Acupuncture and herbal therapies have been gaining popularity in the United States over the past 30 years, but popularity does not necessarily mean efficacy. How do you decide with all the therapies and products that are out there which ones are safe? How do you know which ones will work? Deciding which modalities will improve your horse’s health and performance can be dizzying and it is important to look at the facts. It would be incorrect to state that all the research performed in the past 30 years has supported the efficacy of acupuncture. It has not. I must, as a scientifically minded practitioner, include all the evidence in my decision making process and this is what I have decided. Regarding portions of acupuncture, the jury is still out. Most of the research that proves acupuncture in animals is successful is very old and has not been repeated or is lacking in its scientific method. Most of the research that states acupuncture does not work has great study parameters such as large sample size and double blinded observers, but has over simplified the method. So far we have done a poor job on both sides of the argument producing research that definitively proves or disproves the usefulness of acupuncture. So why do I practice TCVM (traditional Chinese veterinary medicine)? I practice TCVM because there is real and proven research supporting the mechanism of action and because I, along with many practitioners, have seen the results. Being a good veterinarian requires that I utilize both research and my clinical experience to make a decision; and so I have.
The research that most strongly supports acupuncture refers to the use of electro-acupuncture to stimulate serotonin and beta-endorphin release. The detractors of acupuncture will state that this is really using TENS which has had supporting research on the human side of things for a very long time. They argue that the points do not matter. My response is: So you admit it works. At this point nobody is arguing against the benefit of electricity to cause muscle relaxation and pain relief. The concept of combining electricity and acupuncture is a newer concept, however, and is currently still being debated. To understand why using acupuncture points would work with electricity should be beneficial we first have to understand what acupuncture points are.
Acupuncture points are designated areas on the body where TCVM has determined there is a whole body response to stimulation. These points have been shown to be areas of anatomical importance such as regions with large numbers of nerve endings, musculotendinous junctions or endocrine associated regions. In fact the myofascial trigger points that we are used to stimulating during physical therapy or massage overlap greatly with acupuncture points. The human side of acupuncture has done a better job of producing research that proves the pathophysiology and efficacy of these points. Acupuncture points on horses fall into two categories: classical points and meridian based points. Classical points do not follow a particular map and are areas that were classically used for acupuncture on horses. They have been studied for thousands of years and are named for the diseases they treat. The other type of acupuncture points are meridian points, AKA transpositional points, and are based on the human study of acupuncture. These points can correlate with classical points, but often times do not and are subject to change because of the difference between human and animal anatomy. Meridians were developed to function with the theory that there is Qi (pronounced Chi) or energy that flows through the body in certain patterns in healthy individuals. TCVM teaches that disruption in this flow of energy, or lack of energy, results in disease. So this is the part where I start to sound a bit crazy and talk about flow and movement of Chi, but western medicine describes this phenomenon with its own terminology. In western medicine we use the terminology “referred pain” when a leg issue causes a back issue, a heart attack results in arm pain, or a kidney problem results in back pain. In TCVM the pattern is mapped and the result is the formation of a meridian and points are defined based on this pattern of referred pain. This brings us back to performance.
Anyone who has had a leg injury understands that after a few days of hobbling around, your back hurts and sometimes badly. It doesn’t take a big limp to make a big back ache, and this is one area in which acupuncture shines. The TCVM acupuncture scan uses pressure to determine sensitive points on the body and then allows the practitioner to make a diagnosis of where the pain comes from. You can use the concept of referred pain or meridians to explain why it works, but the fact is it is an added diagnostic tool. This should not replace traditional lameness examination with definitive diagnostics such as ultrasound and radiography especially in cases of severe lameness and injury. However, when it comes to pinpointing a source of pain or an area of weakness that is preventing optimal performance acupuncture is extremely useful.
The beta-endorphins and serotonin produced by acupuncture are useful for two things that are especially important in performance animals. The first is pain relief. Acupuncture is most notably useful for pain relief and that function is well documented by research on the human and animal side. Acupuncture can decrease the need for pain relievers which are not allowed during showing and may have negative effects on your partner over time. It also will help decrease the frequency of or delay the need for joint injections which can degrade cartilage over time and decrease the performing lifespan of your horse. The second is relaxation. For many of our equine friends this is an added bonus but not necessary for their function. I would argue, however, that for the performance horse from whom we expect concentration and willingness, relaxation is of the utmost importance. This is another area we can look to the human side for guidance. Human athletes and sports medicine practitioners know that state of mind is a huge part of performance. They utilize things like massage and sports psychologists to improve performance with proven results. Unfortunately, I have yet to meet a real life Dr. Doolittle, so in the meantime the natural relaxation of neurotransmitters is the best we can get.
For the naysayers out there, I agree, TCVM has a long way to go when it comes to defining why and how it works. Luckily for performance horse enthusiasts the research so far supports its use for safe relaxation and pain relief. These uses allow us to support our athletic partners so they may perform stronger and longer.