Stress and acupuncture
Up to half a million people in the UK experience work-related stress every year, which often results in illness.(Health and Safety Executive 2011) Other factors that affect stress levels include alcohol, smoking, exams, pregnancy, divorce, moving, death in family, lifestyle, drugs, poor nutrition and unemployment.
The signs of stress can vary from one individual to the next.(NHS Choices 2011) They may manifest physically as an illness, tiredness or lethargy, or as symptoms such as sore, tight muscles, dull skin, lank hair, or erratic sleep patterns. Mental stress can result in depression, mood swings, anger, frustration, confusion, paranoid behaviour, jealousy or withdrawal.
Stress is a common complaint cited by acupuncture patients, with a variety of possible associated symptoms. The most prevalent of these is anxiety. Some other conditions that can be affected by stress are back pain, chronic pain, depression, headache, insomnia, irritable bowel syndrome, menopausal symptoms, migraines, premenstrual syndrome and urinary incontinence.
Conventional treatments include medication such as anti-anxiety drugs, antidepressants, cognitive behavioural therapy and relaxation techniques.(NHS Choices 2011)
How acupuncture can help with stress
Some studies have found acupuncture to be of benefit in reducing stress, among these are the following;
In a study using 17 volunteers, the use of one specific acupuncture point led to marked reductions in stress (Chan 2002). The acupuncture point called “Heart 7” was needled in four weekly sessions using volunteers recruited from staff in a hospice. 16 of them (94%) showed improved ‘psychological stress’ according to the Edinburgh Postnatal Depression Scale (EPDS). The greatest fall in the EPDS scores was observed within the first two treatments and at the end of the study the average reduction was 44%.
Another study, which was a randomised controlled trial (RCT), suggested that acupuncture might be successful in treating the symptoms of chronic stress (Huang 2011). A group of 18 patients was used in the study. The Perceived Stress Scale 14 (PSS-14) and the “Measure Yourself Medical Outcome Profile” (MYMOP) were completed before and after treatment. After 5 weeks, the acupuncture group reported significant changes. Improvements were not limited to the acupuncture group and were observed in other groups too. The study concluded that acupuncture might be successful in treating symptoms of stress
Other RCTs have investigated acupuncture in very specialised situations. As an adjunct to anaesthesia, it was found to help keep haemodynamics stable and reduce the stress response during laparoscopic cholecystectomy (Wu 2011). Acute acupuncture appeared to control excessive sympathetic excitation during mental stress in patients with advanced heart failure (Middlekauff 2002).
Several uncontrolled studies have looked at various aspects of stress and the effects of acupuncture. One found that it might be effective in attenuating psychological distress, as well as increasing cellular immunity (Pavao 2011). In another, acupuncture was associated with less stress around embryo transfer and improved pregnancy rates in women having IVF (Balk 2010).
In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being.
Research has shown that acupuncture treatment may specifically benefit anxiety disorders and symptoms of anxiety by:
- Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);
- Improving stress induced memory impairment and an increasing AchE reactivity in the hippocampus (Kim 2011);
- Reducing serum levels of corticosterone and the number of tyrosine hydroxylase-immunoreactive cells (Park 2010);
- Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain’s mood chemistry to help to combat negative affective states (Lee 2009; Cheng 2009; Zhou 2008);
- Stimulating production of endogenous opioids that affect the autonomic nervous system (Arranz 2007). Stress activates the sympathetic nervous system, while acupuncture can activate the opposing parasympathetic nervous system, which initiates the relaxation response;
- Reversing pathological changes in levels of inflammatory cytokines that are associated with stress reactions (Arranz 2007);
- Reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003);
- Reversing stress-induced changes in behaviour and biochemistry (Kim 2009).
References on Stress
Arranz L et al. Effect of acupuncture treatment on the immune function impairment found in anxious women. American Journal of Chinese Medicine. 2007;35(1):35-51
Balk J et al. The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study. Complement Ther Clin Pract 2010; 16: 154-7.
Chan J, et al. An uncontrolled pilot study of HT7 for ‘stress’. Acupunct Med 2002; 20: 74-7.
Cheng CH et al. Endogenous Opiates in the Nucleus Tractus Solitarius Mediate Electroacupuncture-induced Sleep Activities in Rats. Evid Based Complement Alternat Med 2009; Sep 3.
Fassoulaki A et al. Pressure applied on the extra 1 acupuncture point reduces bispectral index values and stress in volunteers. Anesth Analg. 2003; 96: 885-90.
Health and Safety Executive, 2011.Stress-related and psychological illness [online]. Available: http://www.hse.gov.uk/statistics/causdis/stress/scale.htm
Huang W et al. An investigation into the effectiveness of traditional Chinese acupuncture (TCA) for chronic stress in adults: a randomised controlled pilot study. Complement Ther Clin Pract 2011; 17: 16-21.
Hui KK et al. Acupuncture, the limbic system, and the anticorrelated networks of the brain. Auton Neurosci 2010; 157: 81-90.
Hui K.K.-S. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Human Brain Mapping 2009; 30: 1196-206.
Kavoussi B, Ross BE. The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther 2007; 6: 251-7.
Kim H et al. The effects of acupuncture stimulation at PC6 (Neiguan) on chronic mild stress-induced biochemical and behavioural responses. Neuroscience Letters. 2009; 460: 56-60.
Kim H et al. The effects of acupuncture (PC6) on chronic mild stress-induced memory loss. Neurosci Lett. 2011; 488: 225-8.
Komori M et al. Microcirculatory responses to acupuncture stimulation and phototherapy. Anesth Analg 2009; 108: 635-40.
Kwong EY, Yiu EM. A preliminary study of the effect of acupuncture on emotional stress in female dysphonic speakers. J Voice. 2010; 24: 719-23.
Lee B et al. Effects of acupuncture on chronic corticosterone-induced depression-like behavior and expression of neuropeptide Y in the rats. Neuroscience Letters 2009; 453: 151-6.
Middlekauff HR et al. Acupuncture inhibits sympathetic activation during mental stress in advanced heart failure patients. J Card Fail 2002; 8: 399-406.
NHS Choices, 2011. Stress Management [online]. Available: http://www.nhs.uk/livewell/stressmanagement/Pages/Stressmanagementhome.aspx
Park HJ et al. Electroacupuncture to ST36 ameliorates behavioural and biochemical responses to restraint stress in rats. Neurol Res 2010; 32 Suppl 1: 111-5.
Pavao TS et al. Acupuncture is effective to attenuate stress and stimulate lymphocyte proliferation in the elderly. Neurosci Lett 2010; 484: 47-50.
Wu Y et al. Effect of acupuncture-assisted anaesthesia on stress response during laparoscopic cholecystectomy in aged patients. [Article in Chinese] Zhongguo Zhen Jiu 2011; 31: 155-7.
Zijlstra FJ et al. Anti-inflammatory actions of acupuncture. Mediators Inflamm 2003; 12: 59-69.
Zhou Q et al. The effect of electro-acupuncture on the imbalance between monoamine neurotransmitters and GABA in the CNS of rats with chronic emotional stress-induced anxiety. Int J Clin Acupunct 2008; 17: 79-84.