What is acupuncture?

Acupuncture is a system of medical diagnosis and treatment developed in China beginning over 3,000 years ago. Acupuncture stimulates locations in the body with fine needles to promote the body's self-healing processes. Acupuncture is now practiced worldwide, and has become the subject of modern scientific study regarding its physiologic mechanisms and clinical efficacy[1].

What can acupuncture treat?

The USNIH's National Center for Complementary and Alternative Medicine provides an up-to-date review of research regarding acupuncture for treatment of pain. Acupuncture has also been used for thousands of years in East Asia to treat a wide variety of injuries and diseases.The World Health Organization provides the most complete evidence-based review of what acupuncture can treat. You may also wish to view a list of conditions which I treat frequently with acupuncture.

How many acupuncture treatments are necessary? How long does it take for acupuncture to work?

After an initial consultation, an acupuncturist can project a treatment plan, including schedule of visits, expected benefits, costs, risks, and alternative treatments. The number of treatments required may vary with each patient and their condition(s).

Symptom relief is often felt during the first treatment. Significant and lasting improvement may be evident by the 3^rd or 4^th treatment. Chronic or complex conditions may require 1-3 treatments per week for several months.  More recent conditions may be treatable within 6-12 visits.

If after a trial course of treatment, a patient or their practitioner finds that acupuncture is not effective for the patient's condition, the practitioner should refer the patient to a physician for further evaluation and treatment.

Is acupuncture safe? What are acupuncture risks and side effects?

With sterile, single-use, disposable needles, the risk of infectious disease transmission through acupuncture is negligible. Adverse effects are uncommon and generally limited to temporary and mild dizziness, faintness, bruising, or tissue irritation around needle sites, typical of any procedure involving needles. The National Center for Complementary and Alternative Medicine's statement regarding side effects and risks of acupuncture offers this comparison: "there are fewer adverse effects associated with acupuncture than with many standard drug treatments (such as anti-inflammatory medication and steroid injections) used to manage painful musculoskeletal conditions like fibromyalgia, myofascial pain, osteoarthritis, and tennis elbow."

How does acupuncture work?

Acupuncture triggers the body's own self-healing reflexes through stimulation of neural, vascular, immune, and endocrine responses that result in:

• Pain control and muscle relaxation
• Reduction of inflammation and swelling
• Normalization of blood flow and lymphatic drainage
• Tissue and wound healing
• Enhanced or normalized immune response
• Increased joint range-of-motion
• Normalization of organ activity
• Stress reduction and mood enhancement

Acupuncture restores both local and systemic "homeostasis:" the body's normal state of dynamic, balanced function, know in Chinese medicine as "yin/yang balance."

Acupuncture treatment promotes overall health and well-being. A study of 762 patients who received 6 acupuncture treatments in an outpatient setting showed significant improvements in 7 of 8 outcome measures (General health, Bodily pain, Vitality, Social functioning, Mental health, and Roles-physical and -emotional[1]) compared with a no-treatment control group.

Acupuncture's broad range of actions on all body systems may account for its general health benefits. With repeated treatment, this sense of harmonious well-being may become the norm experienced by the patient in their daily life.

---

What are acupuncture "points" and "meridians?"

Ancient Chinese studies identified over 600 sensitive sites on the surface of the body that can be stimulated for pain relief and other benefits. Ancient Chinese physicians discovered how to regulate the flow of "qi" (often translated as "vital air" or "energy"--may refer to the oxygen-carrying capacity of hemoglobin) and blood throughout the body by using fine needles, in order to stimulate the body's own self-healing potential.

Modern science has found that acupuncture "points" or "nodes" may have properties including higher electrical conductance and inter-cellular communication, and a greater density of fine neural, vascular, and lymphatic structures.

What does acupuncture feel like?

Acupuncture needles are much smaller, more flexible, and therefore usually less painful than hypodermic needles used for injections or blood sampling.

To obtain a therapeutic response, needles are manipulated until the patient feels sensations of warmth, heaviness, or pressure around the insertion site, known as "de qi" in Chinese medicine. Sometimes de qi sensations are felt to travel along pathways in the body. The sensation typically subsides within minutes, but may be re-enforced through manual or mild electrical stimulation.

What is an acupuncture treatment like?

Acupuncture diagnosis and treatment begins with an interview regarding medical history, current symptoms, and goals for treatment. The acupuncturist performs a physical examination, including inspection and palpation of the disease or injury site and associated acupuncture meridians. Special tests may be conducted to further define the nature and cause of the condition. The practitioner may also inspect the patient's tongue and feel the qualities of the radial pulse, which give important clues to the patient's overall health status. Information gathered from the interview and examination is used to reach a diagnosis and treatment plan.

Acupuncture is usually performed with a patient lying comfortably on a treatment table. The acupuncturist inserts the needles at locations which may include the limbs, torso, and head. After the needles are manipulated for a few seconds to produce a therapeutic stimulus, they are left in place while the patient lies quietly for 20-30 minutes or more. Supplementary techniques performed to enhance or complement needling may include:

• Electrical stimulation (milli- or micro-amps)
• Chinese medical massage (acupressure and tui na), suction cups, or friction (gua sha) to mobilize and relax muscle and connective tissue;
• Warming needling sites with an infrared lamp, hot packs, ultrasound, or a smoldering Chinese herb called moxa;
• Topical skin applications of analgesic and anti-inflammatory herbal plasters or oils;

An acupuncturist may also recommend traditional Chinese nutritional supplements and dietary remedies, as well as therapeutic exercises and stretches (taiji, qi gong, dao yin).

Do I have to "believe" in acupuncture for it to work?

No. Beneficial effects of acupuncture have been demonstrated on animals and children, as well as on adults who have never received acupuncture before. Acupuncture effects have not been shown to depend on psychosocial variables[2]. As with any medical modality, a positive and open-minded approach supports healing and improves outcomes.

Injuries and pain are generally easier to treat in the initial stages, and harder to reverse when they have become chronic and established. The sooner after an injury that acupuncture treatment is started, the better the outcomes, and the fewer visits are typically needed to stabilize or resolve a condition.

Can acupuncture be combined with other forms of treatment?

Acupuncture may serve as a stand-alone treatment for either acute or chronic pain, and be safely combined with other treatments. Acupuncture does not generally interfere with other treatment modalities, surgery or drugs.

Patients sometimes ask whether they should wait to try acupuncture until after they have completed other courses of care, or want to try treatment approaches one at a time "to find out which one works for me." While understandable, the "serial monotherapy" approach may risk allowing the condition to progress to an intractable or permanently disabling state. The serial monotherapy approach also misses out on the synergistic benefits of using multiple therapies simultaneously which more effectively address the different aspects of a condition (e.g., postural, dietary, ergonomic, emotional, sensory, motor, etc.).

For you, the patient, the safest and most effective approach to resolving pain and injuries is often to combine all potentially-beneficial treatments, which is more likely to result in synergistic benefits that are greater than trying individual treatments one at a time. The research-oriented "one-at-a-time" approach works better after your condition is stabilized at a safe and satisfactory level, as a way of tapering down or ceasing individual treatment modalities. However, patients are advised not to quit any current regimen of treatment without discussion with the physician or other health care professional who prescribed that care.

How is the acupuncture profession regulated?

Acupuncture in Virginia is regulated by the Virginia Board of Medicine. Information including standards of education, training, and practice and practitioner license status may be obtained at: https://dhp.virginiainteractive.org/lookup/index

Acupuncture in California is regulated by the California Acupuncture Board. Information including standards of education, training, and practice and practitioner license status may be obtained at: http://www.acupuncture.ca.gov/

---