Pain expert Dr. Scott Fishman answers questions about back pain:

Q: My doctor has recently suggested acupuncture. Is acupuncture safe and will it really help?

A: Acupuncture is one of the most time-tested treatments known to mankind. If the value of a treatment were based solely on how long it has been around, and how long people have thought that it was helpful, then acupuncture would probably be the most effective treatment known to humankind. Nonetheless, we still do not know why acupuncture works, how it works best, and for whom it is best used.

Many patients advocate acupuncture as a very effective treatment for many different symptoms. These symptoms include pain from a variety of causes, as well as many other conditions including nausea, smoking cessation, problems with addiction, inflammatory conditions, possibly even anxiety and depression, to name just a few.

There are many different forms of acupuncture. One form of acupuncture completed by one acupuncturist may be quite different than another, and any given practitioner may perform the acupuncture differently than another.

Typically, acupuncture is performed with a very thin needle that causes gentle sensations. It is usually not painful. Classically, acupuncture involves using a needle - although sometimes electricity is passed through the needle, and sometimes the burning of traditional Chinese herbs is employed as well. Burning these herbs is called "moxabustion."

The points that are used for the needle insertions often are at a distance from the actual area of symptoms. So, if someone has pain in their back, they may be getting needles in their feet, their ears or somewhere else distant from the actual site of the pain.

The special points that are chosen for needle insertion are along areas called "meridians." These meridians relate to what the Ancient Chinese felt were true "organ systems" and guide the placement of the acupuncture needles." However, these "organ systems" are not necessarily the same kind of systems that are defined as traditional organ systems by 21st century physicians. For instance, the traditional meridians for the spleen may have nothing to do with the actual organ that we know of today. An acupuncturist traditionally diagnoses a patient's problem by feeling three pulses on each wrist. In some cases, these diagnostic indications determine which ancient meridians are and are not diseased.

Taken all together, acupuncture is an ancient, time-tested form of therapy that seems to have exceptionally few side effects and appears to be safe for pain management. At present, however, it continues to be of unproven value for pain management in scientific circles. In my experience, many patients have found relief from pain through acupuncture. For those of my patients who have not found relief with standard medical therapies, I am always open-minded to any kind of treatment that will help, particularly those that have the fewest side effects. Thus, I embrace acupuncture. I look forward to revelations through science that better explain how it works and how it may be best applied to fight the war on pain.