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.
Conventional treatments include medication such as anti-anxiety drugs, cognitive behavioural therapy and relaxation techniques.(NHS Choices 2011)
Health and Safety Executive, 2011.Stress-related and psychological illness [online]. Available: http://www.hse.gov.uk/statistics/causdis/stress/scale.htm
NHS Choices, 2011. Stress Management [online]. Available: http://www.nhs.uk/livewell/stressmanagement/Pages/Stressmanagementhome.aspx
How acupuncture can help
Stress is a common complaint cited by acupuncture patients, with a variety of possible associated symptoms. The most prevalent of these is anxiety, for which there is information about acupuncture treatment in the Anxiety Fact Sheet. There are also factsheets on other conditions that are affected by stress, such as back pain, chronic pain, depression, headache, insomnia, irritable bowel syndrome, menopausal symptoms, migraines, premenstrual syndrome and urinary incontinence.
Aside from such associated conditions, there is little clinical research on stress per se. One small randomised controlled trial (RCT) suggested that acupuncture might be successful in treating the symptoms of chronic stress (Huang 2011). Another three RCTs have investigated acupuncture in very specialised situations: a) as an adjunct to anaesthesia, it was found to help keep haemodynamics stable and reduce the stress response during laparoscopic cholecystectomy (Wu 2011); b) it did not reduce salivary cortisol concentrations (and so may not be able to reduce emotional stress) in female dysphonic speakers (Kwong 2010); c) acute acupuncture appeared to control excessive sympathetic excitation during mental stress in patients with advanced heart failure (Middlekauff 2002). A crossover study with healthy individuals subjected to stress testing found acupuncture at a point indicated for stress was more effective than a 'control' point (Fassoulaki 2003). 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 a small pilot study, the use of one particular acupuncture point led to marked reductions in stress (Chan 2002).
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).