What Is Acupuncture, 
What Are The Facts and
How Can it Help You??


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What is acupuncture? What is this strange Chinese therapy that uses tiny pins and is the centre of so much attention?

Is it like tattooing, or body piercing, or some strange self-immolation?

Relax! Acupuncture is now at least 2500 years old, possibly far older. It’s been used in most countries worldwide for at least fifty years and why it works and its benefits are under intense scrutiny and scientific research.

The World Health Organisation (WHO) takes it very seriously and has published numerous papers about it.

WHO has also published a standard acupuncture classification, and a list of diseases for which it regards acupuncture as being appropriate. (More on this below.)

So, what happens when you have acupuncture?

After you've had your consultation and your acupuncturist has decided what to do, explained it and received your permission...

... thin, flexible, non-hypodermic, usually steel needles, sterilised before use, are swiftly and almost painlessly inserted into what are called acupuncture points on the skin.

For most people the sensation of insertion is minimal. About as sore as plucking out a hair: often people feel nothing.

The needle is inserted to whatever depth is necessary. There's a considerable theory about choosing the appropriate depth for a given condition, but in Chinese medicine the aim is usually to obtain what is called 'deqi'.

Once 'deqi' is obtained, this needle 'sensation' shows that the treatment has begun, and then, by manipulating the needle in various highly skilled ways, the 'energy' in the point is then 'dispersed', reinforced', 'tonified', or directed along the channel of acupuncture on which the acupuncture point lies.

Let's cover all that in more detail

Needles! How thin are they? This varies because shorter needles don't bend so easily so can be thinner. Widths usually vary between 0.15mm and 0.40 mm.

How long are the needles? Well, only as long as is necessary to reach the appropriate place, the acupuncture point, where it lies under the skin: see below.

Typically acupuncture needles are between 1 cm and 3 cm but can be much longer and for certain purposes are much shorter. The longest I use is about 150mm but acupuncturists can buy longer ones. The one I use most is about 20mm long, not far off an inch in length.

'Non-hypodermic' means that an acupuncture needle has no hole running down its centre, so it can't be used to inject people with anything: no use to drug-takers then. Acupuncture needles are also flexible which means they don't splinter, crack or break in normal use.

'Usually Steel' means that most acupuncturists don't use gold, copper or silver needles - let alone needles made from wood or stone! What is acupuncture nowadays is becoming very different from what it was in times long past.

Steel is cheapest, doesn't rust, bends easily and can be heated safely without melting. However, some acupuncturists believe there are particular benefits from using gold and silver needles, as used for example in some applications of Korean Hand and Japanese acupuncture.

'Sterilised before use'. Until the late 1990s, in most countries acupuncture needles were re-usable, after they'd been cleaned and auto-claved (an autoclave is a pressure cooker that raises the temperature to well above water's normal or sea-level boiling point, so killing any pathogens that remain on the needle).

Increasing awareness of the spread of potentially temperature-resistant pathogens, and Prions (proteins connected with a variant of Creutzfeldt-Jakob disease - CJD - known as vCJD) which might lead to Mad Cow Disease in humans and which can't be destroyed in autoclaves, has led to the use of these sealed, pre-sterilised, packs of needles.

Nowadays, acupuncturists mostly use needles that have been cleaned and sterilised by the manufacturer, who sells them in sealed packages to ensure freedom from pathogens. The package is opened only when the acupuncture treatment commences.

What do we mean by ‘insertion’?

The needle comes in various lengths and widths but rest assured, it’s sharp! - although not so sharp that its point is easily bent. Under the microscope, a good acupuncture needle has a tip that is smoothly rounded to prevent snagging.

Ah, we hear you say, but How Deep?

Good question!

It depends. In some places it might be hardly through the skin or just a couple of millimeters inside. In your buttocks it might be up to 3 inches or 75mms depending on how well built you are.

So ... are you thin, muscular or fat?

Bear in mind that the actual acupuncture point could be just under the surface of the skin, but in other places is at a depth. To do its work, the needle should make contact with the point, where it can manipulate it for your health.

The Effect of being treated according to Traditional Chinese Medicine
If your practitioner is working according to the principles and ideas of traditional Chinese medicine (TCM), then the acupuncture point will have been carefully chosen because of its effect according to TCM. It won’t be chosen merely because you have pain where the acupuncture needle is inserted: that might be a consideration, but it might not.

Don’t be offended if your acupuncturist doesn’t insert the needle where you think it should go! He or she started with years of training and extensive clinical supervision then followed it up with the school of worldly practical experience, possibly years of it.

In short, you may think you know what is acupuncture, but the individual treating you knows much more and wants to get you better as fast as possible. So let her or him make the best choice for you.

Isn't there an acupuncture point for my disease?
What you regard as being the name of your disease or condition might be explained in an entirely different way in Chinese medicine.

As it's the theory of Chinese Medicine that decides the treatment, where you have pain may or may not be where the needle goes.

Most of the acupuncture points normally used lie on acupuncture meridians. Some acupuncture points do not lie on meridians and are important because of their effect near the acupuncture point.

Many acupuncture points influence how your body and its energy functions, in addition to any effect they have locally. For example, there are what are called 'command' or 'five shu' points, 'front-mu' points, 'source' points, 'He-sea' points and so on.

These points may be some distance from where you have pain: indeed they might be the other end of your body!

They are used to try to put right the underlying problem which has led to your condition.

If you own a garden and it's summertime and dry, and all the leaves are turning pale and falling off your plants, you could cut off a stem and stick it in water. Better would be to water the earth under the tree so that moisture could be spread by its roots right up and into every leaf, carrying nutrients at the same time.

Just treating a painful spot with acupuncture is like taking an aspirin for pain when you don't know the cause. Like good doctors, acupuncturists are trained to look beneath the surface so they can try to correct the underlying problem.

In making a diagnosis in traditional Chinese medicine, your acupuncturist also reaches a decision about which acupuncture points will help you.

They may be a combination of points or a single point. Treating just a single acupuncture point is very elegant and can be very powerful, but it's often hard to do, especially when a combination of points might achieve the same effect.

How to Find the Acupuncture Point!

Training in what is acupuncture involves years of study of the actions of the acupuncture points and where they are and how to find them.

The positions of the acupuncture points are all carefully described in text-books, taught in lectures and demonstrated and tested in practical sessions.

However, fairly soon after completing training lots of acupuncturists forget the precise description because they’ve learned where to look, and the final place is selected by finger palpation and touch.

What is acupuncture means that your acupuncturist uses far more than just mental analysis: she or he also uses touch, smell, sound and sight to help decide what to do. She also assesses emotions. It makes what is acupuncture very fulfilling as an art and science.

After the initial consultation or discussion, and after your acupuncturist has decided and explained what she wants to do, the actual points to use are selected.

Beginners might mark the place with a cross (don’t worry, the ink washes off!) or by lightly pressing the finger nail into the area twice, in the form of a cross. Then the area is cleaned, the acupuncturist’s hands are washed, you are prepared (perhaps asked to lie down and get comfortable or to find an easy position in a chair), and using a hollow plastic tube the needle is inserted precisely where it’s needed.

The skin in the area may be lightly stretched while this is done, reducing the sensation, but most people feel hardly anything.

However, that’s just the beginning because the real start of what is acupuncture for you is just commencing. The acupuncturist is now very gently increasing the depth of the needle, searching for the 'energy' of the point.

This 'energy' is hard to describe but is a little like what happens when you take a sharp knife and cut through warmed butter. Initially it goes in easily, then as it touches colder butter inside it seems to encounter resistance and 'stickiness'.

'DeQi' - the Needle Sensation

At the same time you, the patient, often start to feel a sensation variously described as hot, or cold or full, or cramping or heavy or ... This is called ‘deqi’ – the needle ‘grabs’ the qi. (Or the qi grabs the needle!)

The sensation soon goes, though the area or limb can feel heavy for a while.

Once the ‘deqi’ sensation has arrived, the acupuncturist starts the treatment. So now you are really finding out what is acupuncture! He or she may twirl the needle, very slowly raise and lower it, tweak it or just leave it alone. It depends what needs to be done, and what is acupuncture treatment can involve a range of these motions.

After that, the needle is left in position for anywhere between a few seconds and half an hour. Acupuncture points are often used in combinations, together achieving far more than could a single point on its own. Learning what is acupuncture takes a while and acupuncturists develop their own strategies based on their own experience and that of others.

If she wants to use electro-acupuncture your acupuncturist will explain exactly how it works and what you’ll feel.

So now, you the patient are experiencing what is acupuncture. You are lying there (or perhaps sitting) with some needles inserted in various places, perhaps now with a pleasant sense of calmness. You probably feel pleasantly spaced-out.

Often you wake up twenty minutes later feeling wonderfully restored.

Alternatively, your acupuncturist, having done what is necessary, may remove the needles right away - by gently drawing them out, the shaft of the needle surrounded by cotton wool, pressing on the point to prevent or absorb any bleeding.

How does your acupuncturist know that your treatment has finished?

Often she knows because she has monitored your pulses at your wrist before and after inserting the needles. From the change in your pulses she knows that her treatment has done its job: the quality or size of all your twelve pulses has become more balanced.

'Twelve Pulses'?

"Twelve Pulses - I thought I had only one!

Yes, well... Your acupuncturist is taught to assess the pulse at your wrist in six different positions on each wrist, making twelve positions altogether. For convenience, they are called your twelve pulses, or 'your pulses'.

Either that, and/or she knows that it takes a while for the acupuncture needles to finish their work, and having allowed you your small siesta, during which what is acupuncture does its work, she can safely take out the needles and let you get up.

After use, acupuncture needles are usually discarded. They are put in a ‘sharps’ box, which is collected periodically under license and disposed of safely by the local authority. At least that's what happens in the UK where, until about 12 years ago, used acupuncture needles were cleaned and steam-cooked under pressure to kill all the bugs, but nowadays disposable needles must be used.

What happens to the discarded needles? They are put in a 'sharps' box which is disposed of under hygienic conditions - often by the local authority or a commercial firm.

The Sharps Box

But that’s not the end of it. By inserting those needles, your acupuncturist intends to change the metabolism of your body, to help it work more effectively and healthily.

If successful, you’ll feel benefits fairly quickly – sometimes within a few minutes, but usually beginning to take effect within a few days. I have many patients who report that the benefits arrive over a period of up to a week.

But if I've done a treatment specifically for great pain, they'll often notice results within five minutes of inserting the needles.

Come Back Soon!

If possible, return for a follow-up treatment within a week. In some cases you’ll need daily treatment, (which is what happens in China for example) but except in acutely painful or serious situations, weekly treatment is fine.

What if you feel so much better after one treatment that you decide not to return for another treatment?

Well, for one thing – congratulations!

But please, consider your acupuncturist, who is constantly learning more about what is acupuncture and its effects. She needs to know that the treatment you received was effective. She learns that way. (The same applies even if you feel no better, of course.)

But what is acupuncture goes further because generally if someone is ill, their condition has developed over time and there may be a number of things your acupuncturist plans to do to keep you well and to strengthen your system so it doesn’t get sick again. One treatment is seldom enough to achieve everything.

Acupuncturists lament the number of people who come once, think they’re cured and cancel further treatments, but then need to return to re-commence treatment once more, when a few more treatments might have raised their health to a level where they didn’t get sick so easily.

Seasonal, or Regular Treatments

Another side of what is acupuncture comes from regular, or seasonal, treatment. A few treatments spaced out over a year can often detect problems before they manifest and correct the imbalance that might have allowed them to develop.

Your acupuncturist likes to keep her patients well. That requires periodical treatments. It may be a small price to pay for health.

Acupressure

Using acupressure instead of acupuncture means your acupuncturist applies pressure in various ways to your acupuncture points and meridians. It can be very effective especially with children. (The Japanese form is called Shiatsu and practised on people of all ages.) Acupressure is used worldwide.

Background

What is Acupuncture is based on the theory of Chinese Medicine, so that, in principle, someone who receives a diagnosis from one practitioner of Chinese medicine (say an acupuncturist) could attend a practitioner of a different therapy in Chinese medicine (say, a herbalist) who would be able to proceed with treatment without further questions, if he or she trusted the diagnosis.

What’s her aim? To keep your ‘qi’ moving steadily. Why?

Daffodils for Spring
A little theory

 - for more on this click here! Traditional acupuncture relies on a theory of channels (meridians) and collaterals along which Qi is said to move. When qi moves steadily and without constraint there is health. When there is too little, or too much, or the wrong kind of qi, disease arises.

Also, the theory takes account of the seasons, as mentioned above. The treatment for someone in good health in Spring (hence the daffodils on the left) would be different at other seasons.

What is acupuncture treats this by influencing the flow of qi along the meridians, but also by its effect on the zang-fu, blood and fluids so that your qi is strong, helps manufacture good blood that can properly nourish all your body and mind, and defend you from illness. That’s health!

One thing more ...

Exactly what is acupuncture has expanded over the years to include a range of other techniques, all of them used by acupuncturists. And although I've told you about the most common form of acupuncture, there are other types which I use: in one of them, for instance, the 'deqi' sensation isn't needed at all! - because the healing process is thought to work using a completely different set of body responses.

Acupuncturists don’t just use needles. Find out about some of their other techniques, by clicking on moxibustion, cupping, gua sha, herbs, diet and nutrition, meditation and exercise.

What is acupuncture if it can't cure disease?

Well, here's a tricky question, because traditional Chinese medicine treats what it calls syndromes. These have wonderful names like Liver Qi stagnation,or Gallbladder Damp-Heat. If a disease in Western medicine can be categorised into its Chinese syndromes, then traditional Chinese medicine can treat it. But it treats the syndrome, not the Western-named 'disease'.

So, for example, take Anxiety. Anxiety in Chinese medicine has many possible causative syndromes as you'll read if you click on that page. Treat the wrong syndrome and there won't be much improvement. Treat the right syndrome, and the patient will improve.

But of course, we're Westerners, and all we want to know is whether what is acupuncture helps anxiety! Not all the background 'guff'.

The World Health Organisation and NICE

So, very helpfully, the World Health Organisation has gone through the huge amounts of research on acupuncture and its effects, and published what it's found. Read more about their criteria here. But just because your problem isn't listed don't assume that what is acupuncture can't help you!

It's quite possible that acupuncture can help you, but that the World Health Organisation hasn't seen research on it, or that the acupuncturists who get such good results for your problem are too busy to publish their findings.

In the UK there's another problem. See ASA for more about it.

However, NICE is beginning to accept that acupuncture works, as with low back pain, for example.


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If you live in the Edinburgh area of Scotland, where the author of this site (and of the books described below) works, click on Edinburgh Acupuncturist.

If you live elsewhere, click on BAcC.


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