Many patients have found acupuncture helpful for a variety of musculoskeletal and neurologic conditions. Acupuncture follows a long tradition of healing starting in the Orient. What is herbology (phytomedicine)? Are herbs regulated by the FDA? What should you expect during treatment? Do I need a referral from a doctor to see an acupuncturist? Will my insurance cover treatment?
Acupuncture is a primary health care modality that has flourished in Asia for at least 2,500 years and is used widely throughout Europe. Acupuncture is considered one of the newest primary health care professions in the United States. The benefits of acupuncture have become widely recognized and integrated with mainstream healthcare. Acupuncture means the stimulation of certain points on or near the surface of the body by the insertion of needles to prevent or modify the perception of pain or to normalize physiological functions, for the treatment of certain diseases and includes the techniques of electroacupuncture, cupping, and moxibustion. The practice of acupuncture is to perform or prescribe the use of oriental massage, acupressure, breathing techniques, exercise, or nutrition, including the incorporation of drugless substances and herbs as dietary supplements to promote health. Far more than a technique of inserting tiny threadlike needles along meridian lines of the body, acupuncture's complex system of diagnostic methods take into consideration the person as a whole, not just isolated symptoms. Acupuncture is practiced based on discerning the bodies' "pattern of disharmony" and treating accordingly.
What is Herbology (Phytomedicine)? Acupuncturists are trained to recommend herbs to their patients. Besides herbs, practitioners often prescribe various other substances, such as mushrooms (St. Johns Wart) and bark. To describe all these different items, the terms "phytomedicine" and "phytotherapy" were coined. The restoration of harmony is integral to Chinese herbal medicine. Harmonious balance is expressed in terms of the two complementary forces, yin and yang, and the five elements: fire, earth, metal, water, and wood. The five elements are of particular importance to the Chinese herbalist; they give rise to the five tastes by which all medicinal plants are evaluated. Fire gives rise to bitterness, earth to sweetness, metal to acridity, water to saltiness, and wood to sourness. Each taste is said to have a particular medicinal action. Bitter-tasting herbs drain and dry, sweet herbs tonify and may reduce pain, acrid herbs disperse, salty herbs nourish the kidneys, and sour herbs nourish the yin and astringe, preventing unwanted loss of body fluids or qi. Herbs that have none of these tastes are described as bland, a quality that indicates that the plant may have a diuretic effect. The taste of a plant can also indicate the organ to which it has a natural affinity. Besides defining particular herbal tastes, the Chinese ascribe different temperatures to herbs (hot, warm, neutral, cool, and cold). Each individual herb has different properties such as taste and temperature, and enters different organs in the body. When the herbs are combined, through mutual harmony, the treatment effect is increased and the side effects reduced. A usual prescription or formula can consist of multiple herbs. After a diagnosis is made, herbs are selected and combined, or a well-known traditional formula is prescribed. The formula is adjusted to fit the patient's symptoms and diagnosis. The formula brings about the treatment effect by regulating qi (pronounced, "chee," meaning energy), blood and body fluids. Since Oriental herbal medicine is also based upon yin-yang and the five elements theory, when it is used in conjunction with acupuncture, it gives total harmony and balance to the whole body, effecting maximum treatment.
Are Herbs Regulated by the FDA? The Food and Drug Administration (FDA) regulates medications that physicians prescribe. That do not have control over supplements or herbs. Therefore, patients are on their own when it comes to taking herbal remedies. The manufacturer has no obligation to put any active ingredients in the pill, and the label does not need to reflect what is actually in the pill. Long-term rigorous studies are lacking with most of these, so risks of taking them cannot yet be determined. Likewise, the benefits of these herbs is not supported by well-performed studies comparing them to the current standard or to an inactive placebo control. To minimize risk, supplements should be taken at the recommendation of someone who is familiar with reputable makers, and has had good experiences with them in the past. Many acupuncturists have a substantial knowledge of where to obtain the highest quality herbs, often purchasing them first-hand from vendors and manufacturers in Chinatown.
Numerous studies have been performed in well-respected journals, showing physiologic and neurologic changes during acupuncture treatments. These collectively make up the Western explanation of its efficacy. The traditional Oriental explanation discusses the belief that health is determined by a balanced flow of qi, the vital life energy present in all living organisms. According to acupuncture theory, qi circulates in the body along twelve major energy pathways, called meridians, each linked to specific internal organs. The "vital energy" in humans is believed to flow along meridians that have their root in the internal organs. On the surface of the twelve main meridinal pathways are up to 365 main acupuncture points where needles are inserted to restore the proper balance of energy. The acupoints within the meridial system can be stimulated to enhance the flow of qi. When acupuncture needles are inserted into these acupoints (just under the skin), they help correct and rebalance the flow of energy and consequently relieve pain and/or restore health. These acupoints are grouped along specific pathways or meridians that cross the body. The flow of energy through these pathways helps to maintain good health. When the flow of energy is blocked for any reason, there is disruption of health, resulting in pain and illness. By stimulating appropriate acupuncture points along these meridians, the energy is released and regulated, and health may be restored. Acupuncture can play a vital role as an adjunctive therapy due to how effective the meridian system is as a means of proper diagnosis. Because the meridians influence every cell in the body and pass through every organ and organ system, acupuncture provides health practitioners with an accurate means of determining health deficiencies, as well as a method of reestablishing balance. Additionally, studies indicate that acupuncture influences the central and peripheral nervous system. Experience shows it can be particularly effective in pain control. Among a host of factors, acupuncture affects sugar, cholesterol, and triglyceride levels in the blood, the functioning of the gastrointestinal system, and the activity of the endocrine system. Acupuncture works with the body, harmonizing and balancing energy. It improves circulation, releases endorphins to control pain, and allows the body to heal itself more quickly and more completely.
Acupuncture is approved by the National Institutes of Health (NIH) and the American Medical Association (AMA) in the treatment of pain and nausea. No conclusion could be made about acupuncture's efficacy in treating other conditions. However, acupuncturists do treat a wide range of disorders, including migraines, sinusitis, the common cold, tonsillitis, asthma, inflammation of the eyes, addictions, myophia, duodenal ulcer (damaged mucous membrane in a portion of the small intestine) and other gastrointestinal disorders, trigeminal neuralgia (a severe facial pain), Meniere's disease (ringing in the ears coupled with dizziness), tennis elbow, paralysis from stroke, speech aphasia (loss of language abilities due to brain damage), sciatica, and osteoarthritis.
What Should You Expect During Treatment? An important method of diagnosis used by acupuncturists involves analyzing the pulses of a patient. Other diagnostic methods include questioning the patient regarding symptoms and living habits, careful observation of the patient's tongue, facial and body coloring as well as observation of skin texture and temperature distribution on different body areas. Selected points are cleaned with alcohol, and sterilized needles are inserted along the appropriate meridians. Acupuncture needles are of different lengths and gauges, but are generally hair-thin, solid, and made of stainless steel. The part of the body into which the needles are put will often appear to bear no relation to the site of disease or symptoms. The depth of the needle insertion varies, depending on the points being used. Most needles are inserted just below the skin's surface, but some may go from a depth of a quarter inch to as much as three inches. In most cases the needle insertion can hardly be felt by the patient. Usually there is only a brief sensation as the needle is inserted, and it is rarely painful. Once the needles are in place, they generally cannot be felt. The needles typically stay in place for about half an hour. For some conditions, however, they may be in place for only a few minutes or for up to an hour. Sometimes an electrical current is used to further enhance the stimulation of the acupuncture points (electroacupuncture). The needles may also be manipulated in twirling or push-pull movements. Moxibustion can also be used in conjunction with acupuncture. It may consist of rolling a ball of dried herb (mugwort) around the needle's shaft and lighting it so that the needle is warmed. Many patients find the treatment very relaxing, which brings on a feeling of well-being. Often patients are surprised at how comfortable they are during treatment and how easily the needles are placed. A patient may feel a slight sensation upon entry and then pressure or a "dull" or "surging" reaction when the needle reaches the correct point. Needles are sterile, generally cause no bleeding upon entry or removal, with little or no pain being felt; however, slight bruising may be experienced on occasion. The number of treatments necessary will depend upon your condition, if your symptoms are chronic or acute, and your health in general.
Who Can Perform Acupuncture?
Do I Need a Referral from a Doctor? Will my Insurance Cover Acupuncture?
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Susan Rodnunsky is a licensed acupuncturist and herbologist, and has
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| About our Acupuncturists |  |
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Don Lee is a diplomate of the National Board of Acupuncture Orthopedics (DNBAO), and has special expertise in the evaluation, diagnosis and treatment of musculoskeletal disorders. His general
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been in practice since 1998. She studied acupuncture and herbology at Samra University and earned her Masters degree in Chinese medicine at Santa Barbara College of Oriental Medicine in 1998. Prior to that she studied ballet at the Boston Conservatory School of Music and at California Institute of the Arts. She is available to see patients at The Marlowe Institute by appointment. Call for further information.