For many patients, acupuncture embodies the essence of alternative medicine. The practice is looked at as an exotic and mysterious form of healing from a distant part of the world. In truth, acupuncture is an ancient therapy, with Chinese descriptions dating back as far as 300-200 B.C. As a test of time, acupuncture continues to be used in small villages, as well as major medical centers throughout the world.

Doctors and patients not familiar with acupuncture are commonly surprised to see that sticking needles, with no medicine on them, into the body has any positive effect. People want to know how it works. Mechanisms of acupuncture have been studied in various medical centers throughout the world. Since it’s used to alleviate such a wide array of problems, the truth is, it works through so many different mechanisms, we don’t understand them all yet.

Traditional Chinese medicine has, for millennia, suggested acupuncture is the tool needed to balance qi (or chi, pronounced “chee”) in the body. Qi is not well-defined in Western medicine, though it’s generically correlated with energy. As research better outlines how acupuncture works in Western medicine studies, we might be able to find common ideas between current understandings and ancient teachings.

Historically, acupuncture has been used to treat a buffet of conditions, so when patients ask me if it can help, my quick answer is, “of course.” In truth, acupuncture offers a tool to help where conventional treatment has not succeeded, or needs a boost. A National Institutes of Health consensus panel concluded that acupuncture held promise for a variety of conditions including vomiting following chemotherapy, dental pain, muscle pain and fibromyalgia, headache and lower back pain [Source: JAMA]. Patients commonly seek acupuncturists for pain, often when medications and other procedures have failed. Infertility is another condition that leads patients toward alternative options. Acupuncture has been shown to increase sperm count and even improve outcomes of in vitro fertilization [Source: Siterman, Dieterle]. Like nearly every other modality available, patient experiences vary.

Those not familiar with acupuncture often wonder what to expect. The doctor will take a history and perform an exam. This information will help determine which points on the body will best treat the given condition. Interestingly, points on the body used are not always located directly against the problem area. For example, pain in the lower back might also be helped by needles in the knee and ankle areas. Once the points are decided, the practitioner will allow the patient to get into a comfortable position and then they will begin the treatment. Any discomfort from the needle is usually just for a few seconds. If the pain lasts any longer, the needle can be removed and replaced. The patient will rest with the needles in place for 10-20 minutes (time of treatment varies). The needles are then removed.

The day of the treatment, patients may feel relaxed or even a light sense of euphoria. Those treated for pain conditions can feel anything from quick pain relief to an aggravation of symptoms. Any aggravation will likely be followed by improvement of pain over the next 24-36 hours. Repeat treatments may be done later in the week depending on the condition and needs of the patient.

Acupuncture is typically tolerated very well. The needle is extremely thin since fluid does not have to be transported through it. Pain associated with the placement of the acupuncture needles varies on the site of the body. Points done on the back, shoulders, arms, legs and abdomen generally carry much less sensation than the face or hands.

Mild side effects include occasional bruising at the site of entry, fainting or light-headedness. These are rare and short-lived. More serious side effects include puncture of a vital organ (including the lungs) or skin infection. Skin infection is rare but treatable. Puncture of an internal organ with an acupuncture needle would be extremely rare in the hands of an experienced practitioner, but still a side effect of which you should be aware.

Currently, nearly all practitioners in the United States use disposable needles. This means the needles are used only once, eliminating the possibility of HIV or hepatitis infection. Patients should always ask if they’re unsure if their practitioner uses sterile, disposable needles. Patients should also feel free to ask a practitioner’s training and experience with a given condition. Sites such as medicalacupuncture.org are available to find a local practitioner.