan said. "We are seeing more and more evidence
suggesting that alternative therapies are beneficial, and patients are
gradually demanding it."
To some extent, the increased
acceptance of acupuncture reflects a growing understanding of its
biological mechanism, Dr. Gan said, which until now has largely been a
mystery. Research suggests that stimulating acupuncture points somehow
prompts the flow of endorphins and other hormones that soothe pain. Other
studies find that it affects parts of the central nervous system that
mediate blood pressure and body temperature, among other things.
Dr. Nahin said several imaging
studies that can shed light on how the treatment influences brain activity
are under way.
But whatever acupuncture's
underlying effects turn out to be, experts say its gradual merger with
conventional medicine will have broad implications, eventually opening the
door to closer examination of other popular therapies that lie outside the
"Until now, we've had very little
in the way of credible scientific evidence to compare Eastern or
traditional medicine to a pharmaceutical approach," said Dr. Steven
Eubanks, chairman of the department of surgery at the University of
Missouri. "Hopefully, this will add to our willingness to evaluate other
alternative therapies, and to do so with our usual scientific scrutiny."