Acupuncture

History 

The traditions of acupuncture traces its history back thousands of years.  It emerged out of systems of ritualistic piercing and tattooing which were present in nearly every early civilization from all over the world. The earliest surviving physical evidence of a practice which appears to be utilizing the acupuncture meridians is from the tribal tattoos of Ötzi the ice mummy who was discovered in the Italian (Ötzal) Alps in 1991 and tattooed in clusters on many of the major acupuncture points used to treat back pain.  This man lived circa (-) 3000. 

Han Dynasty Chinese texts suggest acupuncture was practiced during the late Xia/early Shang Dynasties using sharpened stones, thorns, and bamboo splinters as needles and as an accompanying therapy with moxibustion.  Methods during this time period are likely to have been largely intuitive and empirical with oral tradition carrying any theoretical framework extant within the Daoist Shamanic tradition through the preliterate period.  As society stabilized and scholars emerged, the theory underlying these practices was examined more closely and expanded upon.  The advent of bound script during the Han Dynasty provided a platform upon which this medicine could truly begin to grow, and despite the persistence of oral tradition as the standard within Daoism, books were compiled and the rich history of Chinese medical literature and debate issued.  

Printing and widespread distribution of the Chinese medicine classics inevitably gave way to commentaries rich in debate, criticism, and discussion over the traditional methods.   A flurry of new ideas and revisions to the traditional ways were emerging and competing for popularity.  Some of these ideas took root, generating widespread reform in the medical community and many have since fallen by the wayside (as it is with science).  Today we are in a period of unification, where Chinese medicine and European medicine are working together to find common ground.  Disparate as they are, these systems complement one another and make a stronger medicine together.     

the process

Acupuncture is the insertion of needles into the body in order to elicit a therapeutic response.  This is one amongst many modalities within the scope of practice of Chinese medicine.  The depth of insertion and the duration of retention varies according to the style of treatment being administered and the intended effect.  Needle insertion is generally painless and is often quite relaxing, even to the point that many patients doze off.

Mechanism of action

According to Chinese medicine:  Acupuncture stimulates the body in different ways according to where the needle is placed, how it is manipulated, depth of insertion, and duration of retention in order to provoke changes in the behavior of qi within the organ systems and provoke corresponding systemic change.  The body and mind are simultaneously affected by the insertion of a needle and respond in turn.  This psycho-somatic feedback generates a cascade of responses which effect changes in the physiology from a top-down approach, working with the subtle aspects of the body to influence the gross.    

According to western medicine:  Acupuncture needles are inserted into neuro-muscular junctions where they mechanically stimulate nerve endings.  This stimulation is translated by way of the hypothalamus-pituitary axis into an endocrine response which then delivers systemic effect.  

Why Needles?

• Needles are precise.  When it comes to stimulating the channels of the body, this can be done in many ways, through massage, stretching, qigong, moxibustion, etc., but of all the methods, the needle is the most direct.  This allows for specificity and refinement in treatment.

• Needles are conductive.  The needle is designed to facilitate the movement of qi at a particular point on the body.  Because metals have a low electrical resistance, they will conduct when put in an electromagnetic field.   Traditionally a golden needle is used to consolidate qi, a silver needle to disperse qi, and a copper needle to regulate.  The design of the needle further enhances this function, being made of a single piece of metal, twisted into a tight coil with a loop on one end and straightened to a point on the other.  

Are there risks?

The risks associated with acupuncture are astronomically slim in comparison to western medical procedures.  The only serious risks involved are the piercing of a vital organ (especially the lung) or delivering damage to a structure such as a nerve or an artery.  This happens very seldom because of the degree of training involved in becoming a licensed acupuncturist.  All acupuncturists have a four year master's degree.  The training in anatomy and physiology is extensive.  Classes are in both western medicine and Chinese medicine (about 50/50) and before graduation every student is required to accumulate over 800 clinical hours in a supervised residency program.  The most common cause of injury from acupuncture is when it is delivered by someone other than a trained professional.  

what it treats

Chinese medicine is an independent, complete system of diagnosis and treatment.  This system was the only form of medicine practiced in China for 2000+ years.  Between acupuncture and herbal medicine, it treats everything.  It is worth mentioning that Chinese medicine excels in the treatment of some disorders that western medicine does not have effective treatment for.  Similarly, western medicine surpasses Chinese medicine when it comes to some procedures, especially with regard to surgery.  Because the scope of discussion on this topic is so large, I will not attempt to go into detail on any specific diseases here, but please email or call if you have specific questions.

Types of needles

Traditionally there were nine needles used during acupuncture treatments.  These ranged from large blunt tools used for massage, to small knives for creating incisions, to the small, round filiform needle that most are familiar with.  Today Chinese medical physicians utilize several types of needles in common practice.  All of the needles are completely sterilized before use and disposed of after the treatment.  Although needles can be made of several different metals, most are stainless steel.  For patients with a sensitivity to stainless steel, accommodations can be made for silver, gold, copper, or silicone coated needles.  

Filiform needle:  This is the small, round needle which is standard in most acupuncture treatments.  It is most commonly .25 mm in diameter and 30 mm in length.  This needle is used to stimulate the acupuncture points alone, or it can be used in conjunction with electrical stimulation or moxibustion.

Lance needle:  Also called the three-edge needle because of it's shape, this needle is used for lancing to induce bleeding.  This technique is used in luo treatments to bleed spider veins, when there is blood stagnation following trauma, or when there is an extreme excess of heat and inflammation in a channel.  

Dermal needle:  Also called the plum blossom or the 7-star hammer, this is a cluster of seven short needles mounted together at the end of a flexible plastic or wooden handle.  The needles are used to perforate just down to the dermis and induce bleeding by tapping repeatedly.  This method is useful for many skin conditions, for rashes and itching, and for swellings and masses.  

Press needle:  Sometimes called the intradermal needle or press tacks, these are short, semi-permanent needles which are inserted into points (often on the ear) and left in place for several hours or several days.  They are short and thing gauge, and are useful for more constant stimulation of points.  These are useful for psycho-emotional disorders, anxiety, eating disorders, addictions and withdrawal, depression, etc.  

Long needle:  Also commonly called the big needle, this is just as the name suggests -- a larger needle.  These needles average around .40 mm in diameter and 100 mm in length.  They are used for treatment on the larger muscle groups, especially the gluteal muscles, and for threading along the length of a muscle for treatment of muscular spasm.  

E-stim

Acupuncture with electrical stimulation has grown in popularity since its introduction in the 1930's.  This is the application of a low grade pulsating electrical current directly to the needles in order to achieve stronger stimulation to the nervous system.  This method is particularly useful in the treatment of motor function disorders, post-stroke recovery, paralysis, muscular degeneration, chronic and difficult to treat pain conditions, and in the mending of broken bones.  

Auricular Acupuncture

Developed in 1957 by the French neurologist Paul Nogier.  Auricular acupuncture focuses exclusively on placing needles in the ear.  This method developed with two basic tenets in mind.  The external ear is highly innervated and it is highly vascularized.  As a result, stimulation tends to produce more powerful systemic response here than elsewhere in the body. The mapping of points is based on the "inverted fetus" model, which recognizes that the ear is shaped like a fetus in utero.  The lobe is used to treat the head, the helix treats the spine, etc.  

Ear acupuncture has become most famous for treating anxiety, pain, PTSD, depression, addiction, and withdrawal.  The NADA (National Acupuncture Detoxification Association) protocol has become a worldwide treatment method for easing the withdrawal symptoms from tobacco, alcohol, and opiates by using five points in the ear which stimulate the release of seratonin, dopamine, endorphins, and norepinephrine.  

Acupuncture analgesia 

It is widely recognized that acupuncture excels in pain relief.  This applies to chronic pain as well as acute pain.  In China, acupuncture has traditionally been used in lieu of chemical analgesics and anesthetics and even today many hospitals in China and in the US offer acupuncture as a pain management option when it comes to surgeries, tooth extractions, and other procedures.  This can be used as a stand alone pain management method or in order to reduce the dosage of chemical anesthetics, speeding recovery time and minimizing risk.  

Acute Injury

Acupuncture is very effective in the treatment of acute injury including sprains, strains, fractured bones, etc.  Immediately following injury treatment on the sinew channels is indicated to speed recovery.  This may involve the use of needles in conjunction with cupping, gua sha, moxibustion, and manual sinew releases.  Ligaments and tendons are unique in that they have very little vascularization.  This means they do not receive large amounts of circulating blood, which is relied on heavily in the healing and repair process with muscles. Because of this poor blood perfusion, electrical stimulation on needles placed around the injury is one of the most helpful ways to directly stimulate the injured tissues, hastening repair and returning strength to the area.  Regular treatments like this can cut recovery time in half.  Likewise with fracture and broken bones.  Once the bone is set, there is often an immobilization of the area through casting or splinting.  This reduces circulation, slowing the body's natural healing time and laying a foundation for blood to stagnate, leading to chronic pain and obstruction patterns.  Electrical stimulation at certain frequencies on needles places around the bone have been shown to stimulate the osteoblasts in repairing bone tissue.  

pregnancy and labor

Acupuncture is useful in promoting fertility (for men and women), managing nausea and discomfort during the course of pregnancy, re-positioning breech babies, inducing labor, relieving delivery pain, speeding post-partum recovery and treating post-partum depression.  Childbirth is an extreme experience for both mother and child.  A lot has been demanded of the body, and though humans are resilient in our ability to cope with change and to bounce back, it is important to honor your experience with as much support as you can in the weeks leading up to and following birth.  

transition into death

A topic too often taboo in the medical community, the transition into death is just as important as the one into life.  Chinese medicine has a well developed relationship with the process of dying, and like all major transitions it can be alarming and daunting if we don't prepare for it.  There are considerations to be made when it comes to the body, the mind, and the spirit, and this medicine has the tool set to be a support system, to ease anxiety or pain and to do so without pharmaceuticals in order that you should be able to face the transition with clarity of mind and clear intentions.