What is acupuncture?
Acupuncture is a treatment based on Chinese medicine, a system of healing that dates back thousands of years. At the core of Chinese medicine 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 organ, or group of organs, that govern particular bodily functions. Achieving the proper flow of qi is thought to create health and wellness. Qi maintains the dynamic balance of yin and yang, which are complementary opposites. According to Chinese medicine, everything in nature has both yin and yang. An imbalance of qi (too much, too little, or blocked flow) causes disease. To restore balance to the qi, an acupuncturist inserts needles at points along the meridians. These acupuncture points 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.
Acupuncture gained attention in the United States after President Nixon visited China in 1972. Traveling with Nixon was New York Times reporter James Reston, who received acupuncture in China after undergoing an emergency appendectomy. Reston was so impressed with the post-operative pain relief the procedure provided that he wrote about acupuncture upon returning to the United States.
In 1997, the U.S. National Institutes of Health (NIH) formally recognized acupuncture as a mainstream medicine healing option with a statement documenting the procedure's safety and efficacy for treating a range of health conditions. While awareness of acupuncture is growing, many conventional physicians are still unfamiliar with both the theory and practice of acupuncture.
There are hundreds of clinical studies on the benefits of acupuncture. Many of these clinical studies were performed in China. Acupuncture has been used successfully in the treatment of conditions ranging from musculoskeletal problems (back pain, neck pain, and others) to nausea, migraine headache, anxiety, and insomnia.
How does acupuncture work?
The effects of acupuncture are complex. How it works is not entirely clear. Research suggests that the needling process, and other techniques used in acupuncture, may produce a variety of effects in the body and the brain. One theory is that stimulated nerve fibers transmit signals to the spinal cord and brain, activating the body's central nervous system. The spinal cord and brain then release hormones responsible for making us feel less pain while improving overall health. In fact, a study using images of the brain confirmed that acupuncture increases our pain threshold, which may explain why it produces long-term pain relief. Acupuncture may also increase blood circulation and body temperature, affect white blood cell activity (responsible for our immune function), reduce cholesterol and triglyceride levels, and regulate blood sugar levels.
What does an acupuncturist do?
In addition to asking questions, the acupuncturist may take your pulse at several points along the wrist and look at the shape, color, and coating of your tongue. The acupuncturist may also look at the color and texture of your skin, your posture, and other physical characteristics that offer clues to your health. You will lie down on a padded examining table, and the acupuncturist will insert 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 disappears when the needle is completely inserted. Once the needles are all in place, you rest for 15 to 60 minutes. During this time, you will 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 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. In this procedure, you may feel a mild tingling or nothing at all. Acupuncturists trained in Chinese herbal preparations may prescribe herbs along with acupuncture.
Are there different styles of acupuncture?
There are several different approaches to acupuncture. Among the most common in the United States today are:
- Traditional Chinese Medicine (TCM) based acupuncture. The most commonly practiced in the United States, it bases a diagnosis on eight principles of complementary opposites (yin/yang, internal/external, excess/deficiency, hot/cold).
- French energetic acupuncture. Mostly used by MD acupuncturists, it emphasizes meridian patterns, 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. This technique is widely used in treating addiction disorders. It is based on the idea that the ear is a reflection of the body and that applying acupuncture needles to certain points on the ear affects corresponding organs.
- Myofascially-based acupuncture. Often practiced by physical therapists, it 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," it emphasizes 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 is a chronic or recent condition, and your general health. For example, you may need only one treatment for a recent wrist sprain, while a long-term illness may require treatments for several months to achieve good results.
What is acupuncture good for?
Acupuncture is particularly effective for pain relief and for nausea and vomiting after surgery or chemotherapy. In addition, both the World Health Organization (WHO) and the NIH 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 menstrual cycles, polycystic ovarian syndrome, 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 monitor how acupuncture treatments may be affecting your conventional therapies.
The American Academy of Medical Acupuncture also lists a wide range of conditions for which acupuncture is appropriate. In addition to those listed 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, anorexia, memory problems, insomnia, multiple sclerosis, sensory disturbances, drug detoxification, depression, anxiety, and other psychological disorders.
Should anyone avoid acupuncture?
In general, acupuncture is safe and well tolerated. One large study found only 43 minor adverse events associated with 34,407 acupuncture treatments. No serious adverse effects were reported. Some health care providers may avoid treatment during pregnancy. Others may be very competent in treating women who are pregnant. There are certain points that are contraindicated during pregnancy, however other points are thought to benefit pregnancy. Make sure your acupuncture practitioner is competent in addressing the question of risks and benefits of acupuncture during pregnancy before you receive treatment. Tell your acupuncturist about any treatments or medications you are taking and all medical conditions you have. According to some theories, acupuncture is not recommended during menstruation.
Should I watch out for anything?
Be sure your acupuncturist uses only disposable needles. If your acupuncturist prescribes herbs and would like you to take them as part of your treatment, talk to your doctor. 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. It is best to avoid strenuous physical activity, heavy meals, alcohol intake, or sexual activity for up to 8 hours after a treatment.
How can I find a qualified practitioner?
Most states require acupuncturists to be licensed and confer a title (LAc). The American Academy of Medical Acupuncture 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) who pass a qualifying exam. Other medical practitioners may perform acupuncture as well. In particular many naturopathic physicians and Oriental Medical Doctors (OMDs) practice acupuncture along with medical doctors and nurse practitioners.
Does my medical insurance cover acupuncture treatments?
An increasing number of insurance providers 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.
Chen D, et al. Clinical study on needle-pricking therapy for treatment of polycystic ovarial syndrome. Zhongguo Zhen Jiu. 2007;27(2):99-102.
Cheuk DK, Yeung WF, Chung KF, Wong V. Acupuncture for insomnia. Cochrane Database Syst Rev. 2007;(3):CD005472.
Choi SM, Park JE, Li SS, et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013;68(3):365-74.
Benzon: Raj's Practical Management of Pain. 4th ed. Philadelphia, PA: Elsevier Mosby; 2008.
de Leon: Cancer Pain. 1st ed. Philadelphia, PA: Elsevier Saunders; 2006.
Deare JC, Zheng Z, Xue CC, et al. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013;5:CD007070.
Dickman R, Schiff E, Holland A, Wright C, Sarela SR, Han B, Fass R. Acupuncture vs. doubling the PPI dose in refractory heartburn. Aliment Pharmacol Ther. 2007; [Epub ahead of print].
Facco E, Liguori A, Petti F, et al. Traditional Acupuncture in Migraine: A Controlled, Randomized Study. Headache. 2007; [Epub ahead of print].
Flachskampf FA, Gallasch J, Gefeller O, et al. Randomized trial of acupuncture to lower blood pressure. Circulation. 2007;115(24):3121-9.
Gadau M, Yeung WF, Liu H, et al. Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials. BMC Complement Altern Med. 2014;14:136.
Haake M, Muller HH, Schade-Brittinger C, et al. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007;167(17):1892-8.
Hollifield M, Sinclair-Lian N, Warner TD, Hammerschlag R. Acupuncture for posttraumatic stress disorder: a randomized controlled pilot trial. J Nerv Ment Dis. 2007;195(6):504-13.
Itoh K, Katsumi Y, Hirota S, Kitakoji H. Randomised trial of trigger point acupuncture compared with other acupuncture for treatment of chronic neck pain. Complement Ther Med. 2007;15(3):172-9.
Kelly R. Acupuncture for Pain. American Family Physician. 2009;80(5).
Law S, Li T. Acupuncture for glaucoma. Cochrane Database Syst Rev. 2007;(4):CD006030.
Li Y, Zheng H, Witt CM, et al. Acupuncture for migrain prophylaxis: a randomized controlled trial. CMAJ. 2012;184(4):401-10.
Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for migraine prophylaxis. Cochrane Database Syst Rev. 2009;1.
Lu W, Dean-Clower E, Doherty-Gilman A, Rosenthal D. The value of acupuncture in cancer care. Hematology/Oncology Clinics of North America. 2008;22(4).
Manheimer E, Linde K, Lao L, Bouter LM, Berman BM. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med. 2007;146(12):868-77.
Pilkington K, Kirkwood G, Rampes H, Cummings M, Richardson J. Acupuncture for anxiety and anxiety disorders -- a systematic literature review. Acupunct Med. 2007;25(1-2):1-10.
Price S, Lewith G, Thomas K. Acupuncture care for breast cancer patients during chemotherapy: a feasibility study. Integr Cancer Ther. 2006;5(4):308-14.
Rakel: Integrative Medicine. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012.
Schneider A, Streitberger K, Joos S. Acupuncture treatment in gastrointestinal diseases: a systematic review. World J Gastroenterol. 2007;13(25):3417-24.
Sierpina V, Frenkel, M. Acupuncture: A Clinical Review. Southern Medical Journal. 2005;98(3):330-7.
Wu J, Yeung AS, Schnyer R, Wang Y, Mischoulon D. Acupuncture for depression: a review of clinical applications. Can J Psychiatry. 2012;57(7):397-405.
Wu TP, Chen FP, Liu JY, Lin MH, Hwang SJ. A randomized controlled clinical trial of auricular acupuncture in smoking cessation. J Chin Med Assoc. 2007;70(8):331-8.
Review Date: 2/2/2016
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.