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FAQs:

What is Acupuncture?

Acupuncture is the practice of penetrating the skin with thin, solid, metallic needles which are then activated through gentle and specific movements of the practitioner's hands or with electrical stimulation. 

Acupuncture is part of the ancient practice of Traditional Chinese medicine. Traditional Chinese medicine practitioners believe the human body has more than 2,000 acupuncture points connected by pathways or meridians. These pathways create an energy flow (Qi, pronounced "chee") through the body that is responsible for overall health. Disruption of the energy flow can cause disease. Applying acupuncture to certain points is thought to improve the flow of Qi, thereby improving health.

Studies have shown that acupuncture is effective for a variety of conditions.

Acupuncture is not for everyone. If you choose to see an acupuncturist, discuss it with your doctor first and find a practitioner who is licensed and has proper training and credentials.

What is an Acupuncturist?

Acupuncture is an ancient practice in which tiny needles are placed on specific points under your skin. These needles are used to stimulate certain points of the body. People choose acupuncture both for therapeutic and preventative purposes.

There are two kinds of acupuncturists, professionals who practice acupuncture. A licensed acupuncturist is a professional who has studied acupuncture and Eastern medicine to maintain the health of their patients. A certified acupuncturist is a licensed doctor or dentist who has completed a training program equivalent to at least 200 hours and 100 hours of supervised experience. Program and certifications may vary, though, depending on the state that you live in.

Acupuncture is now a popular practice in the Western world. The National Health Service (NHS) in the UK uses acupuncture in some of its general practices and pain clinics and hospices. The National Center for Complementary and Alternative Medicine (NCCAM) reports that the number of people using acupuncture for pain management is rising. About 35 million Americans regularly use acupuncture, so the need for certified acupuncturists is high.

How Does Acupuncture Work?

Chinese medicine calls the energy that flows through the body qi. Chinese medicine practitioners believe qi disruptions create imbalances in the body’s energy that lead to illness.

Some forms of acupuncture aim to rebalance qi with needles that touch acupuncture points (acupoints) throughout the body. There are hundreds of acupoints in the body along 14 major meridians, also called energy-carrying channels.

The needles stimulate the body’s existing systems to:

1. React to an illness or symptom.

2. Rebalance the body.

3. Release natural chemicals, such as endorphins, the body’s natural painkillers, and neurotransmitters, chemicals that control nerve impulses.

Is Acupuncture Safe?

Relatively few complications from using acupuncture have been reported. However, complications have resulted from the use of nonsterile needles and improper delivery of treatments. When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs, and injury to the central nervous system.

The U.S. Food and Drug Administration (FDA) regulates acupuncture needles as medical devices and requires that they be sterile and labeled for single use only.

Does Acupuncture Work?

Some studies show that acupuncture can help with treating pain. Other studies suggest that there may be a placebo effect. Studies that look at placebo effects often compare acupuncture with “sham acupuncture.” This is a procedure where an acupuncturist inserts needles into the body but not at actual acupoints. The purpose of this is to see if simply inserting needles has the same beneficial effect as real acupuncture.

One study compared acupuncture with a placebo and reviewed many trials of acupuncture and sham acupuncture. It found that there was not much difference in chronic pain improvement between people who had actual acupuncture and those who just thought they did. Acupuncture and sham acupuncture seemed to relieve pain similarly. But both relieved pain more than medications alone. This may mean that, for some people, just the experience of having acupuncture can help treat pain, even if the procedure itself is not.

Does Acupuncture Hurt?

Acupuncture needles are different from blood draw or injection needles. Acupuncture needles are solid, thin, and smooth; blood draw and injection needles are beveled, sharp, and designed to cut the skin. So pain from acupuncture needles is much weaker. It’s the equivalent of pinching your skin between your fingernails, but that pain goes away very quickly in about a half-second. However the vast majority of my patients who experience acupuncture continue with it and say that the pain is nothing compared to the benefits.

How Often Should You Get Acupuncture?

The number of treatments depends on your condition, its severity, and how your body responds. Most patients have an appointment once a week. Others get treatment more or less often, depending on how long the effects last. Your acupuncturist will recommend a schedule that is right for you. You may not get the full benefits of acupuncture on the first or second treatment. If you decide to try acupuncture, you should give it at least five treatments.

How Long Does Acupuncture Last?

The benefits of acupuncture can last for weeks, months, or, even up to a year in some cases. However, this depends entirely on the condition that your patient is being treated for, the severity of their symptoms, and their medical history. Some may see longer-lasting benefits than others.

Those with more severe symptoms tend to require more acupuncture sessions than those with more minor symptoms. Because of this, it can take longer to experience results, and those results may not be as potent as with more minor symptoms.

If your patient is unsure, or reluctant, explain to them why you recommend a certain treatment plan, any expected outcomes, and when you think they should start seeing results, as well as how often they should return to maintain those results.

How Does Acupuncture Lower Blood Pressure?

According to TCM practitioners, acupuncture helps balance your body’s qi or vital energy. Acupoints are the specific points where qi can flow from your organs to the surface of your body. Meridians, or pathways, connect these external points to your internal organs.

When an acupuncturist stimulates combinations of specific acupoints in the right way, it’s thought to balance your qi and help regulate different bodily functions, including your blood pressure.

Scientific evidence has yet to find an explanation for exactly how acupuncture works, but stimulating certain points in your body may act on your body’s central nervous system, influencing blood flow as well as the way your body produces key hormones.

When it comes to hypertension, acupuncture may help regulate your blood pressure by acting on the hormones involved in the renin-angiotensin-aldosterone system (RAAS). This system keeps up a level of blood pressure and balances your fluids and electrolytes.

In particular, acupuncture may change how the hormones and enzymes in your RAAS show up in your blood and stimulate receptors in your body that regulate blood pressure.

Acupuncture could also act on your limbic system to increase your levels of the neurotransmitter dopamine, which plays a key role in your brain’s reward system. Research from 20201 suggests dopamine may lower oxidative stress — an excess of free radicals — and help keep your blood pressure balanced.

Research also highlights acupuncture’s relaxing effects on the walls of your arteries and veins, which may help lower your blood pressure.

Does Acupuncture Relieve Stress?

From the perspective of Traditional Chinese Medicine (TCM), acupuncture relieves stress by promoting the movement of Qi in the body. According to TCM, the energy that usually flows smoothly throughout the body can become stuck or scattered due to stress or disease. This can lead to:

- muscle tension

- headaches

- irritability

- restlessness

- distractedness

- Qi can also become deficient.

When acupoints are applied to areas of stagnation or along energy channels where energy is not flowing properly, it can improve the flow of Qi and resolve those symptoms, resulting in relaxation and relief, feeling the way we should when our bodies are getting what they need. This may be because acupuncture can release hormones like endorphins.

From a physiological perspective, the stimulation of acupoints promotes the release of ‘happy hormones,’ like endorphins and other natural chemicals that signal to the body that it is safe, and secure, and can relax and turn off its stress response.

How Many Sessions of Acupuncture for Back Pain?

Acupuncture treatment can be scheduled twice weekly for several weeks, and then once a week as the back pain improves. The benefits of treatment build over the first 24 to 48 hours, with therapeutic benefits lasting about a week.

Patients may feel relief after the first acupuncture session and resolve completely after several treatments, depending on the severity of the back pain and how long it has been present.

Chronic conditions may require 10 or 12 treatments and possibly recur at a reduced level of pain. If increasing pain returns in the future, regular acupuncture can be helpful.

Acupuncture and traditional Asian medicine have been used for thousands of years and have been very effective in treating pain and other health conditions. Given the concerns about strong and potentially habit-forming medications being used to mask pain, acupuncture stands out as a safe and nonaddicting alternative.

Can Acupuncture Help Neuropathy?

Acupuncture is a technique used to treat pain and relieve discomfort. The needles used in acupuncture are inserted into your body’s pressure points to stimulate the nervous system. This releases endorphins, your body’s natural painkillers, in the muscles, spine, and brain. This technique changes your body’s response to pain. 

Many people with neuropathy turn to acupuncture to relieve their chronic pain. Acupuncture also stimulates blood flow to restore nerve damage. Though research is still being done to test the effectiveness of acupuncture on peripheral neuropathy, there have been some successful studies.

In 2007, a pilot study confirmed that acupuncture as an alternative treatment improved symptoms for more neuropathic patients than those receiving traditional medical care.

Is Acupuncture Covered by Health Insurance?

Some health insurance policies cover acupuncture, but others don’t. Coverage is often limited based on the condition being treated. An analysis of data from the Medical Expenditure Panel Survey, a nationally representative U.S. survey, showed that the share of adult acupuncturist visits with any insurance coverage increased from 41.1 percent in 2010–2011 to 50.2 percent in 2018–2019. Medicare covers acupuncture only for the treatment of chronic low-back pain. Coverage began in 2020. Up to 12 acupuncture visits are covered, with an additional 8 visits available if the first 12 results in improvement. Medicaid coverage of acupuncture varies from state to state.

How Much Does Acupuncture Cost?

The cost of acupuncture varies depending on the practitioner, region, and whether your insurance will cover sessions. In one out-of-pocket cost analysis, researchers gathered prices from 723 acupuncture clinics throughout 39 metropolitan areas in the United States. They found that the cost range for a first-time acupuncture visit was $15 to $400. Your health insurance may or may not cover acupuncture, so it’s a good idea to check with your provider before receiving acupuncture treatments.

Brief History of Acupuncture

Acupuncture is thought to have originated thousands of years ago in China. The first document to describe acupuncture dates from around 100 B.C., according to a past historical review.

Acupuncture didn’t gain attention in the United States as a potentially effective complementary therapy until 1972 when a physician to President Nixon wrote an article about witnessing acupuncture during a trip to China.

In 1997, the National Institutes of Health (NIH) formally acknowledged acupuncture for its value in relieving pain and nausea after surgery or chemotherapy, as well as its potential as an adjunct treatment for headaches, menstrual cramps, low back pain, and myofascial pain. This has led to increased research, clarification on licensure for practitioners nationally, insurance coverage reform, and incorporation of basic concepts into many medical schools’ curriculums.

Today, acupuncture is primarily seen as a pain-management modality — especially for migraines, and low back and neck discomfort, according to the National Center for Complementary and Integrative Health, the leading research organization for complementary health topics.

Common Conditions Acupuncture Treat

Acupuncture points are believed to stimulate the central nervous system. This, in turn, releases chemicals into the muscles, spinal cord, and brain. These biochemical changes may stimulate the body's natural healing abilities and promote physical and emotional well-being.

National Institutes of Health (NIH) studies have shown that acupuncture is an effective treatment alone or in combination with conventional therapies to treat the following:

1. Nausea caused by surgical anesthesia and cancer chemotherapy

2. Dental pain after surgery

3. Addiction

4. Headaches

5. Menstrual cramps

6. Tennis elbow

7. Fibromyalgia

8. Myofascial pain

9. Osteoarthritis

10. Low back pain

11. Carpal tunnel syndrome

12. Asthma

13. It may also help with stroke rehabilitation

Types of Acupuncture

The most common form of acupuncture the placement of needles without additional stimulation is only one of several types of acupuncture. Here are some others.

1. Electroacupuncture

This type of acupuncture adds weak pulses of an electrical current to acupuncture needles to apply more stimulation to acupoints.

2. Dry Needling

On the surface, dry needling and acupuncture may seem identical. But acupuncture is used to stimulate specific acupoints in the body (according to TCM and related fundamental theories and traditional practices), and dry needling targets isolated trigger points: tight bands or knots in a muscle fiber that can restrict the range of motion or cause pain in other areas of the body.

3. Acupuncture With Moxibustion

According to the American Institute of Alternative Medicine (AIAM), moxibustion is a TCM technique in which dried mugwort (a small, spongy herb) is burned to promote healing. This can be done away from the skin, on the skin, or with acupuncture needles.

4. Acupressure

Acupressure is essentially acupuncture without needles. A practitioner (or patient at home) applies pressure to your acupoints with their fingers, according to the University of Michigan Health Rogel Cancer Center.

5. Ear Seeding

Ear seeding is a form of acupressure performed on the ear, called auriculotherapy. It involves placing ear seeds (small latex stickers containing a ripe seed from the Vaccaria plant, which grows in China and parts of central and southern Europe) on specific acupoints in the ear that correspond with parts of the body where you may experience discomfort or pain.

Benefits of Acupuncture

Results from several studies suggest that acupuncture may be an effective therapy for several health concerns and conditions. Here are several potential benefits of acupuncture:

1. Relieves Chronic Pain

One of acupuncture’s most-researched perks is its effectiveness in easing chronic pain. In meta-analyses of randomized controlled trials that included roughly 18,000 patients with chronic musculoskeletal pain, researchers found that acupuncture was substantially more effective at treating discomfort than standard care approaches like physical therapy.

A past review of drug-free treatment options for lower back pain found that acupuncture reduced pain and improved back function immediately following the therapy. The reviewers also stated it’s unclear how acupuncture may help with lower back pain in the long term.

2. Helps With Insomnia

Acupuncture may offer relief for common sleep problems like insomnia. In a small study, researchers gave acupuncture or sham acupuncture (in this study, the sham control needles did not penetrate the skin) to people with insomnia three times per week for four weeks. Researchers found that the acupuncture intervention group was effective at improving insomnia symptoms during therapy. In addition, people reported significant improvements in anxiety two and four weeks after acupuncture.

3. Eases Nausea From Chemotherapy

Chemotherapy can come with several unpleasant side effects, including nausea. According to a past review of 41 randomized controlled trials, acupuncture is an effective complementary therapy for uncontrolled nausea and vomiting from chemotherapy.

4. Reduces Migraines

Research suggests that acupuncture may help prevent episodic migraines. The authors of a past review found that available evidence supported adding acupuncture to the symptomatic treatment of migraine attacks to reduce the frequency of headaches. The available trials also found that acupuncture was at least as effective as prophylactic drugs.

5. Helps With Overall Symptoms in Hospitalized Cancer Patients

Acupuncture may be an effective complementary therapy for patients recovering from surgery. According to one small study, 172 patients who received acupuncture following surgery reported significant improvements in sleep, anxiety, pain, fatigue, nausea, and drowsiness.

6. Eases Menstrual Cramps

Acupuncture may offer relief for painful periods. According to a meta-analysis of 49 randomized controlled trials, manual acupuncture, and electroacupuncture were more helpful for reducing menstrual pain than nonsteroidal anti-inflammatory drugs (NSAIDs). The authors concluded that acupuncture might be used as a safe and effective treatment for women who experience severe menstrual discomfort.

When Shouldn't Acupuncture Be Used?

The use of acupuncture is not as prominent or may even be contraindicated in the treatment of:

1. Infants and very young children

2. Very weak or very elderly patients

3. People with compromised immunity

4. Patients suffering from certain bleeding disorders or severe blood loss

5. Patients who are very weak, emaciated, who are suffering from low blood sugar, or who have collapsed due to fatigue and exhaustion

6. Patients with significantly low blood pressure

7. Patients who are suffering from extreme anxiety or who are very nervous about the needles

Pregnancy: while acupuncture is generally considered safe for most women during pregnancy, certain acupuncture points are forbidden during pregnancy. Pregnant women should talk with their OB-GYN doctor and their TCM practitioner about these restrictions and any other concerns regarding their pregnancy before undergoing acupuncture treatment.

5 Common Myths About Acupuncture

Right now, acupuncture is all the rage. However, this procedure is far from new. While it is hard to determine the exact moment in history when acupuncture was invented, many agree that it is approximately 2,000 years old. Initially, acupuncture was used predominately in Asian nations such as China. Americans first began to use acupuncture in the early 1970s and the popularity and frequency of its use have continued to grow each year. Here are common myths about acupuncture. 

1. It requires the use of painful needles

Sure, it does require the use of needles, but it is far from painful. Acupuncture is so relaxing that most patients fall asleep during an acupuncture session.  The needles are surprisingly thin and are often referred to as “pins.”  They bear no resemblance to the needles used for injections or drawing blood.  While there may be a slight pinch with the pin set-up, a deep relaxation typically occurs within minutes.  Frequent acupuncture-goers will tell you that the overall calming effect is different from other modalities such as yoga or massage.

2. It doesn’t work

While everyone’s results and experiences with acupuncture may differ, there have been countless studies that demonstrate its effectiveness. 

3. It’s a mystical form of voodoo

There is nothing mystical or magical about acupuncture. It is a clinical modality designed to help balance your body’s various interconnected systems. While it is not entirely clear how acupuncture works to heal the body, research continues to explore the possible neurochemical mechanisms of acupuncture’s pain-relieving effects. This means that many believe that acupuncture works by stimulating a nerve in the body that then sends a signal to the brain to release pain-relieving hormones including beta-endorphins. These hormones can help suppress pain and increase your overall mood, happiness, and pleasure.

4. Becoming an acupuncturist requires no training

This myth couldn’t be further from the truth. To become an acupuncturist in the United States, you must attend at least 3 years of graduate school. The graduate school programs typically include studies in Asian bodywork, nutrition, practice management, ethics, needle technique, acupuncture points, and Western medicine. However, the work requires far more than just memorizing passages from a textbook; students will also be required to undergo several hours’ worth of clinical experiences allowing them to learn acupuncture in a hands-on way. Once you complete your degree and become a certified acupuncturist, your work still is not done. To keep their licenses and certificates, acupuncturists are required to attend many continuing education classes and pass the National Board Licensure Exams.

5. Acupuncture is just for pain

Acupuncture indeed does wonders for pain management.  However, acupuncture has been shown to reduce other side effects and conditions including headaches and migraines, depression, nausea, stress, anxiety, and gynecological conditions as well.

Considerations When Choosing Acupuncture

Because scientific studies have not fully explained how acupuncture works within the framework of Western medicine, acupuncture remains a source of controversy. It is important to take precautions when deciding about acupuncture.

Discuss acupuncture with your doctor first. Acupuncture is not for everyone. Discuss all the treatments and medicines (dietary supplements, prescription, and over-the-counter) you are taking. If you have a pacemaker, are at risk for infection, have chronic skin problems, are pregnant, or have breast or other implants, be sure to tell your doctor. Acupuncture may be risky to your health if you fail to mention these matters.

Do not rely on a diagnosis of disease by an acupuncture practitioner. If you have received a diagnosis from a doctor, you may wish to ask him or her whether acupuncture might help.

Choose a licensed acupuncture practitioner. Your own doctor may be a good resource for referrals to a licensed or certified practitioner. Friends and family members may also be good sources of referrals. You do not have to be a doctor to practice acupuncture or to become a certified acupuncturist. About 30 states have established training standards for certification in acupuncture, although not all states require acupuncturists to get a license to practice. Although not all certified acupuncturists are doctors, the American Academy of Medical Acupuncture can provide a referral list of doctors who practice acupuncture.

Consider costs and insurance coverage. Before starting treatment, ask the acupuncturist about the number of treatments needed and how much the treatments will cost. Some insurers cover the cost of acupuncture while others do not. It is important to know before you start treatment whether acupuncture is covered by your insurance.

What to Expect from Acupuncture

Each person who performs acupuncture has a unique style, often blending aspects of Eastern and Western approaches to medicine. To determine the type of acupuncture treatment that will help you the most, your practitioner may ask you about your symptoms, behaviors, and lifestyle. He or she may also closely examine:

- The parts of your body that are painful

- The shape, coating, and color of your tongue

- The color of your face

- The strength, rhythm, and quality of the pulse in your wrist

An acupuncture session may take up to 60 minutes, although some appointments may be much shorter. A common treatment plan for a single complaint would typically involve one or two treatments a week. The number of treatments will depend on the condition being treated and its severity. In general, it's common to receive 6 to 8 treatments.

A. During the procedure

Acupuncture points are situated in all areas of the body. Sometimes the appropriate points are far removed from the area of your pain. Your acupuncture practitioner will tell you the general site of the planned treatment and whether you need to remove any clothing. A gown, towel, or sheet will be provided. You lie on a padded table for the treatment, which involves:

1. Needle insertion. Acupuncture needles are inserted into various depths at strategic points on your body. The needles are very thin, so insertion usually causes little discomfort. People often don't feel them inserted at all. The typical treatment uses 5 to 20 needles. You may feel a mild aching sensation when a needle reaches the correct depth.

2. Needle manipulation. Your practitioner may gently move or twirl the needles after placement or apply heat or mild electrical pulses to the needles.

3. Needle removal. In most cases, the needles remain in place for 10 to 15 minutes while you lie still and relax. There is usually no discomfort when the needles are removed.

B. After the procedure

Some people feel relaxed and others feel energized after an acupuncture treatment. But not everyone responds to acupuncture. If your symptoms don't begin to improve within a few weeks, acupuncture may not be right for you.

How Acupuncture is Performed

Pre-sterilized disposable needles should be used. Depending on the location of the treatment, you will either sit or lie down. Properly done, acupuncture is painless because the needles are very fine (around 0.2 mm wide). When the needles are inserted, you may feel mild tingling around the site, warmth or heaviness, or even nothing at all.

An acupuncturist may use other techniques including:

1. cupping – suction designed to bring blood to the acupuncture point

2. Chinese herbs – either mixed by the acupuncturist or in a pre-prepared tablet or granulated form

3. laser – used instead of the needles to activate acupuncture points

4. TCM remedial massage – techniques applied to specific acupuncture points or meridians

5. moxibustion – burning herbs held over or applied to acupuncture points.

After a session of acupuncture, you will normally feel relaxed and refreshed, but specific responses depend on each person. For instance, some people feel energized, while others feel sleepy. Occasionally, the symptoms get a little worse before they improve.

The number of treatments you need depends on your condition. In most cases, people experience a reduction in symptoms within a few sessions. The idea of acupuncture is to restore the natural balance of energy inside your body. Once the balance is restored, the body can take care of itself and no further treatments are necessary.

Risks of Acupuncture

In the hands of an unskilled practitioner, acupuncture may lead to several problems including:

1. Allergic reactions – herbs are sometimes burnt over the skin to create specific points of heat near acupuncture points. Herbs are as powerful as pharmaceutical medications and need to be treated with the same respect and caution.

2. Infection – if the needle is unsterile, bacteria can cause a local infection. There is also a risk of contracting hepatitis, HIV, or any other bloodborne disease if the needles are reused

Injury to the skin – clumsy insertion, or entry of a needle into a blood vessel, can cause bleeding, bruising, and pain.

3. Unexpected side effects – such as an increase in pain, depression, convulsions, or insomnia. Acupuncture can produce significant changes within the nervous system and the correct points must be stimulated in the right way.

How to Choose an Acupuncturist

If you're considering acupuncture, take the same steps you would choose an acupuncturist:

1. Ask people you trust for recommendations.

2. Check the practitioner's training and credentials. Most states require that nonphysician acupuncturists pass an exam conducted by the National Certification Commission for Acupuncture and Oriental Medicine.

3. Interview the practitioner. Ask what's involved in the treatment, how likely it is to help your condition, and how much it will cost.

4. Find out whether your insurance covers the treatment.

 

Sources:

Johns Hopkins

Cleveland Clinic

Hackensack Meridian Health

GoodRx Health

NIH

Everyday Health

Breeze

Healthline

SHARP

Taking Charge

Penn Medicine

Mayo Clinic

Better Health Channel

WebMD