Frequently Asked Questions About Acupuncture and Oriental Medicine

Frequently Asked Questions

The following are my answers to some of the more common questions about acupuncture and Chinese medicine. Please note that, as Chinese medicine is such a vast medicine incorporating many complex theories and practices, the answers I give below may not coincide with those of another practitioner. This does not necessarily mean that either is wrong. There are many ways to practice this medicine effectively.

The questions addressed here are:

Traditional Painting of Chinese landscape

1) Does acupuncture work?

The short answer is yes. Due to our unique claim of an unbroken medical lineage going back over two thousand years, our practices have gone through extensive testing and revision. Resultantly, they are very effective, while simultaneously very safe.

That being said, there is no guarantee as to the outcome of your individual treatment. There are many variables and, though our diagnostics and therapeutics have a high probability of getting results, there simply can be no way of claiming 100% efficacy.

To help maximize the possibility of you getting the results, it's important to listen closely to the advice your practitioner gives you and keep an open mind to making lifestyle changes were you can.

More on: Acupuncture, Chinese Herbal Medicine, Other Modalities, What Chinese Medicine Can Treat

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2) Where is the proof that acupuncture works?

Chinese medicine has been around for a long time. Most of our theories and practices have been working in a clinical setting for longer than the United States has been a country.

As practitioners go, I'm pretty strict with what I incorporate into my practice. The feeling I have burning inside of me is that I need to have a high degree of confidence that what I'm doing will have a specific effect in a specific amount of time. It's a constant, pressing drive.

My internal response to this need is to seek out treatments and modalities that have the most reliable evidence behind them. Though it may sound odd in a modern context, I believe the more recent additions to Chinese medicine are the least reliable. This is not merely academic. I simply don't have complete trust in a theory or technique unless I can see its safety and efficacy demonstrated in a real-world clinical setting over generations. It takes that amount of time and that type of setting to truly make a medical therapy safe and to 'prove' its effectiveness.

A great example of this is 'electro-acupuncture', a modern practice where a device is hooked up to the needles and a small current is passed through the needles into the patient. Though there is research behind the safety and efficacy of 'e-stim', as it is called, I am simply not comfortable in using it in my clinic. Again, I have this need to know there's a good chance of having a very specific effect in a specific amount of time. It takes generations and thousands of patient interactions to develop what I, as a practitioner, feel I need in a treatment.

Fore more information, here, I devote a whole page to research. I also dedicate a section of my blog to clinical research, and under the section What Can Chinese Medicine Treat? I give links to other collections of research on acupuncture and Chinese medicine.

For more on Chinese medicine, to include acupuncture, Chinese herbal medicine, Chinese medical counseling, and so on, please see About Chinese Medicine.

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3) How many treatments will I have to get? How long does it take to work?

We have a saying in the medicine - "Seventeen years into the forest, seventeen years out."

The idea is that the longer a condition has been around, the longer it will take to be effectively treated. For example, I treat a lot of martial arts injuries (some of which have been my own!). If a person receives an injury and seeks treatment immediately, there is a good chance there will be immediate effect (depending, of course, upon severity - eg. broken bones take longer to heal than sprains).

Conditions tend to get worse, or from a diagnostic standpoint more complex, over time, especially when other treatments have been attempted and failed. By its very nature, Chinese medicine works to restore health. 'Restoring' implies working backwards up the path of disease. We work to return a person to a healthy state. Where an illness has progressed down a long path, we have to traverse that same path back to health.

That being said, there should be noticeable effects, improvement seen, within a couple weeks of treatment for most illnesses. There will be obvious evidence of progress during the course of treatment.

A specific example that comes to mind is a patient I had several years back who was suffering from symptoms of menopause. The worst of her symptoms were reduced by two-thirds within two weeks of acupuncture and herbal medicine treatments. Now, obviously, the menopause wasn't 'cured' in that time, but suffering was drastically reduced.

Another example, occurring more recently, I had a patient come with severe (read 'excruciating') knee pain due to what was being diagnosed as gout. He came to me roughly two weeks after onset of symptoms. Immediately prior to coming to me, he had been on high doses of pain medications and steroids for swelling and pain. With these meds there was little improvement in symptoms. Within five hours of the first acupuncture treatment, the pain was significantly reduced allowing the patient to move without the use of crutches. I believe that had the patient waited longer, the results of acupuncture would have been much slower to come (especially since he was on very strong medications which to tend to complicate the picture).

Generally speaking, it's very important to at least consult an acupuncturist early-on in any medical condition (along with your M.D. physician). They will be able to say how important it is to get Chinese medical treatment, and what type of treatment to get (e.g. acupuncture, herbal medicine, diet therapy, etc.).

Here's more information on what to expect at your acupuncture session.

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4) Does acupuncture hurt?

There is often sensation associated with acupuncture treatments. Whether this sensation amounts to 'pain' and how tolerable that discomfort may be is extremely subjective and will vary with patient to patient, treatment to treatment.

Classically, we need to get sensation during a treatment. This is immediate evidence that the treatment is 'working'. This sensation is often described as 'dull', 'an ache', 'throbbing', 'moving' through the body, or 'mildly electrical'. Often the patient does report feeling the insertion of the needle, describing it as a slight pin prick.

It is important to note that the needles used are generally 32-36 gauge. Compare this to the needles used in a hospital setting, which are usually 12-18 gauge (the lower the number, the larger the needle).

Lastly, whatever sensations are experienced, be they 'pain'ful or not, they last for no longer than 10-30 seconds after needle insertion.

More information: Acupuncture, Chinese medicine, in general, What this medicine can treat

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5) What can acupuncture treat?

This question is addressed at length under the What Can Chinese Medicine Treat? section.

Think of the equivalent question being posed to an M.D. What can Western medicine treat? There really is no clear, concise answer, as the medicine is so vast. Now imagine a medicine that's been in development for a hundred generations; there is no simple, short answer.

Generally, it's safe to say we're not appropriate for the acute stage of serious medical emergencies (though we're great for support of initial care and for follow-up and recovery), and, though we were the first, we no longer do surgery (my malpractice insurance would skyrocket!).

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6) How much does it cost?

This will vary widely between practitioners. I have seen acupuncturists charge between $40 and $100 per session in the Denver-metro area. Generally, the first session is $20-$40 more than follow-up visits as it is usually longer in duration.

It's tempting to say 'better' practitioners charge more, but I remember my pulse diagnosis teacher, a true and rare master, charged far less than a lot of acupuncturists. I have also seen some practitioners charge significantly above average and, yet, spend much less time and energy on each individual patient.

Many acupuncturists also make treatment 'packages' available where you pay a lump sum upfront for several treatments and the per treatment cost is reduced.

I would not suggest basing your choice of practitioner on relative cost.

Details on the rates of my private practice.

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7) How do I find a good acupuncturist?

Excellent question. Unfortunately, there is no easy answer.

To begin with, and this may sound obvious but be sure to go to a licensed acupuncturist (L.Ac.) to get acupuncture. There other medical professionals that are allowed, by law, to do acupuncture despite their lack of training. There are some non-acupuncturists with minimal training, say 100-500 hours, that will do acupuncture, as well (versus the 3,000+ hours L.Ac.s receive - see Acupuncturist Training.)

Due to the unique nature of acupuncture, anyone could get some effect with minimal training. The medicine is simply that well developed. However, with more training, the practitioner's competency, effectiveness, and range of disorders they can treat all increase tremendously. To get acupuncture practiced closer to its full potential, go to a Licensed Acupuncturist (L.Ac.).

Beyond ensuring your acupuncturist is trained in acupuncture, it's very difficult to objectively predetermine ability. The advice I generally give is to ask friends and family members. Talk to others you know that have received acupuncture. Then talk to the practitioner themselves.

Once you settle on a practitioner and begin treatments, be sure to keep an open dialogue with them. Make sure you are getting what you need and what can be reasonably expected.

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8) What about insurance? Does it cover acupuncture?

More and more insurance companies are covering acupuncture, at least to some extent. Please contact your provider to inquire, and if they don't ask them why and let them know you want it as a consumer.

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9) Are there side effects to acupuncture? Chinese herbal medicine?

Yes and no. Events that could be considered side effects are bruising at the site of needle insertion (less than 10% of the time), pain or sensation with needle insertion and manipulation, bleeding at site of needle insertion (rarely more than a drop or two and only occurring in 10-15% of the cases), and, on rare occasion (I've never seen it), patients may faint upon needle insertion. This is quickly and easily remedied. (Please see the section on acupuncture for further discussion.)

Chinese herbal medicine is a different story. In proper, professional Chinese herbal medicine (CHM) there are very few side effects, and they are minor and easily managed. One of the reasons Chinese medicine is so safe and effective is that it's patient-centered, not disease-centered. Every patient presents with a unique 'disease picture'. We, therefore, diagnose that patient's specific way of having that disease, and we treat that individualized presentation. Every treatment is tailored for the individual. This makes for very effective treatments and very low occurrence of side effects.

In the first few weeks of CHM treatment there may be some mild digestive upset or change in bowel movements while the practitioner adjusts the herbal formula for your unique presentation.

At no time should side effects persist. You should never have to put up with side effects. Unintended or negative effects of medical care are signs of inappropriate medical care. (Please see What is Chinese Herbal Medicine? for further discussion.)

It should be noted that there is always the possibility of individual allergic reactions to herbs. There simply is no way to predict whether a given individual will have such a reaction to an herb. In my practice, the occurrence of these reactions is very low, with symptoms such as digestive discomfort, irregular bowel movement, nausea, etc. when they do occur. Normally, we can find substitute herbs with similar therapeutic effect.

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10) What is Chinese herbal medicine?

Professional Chinese herbal medicine (CHM) is a modality of Chinese medicine where the practitioner creates a tailored herbal formula for a specific presentation of illness in a patient. This formula may consist of two to twenty 'herbs' (there are some from animal sources) that are cooked like a soup by the patient and then ingested a couple cups a day.

Professional CHM is very effective and very safe. As a separate modality, it is able to treat a wide range of illness and disease, and because every formula is created specifically for the individual patient, the occurrence of side effects is extremely low.

Some practitioners make a compromise in effectiveness of herbal formulas for greater convenience and use herbal pills or powders in place of the actual raw herb. Though some effect is retained, this practice is a divergence from classic practice and theory, limiting its specific claims to efficacy. (Please see What is Chinese Herbal Medicine? for further discussion.)

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11) Are the needles sterile?

Yes. The needles are sterile and are used once and then discarded.

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12) How many needles do they use during a treatment?

A typical treatment may use as few as 2-4 needles. In certain situations, that number may be as high as twenty.

For detailed discussion see the section devoted to acupuncture.

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13) Where do they put the needles?

There are acupuncture points located all over the body. The practitioner will choose specific points based on your unique diagnosis and the actions of the points on the body.

For more, see the section on acupuncture.

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14) How big are the needles?

Most acupuncturists use 32-36 gauge needles. For comparison, most needles used in the hospital setting (IV needles) are 12-18 gauge (the lower the number the larger the needle). You could fit dozens of acupuncture needles in one IV needle! I often say 'needle' is the wrong word for what acupuncturists use.

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15) Do the points bleed after acupuncture?

Only occasionally do any of the points bleed (maybe one in ten needles results in bleeding), and when they do it is usually less than a drop, rarely more than two.

For more on side effects, see the section on acupuncture.

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For specific information on setting up an appointment, please visit my private practice page or simply contact me.

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John Aguilar, Jr, MSTCM, LAc

Dipl Ac & CH (NCCAOM)

Licensed, Board Certified Acupuncturist and Chinese Medical Herbalist