How does acupuncture work?
Basic science research performed over the past 50 years has shown that acupuncture has a number of mechanisms of action:
a) Insertion of acupuncture needles causes release of endorphins (naturally occurring pain relieving chemicals) in the brain, along with serotonin and norepinephrine (both of which can improve mood and lessen pain), and cortisol (which has anti-inflammatory effects).
b) Acupuncture also appears to balance the 2 arms of the autonomic nervous system, lowering Sympathetic (fight or flight) over-activity while enhancing Parasympathetic (calming) activity. Harmonizing the autonomic nervous system can benefit mood, lessen anxiety, and modify the experience of pain.
c) Acupuncture is additionally believed to act via local effects when needles are inserted at sites of pain and tenderness. It is theorized that the local “micro-trauma” induced by the needles, results in a targeted response from the body, which in turn facilitates regional healing.
d) Research has shown that acupuncture has many other effects and there is still much to be learned.
What is Qi and how does it relate to acupuncture?
Qi (pronounced “chi”) is roughly translated as the universal vital force flowing through all living things.
The ancient Chinese and most traditional acupuncturists believe that illness is caused by disruption in the flow of Qi and that acupuncture works by restoring normal circulation of Qi in the body.
As noted above, modern research has defined more plausible and tangible explanations for acupuncture’s beneficial effects.
How does “Medical acupuncture” differ from “Traditional acupuncture”?
Medical acupuncture is the term used to describe acupuncture performed by a doctor trained and licensed in Western medicine, who has also had thorough training in acupuncture as a specialty practice.
Does acupuncture work for conditions other than pain?
Although most commonly employed for treatment of pain, acupuncture can be effective for a variety of other conditions including PTSD (post traumatic stress disorder), anxiety, insomnia, hot flashes, and infertility. (Please see the Acupuncture section under the “Services Provided” heading for a comprehensive list of conditions).
Is acupuncture painful?
Acupuncture needles are very thin and have smooth tips (as opposed to hypodermic needles which have beveled “cutting” tips). Most patients feel minimal discomfort when the needles are inserted.
Does acupuncture have side effects?
Minor bruising at the needle insertion site is the most common side effect. Significant bleeding is rare. Needles are sterile and disposable, so the incidence of the needles inducing infection is negligible.
When acupuncture is performed by a trained practitioner, the likelihood of significant side effects is extremely low.
How many treatments are required?
This varies by patient and condition.
Generally speaking, acute conditions may only require 1-3 treatments while long-standing problems can sometimes require 1-2 treatments per week for a month or more.
Some patients respond much better to acupuncture than do others. The reasons for this are not clear. My general policy is to discontinue acupuncture if there is no response by the 3rd treatment.
Does Medicare pay for acupuncture?
Medicare does NOT reimburse for acupuncture.
Do private insurance companies pay for acupuncture?
Some private insurance companies reimburse for acupuncture, some limit coverage only for certain conditions, some place limits on the number of allowable treatments and some do not cover acupuncture at all. It is always best to check with your carrier. (see also the “Practice information” section)
Why do insurance companies and some scientists and doctors attribute acupuncture’s benefits to placebo effect?
A number of clinical trials have shown sham (simulated) acupuncture to be nearly as effective as true acupuncture, leading some to conclude that acupuncture’s benefits are entirely due to placebo effect (i.e. related to the patient’s anticipation of benefit from the intervention).
The problems with such a conclusion are threefold:
1) A true placebo intervention must be physiologically inert i.e. not expected to produce any effect in the subject (e.g. a pharmacological study might employ a capsule which looks identical to the drug being tested, yet which contains only inert dextrose powder). It is very difficult to simulate true acupuncture in a manner that satisfies this definition of placebo. Most studies mimic acupuncture by placing needles a few inches away from traditional point locations or employ needling at shallow (theoretically non-therapeutic) depths. Modern research however, suggests that there is nothing “magical” about traditional acupuncture point locations- they are simply defined points on the body which have been determined by trial and error over thousands of years, to be the most influential sites for needle placements. Present day studies show that inserting acupuncture needles at any location or depth will produce some degree of physiologic response (e.g. endorphin release). Thus “sham” acupuncture is not equivalent to “placebo” acupuncture.
In fact, most clinical trials confirm just what one would expect given the above information: That true acupuncture AND sham acupuncture both outperform no treatment and that true acupuncture slightly outperforms simulated acupuncture.
2) Functional MRI studies show subtle but definite differences in areas of brain activity following “sham” vs. “true” acupuncture. Thus MRI imaging supports differential effects between actual and simulated acupuncture.
3) Acupuncture has been demonstrated to be effective in animals, and animals are not subject to placebo effect.