Acupuncture – A Guide to its Method and Practice
Acupuncture is the insertion of fine needles into specific areas of the body known as acupuncture points. The theory of acupuncture was first documented in an ancient Chinese text called ‘The Yellow Emperor’s Classic of Internal Medicine’, which is thought to have been written around 2500 years ago. It is believed that missionaries and other people returning from the Chinese colonies first brought acupuncture to Europe in the 17th century. However, its use did not become widespread until the 1970s. Today the theory of medicine discussed in the ‘The Yellow Emperor’s Classic of Internal Medicine’, still plays a major part in the practice of traditional Chinese acupuncture. Over the last few decades as acupuncture has increased in popularity in the west, Medical acupuncture (also known as Western acupuncture) has emerged.
How does the acupuncture work?
Traditional Chinese medicine is a complete healing system and has a different philosophy from that of conventional medicine. It has its own theory of what causes disease, its own system of classifying disease and its own diagnostic style. It is based on the theory that we all have energy or life force called Qi (pronounced ‘chee’) flowing through our bodies. While Qi is said to flow in all parts of the body it is mostly concentrated in defined channels along which lie the acupuncture pressure points. In a healthy person Qi is said to flow freely, be evenly dispersed and be neither lacking or in excess. Illness is seen as a disharmony or imbalance due to blocked Qi. Variations in Qi can occur at physical, emotional and spiritual levels. The concept of Qi is used to explain physical, mental and spiritual processes in the body.
Another fundamental concept in traditional Chinese medicine is that of Ying and Yang. These are opposite but complimentary forces whose perfect balance within the body is essential for well-being. Ying denotes cold, damp, slowness and darkness. Yang denotes heat, dryness, action and light. It is the interaction between Ying and Yang that gives rise to Qi. In traditional Chinese medicine disease is described in terms of our patterns of disharmony, most commonly using imbalances in Ying and Yang as a basic cause. Diagnosis involves assessing patients Qi, while treatment involves manipulating it in some way. The focus of traditional Chinese medicine is on stimulating the body’s own healing responses to help restore its natural balance and so improving the overall well-being of the patient.
Western acupuncture does not fully embrace the methods used in traditional Chinese acupuncture but rather borrows from traditional Chinese acupuncture techniques and applies them on the basis of a conventional medical diagnosis. Treatments mostly use a limited number of symptomatic points and focus on bringing about the relief of specific symptoms. Needles may be inserted into traditional Chinese acupuncture points or to trigger points unrelated to the traditional Chinese model of acupuncture. Some medical acupuncturists have dispensed with traditional Chinese theory entirely and question whether energy channels and acupuncture points exist. The favourite scientific explanation of how acupuncture works is that it stimulates nerve cells in the central nervous system to produce a variety of effects on the body’s hormones, nervous system, muscles, circulation and immune system. This in turn stimulates the release of substances such as natural pain relieving opiates or anti-inflammatory substances. As well as providing immediate pain relief acupuncture can have a long-term effect on pain reduction that builds up over weeks or months. This may be related to the responses of the autonomic nervous system near acupuncture sites. The autonomic nervous system has a profound effect on health, so this could be at least one explanation for the therapeutic effects of acupuncture. Another possible theory is that acupuncture works via the connective tissue which runs the length of the body.
Finally, auricular or ear acupuncture is widely used by traditional Chinese acupuncturists and medical acupuncturists. It is based on the theory that a map of the human body is mirrored on the ear. Ear acupuncture is used alone or in combination with full body acupuncture, and it is widely used to treat addictions. Some research suggests that needling ear points may trigger the release of neurotransmitters in the brain.
Who can use acupuncture?
Acupuncture can be used on individuals of all ages and is suitable for treating a wide range of physical, mental and spiritual conditions. Some of the ailments that can be treated using acupuncture include insomnia, arthritis, asthma, and migraines. Some individuals use it as a preventative measure to keep them well and strengthen their constitution. It can also be used during pregnancy but some of the points must be avoided. In China acupuncture is used alongside sedatives to anaesthetise patients before surgery.
What happens during an Acupuncture Session?
The first consultation with an acupuncturist takes about 60 to 90 minutes. A traditional Chinese acupuncturist will ask detailed questions about the condition you have come to have treated. They will also ask about your general health, health problems, medications, diet, lifestyle, emotional state, sleeping patterns and your medical and family history. A traditional Chinese acupuncturist will also carry out a few standard tests which include feeling pulses and looking at your tongue to assess the state of your Qi. The pulses are checked on both your wrists for quality, strength and rhythm. The tongue is examined to assess its colour, size and coating. Some traditional Chinese medical acupuncturists also press various acupuncture points to assess which ones are tender or painful. Gathering all this information together, the acupuncturist will determine the imbalances you have and the best course of treatment. A Western acupuncturist will spend some time taking a medical history and will also press points to assess which are tender and require attention.
Once the practitioner has made a diagnosis, you may be asked to undress and lie on a couch for the treatment. There are about 500 acupuncture points altogether, from which the acupuncturist will probably choose between two and 20 points to needle in anyone treatment. Needles are usually inserted in both sides of the body, to a depth of about 1 to 2 cm, but they can go as deep as 12 cm, depending on which part of the body the acupuncturist is treating and how fat and muscular you are. Once a needle has been inserted it is usually left in place for about 15 to 20 minutes. During this time it should not hurt but some people feel tingling or a dull heat around the needle.
The acupuncturist may also supplement needling by using herbs burnt on, or over the end of a needle. They may use a technique called cupping by placing cups (to create a vacuum) on the skin in strategic places. Sometimes the acupuncture needles are connected via wires and electrodes to a battery operated electrical device that vibrates and produces a tingling sensation, a technique known as electroacupuncture. Sometimes tiny press needles or seeds are fixed with a plaster over ear points and left in place for 1 to 2 weeks. A traditional Chinese acupuncturist may also give you dietary advice, exercise suggestions or Chinese herbs to supplement your treatment. At subsequent treatment sessions your acupuncturist will probably spend 10 to 15 minutes talking to you before inserting the needles with the whole session taking about 30 to 45 minutes.
It is not possible to say exactly how many acupuncture treatments someone will need, but a rule of thumb is that the longer you have had a problem the more treatments you will need. Most people with an acute problem need to have at least three treatments at weekly intervals. Those with chronic conditions may need to have weekly treatments for a total of six sessions, then fortnightly for a few sessions, then monthly and so on. Most people should notice some change after five or six treatments. Some people, particularly those with chronic conditions, consult their acupuncturist for repeat or preventative treatments.
Is Acupuncture safe?
Acupuncture is a relatively safe treatment in the hands of a competent practitioner. Although acupuncture is one of the most invasive of the complimentary therapies, serious adverse events such as infection, punctured lung or spinal cord injury are extremely rare. Such events are probably almost wholly due to an inadequately trained practitioner or bad practice. It is important to make sure you go to a properly trained and registered acupuncturist. Also, make sure that your acupuncturist uses disposable needles, which are used once and then destroyed, to eliminate the risk of cross infection.
There are few contraindications to acupuncture, but some points should probably be avoided in pregnancy and electroacupuncture can interfere with cardiac pacemakers. Acupuncture is inappropriate for people with uncontrolled severe bleeding disorders. Care should be taken to avoid certain points in patients using anticoagulant medication. Needles that are left in place for any length of time, such as the press needles, are unsuitable for people who have an increased risk of infection.