Frequently Asked Questions
1. How can acupuncture help?
In Chinese medicine, a disharmony can result from a variety of factors such as a deficiency or an excess of the Yin and /or Yang energy of the body; an invasion by external pathogenic factors, which may remain superficially on the outside of the body or penetrate more deeply into the interior of the body; a problem at the level of the channels or the collaterals, or affecting the functioning of the internal Zangfu system of the body; Heat or Cold associated with the disharmony.
The diagnosis of the patient’s disharmony in terms of the Eight-Principle patterns leads to an understanding of what the treatment seeks to achieve. Acupuncture works by addressing the identified treatment principles. Thus, for example, when a pattern of deficiency is identified, acupuncture is used to tonify the appropriate energy system of the body. Since Chinese medicine sees any illness as a process of energetic disharmony – which acupuncture can help to reestablish – there are no disorders for which this form of treatment is inappropriate.
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2. Tools and Techniques?
The practitioner needles the selected points and uses different types of manipulation to achieve certain effects. When there is the intention to reinforce a deficiency, the reinforcing technique is used; when there is the intention to reduce an excess, the reducing technique is used; when there is no particular reason to overly reinforce or reduce, the even technique is applied. In certain Excess conditions, the needle reducing function can be stimulated by passing a minute direct current electrical pulse through paired needles.
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3. What Actually Happens When I Visit An Acupuncturist?
Most patients are naturally anxious and uncertain when they first decide to try acupuncture. A typical acupuncture session is as follows:
The Diagnosis Interview:
Acupuncture treatment is not simply a mechanical process in which one person sticks steel needles into another. In essence, it is a combined physical, psychological, and spiritual process, and should be respected as such. As in any other system of medicine, on the first visit the acupuncturist will gather the information necessary to make an accurate diagnosis through the four traditional ways: looking; hearing and smelling; questioning; and touching. It usually lasts about an hour, sometimes longer, sometimes less.
Once the practitioner has completed the interview, he or she will have formulated a diagnosis and have a treatment strategy in mind. Naturally the practitioners will carefully explain the nature of the problem, and the suggested treatment so that the client understands clearly.
In most cases, it is very unlikely that one acupuncture treatment will completely resolve the problem. More than likely, especially for long-standing, chronic conditions, a series of treatments, spread over several weeks or months, will be necessary. The practitioner should make it clear to the patient in what way acupuncture can be expected to help with the problem; and the patient should be told how many treatments are likely to be required, and over what length of time.
4. Would Acupuncture Be Suitable For Me?
Traditionally acupuncture has been used to treat almost the entire spectrum of illnesses; physical and psychological, acute and chronic. The following conditions (using Western medical terminology) are amongst those most commonly seen by acupuncturists in the West.
Disorders of the circulatory system: angina, atherosclerosis, chronic heart failure, high blood pressure, palpitation, poor circulation.
Diseases of the respiratory system: asthma, chronic breathlessness, chronic bronchitis, hay fever.
Diseases of the digestive system: colitis, constipation, diarrhea, irritable bowel syndrome, indigestion, stomach ulcers.
Disorders of the urinary and reproductive systems: impotence, incontinence, cystitis, infertility, abnormal menstruation, morning sickness, prostatitis, seminal emission, premature ejaculation.
Skin disorders: acne, eczema, psoriasis.
Neurological and musculo-skeletal problems: arthritis, low back pain, facial palsy, epilepsy, headaches, migraines, multiple sclerosis, neuralgia, rheumatism, sciatica, sports injuries, stiff neck, stroke, tinnitus.
Infections: Bronchitis, common cold, hepatitis, influenza, sinusitis, ear infections, eye conjunctivitis.
Mental-emotional syndromes: anxiety, stress, depression, eating disorders, insomnia, etc.
Giving up smoking, alcohol and drugs, and rehabilitation.
This is not be a definitive list. If your own condition is not covered by any of the above categories, please contact the acupuncturist.
5. What Will I Feel During the Acupuncture Treatment?
The acupuncturist selects appropriate points for their specific actions in relationship to the identified disharmony. Acupuncture needles are so fine that the prick of the needle as it goes through the skin is barely felt. When the acupuncturist inserts the needle and it reaches the required depth and touches the flow of Qi in the meridian, a very remarkable thing happens. This is a distinctive sensation which is often described as a dull, aching pain to a tingling “shock”. The local area needled may begin to feel heavy, and the sensation of the needling may travel along the line of the meridian. The effect can thus spread beyond the local area. This sensation is known as ‘De Qi’ and indicates to both practitioner and patient that the point has been accurately located. The sensation only lasts for a second or two, even if the needles are left in for some time. Many patients comment that having needles was nothing like as bad as they had imagined. The patient may feel a bit tired or washed out shortly after a treatment, but this usually passes quite quickly.
Some people are more responsive to needling than others and may experience the sensations and discomfort to a much greater degree. However, responsiveness to needling is not in itself indicative that acupuncture is working well, and patients who experience little or no sensation should not feel that acupuncture is not working. Depending on the treatment principle, the acupuncturist may or may not offer further stimulation to the needle once it is in place. This may cause the needling sensation to
be re-experienced. However, people vary in their reactions to acupuncture and some of these effects may be minimal or totally absent in some patients.
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6. How Long Will A Course of Treatment Last?
This will be determined by many factors; whether the illness is chronic or acute, whether the person’s constitutional Qi is relatively healthy, how severe the imbalance is, how accurate a diagnosis the acupuncturist has made and whether there are currently any factors in the patient’s life which are exacerbating his illness.
Treatment may be frequent if the symptoms are acute, but if the illness is chronic it is usual for the patient to come for treatment weekly. This phase continues until the symptoms have significantly improved and the practitioner is assured, through assessment of the pulse, tongue and other criteria,
that the underlying Qi imbalances are markedly less severe. Once the patient starts to improve, the frequency of the treatments diminishes. Generally one expects the patient to show some improvement within the first three or four treatments although it may well take longer if the illness is severe or if it has been present for a long time.
The needles are usually retained in the body for between fifteen and twenty minutes, although this can vary from very short periods (seconds), often with children or infants, up to an hour or longer with certain stubborn patterns. A common course of treatment may initially involve between ten and fifteen treatments spaced at approximately weekly intervals. The frequency could be less than weekly if the condition called for it, especially early on in a treatment program, and may spread out to fortnightly or even monthly later in a program.
Certain factors – such as how the patient responds to acupuncture – will determine the rate of progress and the number of treatments required, but, obviously, cannot be known prior to treatment commencing. Most practitioners suggest that five to ten treatments are agreed to initially, after which progress will be reviewed. The main point is that, at all stages of the progress, patients should be clear about what they have or have not agreed to in terms of a treatment program.
7. Will I Feel Different Immediately After A Treatment? What are the effects of treatment?
After treatment it is quite common for the patient to feel energized and vital, but it is probably more common to feel rather relaxed and drowsy. This is because the body needs some time to adjust to the changes that have been brought about by the treatment. If the patient is suffering from an acute symptom, such as a headache, however, it is common for an improvement to be felt at the time of the treatment.
Exacerbation of symptoms is a quite common feature of acupuncture treatment. In this regard, the patient may find that in the short term after treatment, the symptoms may in fact get worse before an improvement sets in. A professional practitioner will always warn the patient of the possibility of exacerbation at the start of a course of treatment.
The speed of response varies considerably from patient to patient, and with each disease.
Certain patients feel a response within a few seconds of the first needles being in place the first time they come for treatment. Others may have to be treated four or possibly even more times, for the first response to be felt.
The effect of a single treatment may be noticed during the treatment or several hours or days later.
After a treatment nothing tangible may be noticed. At other times there may be an increase in energy, a lightness and buoyancy due to the stimulating effect of the treatment. In some people there is a great feeling of relaxation that may be followed by a pleasant drowsiness due to the sudden release of tension.
The improvement that is noticed during a course of acupuncture does not follow a steady course. As a rule the degree of improvement and its duration increases with each treatment till the stage is reached where the improvement persists and becomes a cure that lasts.
The improvement from the first treatment may last minutes, hours or days, the effect lasting longer with each repetition. Some patients improve rapidly at the beginning of treatment but may take a long time to achieve that extra little bit that makes the cure; others improve slowly at the beginning and then take a sudden turn and are cured in no time. The majority follow an intermediate course. Most often there are various ups and downs during treatment and there is rarely an absolutely steady improvement- nature does not know straight lines. Not infrequently there is a setback at some stage of the treatment, which is then overcome by altering the acupuncture points used.
Acupuncture can be remarkably effective in many conditions that occur today. The effectiveness is strongly dependent upon a thorough and accurate Chinese medical diagnosis. The needling skills and techniques of the practitioner will also influence greatly the effectiveness of the outcome. The typical pattern in the West has often been to see acupuncture as the last port of call for individuals with long-term chronic problems. Treatment, not surprisingly, has often been slow and in some cases of marginal benefit. However, as acupuncture establishes itself more and more, it is becoming the treatment of choice for many people, and the effectiveness of the approach with acute as well as with more chronic conditions is being increasingly recognized.
However, in the West, acupuncture for most people is very often a last resort for their long-term chronic conditions, and in such situations progress is likely to be slow, with a large number of treatments being required. This, of course, is not always the case; sometimes acupuncture can produce rapid and dramatic results.
8. Can Acupuncture Help to Give Up Drugs, Alcohol, or Tobacco?
Acupuncture treatment for patients addicted to opiates was started in Hong Kong in the 1960s. Surprisingly, these patients had no withdrawal syndromes in the acute phase. Acupuncture treatment in drug and alcohol addictions, besides discontinuing withdrawal symptoms, also has a psychologically stabilizing effect. Acupuncture can be extremely effective at reducing the intensity of the chemical dependence. Much clinical and research work has been carried out on this modern use of acupuncture in different clinics throughout the world. Acupuncture aimed at treating the whole person can also be highly effective in reducing the psychological dependency on certain substances. Nevertheless, the success of the treatment is dependent on the therapeutic circumstances, the attendant psychotherapeutic measures, and social conditions.
Acupuncture treatment is also very effective in patients who wish to discontinue smoking. The withdrawal symptoms, such as agitation, nervousness, excessive appetite, desire for cigarettes, sweating and palpitations, are relieved by acupuncture. As in all drug addictions patient motivation is important for the success of treatment.
9. Can Acupuncture Help to Lose Weight?
If the case of the excess weight is due to over-eating, acupuncture may well be able to help in reducing the psychological dependency. Many people, however, put on weight despite eating very little. This may be due to lack of physical exercise but it may also be due to a failure of the metabolism to utilize efficiently the food that it receives. Acupuncture is often effective in making the metabolism more efficient and many patients lose weight during the course of treatment if they are over-weight, just
as many patients put on weight if their bodies are too thin.
Acupuncture reduces excessive appetite. According to traditional criteria overweight patients are characterized by deficiency type disturbances, most frequently of the stomach-spleen system but in some cases even of the kidney.
10. Is Acupuncture Safe?
An understandably common anxiety expressed by new patients is whether it is safe to have the body punctured by needles. The answer would have to be that if the practitioner does not know what he or she is doing, it is possible to inflict injury with an acupuncture needle. However, any fully trained and experienced practitioner knows how to use needles safely and effectively, and how to avoid any potential danger areas. Particular care needs to be exercised over the lung area on the upper back, where the direct vertical insertion of a needle could cause a pneumothorax (lung puncture). However, with the correct needling techniques there is no danger of this whatsoever. The importance of seeking an appropriately trained practitioner cannot be overstated. In the hands of such practitioners, acupuncture is a very safe and effective form of therapy.
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11. Will Any Other Therapies be used?
Other treatment methods may be applied during acupuncture session.
In certain conditions it may be appropriate to stimulate the flow of Qi by connecting a pair of needles to a small DC charge from a special designed electro-acupuncture stimulator. Several pairs can be connected at the same time, and the frequency and strength of the electric pulse can be varied in order to achieve the desired effect.
It is quite common to combine acupuncture treatment with moxibustion. Moxibustion is the process whereby a dried herb called moxa – usually the species mugwort – is burnt, either directly on the skin or indirectly above the skin over specific acupuncture points. The purpose of this process is to warm the Qi and Blood in the channels. Moxibustion is most commonly used when there is the requirement to expel Cold and Damp or to tonify the Qi and Blood. When lit, moxa burns slowly and provides a penetrating heat that can enter readily into the channels and influence the Qi and Blood flow. Moxibustion can also be applied over an area of the body which has become cold; such as a ‘frozen’ shoulder, the lower back or the lower abdomen (as is commonly found in women suffering from gynaecological problems).
As moxibustion puts heat into the body, it is clearly not indicated in conditions of internal Heat, and although it may be useful with exterior Excess conditions in the channels, generally it is not used for interior Excess conditions. Moxibustion is rarely used on patients who are predominantly Yin deficient, who barely feel the cold and tend to find hot weather difficult to deal with.
There are various methods for warming an area with moxibustion, the most common being a ‘moxa stick’ which is rather like a large cigar which is about 15 – 20 cm long and about 1 -2 cm in diameter. A moxa cone, which is made using loose moxa, is placed on the acupuncture point, then lit and allowed to smoulder slowly until the patient feels his skin become warm. It is then removed. This is repeated several times on each point.
Cups are either of robust rounded glass construction or of bamboo. By far the most common type of cup used by practitioners in the West is glass. Cupping utilizes vacuum suction within glass cups or bamboo jars to disperse localized congestion such as that caused by Wind- Cold or Dampness. Cupping is especially useful in treating channel problems resulting in localized stagnation of Qi or in helping to expel the external pathogenic factors, Wind – Cold, which have invaded the lungs. The vacuum is created inside the cup by burning a taper for a very short period of time in the cup and then immediately placing the cup down over the selected area. The effect of this is to encourage the flow of Qi and Blood in the area beneath the cup. By moving the Qi and Blood, local stagnation can be cleared. In the case of cupping to expel Wind – Cold, the cups would be placed over the lung area in the upper back. In appropriate cases, cupping can be carried out over an inserted acupuncture needle.
Cupping may precede an acupuncture treatment in some conditions; in other specific situations a cup may be placed over a needle and retained there for some time. In some specialized treatments the cup may be placed over a point that has deliberately been bled, thus stimulating the flow of blood.
Cupping naturally draws blood to the external capillaries of the body and as a result minor weals or bruises may be left after a treatment. If the practitioner is using cupping then this should be explained as a possible consequence of treatment.
Acupressure Massage (An Mo)
Massage is widely used in Chinese medicine and various different techniques have been developed as part of the evolution of Chinese medicine in general. In Chinese, massage is called An Mo, where An translates as ‘push’ and Mo translates as ‘rub”.
Acupressure can be used over general areas of the body to promote the flow of Qi and Blood through the meridian system. This approach can be invaluable for minor channel disharmonies involving a local stagnation of Qi and Blood.
Cavity press massage concentrates on applying pressure to specific acupuncture points in order to achieve specific systemic changes in the body. In this instance, different forms of pressure are applied depending on whether the aim is to tonify, to reduce or to achieve a more neutral, calming effect. The choice of points used in any acupressure prescription will be based on a differential diagnosis resulting from an exploration of the patterns of disharmony as previously described. Acupressure massage techniques can be used in conjunction with other approaches to treatment in Chinese medicine.
Ear points are sometimes needled during a more general acupuncture session. Press needles or ear seeds are put in position and kelp there between sessions. It is broadly used in stopping smoking and giving up alcohol and drug addiction.
Chinese Herbal Medicine
Alongside acupuncture, herbal medicine is a major pillar of Chinese medicine. Herbal preparation have long been used in Chinese medicine and a comprehensive ‘Materia Medica’ can be found dating back to about 650 AD. As the knowledge base grew over the centuries more and more information regarding herbs and their properties was collected and in 1977 a modern compilation recorded some 5767 herbal entries in terms of their properties and the disharmonies that they were helpful with.
Patent herbal remedies in the form of pills, decoctions and teas are available for more general symptomatic treatments. These patent remedies are well tried and tested combinations of ingredients prepared in pill, capsule or decoction form. A growing number of preparations manufactured in the West are now supplementing traditional patent remedies from China.
As with Western drugs that can be bought over the counter without prescription, herb remedies can offer a more general effect that can be very helpful with less severe symptoms and disharmonies. However, their effects will, by their very nature, be less symptom – specific than the effect of a customised herbal prescription based on individual’s specific disharmonies. Chinese herbs are often used in combination with acupuncture treatment as an adjunctive therapy to support the overall treatment plan and facilitate a speedier recovery from the presenting disharmony.
Probably one of the most dramatic growth areas in terms of Chinese medical practice in the West is the interest in Qigong. Many people are being attracted to Qigong through an interest in Taiqi, which despite the fact that its roots lie as martial art, is essentially a form of moving Qigong and share the same basic principles. In terms of Chinese medicine, Qigong is the art of promoting the strength of the ‘Three Treasures’ – Jing, Qi and Shen through calming the mind, breath control, physical movements and stances. The Chinese view believes that a illness is manifestation of a disharmony and weakness in the individual’s energy system. Consequently, if the energy system is strong and balanced, there will be no illness. Thus, Qigong practices can be an invaluable aid in maintaining the vitality of the energy system and the health and well-being of the individual.
Qigong practices probably predate the earliest accounts of primitive acupuncture and may well have been used some 500 years ago, or even earlier than that. Over this period of time, literally thousands of Qigong exercise and strategies were developed, handed down and refined through generations of families and practitioners. In the last twenty years or so, many of these practices have spread from China to the West, and there is a growing articulation of Qigong as an important aspect of Chinese Medicine. Qigong practice is now being subjected to scientific research methodologies and there is growing body of impressive evidence for the effectiveness of these practices.
Diet and lifestyle
The Chinese have always placed great emphasis on eradicating, if possible, the cause of a person’s illness. Advising the patient on aspects of his lifestyle which the acupuncturist considers detrimental to his health is regarded as extremely important. This could involve discussion about a more appropriate diet, exercise, the skillful avoidance of excessive stress and how to become less overwhelmed by the various ‘internal causes’ of illness, the emotions. Traditional Tai Ji Quan, Qi Gong and meditation have often been prescribed by practitioners to help harmonize the individual’s Qi.
As diet can be considered an aspect of general lifestyle, these two will be considered together. Chinese medicine is no different from Western medicine in recognizing the importance of lifestyle attitudes and behaviour patterns in the health and well being of the individual. Therefore, any treatment strategy that is agreed between the practitioner and the patient will reasonably include advice regarding these factors.
A patient’s readiness to make changes in his lifestyle can make or break the success of the treatment. It is considerably harder, for example, for the acupuncturist to improve the condition of the Liver Organ if the patient continues to place a strain on it by drinking too much alcohol, repressing his anger or overloading his planning and organizing faculty through overwork. A patient who is prepared to make a commitment to reduce certain stress in his lifestyle can play a major part in the process of returning to, and maintaining, a better state of health.
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12. Are there ant Side Effects?
Some patient are anxious about whether there will be any side effects and what they are likely to feel after the needles are taken out. The vast majority of patients show absolutely no adverse reactions. However, a very small number of patients have quite dramatic reactions to needling, including light-headedness, nausea, and vomiting, and in some cases they may even pass out during treatment.
Such extreme “needle shock” reactions are very rare and are easily reversed by laying the patient down in the recovery position and removing the needles. Finger acupuncture on specific points can bring around a patient who has fainted. The less dramatic reaction of slight light-headedness or nausea usually wears off after a few minutes.
Women patients should always inform the practitioner if there is any chance they may be pregnant: there are certain acupuncture points that have to be avoided in pregnancy. It is of course the responsibility of the practitioner to check with any women patients whether pregnancy may be a possibility.
13. Contraindications for acupuncture:
There are very few situations where acupuncture is contraindicated.
- When the patient has a haemophilic condition
- When the patient is pregnant (certain points and needle manipulations are contraindicated in pregnancy)
- When the patient has a severe psychotic condition.
- When the patient has recently taken drugs or alcohol. Although acupuncture would generally be contraindicated in these circumstances, it should be stresses that it can be very helpful in drug and alcohol rehabilitation regimes.
There are no contraindications for the use of acupuncture in the treatment of patient with HIV-related disorders, although rigorous hygiene protocols must be adhered to. Given the energetic nature of most HIV-related disorders, acupuncture can be very helpful to patients suffering from AIDs, since it can address a particular disharmony in a very specific manner – often more effectively than drugs. Acupuncture cannot offer a cure for the AIDs, but it can be most helpful in supporting the management of a variety of symptoms connected with it.