Most Americans associate needles with the pain of being pricked.
And those thoughts might influence their experiences with acupuncture, suspects Ernest Volinn, a research associate professor at the University of Utah Pain Research Center.
Natives of China, aware of their qi the internal flow of energy said to be balanced by the insertion of acupuncture needles may respond to the treatment differently, he said.
"When needles go in, they have a different sensation," he said. His wife, Weining Volinn, is a native of Chengdu, China, and "she feels the qi," Volinn said. "She's always known it. She's grown up with it."
Ernest Volinn received a Fulbright Research Award in May to evaluate the effectiveness of acupuncture treatments for back pain in southwestern China. Beginning this fall, he will spend 10 months examining the cultural and social support for acupuncture, and its effect on outcomes, at the West China Hospital in Sichuan province.
He believes that because acupuncture is more commonly practiced and accepted as a form of medicine in China, patients there will have greater success rates with it than patients in the United States.
While patients in China and the U.S. have similar physical experiences, "I think people are more than passive receptacles of biological effects," Volinn said. "These results they're experiencing are strained through culture."
Research has indicated acupuncture may be effective for chronic low-back pain and osteoarthritis of the knee, but for most other conditions, more study is needed, according to the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health.
Previous studies have shown some support for Volinn's theory that attitudes can affect success. In a 2007 study, researchers concluded chronic pain patients who expected acupuncture to help reported significantly greater relief, according to NCCAM.
Scientists are examining potential biomechanisms behind acupuncture, including a theory that it activates opioid systems in the brain that respond to pain.
In China, Volinn said, culture teaches people to acknowledge their qi, (pronounced chee) energy transported throughout the body by channels called meridians. Qi powers the organs, and when it cannot flow properly or is deficient, that condition can lead to pain and illness. Oriental medicine heals by allowing qi to flow more freely, or by bolstering it through herbal supplements, Volinn explained. Tyehao Lu, a master of Oriental Medicine and a licensed acupuncturist in Salt Lake City, said he has seen acupuncture grow vastly more popular in Utah as more people open up to the idea of being poked. People with chronic pain often consult him after exhausting other options, he said.
All people have qi, Lu said, but some are more in tune with their qi than others. He said he often explains to clients that strange sensations during acupuncture, including warmth and tingling, are caused by qi moving through the body.
"They'll be wondering, 'Why am I feeling something on my foot?' and I'll usually have to explain to them that's their qi," Lu said.
Lu's father, Master Cheng Tsang Lu, came to Utah from Taiwan in the 1970s. He was the first acupuncturist to be licensed in the state when regulation began in 1983. The Utah Department of Occupational and Professional Licensing has licensed more than 100 acupuncturists since then.
Lu believes all clients experience some benefit from acupuncture, regardless of their initial beliefs. "It can have a physiological effect whether your mind is skeptical or not," Lu said.
Both Lu and Volinn say acupuncture can reduce pain without the side effects of drugs. Volinn hopes to make more people suffering with pain aware of the positive effects of acupuncture.
"I really want to give it a good thorough testing in its native culture," Volinn said."I hope to open people's minds to this as an alternative."