Here, we outline the potential benefits of acupuncture, safety considerations to keep in mind, what to expect at your first session, and how to get started.
Over the years, researchers in the U.S. have examined acupuncture to identify the mechanisms behind it. “We know so much more about how acupuncture works now,” says Rosanne Sheinberg, MD, a medical acupuncturist and the director of integrative medicine for anesthesiology and critical care medicine at Johns Hopkins Hospital in Baltimore.
For one thing, they discovered that acupoints aren’t random sites on the body. “Scientists took tissue samples from those points and looked at them under a microscope. They found that the tissues have anatomic characteristics that make them different from other points in the body,” Dr. Sheinberg says.
Acupuncture needles are inserted into the fascia, a type of connective tissue that wraps around every muscle and organ in your body. “The fascia itself is richly innervated with the autonomic nervous system, which is that involuntary part of the nervous system,” says Sheinberg.
In other words, when a licensed acupuncture practitioner puts a needle into the fascia and stimulates an acupoint, the fascia sends “SOS signals” to the rest of the body, which prompts a response. “When the body feels that something is out of pocket, it brings blood flow, lymph flow, and other things to clear out whatever is going on there,” says Sheinberg.
Acupuncture is generally considered safe, but it’s essential to seek treatment from a qualified practitioner, says Grant Chu, MD, an acupuncture practitioner, board-certified internal medicine physician, and an associate director of education at the UCLA Center for East-West Medicine in Torrance, California.
Sheinberg also recommends finding an acupuncturist who’s been trained by the American Academy of Medical Acupuncture (AAMA). Depending on the state, MDs and DOs who have undergone proper training for physicians are also able to practice acupuncture.
The most common form of acupuncture — the placement of needles without additional stimulation — is only one of several types of acupuncture. Here are some others.
This type of acupuncture adds weak pulses of an electrical current to acupuncture needles to apply more stimulation to acupoints. “We don’t quite understand the mechanism behind how it works, but in my mind, I think of it as blasting away the dams in the flow of energy,” Sheinberg says.
“This can be done away from the skin, on the skin, or with acupuncture needles,” says Chu.
Ear seeding is a form of acupressure performed on the ear, called auriculotherapy.
”Patients can have the seeds on for up to [a few] days, and they can stimulate the point themselves [under guidance from their acupuncturist],” Sheinberg says.
Like other forms of acupuncture, ear seeding should only be practiced by a qualified practitioner, or under their guidance.
Results from a number of studies suggest that acupuncture may be an effective therapy for a number of health concerns and conditions. Here are several potential benefits of acupuncture, though this is only a sampling.
Acupuncture is generally safe, but as with any treatment or procedure, there are some risks involved.
According to Chu, potential side effects of acupuncture may include pain from needle insertion, minor bleeding or bruising with needle removal, light-headedness or dizziness, and nausea. Infections are rare, but they can happen if the skin is improperly cleaned prior to needle insertion, or if acupuncture needles are handled inappropriately, he adds.
But the majority of acupuncture’s side effects can be avoided if you visit a qualified practitioner. “People who get less training tend to have higher rates of complications,” says Sheinberg. Practitioners with less training and experience are more likely to cause injury to blood vessels, nerves, or even organs, she adds.
The greatest concern lies with needles applied to the core of the body — in particular, the belly and the chest. “If you go too far inserting a needle into the belly you can hit the bowels and gut, and that can cause problems,” Sheinberg says. If a practitioner goes too far into the chest cavity, there’s a risk of collapsing a lung. “It’s a fairly rare complication, but it is possible,” says Sheinberg.
But some populations may need to take extra care when seeking acupuncture therapy — or even avoid it altogether.
For example, people with dementia, or those in the recovery room waking up from anesthesia, may not be ideal for acupuncture because they're likely unable to lie still. “You don’t want people moving around when you’re inserting acupuncture needles; they have to be [aware],” says Sheinberg.
People with a phobia of needles may also want to steer clear of acupuncture, as any fear and anxiety will likely make the therapy an uncomfortable experience, Chu says.
He advises patients with pacemakers to avoid electroacupuncture specifically, as the electrical stimulation may affect pacemaker function.
Here are a few tips to get you started with acupuncture.
It can take several visits to see lasting results from acupuncture, especially if you’re hoping to treat a specific health condition. “Most people think they can go one week, and then maybe again a couple of weeks later, and then you’re done, but you’re not going to get the benefits for an acute indication with that approach,” Sheinberg says.
For example, if you’re developing peripheral neuropathy (nerve damage in the hands or feet that leads to weakness, numbness, or tingling) as a side effect of chemotherapy, you may need an intensive course of acupuncture to receive the maximum benefits. “You may need to go two or three times a week for 10 weeks in a row,” says Sheinberg.
Acupuncture treatments can be done in clinics, hospitals, medical spas, chiropractic offices, and wellness centers. “The physical environment may be a conventional clinic or resemble a spa,” Chu says. The treatment room is typically a quiet, private space, and patients are often given a means of communicating with the practitioner through a bell or call device, he adds.
New patients should expect to complete a medical history intake form upon arrival, just like at any other healthcare visit. You’ll also spend time, from a few minutes to longer, discussing with the provider your concerns, similar to a medical doctor taking a history. “There’s a little back-and-forth of questioning and diagnosing,” Sheinberg says. This helps the provider understand any health concerns you’re hoping to address through acupuncture, so they can create the best treatment plan for you, usually in a collaborative way.
From there, you may undress, lie on the treatment table, and cover yourself with the sheets, as you would prepare for a traditional massage. Or, the practitioner may provide you with a gown to wear over your undergarments.
You may feel nothing or you may feel a mild discomfort when the needles are placed in the skin, but there shouldn’t be any pain once the needles are in place. “If there is persistent pain, notify the practitioner,” Chu says.
While you shouldn’t feel pain, you should feel a deep ache or pressure in the regions where the needles were inserted. That deep ache signifies that the needles have been inserted at just the right level within the fascia to stimulate the acupoint. “Sometimes, I ask patients for feedback because I want to ensure I’m in the right place,” Sheinberg says.
Acupuncture sessions can last for a few minutes of up to an hour, depending on the purpose of your visit and the provider’s style of practice. Forty-five to 60 minutes is pretty typical, Sheinberg says.
What’s more, you may feel sleepy, drowsy, or light-headed after your acupuncture session. “Drinking warm water or tea afterward is encouraged,” Chu says.
Before leaving the clinic, check your body to make sure all acupuncture needles were removed. “It’s uncommon, but acupuncture needles are sometimes unintentionally left in,” Chu says. Don’t be alarmed if you find a needle; simply notify the practitioner and they’ll remove it.
The results of acupuncture typically aren’t immediate. It can take several months of weekly treatments to see lasting changes, depending on your desired outcome. Some short-term effects may indicate that the acupuncture sessions are working. One sign is you notice slight improvements in your symptoms. Curiously, the other is a worsening of symptoms. “It’s actually not a bad sign if you feel worse after acupuncture,” Sheinberg says. “It means we’ve stirred things up.”
On the other hand, if you don’t notice any changes following acupuncture, that may indicate that you haven’t landed on the right acupoints yet. “Just like everything in medicine, there’s a bit of experimenting to find what works best for any one person,” says Sheinberg. Take notice of how you feel after your acupuncture sessions and share that information with the practitioner at the next appointment. This will help the practitioner fine-tune your treatment.
Your health insurance may or may not cover acupuncture, so it’s a good idea to check with your provider before receiving acupuncture treatments.
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