When I'm asked about acupuncture, I'll be honest, my answer mainly comes from what I've read in a few published articles and one session I've had done on myself. My colleague, and oldest and dearest friend, Dr. Sharon Garland is a much more legitimate resource for acupuncture answers. She is a Board-Certified Family Physician and is also certified in medical acupuncture. She is currently living in Japan with her husband and graciously agreed to share some basics of acupuncture with us.
Traveling and living abroad in Japan has provided me the opportunity to think about the general practice of medicine in the United States and how much it differs from the approach here locally. Here in Japan, medications, including antibiotics, are taken much more seriously, and are only used when necessary and DO NOT include many of the controlled substances frequently prescribed in the US (such as stimulant meds for ADHD or opioid pain medications other than for cancer patients). Japanese choose to manage their health with diet, a highly active lifestyle (people walk everywhere here), and other integrative therapies (manual manipulation such as massage or chiropractic care, evidence-based herbal therapies called Kampo, and traditional energy medicine such as acupuncture or reiki). The overall cost of healthcare is much lower in Japan compared to other countries and their average life expectancy is one of the longest/healthiest in the world. They must be doing something right! So let us do a deeper dive into one of the traditional therapies that do not involve prescription medications, specifically acupuncture.
What is acupuncture?
Acupuncture is a therapy that is used to encourage the body to promote natural healing and improve function. This is done by inserting very thin needles and applying manual stimulation, heat, or a small electrical current at very precise anatomic locations on the body called acupuncture points.
How does acupuncture work?
The classical Chinese explanation is that energy, also known as Qi, runs through the body in regular patterns called meridians. We know this energy (Qi) exists - think of cardiac EKGs that show the heart’s electrical activity. If energy (Qi), is blocked, the body becomes unbalanced and disease states or pain can occur.
Acupuncture treatments can help Qi flow more easily by re-establishing energy flow and unblocking obstructions. Think of meridians like “rivers” of energy/electricity (Qi) that run through the body and can become blocked, like putting a dam in a river and obstructing its flow. With acupuncture, the goal is to remove any blockages and improve energy flow which in turn helps to treat disease and relieve pain.
The modern science explanation is that the use of needles at acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain. These chemicals can help change the body’s perception of pain as well as trigger the release of other chemicals and hormones which influence the body’s own ability to heal itself.
What is medical acupuncture and how is it different from ordinary traditional acupuncture?
Medical acupuncture is the term used to describe acupuncture that is performed by a licensed medical physician (MD or DO) who has had additional training in acupuncture techniques. The benefit of medical acupuncture is that the physician can use the most appropriate approach, traditional medicine or acupuncture or a combination of both, to treat a particular condition. Traditional acupuncture is performed by a provider who has attended training through an accredited traditional Chinese/herbal medicine course/school and is NOT an MD or DO.
It is becoming more common for chiropractors and physical therapists to advertise that they perform “dry needling” in their offices - be aware, training, and experienced is HIGHLY variable. The term “dry needling” is used in the state of Florida because only physicians and providers who are graduates from certified acupuncture schools can legally advertise that they perform "acupuncture". “Laser acupuncture” is another common term you will hear frequently - this has not been shown to have the same benefit as traditional or medical acupuncture and is more of a gimmick advertised to those seeking a “needle free” experience. You should not need a needle free experience if in the hands of a skilled acupuncturist.
Who benefits from acupuncture?
Acupuncture is often associated with pain control and research shows it can help people with chronic pain, particularly musculoskeletal pain. Acupuncture also has a broader range of applications and has been shown to help with nausea, migraines, insomnia, seasonal allergic rhinitis, and smoking cessation amongst other conditions. Medical acupuncturists tend to focus more on musculoskeletal pain and physical symptoms, but this varies from provider to provider. I love to treat allergies and have had remarkable success helping patients with chronic sinusitis.
How many treatments will I need? How do I know if acupuncture will work?
The number of treatments varies from person to person and based on the condition. These visits may last from 15 minutes to 1 hour. Often treatments are performed at weekly intervals initially and may be spaced out as the treatment progresses. I tell my patients that if you have not noticed any difference after 2-3 treatments consider looking at other therapies. About 5-10% of the general population are considered acupuncture non-responders and may notice no benefit regardless of the number of treatments. In terms of duration of results, some people experience symptom reduction for hours, days, or weeks. For acute pain or the treatment of sinusitis/allergies, the results can be felt almost immediately. Follow up visits for maintenance care may be of benefit to continue the effect.
Does acupuncture hurt?
The needles usually do not hurt as they are very thin (thinner than a strand of hair). Most patients feel very minimal pain and only at the time of insertion, many feel no pain at all. Usually, my patients are very pleasantly surprised by the lack of discomfort and report more often a deep sense of relaxation during their treatment.
Is acupuncture safe?
With any procedure there are risks, side effects, and rarely complications. Acupuncture is generally very safe. Medical acupuncturists use sterile disposable needles that are only used one time, thus the risk for infection is exceptionally low. Occasionally patients will have a pinpoint amount of bleeding or bruising at the site of needle insertion. Sometimes people feel faint or lightheaded during or after the procedure (not much different from people who experience these symptoms with injections or vaccinations). Other risks are extremely rare and include infection, puncture of a lung or other organ, and nerve damage.
Is acupuncture covered by health insurance?
Most insurance companies do not cover the cost of acupuncture, although you may be able to pay with your FSA if you have one. Check with your insurer before you start treatment.
Resources
Dr. Sharon Garland is a Jacksonville, FL native and graduate of Stanton College Prep and the University of Florida. She attended the Uniformed Services University School of Medicine and completed her Family Medicine internship and residency in the military. She proudly served as a Naval officer and physician for 14 years. She has continued to practice medicine as a board certified family physician in her home state of Florida, but is currently enjoying a sabbatical while stationed with her husband in Yokosuka, Japan.