Not long after Maria Bruno moved to the Triangle from New York 14 years ago, she started getting bad headaches.
"I suffered from sinus migraines," says Bruno, 40. "I don't think that's the technical term, but it's what I called it."
The headaches got worse after she turned 30, worse still after her son, now 10, was born. She went to an ear, nose and throat doctor who suggested sinus surgery.
"For a year after that," Bruno says, "I was great."
But she was warned that sinus surgery is not always forever. Sure enough, the headaches and sinus pain returned.
"It got to the point where I was worse than before," she says.
She went to a neurologist who aggressively tried to help with beta blockers to ease the pressure of blood pulsing through her brain. That didn't work. She tried Imitrex, a drug used to treat migraines. That didn't help, either. Meanwhile, Bruno experimented with decongestants -- Sudafed, Flonase, a neti pot -- for sinus relief. Nothing.
A single mom, she would take her son to his ballgames and then head underneath the bleachers between innings to get sick. She soldiered in to her job at Quintiles Transnational Corp., where she works in the compensation and benefits department, with her head feeling like it was about to explode. Sometimes she spent entire weekends vomiting.
In March, she remarried. After returning from a honeymoon in Las Vegas, she was sick for eight straight days.
"I can't do this anymore," she remembers saying to herself. Having needles stuck in my head would be better than this, she thought.
As she was about to find out, she was right.
A friend with digestive problems suggested that Bruno try what was working for her: acupuncture.
In search of proof
Acupuncture has been widely practiced in China for thousands of years but in the West has been recognized as an effective treatment only over the past decade or two. In large part, that's because there has been a lack of empirical data to prove its effectiveness.
That dearth of data even had Dr. Tong Joo Gan, an anesthesiologist at Duke University Medical Center, wondering. Which was especially curious because while Gan was going through a traditional Western medical school, London Hospital Medical College, he was also becoming accredited in acupuncture through the British College of Acupuncture.
"I had all of these patients with chronic headaches wondering if acupuncture was helpful," Gan says.
The National Institutes of Health had recommended acupuncture as a treatment for chronic headaches a decade earlier and says it is also effective in treating other issues, including infertility, menstrual cramps and tennis elbow.
But the Western-trained doctor in Gan wanted proof. So he gathered all the solid research on acupuncture's effectiveness he could find.
His conclusion, published in the December issue of the journal Anesthesia and Analgesia, found that Bruno isn't the first to find relief from debilitating headaches. Among the report's findings:
In 17 studies comparing acupuncture versus medication, 62 percent of patients receiving acupuncture reported relief from their headaches compared with 45 percent of those taking medication.
In 14 studies comparing acupuncture versus "sham" acupuncture -- the patients were stuck with needles, but not at the key points -- 53 percent of those receiving true acupuncture said it helped compared with 45 percent who received the sham therapy. (Gan said the high number of positive responses to sham therapy may be because the needles were placed close enough to the sensitive points to make a difference.)
"This analysis reinforces that acupuncture also is a successful source of relief from chronic headaches," Gan says.
Chinese acupuncture practitioners and Western doctors use different words to describe the essence of acupuncture. To the Chinese, there are about 360 key points on the body, and pricking them allows bottled-up energy to flow throughout the body.
How it works
In Western vernacular, puncturing the skin with the hair-fine needles stimulates nerves, muscles and connective tissue, which in turn releases the body's naturally occurring painkillers, such as endorphins.
Where exactly those needles go depends on the ailment and how the patient is faring. Even then, how the points are determined defies easy explanation.
Bruno goes in for treatment about every three weeks. On a recent Wednesday, she showed up for her regular appointment at Triangle Acupuncture in Cary. Acupuncturist Tory Wegner greeted her with a hug, then led her into a treatment room.
The room was much like an exam room in a typical doctor's office, with a few exceptions. The walls were a soothing sea-foam green, the windows covered with stylish drop-down fabric shades. Soothing Chinese music filtered in through a pair of speakers.
"How have you been doing?" Wegner asked. While Bruno described a "doozy" of a headache that she had had over the weekend, Wegner took the pulse on her left and right wrist. ("The body has six pulses," Wegner explained) and checked her tongue. The tongue, Wegner said, is the only muscle not covered by skin; by its color and puffiness, she can tell a lot about how a patient is doing.
After taking Bruno's pulse, Wegner got a cotton ball, wet it with alcohol and dabbed a dozen points on Bruno's body. She inserted the needles and gently twisted them between her index finger and thumb to help stimulate energy flow, or encourage the release of painkillers.
One needle went into Bruno's right arm near her elbow, two into her left and right shins, one into the arch of each foot and one at the base of her left thumb. Smaller needles with red ends went into her scalp, between her eyes and into the fleshy part of her left ear.
Wegner put a heat lamp on Bruno's feet ("That's just to keep them warm. It's not part of the treatment," she said), dimmed the lights and told Bruno she would be back in 30 minutes.
In the hallway, examining maps of the 360 sensitive points on the human body, I asked Wegner if she could explain, in lay terms, how she figured out which 12 points to stimulate.
She paused. "In layman terms? It's complicated. I spent two years in a master's program figuring that out." (To practice in North Carolina, an acupuncturist must have a degree from an accredited allopathic or osteopathic medical school.)
Not that a Western medicine explanation is important to Bruno. All she knows is that for 14 years, she tried a range of medicinal solutions to cure her sinus and migraine miseries. After a month of acupuncture, her problems have all but disappeared. When the occasional headache does flare, she says it is typically vanquished with an Advil.
"I can function better," she says of her life since acupuncture. "It's definitely made a big difference."
joe.miller@newsobserver.com, 919-812-8450 or blogs.newsobserver.com/joemiller To see more of The News & Observer, or to subscribe to the newspaper, go to http://www.newsobserver.com. Copyright (c) 2009, The News & Observer, Raleigh, N.C. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
Copyright (C) 2009, The News & Observer, Raleigh, N.C.