Acupuncture

WHAT IS ACUPUNCTURE?

Acupuncture uses specially placed thin needles to enhance the natural healing ability of the body. Acupuncture needles are about half the size of the smallest needles used for injection. In contrast to a needle used for injection, which is hollow with a cutting tip, an acupuncture needle is solid and smooth.

The Food and Drug Administration considers acupuncture needles to be legitimate medical instruments. The National Institutes of Health has endorsed the use of acupuncture for many conditions, states that acupuncture is no less effective than many other modalities offered for various conditions, and has a low-risk profile.

Acupuncture has developed in many countries, over many centuries, with many different technique styles evolving. Methods include "Traditional Chinese," "Five Element," "Six Energy," dermatomal, ear, hand, scalp acupuncture, and others. No single method is superior, though different styles may better suit different patients or different problems. Different practitioners often feel an affinity for a particular technique based on their background and experience.

Use of special electrically conducting pads, electrodes, and magnets can sometimes allow patients to be treated without needles.

WHO IS QUALIFIED TO PERFORM ACUPUNCTURE?

Practitioners from a number of different backgrounds may offer acupuncture. A physician acupuncturist has studied the techniques in addition to obtaining training and licensure in Western medicine. Non-physician acupuncturists are graduates either of schools of acupuncture or of oriental medicine. Acupuncture is taught in various levels of detail in medical schools in China.

WHAT CONDITIONS CAN ACUPUNCTURE TREAT?

In Western medical circles, acupuncture is best recognized for its role in pain management. It may be effective as the only treatment against pain or as part of a program involving other approaches as well. Types of pain that seem to respond especially well to acupuncture include back, neck, facial, muscular, and shoulder pain; sciatica; some types of arthritis; and headaches. Some forms of abdominal pain, pelvic and menstrual pain, nerve pain, and scar pain may also respond to acupuncture. Research also looks promising regarding the use of acupuncture to treat asthma and nausea. Other conditions, in which acupuncture has been studied with good results, include cardiac disease, genitourinary problems, and neurologic disorders including stroke and head injury.

The World Health Organization recognizes the utility of acupuncture in the treatment of several other medical conditions including respiratory and digestive disorders. Psychological conditions such as depression and anxiety may also be suitable for treatment. Research also supports the use of acupuncture in urinary and neurological conditions.

HOW DOES ACUPUNCTURE WORK?

There are probably several mechanisms of action of acupuncture. Three basic concepts are commonly used today to explain acupuncture's benefits:

… Acupuncture alters body chemicals, including stimulating natural painkillers.

… Acupuncture sensations affect nerves and cause beneficial reflex responses and possibly resetting of the nervous system.

… Acupuncture affects the body's natural electromagnetic fields.

Acupuncture is NOT a placebo. You need not "believe in" acupuncture for it to work, although a positive attitude during any type of therapy is probably beneficial.

In general, it seems that the body wants to be healthy, and acupuncture may provide the nudge the body requires to do so.

WHAT ARE THE CHANCES THAT ACUPUNCTURE CAN HELP ME? HOW CAN I EXPECT TO FEEL?

Acupuncture has helped many people who have not responded to conventional medical or surgical management, but there is a tremendous difference in the response to acupuncture from patient to patient.

Some people notice an immediate improvement; some notice a change a day or two after treatment. Some people are not helped at all. Some people who initially think they had no response notice a delayed improvement several weeks after treatment.

Occasionally, pain is temporarily worse following a treatment. This is not cause for alarm or discouragement. Worsening of pain may be followed by significant improvement. Increased pain after treatment also shows that acupuncture can affect your pain and that further treatment has a good chance of decreasing pain.

Everyone needs to be considered on an individual basis, and sometimes patience is required as different acupuncture approaches are tried and the body takes its time to respond. Through the use of nutritional guidance, botanicals, proper exercise, and stress reduction, your body is put into the best possible state to respond to acupuncture.

HOW MANY TREATMENTS ARE GIVEN? HOW OFTEN?

Both the number of treatments needed and the frequency vary from person to person. In general, complex or long-standing conditions, such as pain of many years, will require one to two treatments a week for several months. Treatments will often be spaced increasingly far apart as response develops and holds. Acute problems, such as sprains, usually require fewer visits. Some people like to return for four treatments per year with season changes to maintain acupuncture's benefits and support general health.

Specific recommendations for the number and frequency of treatments are made on an individual basis following detailed review of your condition and ongoing evaluation of your response.

DOES ACUPUNCTURE HURT?

People experience acupuncture differently. Most feel only minimal pain as needles are placed; others feel no pain. Once the needles are in position, they should not be painful. If a needle is causing pain, ask that the needle be checked for repositioning.

After needles are placed you may feel tingling, warmth, a dull ache, numbness, or heaviness, either locally or in a part of the body distant from the needle. Needles are sometimes connected to an electrical stimulator, which should cause a comfortable tapping or buzzing sensation. Some people notice a generalized feeling of relaxation or well-being and find themselves either sleeping or smiling or both.

WHAT ARE THE POSSIBLE SIDE EFFECTS OR COMPLICATIONS OF ACUPUNCTURE?

Acupuncture can activate chemical, hormonal, and other changes, with change in emotions, sleep patterns, appetite, bowel, or urinary habits. Occasionally there may be transient worsening of symptoms. If this occurs it is early in the course of treatment and is followed by significant improvement. These changes are normal and indicate that your body is responding to treatment.

People often feel deep relaxation or mild disorientation following treatments, especially after the first one or two. This passes within a short time. We recommend that you rest in the waiting area after treatment, until you feel ready to leave. Since these effects are often strongest after the first treatment, you may wish to have someone escort you from the office after your first visit.

People occasionally feel faint during acupuncture, especially at the start of the first treatment. We suggest that to help avoid faintness, you arrive a few minutes before your scheduled appointment time in order to relax before treatment and that you not be hungry at the time of treatment.

Any time a needle is placed in the body, there is a risk of bleeding or infection. Usually you cannot see a mark where the needle was placed, but occasionally a small vessel under the skin may be pricked, resulting in a black-and-blue mark.

Rarely, infections have occurred following acupuncture; however in all cases, they were traceable to the use of non-sterile needles. Rare but serious complications involve puncture of the chest or abdominal organs. Transmission of Hepatitis B has been described, and HIV (AIDS) infection is a possibility. Needles have been reported to break off subcutaneously and require surgical removal. Pneumothorax (punctured lung) from needles placed too deep in the chest has been described.

Alert your practitioner if you have a bleeding tendency, pacemaker, or metal sensitivity or are pregnant. Special considerations may need to be discussed if you have abnormal heart valves, silicone implants, or a seizure disorder or are taking narcotics or steroids.

ARE THERE ANY SPECIAL INSTRUCTIONS I SHOULD FOLLOW ON THE DAY OF TREATMENT?

Following the suggestions below will enhance the effects of treatment:

… Do not eat an unusually large meal immediately before or after treatment.

… Avoid over-exercise, sexual activity, and alcoholic beverages within 6 hours before or after treatment.

… Plan some rest or at least avoid having to work at top performance after treatment, especially after the first few visits.

… Continue to take prescription medications as directed by your regular doctor.

… Remember that substance abuse and smoking will seriously interfere with acupuncture's effectiveness.

… Observe and keep track of your response to treatment, so that we can better work with you to optimize your therapy.

… Always take a shower with antibacterial soap, prior to treatment. This will minimize the possibility of infections.

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DOES HEALTH INSURANCE COVER ACUPUNCTURE?

Policies differ among insurance companies. You may be provided with receipts that you may submit to make a claim. We suggest you check with your insurance company for specifics regarding your coverage. The financial responsibility for professional services is yours.