Acupuncture, the insertion of needles into the body for the treatment of disease, has been practiced in China for at least 4500 years and is currently practiced throughout the world. The Chinese used acupuncture and herbal medicines to treat essentially all illnesses. Other cultures which have developed acupuncture include Koreans, Japanese and Vietnamese. Recently, it has been further developed by the French, British, Germans and Americans.
The development of Traditional Chinese Medicine (TCM) and acupuncture predates Western scientific theory. The basic theories were developed through observation of changes in the human body caused by acupuncture and herbal medicines, and on events observed in the natural environment.
Chinese medicine and acupuncture is based on the concept of qi (pronounced “chi”), which means life force or energy. This energy is continuously generated and flows in twelve major meridians in the body. It also has two polarities: yin and yang. When these forces are balanced and the energy flows harmoniously in the twelve meridians, the body is then in a state of health. When these energies are unbalanced by pathogenic factors, the flow of these energies become disturbed; the body is then diseased. Acupuncture and Chinese herbal medicines treat disease by normalizing the flow and balance of qi in the meridians. The body is then returned to a state of health.
Over the past several decades, Chinese medicine and acupuncture research, which began in China, has continued and been extended to the United States and Europe. There are now several thousand scientific articles and studies published in Western medical journals about the effectiveness of these techniques in clinical trials.
Conditions That May Benefit From Acupuncture
In 1979, the World Health Organization Interregional Seminar compiled a list of illnesses that may benefit from acupuncture treatment. The list, which follows, is incomplete and is based on clinical experience, and not necessarily on controlled clinical research.
Upper Respiratory Tract
Common Cold & Flu
Central Retinitis Myopia
Post Extraction Pain
Acute & Chronic Pharyngitis
Mental & Emotional Problems
Reproductive & Gynecological Conditions
Spotting & Excessive Bleeding
Spasms of Esophagus
Acute & Chronic Gastritis
Acute & Chronic Colitis
Acute Bacillary Dysentery
Neurologic & Musculoskeletal Disorders
Headache & Migraine
Pareses (following a stroke)
Sequelae of Poliomyelitis
Neurogenic Bladder Dysfunction
Neurologic & Musculoskeletal Disorders
Low Back Pain
Carpal Tunnel Syndrome
Back & Knee Pain
Sports Injuries & Pains
Acupuncture as a Therapeutic Intervention
In 1997, the National Institutes of Health (NIH) published a consensus statement on acupuncture, detailing its uses and gauging its effectiveness as a therapeutic treatment. The following is from the original 1997 statement:
Acupuncture as a therapeutic intervention is widely practiced in the United States. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, showing efficacy of acupuncture in:
Adult Post-operative & Chemotherapy Nausea & Vomiting
Post-operative Dental Pain
Fibromyalgia & Myofascial Pain
Low Back Pain
Carpal Tunnel Syndrome
Current Outlook for Acupuncture
A lot has happened since then. Acupuncture-related published research has grown exponentially in the past ten years, and the sophistication of that research has grown as well. Work focusing on mechanisms has increased. Some questions (“Is acupuncture real?”) have been answered, while others (“Is there such a thing as sham acupuncture?”) have been raised and are being grappled with.
The Society for Acupuncture Research is a loose association of clinical and laboratory researchers from both the US and abroad, whose primary research focus is acupuncture. At the most recent meeting of the Society in November 2007, the group reevaluated the current literature and came up with the latest list of acupuncture treatable illnesses that have been verified by clinical studies. It is an addendum to the original NIH list and includes:
In addition to the conditions on the 1997 NIH list and the 2007 Society list, the following conditions are among those which I see most frequently and treat in my practice.
Pain of Lumbar Spine
Pain of Cervical Spine
Osteoarthritis of Knee & Hip
Osteoarthritis of Hand & Wrist
Symptoms Related to Spinal Cord Injury
Symptoms Related to Stroke
Referring Patients for Acupuncture Treatment
A patient may be referred to acupuncture treatment when he or she: (1) has not been responsive to usual Western care practices such as prescribed medications, surgery, physical therapy and rehab, (2) experiences intolerable side effects of usual care or (3) has continued symptoms after a definitive procedure. The decision to proceed with treatment after a referral is the patient’s choice.
Referring patients for acupuncture treatment is much like making a referral to any other kind of medical specialist. For example, there are different types of acupuncture practitioners in the US. There are physicians who practice acupuncture as well as licensed acupuncturists who practice after graduating from a three-year acupuncture school.
What to Expect Before & During Acupuncture Treatment
Before seeing an acupuncturist, patients should verify coverage by contacting their insurance company directly. The initial course of treatment will typically last five to eight visits, and symptoms should improve by the fifth visit. After the fifth visit, other modalities such as physical and occupational therapies are added, and the acupuncture treatments are tapered depending on patient response.
At the first visit, I will interview and examine the patient and then decide whether or not acupuncture is useful for the patient. If acupuncture is an appropriate modality, I will recommend a series of acupuncture treatments. The number of treatments varies with the clinical setting, but usually within a series of five treatments over a period of two to three weeks, the patient should begin to feel some positive change.
Depending on area treated, the patient may lie face up, face down, or on his or her side on the treatment table. Stainless steel disposable acupuncture needles (about thirty-six gauge) are inserted, using an aseptic technique. Anywhere from ten to twenty-five needles can be used, and they are retained in the body for fifteen to twenty minutes before being removed. Patients are checked for bleeding or other complications before they leave the exam room.
Most people are concerned about the needles. Usually, there is just a momentary pinch; in some cases the needles cannot be felt at all. The needles themselves are sterile, disposable and made of surgical-grade stainless steel. The depth of needle insertion varies depending upon the acupuncture point. When the acupuncture point is reached, there is a feeling of dechi, a sensation which roughly translates to “arrival of energy.”
If there is no change after five visits, I often send the patient back to the referring physician for further consultation and evaluation before continuing with more acupuncture.
The energy to heal begins with you.
Dr. Gene Hong