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Acupuncture is one of the oldest, most commonly used medical procedures in the world. Originating in China more than two centuries ago, it first became widely known in the United States in 1971 when New York Times reporter James Reston wrote about how doctors in Beijing, China used needles to ease his abdominal pain after surgery.

Acupuncture meridian points

(Reprinted with permission from
Acupuncture By Carole Forbes)

Traditional Chinese medicine theorizes that more than 2,000 acupuncture points on the human body connect with 12 main and 8 secondary pathways, called meridians. Acupuncture practitioners believe these meridians conduct energy, or qi, between the surface of the body and internal organs.

Qi is influenced by the opposing forces of yin and yang, according to practitioners. When yin and yang are balanced, they work together with the natural flow of qi to help the body achieve and maintain health.

Acupuncture is believed to balance yin and yang, keep the normal flow of energy unblocked, and restore health to the body and mind.

Several processes have been proposed to explain acupuncture’s effects, primarily those on pain. Acupuncture points are believed to stimulate the central nervous system (the brain and spinal cord) to release chemicals that influence the body’s self-suppressing pain mechanisms.

Western scientists have found evidence that acupuncture points are strategic conductors of electromagnetic signals. By stimulating points along these pathways, acupuncture may enable electromagentic signals to be relayed at a greater rate than under normal conditions. These signals may start the flow of pain-killing biochemicals, such as endorphins, and of immune system cells to specific sites in the body that are injured or vulnerable to disease. Additional research has also found that several types of opioids may be released into the central nervous system during acupuncture treatment, thereby reducing pain.

On your first visit, the acupuncturist will ask questions to develop a complete medical history. You will be asked about diet, mood and sleeping patterns. Diagnosis may also include examination of your tongue for its structure, color and coating and of the pulses at your wrists, ankles or carotid artery in the neck which are felt for their quality, rhythm and strength.

According to the Northwest Institute of Acupuncture and Oriental Medicine in Seattle, Washington, the first visit to a practitioner lasts from an hour to an hour and a half. Follow-up visits usually run about an hour.

Acupuncturists can use as many as nine types of acupuncture needles, though only six are commonly used today.

Acupuncture needles are hair-thin and usually made out of stainless steel. Occasionally silver or gold needles are used - the ancient Chinese acupuncturists attributed different Qi effects to each of these metals - gold

Acupuncture

needles were used to tonify or strengthen and silver needles used for sedation . Needles are inserted to a depth of between half an inch to an inch, depending on the treatment.

Today, most needles are disposable. They are used once and discarded in accordance with medical biohazard regulations and guidelines.

The needles are pushed beneath the skin either directly, by tapping sharply on the top of an introducer tube or by means of a spring-loaded injector.

Once a needle has been placed, the acupuncturist manipulates the needle in one of the following ways which is called "needling": Raising and Thrusting, Twirling or Rotation, Combination of Raising/Thrusting and Rotation, Plucking, Scraping (vibrations sent through the needle), and Trembling (another vibration technique). Points can be "needled" anywhere in the range of 15 degrees to 90 degrees relative to the skin surface.

While the needles may feel uncomfortable at times, patients rarely describe the sensation as painful. Some patients describe a tingling pins-and-needles feeling, others may feel numbness or nothing at all. Some find the sessions relaxing, and according to practitioners, many patients fall asleep during or immediately after treatment. The sensation felt by the patient is called deqi (pronounced dah-chee). According to acupuncture theory, it's this process of needle manipulation which produces an effect on the acupuncture point.

Acupuncture needles are usually left in from 15 to 40 minutes depending on the ailment. Often, treatments are given once or twice a week over several months.

The "needling" process is sometimes replaced or augmented with very low voltage electric stimulation of the acupuncture points. This is called electro-acupuncture. Unfortunately, there are no clear guidelines about the frequency or intensity of electrical current that should be used on patients.

Moxibustion

Sometimes, acupuncture is accompanied by moxibustion which is the burning of the herb mugwort.. Practitioners apply moxibustion in different ways. They may put the moxi (herb) on an acupuncture needle and burn it. They may burn a stick of moxi over the needling site. There are other methods, such as applying moxi onto a piece of aconite which is placed directly on the body.

Finally, another procedure called "cupping" is sometimes performed in an effort to alleviate pain. ys on his stomach.

Cupping

Small glass, ceramic or bamboo cups are placed on the skin after a small flame consumes the oxygen in the upside-down cup. A vacuum is created between the cup and the skin. Cupping is usually done on the patient's back while the patient leans forward or la

A number of studies by Western researchers have documented acupuncture’s effects, but they have not been able to fully explain how acupuncture actually works. Western scientists have found meridians hard to identify because they do not directly correspond to nerve or blood circulation pathways.

Nonetheless, advances in imaging techniques are now making it possible to track at least some of the physiological changes that take place during acupuncture treatment. For example, scientists at the University of Medicine and Dentistry of New Jersey recently compared brain images of 12 people experiencing pain with images after they received acupuncture. Under brain imaging, the brain shows activity in specific areas when a person experiences pain. Following acupuncture, the researchers found a marked depletion in that activity.

Dr. Zsang-Hee Cho of the University of California at Irvine used positron emission tomography (PET) and magnetic resonance imaging (MRI) to further track the neurological effects of acupuncture. Presenting his findings at a conference sponsored by the National Institutes of Health, Cho cited findings that demonstrated changes in glucose utilization and oxygen consumption in different areas of the brain as a direct result of acupuncture stimulation.

At an earlier NIH-sponsored conference, Dr. Abass Alavi described a University of Pennsylvania study which used a high-tech imaging technique called SPECT to spy on the brains of chronic pain patients undergoing acupuncture. The tests showed that the brain’s thalamus, which plays a role in pain perception, “lit up” after acupuncture needles were inserted elsewhere in patients’ bodies. Before acupuncture, the SPECT images showed an irregular blood flow in the thalamus. With acupuncture, the irregularity—and pain—disappeared.

The Food and Drug Administration only approved acupuncture needles for use by licensed practitioners in 1996 and now requires manufacturers of acupuncture needles to label them for strictly single use. The National Institutes of Health finally published official guidelines for the use of acupuncture in 1997.

Relatively few complications from the use of acupuncture have been reported to the FDA when one considers the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. When not delivered properly, acupuncture can cause serious adverse effects, including infections and puncturing of organs.

Nonetheless, acupuncture is increasingly being used to complement conventional therapies. For example, some doctors are combining acupuncture and drugs to control surgery-related pain in their patients. By providing both acupuncture and certain conventional anesthetic drugs, doctors have found it possible to achieve a state of complete pain relief for some patients. They also have found that using acupuncture lowers the need for conventional pain-killing drugs and thus reduces the risk of side effects for patients who take the drugs.

There are an estimated 10,000 acupuncturists in the U.S. and 32 states have established training standards for the licensing and practice of acupuncture.

The American Academy of Medical Acupuncture is a professional association of medical doctors who practice acupuncture. You can obtain a referral list of doctors and get general information about acupuncture by calling them at 1-800-521-2262 or visiting their Web site at http://www.medicalacupuncture.org

The National Acupuncture and Oriental Medicine Alliance is a professional society of state-licensed, registered and certified acupuncturists. It lists thousands of acupuncturists on its Web site and provides the list to callers to their information and referral line. You can reach them by calling 253-851-6896 or going to their Web site at http://www.acuall.org

The American Association of Oriental Medicine is a nonprofit organization that will provide you with the state licensing status of acupuncture practitioners across the United States. They can be contacted by calling 610-266-1433 or going online at http://www.aaom.org

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