Acupuncture Treatment

Acupuncture

What is acupuncture?

Acupuncture is a treatment based on Traditional Chinese Medicine (TCM), a system of healing that dates back thousands of years. At the core of TCM is the notion that a type of life force, or energy, known as qi (pronounced "chee") flows through energy pathways (meridians) in the body. Each meridian corresponds to one specific organ, or group of organs, that governs particular bodily functions. The proper flow of qi is thought to create health. Qi maintains the dynamic balance of yin and yang, which are complementary opposites. According to TCM, everything in nature has both yin and yang. An imbalance of qi (too much, too little, or blocked flow) results in disease. In acupuncture, needles are inserted at points along the meridians to restore balance to the qi. Acupuncture points, or the specific locations where needles are inserted, are places where the energy pathway is close to the surface of the skin.

What is the history of acupuncture?

The earliest recorded use of acupuncture dates from 200 BCE. Knowledge of acupuncture spread from China along Arab trade routes towards the West. Up until the early 1970s, however, most Americans had never heard of acupuncture.

Acupuncture gained the attention of the American public after President Nixon's trip to China in 1972. Traveling with Nixon was a New York Times reporter, James Reston, who received acupuncture in China after undergoing an emergency appendectomy. He was so impressed with the procedure's ability to relieve his postoperative pain that he wrote about his experience upon returning to the United States.

Acupuncture was formally recognized as part of mainstream medicine's range of healing options in 1997, when the National Institutes of Health issued a statement documenting its safety and efficacy for a range of health conditions. Although slowly changing, many conventional physicians remain unfamiliar with both the theory and practice of acupuncture.

How does acupuncture work?

The effects of acupuncture are complex and how it works is not entirely clear. Research suggests that the needling process, and other modalities used in acupuncture, may produce their complex effects on a wide variety of ways in the brain and the body. For example, it is theorized that stimulated nerve fibers transmit signals to the spinal cord and brain, thus activating parts of what is called the central nervous system. The spinal cord and brain then release certain hormones responsible for making us feel better overall and, more specifically, feel less pain. In fact, a study using images of the brain confirmed that acupuncture increases our pain threshold, which may explain its ability to produce long-term pain relief. Also, acupuncture may increase blood circulation and body temperature. It may also affect white blood cell activity (responsible for our immune function), reduce cholesterol and triglyceride levels, and regulate blood sugar levels. In general, acupuncture appears to transmit its effects via electric, neurologic, hormonal, lymphatic, and electromagnetic wave pathways.

What does an acupuncturist do?

In addition to asking questions, the acupuncturist may want to take your pulse at several points along the wrist and look at your tongue to observe its shape, color, and coating. He or she may also observe the color and texture of your skin, your posture, and other physical characteristics that offer clues to your health. The acupuncturist then asks you to lie down on a padded examining table, and he or she inserts the needles, twirling or gently jiggling each as it goes in. You may not feel the needles at all, or you may feel a twitch or a quick twinge of pain that subsides as soon as the needle is completely in. Once the needles are all in place, you rest for 15 to 60 minutes. During this time, you'll probably feel relaxed and sleepy and may even doze off. At the end of the session, the acupuncturist quickly and painlessly removes the needles.

For certain conditions, acupuncture is more effective when the needles are heated using a technique known as "moxibustion." The acupuncturist lights a small bunch of the dried herb moxa (mugwort) and holds it above the needles. The herb, which burns slowly and gives off a little smoke and a pleasant, incense-like smell, never directly touches the body. Another variation is electrical acupuncture. This technique consists of hooking up electrical wires to the needles and running a weak current through them, which may cause no sensation at all or a mild tingling. Acupuncturists trained in Chinese herbal preparations may also prescribe herbs along with acupuncture.

Are there different styles of acupuncture?

There are a number of different approaches to the practice of acupuncture; some of those most commonly found in the United States today are as follows:

	TCM-based acupuncture -- the most commonly practiced in the United States today. It focuses on a diagnosis based on eight principles of complementary opposites (yin/yang, internal/external, excess/deficiency, hot/cold).
	French energetic acupuncture -- mostly used by MD acupuncturists. Meridian patterns are emphasized, in particular the yin-yang pairs of primary meridians.
	Korean hand acupuncture -- based on the principle that the hands and feet have concentrations of qi, and that applying acupuncture needles to these areas is effective for the entire body.
	Auricular acupuncture -- based on the idea that the ear is a microcosm of the body. This means that applying acupuncture needles to certain points on the ear affects corresponding organs. This type of acupuncture is used widely in treating addiction disorders.
	Myofascially-based acupuncture -- often practiced by physical therapists, involves feeling the meridian lines in search of tender points, then applying needles. Tender points indicate areas of abnormal energy flow.
	Japanese styles of acupuncture -- sometimes referred to as "meridian therapy," tend to put more emphasis on needling technique and feeling meridians in diagnosis.

How many treatments do I need?

The number of acupuncture treatments you need depends on the complexity of your illness, whether it's a chronic or recent condition, and your general health. For example, you may need only one treatment for a recent wrist sprain, whereas for a long-standing, chronic illness you may need treatments once or twice a week for several months to get good results.

What is acupuncture good for?

Acupuncture is particularly effective for pain relief and for post-surgery and chemotherapy-associated nausea and vomiting. In addition, both the World Health Organization and the National Institutes of Health recognize that acupuncture can be a helpful part of a treatment plan for many illnesses. A partial list includes: addiction (such as alcoholism), asthma, bronchitis, carpal tunnel syndrome, constipation, diarrhea, facial tics, fibromyalgia, headaches, irregular periods, low back pain, menopausal symptoms, menstrual cramps, osteoarthritis, sinusitis, spastic colon (often called irritable bowel syndrome), stroke rehabilitation, tendinitis, tennis elbow, and urinary problems such as incontinence. You can safely combine acupuncture with prescription drugs and other conventional treatments, but it is important for your -primary care physician to be aware of and to monitor how your acupuncture treatment may be affecting your conventional therapies.

The American Academy of Medical Acupuncture also lists a wide range of conditions for which acupuncture can be used. In addition to those already mentioned above, they recommend acupuncture for sports injuries, sprains, strains, whiplash, neck pain, sciatica, nerve pain due to compression, overuse syndromes similar to carpal tunnel syndrome, pain resulting from spinal cord injuries, allergies, tinnitus (ringing in the ears), sore throat (called pharyngitis), high blood pressure, gastroesophageal reflux (felt as heartburn or indigestion), ulcers, chronic and recurrent bladder and kidney infections, premenstrual syndrome (PMS), infertility, endometriosis, memory problems, insomnia, multiple sclerosis, sensory disturbances, depression, anxiety, and other psychological disorders.

Should anyone avoid acupuncture?

Some physicians and practitioners may avoid treatment during pregnancy. If you have been seen by a particular practitioner prior to your pregnancy, however, it is generally safe to continue receiving treatment from the practitioner during your pregnancy.

Should I watch out for anything?

Be sure your acupuncturist uses only disposable needles. In addition, if your acupuncturist is qualified to prescribe herbs and would like you to take them as part of your treatment, first discuss this with your physician. Herbs are potent substances that can be harmful if you suffer from certain conditions; they can also interact with drugs you may be taking and cause side effects.

How can I find a qualified practitioner?

Most states require acupuncturists to be licensed and confer a title (LAc) that these acupuncturists can use to identify themselves. The American Academy of Medical Acupuncture (www.medicalacupuncture.org) can provide a list of licensed physicians in your area who are also trained to perform acupuncture. The National Certification Commission for Acupuncture and Oriental Medicine certifies acupuncturists (Dipl Ac) and practitioners of Chinese herbal medicine (Dipl CH) upon passing a qualifying exam. For a list of these certified practitioners, send a $3 check or money order to the National Certification Commission for Acupuncture and Oriental Medicine, 11 Canal Center Plaza, Suite 300, Alexandria, VA 22314, or find the list for free on the Internet at www.nccaom.org.

Does my medical insurance cover acupuncture treatments?

An increasing number of insurance providers and HMOs now cover all or part of the cost of acupuncture treatments, but these providers may have restrictions on the types of illnesses they cover. Check with your insurance company to see what your policy offers.

Supporting Research

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Review Date: December 2002

Reviewed By: Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma and Senior Medical Editor A.D.A.M., Inc.; Scott Shannon, MD, Integrative Psychiatry, Medical Director, McKee Hospital Center for Holistic Medicine, Fort Collins, CO; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.