What Is Acupuncture?
Acupuncture can be defined as the insertion of dry
needles into the skin at specific locations called acupuncture points.
Acupuncture is performed by certified practitioners
and physicians to treat certain medical disorders.
Depending on the training and experience of the practitioner and the problem being treated, acupuncture
techniques may include electrical current through the
needles (electro acupuncture) or heat (moxibustion)
and pressure (acupressure).
Acupuncture began in China more than 2000 years
ago. It is now practiced throughout the world, particularly in China, Korea and Japan. In the United States,
acupuncture started gaining popularity in the early
1970s.
How Does Acupuncture Work?
The basic idea behind
acupuncture, according to
ancient theory, is that energy
flows within the human body
and can be stimulated to create balance and health. The
energy flow (or vital force)—
called qi and pronounced
“chee”—moves throughout
the body along 12 main channels known as meridians.
These meridians represent
the major organs and functions of the body although
Acupuncture meridians
they do not follow the exact
pathways of nerves or blood flow.
The goal of acupuncture is to correct imbalances of
flow and restore health through stimulation, generally
by inserting needles through the skin at points along
the meridians of the body. Current acupuncture information lists up to 400 different acupuncture points
for various health problems.
Scientists have attempted to explain the actual physical effects of acupuncture on the human body. Some
researchers suggest that pain relief happens when
acupuncture needles stimulate nerves. Another wellaccepted theory is that acupuncture releases pain-relieving chemicals, such as endorphins and serotonin.
Acupuncture may also be effective because it targets
painful tender points, sometimes called trigger points.
Additionally, acupuncture may decrease pain-causing
inflammation by stimulating the body’s pituitary gland
to release cortisol, a hormone that is known to reduce
inflammation. Although the exact manner in which
acupuncture works is unknown, the treatment appears helpful for certain medical illnesses in certain
people at certain times.
Will Acupuncture Relieve Your
Back Pain?
A number of conditions, including back pain, are
commonly treated with acupuncture (see Table 1).
Although some studies have shown that acupuncture
has no benefit in relieving back pain,1,2 others have
demonstrated a positive effect.3-6 A study published
in 2006 demonstrated that acupuncture was effective in relieving pain in patients with chronic low back
pain (pain lasting more than six months).7 It remains
unclear and more research is needed to determine
whether acupuncture helps people who have both
back and leg pain, nerve pain or pain from spine
fractures.
Acupunture may help relieve your back pain. Depending on your back problem, your physician may recommend acupuncture either alone or in conjunction
with other treatments, such as medications, physical
therapy or exercise.
Table 1. Conditions Commonly Treated with
Acupuncture
Chemotherapy-induced Postoperative dental
nausea and vomiting
pain
Tennis elbow
Fibromyalgia
Myofascial pain
Osteoarthritis
Low back pain
Neck pain
Carpal tunnel
syndrome
Addiction
Stroke rehabilitation
Headache
Menstrual cramps
Asthma
What Happens in a Typical
Acupuncture Session?
During the initial acupuncture session, the acupuncturist takes a thorough history and does a physical
examination, including evaluation of the
tongue, face and
pulse. Some acupuncturists may ask about
the patient’s diet to
evaluate his or her
nutritional well-being
and may recommend
changes possibly
including herbal
supplements. The first
session is generally
longer than follow-up
appointments so that
a treatment plan can be created for the specific conditions and complaints of each patient. During followup appointments, the acupuncturist reassesses the
progress of the treatment plan and makes changes if
needed. The initial evaluation may take up to 60 minutes with follow-up and maintenance appointments
between 30-45 minutes.
Following each evaluation, the acupuncturist inserts needles at specific acupuncture points related to
the patient’s complaints. Needle insertion causes very
little pain; some patients describe a pinching, grabbing or tingling sensation. The needles are sterile and
disposable and are not reused on other patients. This
decreases the risk of spreading disease from patient
to patient. The needles are removed at the end of the
session. Depending on the practitioner’s skills and the
condition being treated, other forms of acupuncture
could also be used, such as moxibustion (acupuncture
with heat) and acupressure techniques.
Six to 12 sessions and a few maintenance sessions throughout the year are generally an accepted
treatment plan for a single complaint. Not everyone
responds to acupuncture…it is reasonable to try two
to three sessions per week for three to four weeks. If
there is a good response you may want to continue. If
there is minimal or no response, acupuncture may not
help you at this time or you may need to try a d ifferent acupuncturist.
What Are the Risks of
Acupuncture?
Acupuncture is a relatively safe treatment with minimal risks if done by a trained practitioner (see Table
2). Reasons for avoiding acupuncture may include
bleeding disorders, taking medications that decrease
clotting (blood thinning medications), pacemaker use,
a skin infection in the area where the needle would
be inserted or a systemic infection. Some acupuncturists will not perform acupuncture on pregnant
women. Please notify the practitioner if you have any
of the medical issues listed in Table 3.
Table 2. Possible Risks of Acupuncture
Minor bleeding
Bruising
Infection
Dizziness/
lightheadedness
Sedation
Skin rashes
Pain
Lung trauma (rare)
Nerve injury (rare)
Table 3. Reasons Acupuncture May Not Be
Advised
References
1. Cherkin D, Eisenberg D, Sherman K, et al. Randomized
trial comparing traditional Chinese medical acupuncture, therapeutic massage and self-care education for
chronic low back pain. Archives of Internal Medicine.
2001;161:1081-1088.
2. van Tulder MW, Cherkin DC, Berman B, Lao L, Koes BW.
Acupuncture for low back pain. Cochrane Database
System Review. 2000;2:CD001351.
3. Ernst E, White E. Acupuncture for back pain: a metaanalysis of randomized controlled. Archives of Internal
Medicine. 1998;158:2235-2241.
4. Kerr DP, Walsh DM, Baxter D. Acupuncture in the management of chronic low back pain: a blinded randomized
controlled trial. Clinical Journal of Pain. 2003;19:364370.
5. Vickers A. Statistical re-analysis of four recent randomized trials of acupuncture for pain using analysis of
covariance. Clinical Journal of Pain. 2004;20:319-323.
6. NIH Acupuncture Consensus Development Panel. NIH
Consensus Development Conference on Acupuncture
Program and Abstracts. Bethesda, MD: National Institutes of Health; 1997:1-38.
7. Brinkhaus B, Witt CM, Jena S, et al. Acupuncture
in patients with chronic low back pain: a randomized controlled trial. Archives of Internal Medicine.
2006;166:450-457.
Acupuncture
Bleeding disorders
Blood thinning medications
Pregnancy (1st trimester)
Cardiac pacemaker
Blood or skin infections
What Is the Cost of Acupuncture?
The cost of an acupuncture session varies by region
and may depend on the specific techniques used by
the practitioner. A typical session may range from
$50.00–$100.00 US dollars (as of late 2006). Some
insurance companies may provide limited coverage
for acupuncture; you should verify your insurance
coverage before the office visit.
DISCLAIMER
The information in the pamphlet is for general information and understanding only and is not intended to
represent official policy, standard of care or guideline
recommendations of the North American Spine Society. Please consult your physician for specific information about your condition.
North American Spine Society
7075 Veterans Boulevard
Burr Ridge, IL 60527
Toll-free: 866.960.NASS (6277)
Fax: 630.230.3700
www.spine.org
© 2007 North American Spine Society
n What Is acupuncture?
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How does acupuncture
work?
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Will acupuncture relieve
your back pain?
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What happens in a typical
acupuncture session?
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What are the risks
of acupuncture?
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What Is the cost
of acupuncture?
North American Spine Society
Public Education Series