Acupuncture

Acupuncture is an ancient Chinese healing art that has flourished in the West over the past three decades. Though best known in the U.S. for its effectiveness in treating acute and chronic pain, acupuncture's effects are wide-ranging.

According to a study in The Journal of Alternative and Complementary Medicine,1 people seek acupuncture for a variety of reasons, primarily for painful conditions such as back pain, neck pain, headaches, arthritis, and tendinitis, but also for ailments of the respiratory, digestive, and genitourinary systems. Acupuncture has been utilized for allergies, nausea due to pregnancy or chemotherapy, mood care, wellness care, and substance abuse treatment.

The classical theory of acupuncture is that there are patterns of energy (Qi, pronounced chee) that flow through the body and are essential for health. Disruptions of this flow are believed to be responsible for pain and various other ailments. Acupuncture practitioners seek to correct imbalances of the flow through the careful insertion of hair-thin needles at specific points close to the skin. Contemporary science has also examined acupuncture and found that it influences nerve function, blood flow to the brain and other organs, the production of brain chemicals that control various bodily processes, and the production of the body's own natural pain relievers.

Within the past several years, panels at the U.S. National Institutes of Health (NIH)2 and the British Medical Association3 have recommended including acupuncture in conventional health care.

What is involved in acupuncture treatment?

The primary treatment method is the insertion of exceedingly thin sterilized needles at specific points on the body. Knowledge of these acupuncture points and the meridian pathways that join them enables the acupuncture practitioner to formulate treatments to address the patient's symptoms as well as underlying imbalances. Typically, at least several needles are employed during a treatment session. Some of these may be at local points of pain, while others (frequently on the lower leg and lower arm) are utilized to create a circuit. In certain circumstances (particularly for treating deep nerve pain), low-intensity electrical stimulation may be applied to the needles.

What should I expect on my first visit?

Please allow 60-90 minutes for your first visit, which includes a consultation, examination, and initial treatment. (Subsequent visits generally last about 30 minutes). Dr. Miller takes a thorough case history, reviewing the symptoms for which you are seeking treatment as well as other aspects of your health history. Most questions are typical of a standard health history (addressing your current condition, past illnesses and surgeries, medications you are taking, etc.), while other questions are specifically acupuncture-related, to help determine your individual energetic pattern (examples: do you feel hot more often than cold? are you more likely when stressed to become angry or fearful?) The first visit physical examination varies depending on what has led you to seek treatment. If you have pain, orthopedic (movement) and neurologic (nerve) function will be evaluated. If you have had previous treatment from other practitioners, it is helpful to bring available records or reports with you, including results of any laboratory tests, x-rays, or MRIs.
Dr. Miller's first visit acupuncture examination includes a traditional pulse reading, in which subtle differences in the pulses at the wrist are examined. In traditional acupuncture, this method is used to evaluate a patient's overall energetic patterns. This, in turn, helps to determine which points should be treated.
For your first visit and all other visits, please be certain to eat a small meal or nutritious snack sometime within the previous few hours. Also, please do not wear strong perfume.

How soon am I likely to experience improvement?

As with all types of treatment, the speed of response varies. It is not unusual to feel improvement after the first or second visit, and most people will experience improvement within several visits. Except in highly unusual circumstances, if a patient is not experiencing any noticeable improvement within approximately 8 visits, Dr. Miller will refer him or her to a different doctor or practitioner.

What is the normal course of treatment?

While each case is evaluated individually, a typical initial course of treatment is approximately 6-8 weekly visits. (In more acute cases, visits may be more frequent at the start). At the end of the initial series, progress is evaluated. In some cases, treatment ends at this point. In other cases it continues, usually with a decreasing frequency of visits.

Is acupuncture helpful only for people with bothersome symptoms?

While the vast majority of acupuncture patients seek care for pain or other symptoms, acupuncture has a relaxing, balancing, and integrating effect that many people find to be helpful in relieving stress. According to Asian tradition, balancing treatments are recommended at the change of seasons, when we are most vulnerable to illness.

Can I receive acupuncture treatment while also receiving other types of treatment?

Yes. Acupuncture is complementary to conventional medicine and to various alternative approaches. Dr. Miller has received acupuncture referrals from medical physicians, massage therapists, and other chiropractors. Depending on the particular patient's needs and choices, some receive both acupuncture and chiropractic treatment, while some receive one or the other.

How does acupuncture work?

Asian tradition offers one set of explanations, while Western science offers another. Each perspective expresses part of a broader truth. As mentioned earlier, the traditional Asian answer is that acupuncture releases blockages in the flow of Qi energy in the meridian pathways of the body. This is believed to relieve pain and restore proper function of affected bodily structures.

In the past 30 years, scientific research on acupuncture has grown substantially, both in Asia and at North American and European universities. Among the key findings: acupuncture increases the body's production of its own natural pain relievers; increases output of numerous brain chemicals involved not only with pain but many other bodily functions; and affects blood flow and electrical activity in the brain.4 Condition-based research includes evidence of acupuncture's effectiveness in arthritis,5,6 low back pain,7 neck pain,8 migraines and other headaches,9, 10 facial pain,11 nausea and vomiting from chemotherapy12 and morning sickness of pregnancy13 smoking cessation,14,15 asthma and breathlessness,16 tennis elbow17,18 menstrual and menopausal problems,19,20 and urinary dysfunctions.21

Is acupuncture safe?

Acupuncture is remarkably safe, and the use of sterile, disposable, single-use needles has eliminated the possibility of transmitting disease. Dr. Miller uses needles manufactured to exacting specifications. Under a high-powered microscope, the tips and edges of these acupuncture needles are rounded rather than jagged, allowing for smoother insertion and removal.

Do the needles hurt?

Sometimes the patient is not even aware that a needle has been inserted, while other times there is a momentary stinging sensation.
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References

1. Cassidy CM: Chinese medicine users in the United States. I. Utilization, satisfaction, medical plurality, J Altern Complement Med 4:17-28, 1996.
2. National Institutes of Health consensus panel: Acupuncture, Bethesda, 1997, National Institutes of Health.
3. Silvert M: BMA approves acupuncture. British Medical Journal 321:11, 2000.
4. Hammerschlag R: The physiology of acupuncture. In Cassidy CM: Contemporary Chinese medicine and acupuncture. New York, Churchill Livingstone, 2002.
5. Christensen BV, Iuhl IU, Vilbek H et al: Acupuncture treatment of severe knee arthrosis. A long-term study, Acta Anaesthesiol Scand 36:519-25, 1992.
6. Ezzo J et al: Acupuncture for osteoarthritis of the knee: a systematic review, Arthritis Rheum 44(4):819-25, 2001.
7. Coan R, Wong G et al: The acupuncture treatment of low back pain: a randomized controlled study, Am J Chin Med 8:181-189, 1980
8. Coan R, Wong G et al: The acupuncture treatment of neck pain: a randomized controlled study, Am J Chin Med 9:326-332, 1982.
9. Vincent CA: A controlled trial of the treatment of migraine by acupuncture, Clin J Pain 5:305-312, 1989.
10. Loh L, Nathan PW et al: Acupuncture versus medical treatment for migraine and muscle tension headaches, J Neurol Neurosurg Psychiat 47:333-337, 1984.
11. Hansen PE, Hansen JH: Acupuncture treatment of chronic facial pain: a controlled crossover trial, Headache 23:66-69, 1983.
12. Shen J and Glaspy J: Acupuncture: evidence and implications for cancer supportive care, Cancer Pract 9(3):147-50, 2001.
13. Vickers AJ: Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials, J R Soc Med 89(6):303-11, 1996.
14. Bier et al: Auricular acupuncture, education, and smoking cessation: a randomized, sham-controlled trial, Am J Public Health 92(10):1642-7, 2002.
15. He D et al: Effect of acupuncture on smoking cessation or reduction: an 8-month and 5-year follow-up study, Prev Med 33(5):364-72, 2001.
16. Jobst KA: Acupuncture in pulmonary disease: issues of safety and efficacy, J Altern Complement Med 2(1):179-207, 1996.
17. Haker E, Lundeburg T: Acupuncture treatment for epicondylalgia: a comparative study of two acupuncture techniques, Clin J Pain 6:221-226, 1990.
18. Molsberger A, Hille E: The analgesic effect of acupuncture in chronic tennis elbow pain, Brit J Rheumatol 33:1162-1165, 1994.
19. Helms JM: Acupuncture for the management of primary dysmenorrhea, Obstet Gynecol 69:51-56, 1987.
20. Wyon Y, Lindgren R et al: Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women, Menopause 2:3-12, 1995.
21. Chang PL: Urodynamic studies in acupuncture for women with frequency, urgency and dysuria, J Urol 140:563-566, 1988.