The goal of lupus treatment can vary between clinicians and people living with lupus. A recent study found that rheumatologists’ primary aim is to minimize long-term damage to organs while the top two patient concerns were fatigue and pain. This can lead to Lupus Warriors trying Complementary and Alternative Medicines (CAM) to battle symptoms.
Around 50% of people reported using alternative therapies in a survey of 707 people with lupus (SLE) from Britain, the United States, and Canada. A separate survey found that usage was slightly higher in China at 66.5%.
Alternative treatments encompass a range of treatments and products including:
- natural products (herbs, vitamins, and supplements)
- mind and body medicine
- traditional Chinese medicine (e.g., acupuncture, tai chi)
What is acupuncture?
Acupuncture is the practice of inserting thin, solid metal needles into the skin. The needles can sometimes be administered along with heat, herbal therapies, or mild electrical stimulation. Because the needles are small and carefully placed, and do not penetrate deeply into the body, acupuncture is not usually painful.
There are many unsubstantiated claims about acupuncture including that it can treat infertility and insomnia. However, despite a large number of research studies, there is limited evidence for its effectiveness generically. Though there is evidence that acupuncture provides relief for some pain conditions.
Is acupuncture safe?
When done by a qualified, competent practitioner using sterile needles, acupuncture is safe for people with lupus.
In a study published in 2008, 24 patients with systemic lupus erythematosus (SLE) were observed over several months. Approximately 10 of the patients received acupuncture with manipulation, or “light needling” also known as sham acupuncture. After a 10-session course of acupuncture, these 10 patients were compared to the other 14.
These patients reported reduced pain, and no serious adverse effects were reported. They did experience some temporary mild needling sensations and lightheadedness, however. Other known side effects of acupuncture are mild bleeding, bruising, and soreness.
Other studies on acupuncture have similar results: when done properly, acupuncture will not trigger symptom flares or cause severe side effects.
The risks of acupuncture are low, but you can control even those risks by using a well-recommended, qualified acupuncture practitioner.
You should avoid using acupuncture if you:
- Have a bleeding disorder, which can cause the small bleeding from acupuncture to be more problematic
- Have a pacemaker, since electrical stimulation can interfere with the pacemaker
- Are pregnant, since some forms of acupuncture are thought to stimulate labor
Does acupuncture help for people with lupus?
In the same study from above, the patients who had received acupuncture reported a nearly 30% improvement to their symptoms.
Both anecdotes and research suggest that acupuncture reduces the perception of pain, including chronic pain, for many people. This could help reduce the need for painkillers.
It is still unknown whether acupuncture reduces pain through biological means or by shifting expectations. It may even act through both methods.
How does acupuncture work?
Many researchers believe that acupuncture works through the placebo effect. Even though a therapy might not chemically or physically change anything in the body, it can cause a change in symptoms – even a major improvement – because the person believes that it will work. The placebo effect is very powerful, and new medications and therapies are often compared to control groups given a “sham” therapy, such as sugar pills or non-medicated IV fluid.
Support for the theory that the placebo effect causes the benefits of acupuncture comes from a number of studies where acupuncture was compared to “sham” acupuncture interventions. In many of these studies, the “sham” interventions were just as effective as traditional acupuncture.
But not all researchers believe that the placebo effect is the mechanism for this benefit. A 2012 meta-analysis explored the effectiveness of acupuncture in 29 randomly controlled trials. These studies found that acupuncture reduced pain by 50% while sham acupuncture only caused a 43% pain reduction. The researchers concluded that the entire benefit could not be ascribed to placebo effect alone.
So how does acupuncture work? There are a few theories, though, that may be promising for further research:
- Nervous system stimulation
- Since many of the places where acupuncture needles are placed, known as meridians, are areas with nerve clusters, the use of needles, heat, or electricity may change how they transmit signals to the brain. This may change how the brain perceives pain.
- Pain induction
- By causing many small points of pain or sensation, acupuncture may dilute the sensation of pain to the point where the brain cannot perceive it as strongly.
- Stress reduction
- Acupuncture is often performed in a relaxing and calm atmosphere, with a high degree of care and tailoring to the patient. It is generally non-painful, and may even encourage a positive mood or feelings of calmness. Because of this, acupuncture may reduce both feelings of stress and the body chemicals associated with stress. Stress relief is associated with lower levels of inflammation and milder lupus symptoms in people with SLE.
- The mild pain and skin damage that acupuncture causes may cause the body to release small amounts of beta-endorphins, which dull the sensation of pain throughout the body and promote positive moods.
- Puncturing the skin (or pinching it) may release adenosine into the space between cells and the bloodstream. Adenosine is anti-inflammatory, and the body turns adenosine into opiates, which reduce pain. Other anti-inflammatory chemicals may also be released into the body through this same mechanism.
These may work alongside a placebo effect to support good therapies and good health.
Acupuncture is generally safe and might be effective for people with lupus. If you think it will help your pain or inflammation, talk to your lupus treatment team about it. They may have recommendations for acupuncture practitioners with a good reputation or who are covered by your insurance.
Although acupuncture works well with medications, caution should definitely be used with medications that increase bleeding or skin reactions. Always be sure to discuss acupuncture and other alternative therapies with your treatment team for safety.
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