Should You Try Acupuncture?

The question is not whether acupuncture works, but how it works, and whether it is the appropriate therapy for a particular syndrome, problem, symptom, disease or patient.
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Recently I've been involved in creating and hosting a series of documentaries on integrative medicine. The three films are aimed at healthcare professionals. The first is about the science of tai chi, the second is about the science of meditation and the third is about the science of acupuncture. I've just wound up the last on-location filming (interviewing experts) for the acupuncture film, and am struck by how this ancient healing modality is blossoming in popularity across the country.

A healing tool of Traditional Chinese Medicine (TCM), acupuncture has been successfully administered for more than 2,500 years. According to the TCM view, a vital energy called qi flows through the body along channels called meridians. I like to think of these channels as a sprinkling system for the body, bringing qi to vital organs and extremities in much the way hoses bring water to your garden. In the TCM model of health and disease, when qi flow is blocked it stagnates. Stagnating qi causes illness. Acupuncture therapy unblocks the qi flow, strengthens or weakens the qi (think opening and closing the garden spigot) and directs it to areas of need.

A holistic practice, acupuncture seeks to re-establish the body's healthy equilibrium and function, as opposed to forcing healing using surgery or pharmaceuticals. Interestingly, Chinese practitioners were not the only (and may not have been the first) to identify these energy pathways in the body. The frozen body of a man recovered well-preserved from the Alps features tattoos that correspond to Chinese acupuncture's qi meridians.

Much research is afoot to attempt to define qi in Western terms. This is a challenge, as the word runs deeply through not only Chinese medicine, but through Chinese art, literature, philosophy, pugilism and daily life. From the standpoint of Western medical science, qi is likely to be revealed as some amalgam of endorphins, the bioelectric potential of cell membranes, nervous conduction, circulating hormones and perhaps even photons (light) and infrared radiation (heat). In attempting to define and quantify qi, acupuncture research may end up identifying a whole new system of biological information, such as the conduction of impulses through the body's connective tissue.

A typical acupuncture treatment involves penetrating the skin with tiny needles, but some styles of acupuncture (Japanese toyohari, for instance) don't require such penetration. Some researchers link such distant healing to the so-called "non-local" effects of quantum physics. Cutting edge stuff! Still, studying the effects of acupuncture with the traditional, Western, double-blind placebo controlled model presents certain difficulties. These center on the fact that since we don't fully understand how acupuncture works, we don't know what the variables are; not understanding those elements, we can't adequately control for them. More, the term "placebo effect" (as in this treatment or that pill is no more effective than a placebo) is an inaccurate and pejorative term that is rapidly losing relevance as we learn more about the body's ability to heal itself. It turns out that the effect is powerful, and desirable, perhaps the new "gold standard" for the way the body should heal.

Despite the challenges of study design and the mind-bending possibilities for a new understanding of how the body works, acupuncture has been extensively studied and verified both by international studies and by our own National Center for Complementary and Alternative Medicine (NCCAM). Part of the National Institutes of Health, NCCAM alone sponsors more studies than I can list here, and their website (merely one, orthodox outlet for medical information from a Western point of view) addresses acupuncture for pain, Post Traumatic Stress Disorder, osteoarthritis, fibromyalgia and more.

Some folks, including older Western M.D.s, still talk about whether or not they "believe" in acupuncture. Such thinking is ill-informed and outdated. One might as well speculate about whether to believe in aspirin, morphine, insulin, surgery or an MRI. The question is not whether acupuncture works, but how it works, and whether it is the appropriate therapy for a particular syndrome, problem, symptom, disease or patient. In a clinical setting and performed by a licensed professional (licensure is by state) acupuncture is effective for a variety of complaints.

Over the years, I have received acupuncture myself and watched scores of people from different walks of life receive the treatment for a spate of different ills. While practitioners vary in their needling technique, for the most part acupuncture is not painful and gives results readily. Practitioners use smaller needles here than they do in China, and are generally gentler in their application, citing the lower pain threshold of American patients. In China, needles are thicker, longer, and sometimes as enthusiastically "rowed" while in a patient as an oar in the hands of a whitewater kayaker. Ouch. Discomfort seems to be expected by Chinese patients--here, not so much.

In China, the typical course of therapy seems to be every day for 10 days, a break, then another similar course if needed. On our shores it is more typical to go once or twice a week for a month or two before lasting results are gained. Most sessions last 15-30 minutes in a quiet room, during which the patient often falls asleep.

Does insurance pay for acupuncture? In the state of Washington coverage for acupuncture (along with other complementary treatments such as chiropractic and massage) is mandated. In other states it varies by company and policy. If you are paying for treatment out of your own pocket, the cost can add up, but should be weighed against other treatment options, your pain and suffering, and of course the modality's potential to forestall worsening health.

So should you try it? That depends on a variety of factors. Patients who have tried more familiar therapies without success, particularly for a chronic or recurring problem, are good candidates for acupuncture. Another type of candidate might be someone who is reluctant to endure the side effects of some more conventional Western therapies. A third acupuncture patient profile might be the person who wishes to emphasize wellness and prevention over the disease model of medicine and is willing to make concomitant lifestyle changes to achieve optimum health.

If you have needle fears, remember that acupuncture needles are more like a pin--very small and not open-ended like a hypodermic needle. Consider going to see a treatment and having a close look at the needle, or, if you have a real phobia, choose the nonpenetrating form of the therapy (toyohari) mentioned earlier. It's best not to expect results overnight, even though I have heard tell that it can sometimes interrupt a grand mal epileptic seizure, end an asthma attack and drop blood pressure quickly. Given time, acupuncture may be effective in addiction therapy (including helping patients stop smoking) weight loss, increasing fertility, treating back pain, migraine headaches and the symptoms of fibromyalgia, and valuable in a host of other chronic conditions.

Pushed along by cultural and financial forces, American medicine is evolving. Old prejudices are giving way to open minds. The new model of integrative medicine is patient centered, and embraces any and all effective solutions to the patient's health problems. Read, learn, ask questions, and take advantage of all options available to you in your quest to get well and stay that way.

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