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  » Alternative Medicine  »  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 in the body called "meridians." Each meridian connects to one specific organ, or group of organs, that governs particular bodily functions. Qi maintains the dynamic balance of yin and yang, the complementary opposites that are reflected in all beings and throughout nature. When too little or too much qi exists in a meridian or when the qi stagnates or is blocked, illness results. By applying needles to certain points along the meridian lines, acupuncture restores equilibrium and health by correcting the flow of 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.

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.

There are two major approaches that may guide acupuncture practice: the eight principles (used particularly in TCM acupuncture), and the five-element theory. The eight principles are in fact four sets of complementary opposites: yin/yang, internal/external, excess/deficiency, and hot/cold. The five-element theory of acupuncture holds that there are five elements in the universe—wood, fire, earth, water, and metal—and that these correspond to the internal organs and produce a specific sequence of circulating energy in the body. In parallel with these five elements, there are five internal organs regulating the human body. These five organs—liver, heart, spleen, lung, and kidney—correspond to more than a specific bodily part. The kidney, for example, represents not only the kidney itself, but the entire urinary system and the adrenal glands as well. The heart represents both the heart and the brain.

While there are over 70 identified meridians in the body, acupuncture treatment generally focuses on points that lie along the 12 principal meridians and 2 "extraordinary" ones. A practitioner may also needle "extra" points identified as a result of clinical experience or "ah shi" points that are identified by their tenderness to the touch. The 12 principal meridians are Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Urinary Bladder, Kidney, Pericardium, Gallbladder, Liver, and Triple Warmer. Points are identified by the abbreviation of a meridian and a number to indicate the point. For example, SP6 refers to point 6 along the Spleen meridian, while GB20 refers to point 20 on the Gall Bladder meridian. It is important to remember that the names of these meridians do not refer to the same meanings one might attach, for example, to gall bladder or liver in conventional Western medicine.

The type of needle used and the needling technique are also important. Needles may be inserted at particular angles, for example, they may be stimulated manually, electrically (electro-acupuncture), or with lasers; they may be manipulated and quickly removed, or left in place for up to 30 minutes. In certain acupuncture traditions, particularly some of those practiced in Japan, needles may not be actually inserted into the skin at all.

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

  • TCM-based acupuncture is the most commonly practiced in the United States today and focuses on a diagnosis based on the eight principles (yin/yang, internal/external, excess/deficiency, hot/cold).
  • French energetic acupuncture is mostly used by MD acupuncturists and emphasizes meridian patterns, in particular the yin-yang pairs of primary meridians, as well as treatment of the extraordinary vessels.
  • Korean hand acupuncturists believe that the hands and feet are regions of concentrated qi; applying acupuncture needles to these areas is effective for the entire body.
  • Auricular acupuncture is based on the idea that the ear is a microcosm of the body; 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 palpation of the meridian lines in search of tender points, which indicate areas of abnormal energy flow, often without the comprehensive diagnoses associated with other approaches. Acupuncture needles are then applied to those locations.
  • Japanese styles of acupuncture (sometimes referred to as "meridian therapy") tend to put more emphasis on needling technique, often using very subtle needle stimulation, and a more extensive use of palpation in diagnosis. 

Mechanism of Action

The de qi sensation, or the numbing, tingling sensation caused by the needling, is thought to be essential to the therapeutic effect of acupuncture in TCM and some other styles of acupuncture. This sensation is a result of the activation of nerve fibers, which are thought to transmit impulses to the spinal cord, thus activating the central nervous system.

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 y?ur 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 30 minutes to an hour. 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.

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 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, headaches, irregular periods, menopausal symptoms, menstrual cramps, sinusitis, spastic colon, stroke rehabilitation, tendinitis, tennis elbow, and urinary problems. You can safely combine acupuncture with prescription drugs and other conventional treatments, but it's important for your -primary care physician to be aware of and to monitor your acupuncture treatment.

Are there conditions that acupuncture should not treat?

Some physicians and practitioners may avoid treatment during pregnancy.

Should I watch out for anything?

If your acupuncturist is qualified to give out herbs and would like you to take them as part of your treatment, discuss it first 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. In addition, be sure your acupuncturist uses only disposable needles.

How can I find a qualified practitioner?

You can find a qualified practitioner several ways. Most states require acupuncturists to be licensed and confer a title (such as LAc) that these acupuncturists can use to identify themselves. 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 The American Academy of Medical Acupuncture ( can provide a list of licensed physicians in your area who are also trained to perform acupuncture.

How much does a treatment cost?

The first visit can range from $60 to $110, and follow-up visits may cost from $30 to $80.

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.

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