FREQUENTLY ASKED QUESTIONS (FAQs) - GENERAL
Read below some frequently asked questions regarding acupuncture and Chinese herbal medicine in general. Click here for frequently asked questions regarding traditional Chinese medicine (TCM) for treating infertility.
Regarding Chinese Medicine in General
Q: What is Chinese Medicine? What is acupuncture?
A: Chinese medicine, also called traditional Chinese medicine or TCM, is a complete system of medicine, recognized as such by the World Health Organization. Written records and literature detailing the theory and practice of Chinese medicine date back 2,300 years. Essential concepts of Chinese medicine such as yin and yang, qi, and five-element correspondences have been documented to 4,000 years ago, and are ultimately based on Taoist philosophy. Over centuries, gifted scholars and medical practitioners in China and other Asian countries developed a complex, interrelated way of assessing and treating the human body and its illnesses based on these concepts.
Acupuncture is one modality in Chinese medicine. In acupuncture treatment, fine acupuncture needles are inserted into the acupuncture points located on the body's energy pathways to regulate and balance the energy flows. Chinese medicine also uses several other modalities to treat patients, including Chinese herbal formulas, moxibustion, tuina massage, dietary therapy, the energy-mobilizing practices of Qi Gong and Tai Chi, and lifestyle counseling. The primary objective of treatment is to create and maintain balance and harmony within the body. Since illness and disease are seen as an imbalanced condition of the body, restoring balance means restoring health.
Because Chinese medicine tends to view people as the totality of their bodily processes, including emotional, mental and spiritual aspects, Chinese medicine is generally perceived as more holistic than Western medicine. There is also a strong emphasis in Chinese medicine on maintaining healthy states and preventing illness, rather than waiting until disease presents itself, as Western medicine tends to do. Practitioners of Chinese medicine believe that it is particularly useful in the treatment of chronic, functional diseases or problems which do not respond readily to the quick fixes of surgery or drug therapy. BACK TO TOP
Q: How does acupuncture work?
A: Acupuncture needles are very fine - usually the diameter of a human hair, although they come in different lengths and diameters. Acupuncture needles are inserted into specific points (acupoints) on the surface of the skin which relate either to internal organ systems or to specific conditions. There are approximately 365 acupoints located along the body's fourteen principal meridians. (There are also "extra" acupoints, ear acupoints, hand, foot, and scalp acupoints, and others.) Meridians are essentially energy channels, along which the body's life-force energy called "qi" flows. (Qi is also spelled "chi," and pronounced "chee"). The acupuncturist will select a combination of acupoints along one or more meridians based on the condition(s) being treated.
By stimulating acupoints, qi is manipulated in order to achieve therapeutic results. Qi that is flowing in the "wrong" direction can be redirected, for example in the treatment of nausea. Qi that is "stuck" and therefore causing pain can be mobilized to flow freely through the affected area. In Chinese medicine theory, the fundamental substance of blood also flows in the acupuncture meridians, so acupuncture can be used to manipulate blood-related imbalances such as menstrual discomfort.
Even though Western science has not yet determined the mechanism by which acupuncture works, a number of interesting correlations have been scientifically demonstrated. For example, if a machine that detects electromagnetic force is dragged along a meridian, the acupoints always register a lower electromagnetic level than the surrounding area. This means that the acupoints which were sensed by Chinese medicine practitioners more than 3,000 years ago are also detectable with a scientific instrument. Blood tests have demonstrated that acupuncture needle stimulation is associated with increased levels of serotonin, L-dopa, and other neurotransmitters in the brain, which could explain the pain-reducing effects of acupuncture. And cutting-edge research done with functional magnetic resonance imaging (fMRI) demonstrates that acupoint stimulation at a distal point on the body will cause a reaction in the brain. For example, if an acupoint on the foot which traditionally addresses eye problems is stimulated by needling, the vision area of the brain will be demonstrably affected. BACK TO TOP
Q: What problems can be treated by acupuncture/Chinese medicine?
A: According to the vocabulary of Chinese medicine, treatment is aimed at resolving imbalances of the body's organ systems and fundamental substances such as qi and blood. However, most people who come to a Chinese medicine practitioner will state their problem in Western medicine terms: "I have a bad back," "My periods are very painful," "Can you help me stop smoking?"
Below is a list of conditions which the World Health Organization recognizes as being effectively treated by acupuncture. For most of these conditions, Chinese medicine practitioners would also prescribe Chinese herbs in addition to acupuncture to achieve the maximum effectiveness. In addition to the conditions listed below, Chinese medicine has proven highly effective for weight loss; withdrawal from addictions such as sugar, coffee, cigarettes, alcohol, and cocaine; stress reduction; post-surgical recovery; support for individuals undergoing radiation therapy or chemotherapy; male and female infertility; immune system problems, and many others.
The World Health Organization of the United Nations recognizes acupuncture's effectiveness for over 40 common disorders, including:
1) Ear, Nose & Throat Disorders: toothaches, earaches, sinusitis, rhinitis, laryngitis
2) Respiratory Disorders: common cold, bronchitis, asthma, allergies, emphysema
3) Gastrointestinal Disorders: food allergies, nausea, indigestion, diarrhea, constipation, ulcers, colitis, Crohn's disease
4) Circulatory Disorders: hypertension, high cholesterol, arteriosclerosis, angina pectoris
5) Urogenital Disorders:
cystitis, stress incontinence, urinary tract infections, prostatitis, prostatic hypertrophy
6) Gynecological Disorders: menstrual irregularities, endometriosis, PMS, infertility, menopausal syndrome
7) Musculoskeletal Disorders: low back pain, arthritis / joint pain, tennis elbow, frozen shoulder, TMJ, sciatica, carpal tunnel synŽdrome, fibromyalgia
8) Nervous System & Psychiatric Disorders: depression, anxiety, insomnia, headache, migraine, trigeminal neuralgia, Bell's palsy, post-stroke paralysis, dizziness, tinnitus
9) Skin Conditions: acne, eczema, herpes/shingles, psoriasis
A ten volume acupuncture manual complied by the American Academy of Acupuncture and Oriental Medicine and published in China covers over seven hundred symptoms, conditions and diseases. These conditions and diseases can be treated by acupuncture only or in conjunction with Chinese herbal medicine or conventional western medicine. BACK TO TOP
Q: Will my insurance cover acupuncture?
A: Insurance companies are much more likely to cover acupuncture now than they have been in the past, due to increasing evidence that acupuncture works and is a very cost-effective modality. In particular, worker's compensation and car insurance companies have been quite open to approving acupuncture for their clients. There is still a long way to go, however, before acupuncture is universally recognized by insurance companies. Federal government programs such as Medicare and Medicaid do not cover acupuncture across the board, although some program participants may qualify under their particular provider. Blue Cross / Blue Shield in some states will cover acupuncture performed by licensed acupuncturists, but BC/BS Minnesota will only cover acupuncture performed by MDs at this point.
The best thing to do is to call your insurance company and see if acupuncture is included in your benefits package. You also need to ask if your insurance company will cover acupuncture performed by any licensed acupuncturist, or if there are restrictions such as oversight by an MD, etc. Keep in mind that the medical system in this country is in flux, and benefits may change as the advantages of acupuncture treatment are more widely recognized by insurance companies and providers. BACK TO TOP
Q: Does acupuncture hurt? Is it safe?
A: Most of the time, the insertion of an acupuncture needle causes a slight pinching sensation, much like a mosquito bite. This sensation usually lasts less than a minute, and then the needle is not painful at all. It is difficult to explain exactly what an acupuncture sensation is like, because people experience it differently. There can be a tingling sensation, heat, numbness, an electrical "zing," a lifting or spreading sensation, heaviness, and others. If a needle continues to hurt after insertion, it may be twisted around a muscle fiber. In that case, tell the acupuncturist and he/she will reposition the needle and relieve the pain. People who are afraid of needles because of the pain of hypodermic needles are usually pleasantly surprised by how mild the acupuncture needle sensation is.
Acupuncture needles are extremely safe. They are factory-sterilized and placed in sterile packets. They are used once and then disposed of. There is virtually no chance of infection. Professional acupuncturists are trained in safe needle insertion and are always aware of the body structures lying below the skin surface. BACK TO TOP
Q: Do I need to prepare for an acupuncture treatment? How long do the needles stay in? What about afterwards?
A: It is better not to have an acupuncture treatment if you are very hungry or too full. Some practitioners also advise against a treatment if you are extremely fatigued or emotionally upset. Wear clothing you are comfortable in: you will probably need to pull your pants up above your knees, and women will need to remove pantyhose. Before treatment, make sure you understand everything the practitioner tells you about your condition and how he/she plans to treat you. If you are interested in learning about your condition from a Chinese medicine perspective, ask questions. During treatment, relax as much as possible. Do not move suddenly or reposition yourself without the aid of the practitioner. Many people find acupuncture so relaxing that they fall asleep during treatment.
After the needles are placed, they will stay in twenty to thirty minutes. The acupuncturist will make you comfortable and will check in with you about halfway through the treatment. For an initial visit, when the practitioner needs to take a detailed history from you, you should allow one hour for the entire procedure. Follow-up visits generally take 40-45 minutes.
Patient responses after treatment are quite varied. Some people do not notice any unusual sensations at all afterwards. Some people feel very energized, and some feel the need to go right to bed and sleep. Many people continue to notice sensations in their body like energy traveling around, even after the needles are removed. Ideally, you will notice a reduction in your symptoms after treatment, and will feel better. Some patients have a dramatic improvement immediately after treatment, but most patients make steady improvements over time. BACK TO TOP
Q: How many treatments will I need?
A: That depends on your condition and how well you respond to treatment. As a general rule, acute conditions with sudden onset, such as pulling a muscle in your back, will clear up quickly, sometimes after only one treatment. The longer you have had a condition, the more severe it is, and the older you are, the longer it may take to treat it. A series of 10-12 weekly or bi-weekly treatments can resolve many chronic problems. A severe condition such as recovery from a stroke, or a degenerative condition such as multiple sclerosis will probably require ongoing treatment over time to achieve satisfactory results. A fair test to see if acupuncture will improve your condition is to have two treatments per week for two to three weeks. At that point, most people can judge whether or not they are receiving sufficient benefit from treatment to continue with it, even if they are not cured yet. BACK TO TOP
Q: How do I know if a practitioner is qualified?
A: The practice of acupuncture is licensed in at least 43 states as of 2008. Using Minnesota as an example, the following procedure is similar for most states (with the exception of California, which has its own internal examination and licensing procedure). To become licensed, a candidate must be a graduate of an accredited school of Chinese medicine (or a school which is in the process of accreditation). Most schools of acupuncture and Oriental medicine require their graduates to complete a minimum of 2800 hours of professional training. The candidate must also pass a series of national board examinations administered by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). The NCCAOM will award certifications such as Diplomate of Acupuncture (Dipl.Ac.) and Diplomate of Chinese Herbology (Dipl.CH), depending on which national board exams the candidate passed. In Minnesota, acupuncturists are licensed under the Minnesota Board of Medical Practice, and should have the title of Licensed Acupuncturist (L.Ac.) after their name. In other states, acupuncture may be licensed or certified by a state department of regulatory agencies. In many states, chiropractors are allowed to perform acupuncture services under their scope of practice, but may not be licensed or certified specifically in acupuncture, and often have little or no training in Chinese herbology. When choosing a practitioner it is always a good idea to ask if a practitioner is a licensed acupuncturist, where he/she went to school, what conditions he/she specializes in, etc. BACK TO TOP
Q: How does Chinese medicine actually work?
A: Although the vocabulary of Chinese medicine is specialized, the concepts of treatment are easily understood. It is always about restoring balance in the body systems. If there is heat in the system (such as getting flu), cooling techniques are applied; if something is too cool, it will be heated up. Moist conditions are dried, and dry conditions are moistened. When one of the fundamental body substances such as qi or blood is stuck, the result is pain. Therefore, the way to treat pain is by moving qi and blood. Sometimes energy is flowing in the wrong direction and will be redirected. Conditions of excess are diminished, and conditions of deficiency are built up.
In order to treat a condition, the practitioner must first diagnose the problem. In Chinese medicine, the diagnostic process involves assessing the patient's overall appearance, looking at the tongue, palpating the pulse on both wrists, and asking questions. All the patient's symptoms, taken together, will present the practitioner with a pattern of imbalance. Weaving signs and symptoms into a coherent picture of what is wrong is called "pattern diagnosis" and is the basis of treatment.
Once a practitioner has diagnosed the type of imbalance a patient is suffering from, he/she will employ Chinese medicine techniques to restore the balance. For example, if a patient is diagnosed with the pattern of Spleen Qi Deficiency, acupuncture and Chinese herbs will be used to warm and dry the spleen and to nourish and move spleen qi, and a diet will be recommended which warms and nourishes spleen energy. Moxibustion may also be used as a warming modality. Because the spleen is associated with the emotion of worry or "overthinking," the patient would also be advised to practice stress-relieving techniques such as tai chi or meditation. As a result of this treatment, the patient should experience better digestion, higher energy levels, and clearer thinking. BACK TO TOP
Q: How safe is Chinese medicine?
A: When practiced by trained, qualified professionals, Chinese medicine is very safe. Acupuncture needles are packaged in sterile units and are discarded after a single use, so there is little to no chance of infection from needles. Chinese herbs, while extremely effective when administered correctly, are generally not as powerful as Western drugs and have dramatically fewer side effects. Reported incidents of malpractice and doctor-caused disease (iatrogenic disease) are much higher for Western medicine than for Chinese medicine. In fact, while malpractice insurance rates for Western MDs have skyrocketed over the past decade, malpractice insurance rates for licensed acupuncturists have actually gone down. BACK TO TOP
Q: Is Chinese medicine a "cure-all"?
A: Chinese medicine as it is currently practiced in this country is not intended to be a substitute for Western medicine. It is generally practiced as an adjunct to more conventional forms of treatment. Most Chinese medicine practitioners believe that our medical system would be ideal if it truly integrated the strengths of Western medicine with the strengths of Chinese medicine, as they do in China. Western medicine is especially useful for acute situations such as trauma, heart attack, pneumonia, etc. The use of vaccines, antibiotics, steroids, life-saving surgery, and innovations such as advanced imaging techniques has brought extended life and health to billions around the world. Chinese medicine puts its focus on treating the whole patient and bringing all the bodily systems into balance and harmony. There is more emphasis on catching imbalances early, before they manifest as a disease process - on maintaining the healthy state instead of trying to fix something that is broken. For countless satisfied patients, Chinese medicine provides exceptional, cost-effective treatment for many types of chronic and acute medical conditions. BACK TO TOP
Q: What is Chinese herbal medicine good for? How is it used?
A: Chinese herbs are one of the therapeutic modalities of Chinese medicine. Historically, herbs were considered to be the most critical element in successful patient treatment by Chinese practitioners. Most professional Chinese medicine practitioners in this country combine herbs with acupuncture and other modalities to achieve maximum therapeutic results. As opposed to Western herbal therapy, which tends to use single herbs to address a specific symptom, Chinese herbal formulas are typically made up of six to ten different ingredients, and are usually intended to address a pattern of symptoms, rather than a single symptom.
Chinese herbal formulas are both powerful and subtle in their effect, and can be used to treat almost any health condition. A general statement would be to say that acupuncture alone can be effective in the treatment of musculo-skeletal problems such as acute back pain, joint pain, stress headaches, TMJ, etc. Herbal formulas are most effective to address internal problems arising from organ imbalances, such as gastrointestinal, gynecological, circulatory and respiratory problems. Even though such conditions as allergies, sinusitis and skin problems seem to be more superficial, they are actually a surface reflection of deep internal imbalances and respond well to Chinese herbs.
Chinese herbs are administered in several ways. Standard herbal formulas which are designed to treat common disease patterns are generally available in capsule or pill form, called "patents." Single herbs and formulas are also available as powders, tinctures, granules, and herbal plasters. Decoctions made from raw herbs are the most direct and patient-specific method to administer herbs. Decoctions involve boiling a combination of raw herb material such as roots and leaves, straining out the liquid and drinking it.
In China, decoctions are the most common way to take herbs. In this country, patients often find the process of cooking herbs to be too time-consuming and the taste of raw herbs to be off-putting. However, the advantages of herbal decoctions as therapy outweigh the inconvenience of preparing them. The principal advantage of raw herb decoctions is that the practitioner can tailor the formula to the specific needs of the patient, and can continue to adjust or "tweak" the individual herbs as necessary. For example, if a practitioner is working with a woman's menstrual cycle, a tailor-made formula can be adjusted for the pre-ovulation, post-ovulation, and menstrual phases of the cycle. BACK TO TOP
Q: Are Chinese herbs safe?
A: This question has several aspects. One is the safety of the individual herbs imported into this country from other countries. All herbal imports, both raw herbs and prepared herbs, are required to be inspected and cleared by the U.S. Food and Drug Administration before they can be released to purchasers in this country. The FDA collects samples and sends them at random to non-government testing laboratories. All legitimate herb-import businesses should be able to provide documentation of the origin of their herbs and certification of FDA inspection. You can always ask your practitioner if he/she has researched the origin of the herbs he/she is prescribing.
Although Chinese herbs are not as powerful or as likely to produce side effects as most Western drugs, they are still a form of drug therapy and need to be treated seriously. It is generally not advisable to take any drug or herbal product just because it worked for somebody else. When prescribed by a qualified, professionally-trained practitioner of Chinese medicine, Chinese herbal formulas are both safe and effective. A practitioner needs to assess your condition in person before being able to prescribe herbal therapy. Chinese herbs are used safely by pregnant women, and there are a number of pediatric formulas designed to be used by children. BACK TO TOP
Q: Will my insurance cover Chinese herbal therapy?
A: At this point, probably not. Although there is good scientific evidence for the efficacy of Chinese herbal medicine, the scientific studies have been primarily conducted in Asian countries. Government agencies in this country have not funded scientific studies on Chinese herbal medicine, and Western pharmaceutical companies have no incentive to conduct such studies. There are no insurance codes that apply to Chinese herbs, and without a code, a treatment cannot be billed. BACK TO TOP
Q: What is the evidence that acupuncture / Chinese medicine is cost effective?
A: The National Acupuncture and Oriental Medicine Alliance gathered data from various studies involving acupuncture therapy and arrived at the following conclusions:
Acupuncture treatment results in avoidance of surgery (based on subjects with knee osteoarthritis who were candidates for arthroplasty surgery - 1992).
Acupuncture treatment results in decreased days in hospital or nursing home (based on stroke patients whose standard rehabilitative care was combined with acupuncture - 1994).
Acupuncture treatment allows low-back pain patients to return to physical labor (based on worker's compensation clinic patients whose standard physical therapy or occupational therapy was augmented with acupuncture - 1980).
Acupuncture treatment results in avoidance of surgery, fewer hospital visits and greater return to employment (based on a study of 69 patients with severe angina pectoris - 1996).
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Q: Isn't Chinese medicine essentially a form of folk medicine that has been replaced by science-based Western medicine?
A: Just as modern Western medicine is a complete system of medicine, with a characteristic vocabulary and methods of diagnosis and treatment, so Chinese medicine exists as a complete medical system with its own vocabulary and therapeutic modalities. To Western minds, the vocabulary of Chinese medicine sounds strange, and therapeutic modalities such as acupuncture seem exotic or incomprehensible. But Chinese medicine is solidly based on thousands of years of observation and experimentation. Chinese scholars and practitioners have recorded their theories and clinical experience in thousands of books (30,000-40,000 individual books on Chinese medicine were written before 1900). The accumulated wisdom and observation of millions of patient treatments are documented in these treatises. In modern times, Chinese medicine theories and treatment modalities have been subjected to rigorous scientific testing on the Western model. Acupuncture and herbal therapies have been tested using gold-standard double-blind scientific studies, and the scientific research overwhelmingly confirms the efficacy of Chinese medicine treatment modalities. In most large Chinese hospitals today, Chinese medicine and Western medicine are practiced in an integrated manner, with each patient receiving the treatment modalities that will work best for him, whether it is Eastern acupuncture or Western radiation therapy. Chinese medicine is currently used by at least one-quarter of the world's population as their primary form of medicine for the simple reason that it works. BACK TO TOP
