How does acupuncture work?
Acupuncturists use very fine needles inserted into certain areas of the body where there may be stagnation or imbalance in order to assist the natural flow of energy and restore the body to a state of harmony.
When one encounters an explanation of acupuncture and Traditional Chinese Medicine (TCM), they may come across the terms Qi, Yin and Yang. Qi is a conceptual description for all forms of energy. In relation to health and medicine, Qi can be considered an overall term for the state of all physiological process in the body. Yin and Yang are representations of balance on either end of the spectrum. Yin represents the structure of the body but also entails aspects of the cooling, nourishing, feminine energy, while Yang represents the function of the body and entails aspects of warming, energising, masculine energy. The body requires both complementary forces to remain in balance as much as possible in order to maintain optimum health.
According to TCM, the body is comprised of an expansive network of energy meridians through which Qi travels through and is governed by the state of the body’s balance of Yin and Yang. So when there is blockage of Qi in the body, this may lead to a stagnation. Stagnation leads to pain and eventually disease. When there is an imbalance of Yin and Yang in the body, this causes a disturbance in the natural state of equilibrium which in turn leads to disease.
As acupuncturists, our aim is to promote the smooth flow of Qi within the body and bring body’s Yin and Yang back into balance. We do this with the use of very thin needles inserted at specific areas of the body identified as acupuncture points. Stimulating these points brings activity to the area which helps to remove stagnation, or to balance Yin or Yang. While each acupuncture point may have it’s own specific actions, each treatment is tailored to the individual so an acupuncture point prescription for one person may be different for another.
We take many factors into consideration when determining an appropriate treatment plan and acupuncture point prescription. These may include dietary intake, amount of activity or exercise done during the week, mental cognition and emotional state, quality of sleep and overall general lifestyle. All of these factors play a role in a persons health, not just the absence of pain or physical disease.
The balance of Yin and Yang is a concept best known today in medicine as homeostasis: the tendency towards a relative state of equilibrium in the physiological processes of an organism. The acupuncture meridians or channels can be compared to the cardiovascular, lymphatic, nervous and muscular systems of the human body, as well as the fascia network that connects all structures within the body. All of these systems may be stimulated by acupuncture as a response to the insertion of the needles in order to promote that natural healing process of the body.
What can acupuncture treat?
The following lists are taken from the Acupuncture Evidence Project (McDonald J, and Janz S, 2017).
You can download the Plain English Summary or full document (81 pages) from the Australian Acupuncture and Chinese Medicine Association Ltd (AACMA) website here.
Summary of Findings 1: The following lists summarise the effectiveness of acupuncture for various conditions.
1. Conditions with strong evidence supporting the effectiveness of acupuncture
Reviews with consistent statistically significant positive effects and where authors have recommended the intervention. The quality of evidence is rated as moderate or high quality.
– Allergic rhinitis (perennial & seasonal)
– Chemotherapy-induced nausea and vomiting (with anti-emetics)
– Chronic low back pain
– Headache (tension-type and chronic)
– Knee osteoarthritis
– Migraine prophylaxis
– Postoperative nausea & vomiting – Postoperative pain
2. Conditions with moderate evidence supporting the effectiveness of acupuncture
Reviews reporting all individual RCTs or pooled effects across RCTs as positive, but the reviewers deeming the evidence insufficient to draw firm conclusions. The quality of evidence is rated as moderate or high quality.
– Acute low back pain
– Acute stroke
– Ambulatory anaesthesia
– Aromatase-inhibitor-induced arthralgia
– Asthma in adults
– Back or pelvic pain during pregnancy
– Cancer pain
– Cancer-related fatigue
– Craniotomy anaesthesia
– Depression (with antidepressants)
– Dry eye
– Hypertension (with medication)
– Irritable bowel syndrome
– Labour pain
– Lateral elbow pain
– Menopausal hot flushes
– Modulating sensory perception thresholds
– Neck pain
– Perimenopausal & postmenopausal insomnia
– Plantar heel pain
– Post-stroke insomnia
– Post-stroke shoulder pain
– Post-stroke spasticity
– Post-traumatic stress disorder
– Prostatitis pain/chronic pelvic pain syndrome
– Recovery after colorectal cancer resection
– Restless leg syndrome
– Schizophrenia (with antipsychotics)
– Shoulder impingement syndrome (early stage) (with exercise)
– Shoulder pain
– Smoking cessation (up to 3 months) – Stroke rehabilitation
– Temporomandibular pain
For more information, please click
here to view the website for the Australian Acupuncture & Chinese Medicine Association.
What is the recommended number of treatments?
At a glance…
Every person is different and so every condition is unique within each person. While acupuncture is extremely effective, it is still tailored to treating the health of the human body which is determined by systems that take time to readjust and return to balance.
There are a wide range of factors that determine the amount of time and treatments required for any patient’s condition. Time and severity of the condition play a big part in determining the length and extent of your treatment plan. If the condition is less severe and has only been present for a short amount of time, then a faster recovery time is more likely. With chronic and more severe conditions, weeks or perhaps even months of consistent treatment may be required in order to get you back to feeling your best or for the condition to be manageable.
In the case of musculoskeletal conditions, 2 weekly treatments for at least several weeks are generally advised in the initial stages to gain momentum and see results before spacing the treatments out to once per week/ per fortnight/ per month. This is only a general guideline as a treatment plan will depend on the patient’s response to each treatment and can be tailored to what suites your circumstances. While it is not uncommon for a fair degree of result to be seen either instantaneously or in the hours or days following the treatment, the effects of acupuncture are accumulative, so sticking with your treatment plan is recommended in order to obtain the best results from any treatment.
On a deeper level…
In cases of muscle injury, there are 3 phases following an injury that the body undertakes in order to achieve full recovery of the muscle (1). These are the degeneration phase (1-3 days), regeneration (3 – 4 weeks) and remodelling (3 – 6 months) (2). It is during the regeneration phase where much of the important processes occur as a result of a cascade of activity that includes cells, proteins, and chemical mediators in what is known as the extracellular matrix to activate the repair process (3).
Research has determined that certain cellular components within this process are triggered to undergo remodelling with acupuncture (4) and that mechanical stimulation by acupuncture needle activates many of the cellular structures involved in structural formation of muscle and connective tissue (5). The total length of the regeneration phase can be critically influenced by the duration and intensity of the initial inflammatory response directly following the muscle injury (6). This is why it is best to begin treatment as soon as possible following an injury in order to assist the body’s natural mechanisms and ensure the best healing outcome.
Considering the length of these phases, we see that it can take considerable time for the body to repair itself completely from an injury. While the process can be assisted and potentially sped up with acupuncture as well as providing effective pain relief, we are still at the mercy of physiological process which means that providing an exact time limit for recovery can be difficult.
While there may be expectation as to how each individual responds to acupuncture, remember that everyone’s body is different and so will respond accordingly. Other factors that play a role in response to treatment are age and and general health of the patient. What you do after your treatment also has an effect on how well you respond. The more you can do post-treatment to complement the acupuncture, the better your results will be. This may include performing assigned stretches, or using prescribed herbs or liniment to support the acupuncture, or not exerting yourself in the time following the session which may undo the treatment.
Like all things in life, healing is a process that takes time just like everything else and miracle cures should not be expected in one session.
Garg K, Corona BT, Walters TJ, 2015, Therapeutic strategies for preventing skeletal muscle fibrosis after injury, Frontiers in Pharmacology, Vol. 6, No. 87, PMC, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404830/, viewed 26 July 2016
Langevin, H, Bouffard, N, Badger, G, Churchill, D & Howe, A 2006, Subcutaneous Tissue Fibroblast Cytoskeletal Remodeling Induced by Acupuncture: Evidence for a Mechanotransduction-Based Mechanism, Journal of Cellular Physiology, Vol. 207, pp. 767 – 774, www.ebsco.com, (accessed 5 July 2016), p.769
ibid, p. 770
Garg et al. loc. cit.
How much does it cost?
We provide on-the-spot health rebates for most major funds. Concession rates available at a 25% discount.
Initial Consultation/ Extended Follow Up – $120.00 – Allow 60 minutes
During this consultation a comprehensive history of the condition will be taken. Details may include dietary information, quality of sleep, general well-being etc. to gain a clear picture of the condition and determine the most appropriate treatment. Palpation of sore or injured areas, range of motion or mobility tests may also be involved.
Along with acupuncture, other techniques may be incorporated in order to obtain the best result from your treatment.
These may include:
• Electrical stimulation of the acupuncture needles (TENS machine)
• Cupping Therapy
• Gua Sha (scraping)
• Tui Na (Chinese remedial massage)
Follow Up Consultation – $90.00 – Allow 45 Minutes
During this consultation, the presenting condition will be reassessed in order to tailor the ongoing treatment, as well as to address any other aspects that may need attention.
Variations of these services are available.
What other treatment options are available?
Below is a list of other practices your practitioner may use in your acupuncture treatment in order to obtain the best outcome.
Tui Na – Chinese Remedial Massage
Based on the same diagnostic system and using the samepoints as acupuncture, Tui Na acts as an effective adjunct therapy to any acupuncture treatment. Employing a comprehensive system of techniques and varying pressures, Tui Na is an effective form of medicine even just on its own. When combined with acupuncture, the strength of the treatment is increased and often provides more effective results for most conditions, particularly for musculoskeletal conditions, pain, stress and digestive disorders.
This employs the use of a TENS (transcutaneous electrical nerve stimulation) which is connected to the handle of the acupuncture needles to send a mild current into the the body. As our body’s naturally operate by a system of electrical signals, this is extremely effective for a wide range of conditions and can provide a more effective treatment than just the needles alone. Different aspects of the body such as neurotransmitters, chemical receptors, central and peripheral nerves all respond to different frequencies of electrical signals. The TENS machine can therefore be set to the corresponding frequencies depending on the type of condition being treated for a more effective response.
Heat therapy is employed in acupuncture by the use of a traditional burning herb known as ‘Moxa’. Traditionally a mix of fermented mugwart, these days a smokeless charcoal version is often used. The application of heat to any region of the body improves circulation and promotes the healing process, particularly if there are regions of the body that harbour stagnant energy or are affected by cold. New research also shows that heat application stimulates heat shock proteins (HSP) that promote healing and regeneration of tissues. Moxa in various forms has been an integral part of acupuncture throughout history, so much so that the word for acupuncture in Chinese actually translates to “acupuncture-moxibustion”.
Otherwise known as myofascial decompression, glass cupping is the practice of generating suction between a special glass cup and the skin to release tightness in the muscles and layers of fascia. Aside from being a highly effective tool for promoting health, cupping can also be an enjoyable and relaxing experience. It may also be combined with massage oil to allow the cup to slide over the body for a more therapeutic effect. It is particularly effective for muscle and joint conditions, however is also used for a wide range of other disorders such as the common cold, upper respiratory tract infections, and even Bell’s palsy. It is common to be left with red to dark purple bruise-like marks from the cupping, however they are not painful in the same way.
Gua Sha – Scraping
A special piece of polished bone or ceramic spoon is rubbed repeated over areas of the body to increase circulation and release heat and toxins. Used frequently in Traditional Chinese Medicine on the back of the neck to treat the onset of colds and flues. Scraping generally leaves red marks of the area being treated. This is seen as a positive response from the body for releasing heat and toxins, and moving stagnant energy.
Dermal Hammering – 7 Star/ Plum Blossom Needle
This involves the use of a device that resembles a small hammer with a slender and flexible handle and 7 small needles on the contact end. It is used in a similar fashion to a hammer with a flicking motion to very quickly and lightly stimulate regions of the body and the surrounding acupuncture points. The multiple needle points increase the surface area of contact while dispersing the piercing sensation. This allows for greater coverage with less pain intensity and is great for treating chronic skin conditions, febrile disorders, paresthesia, or decreased sensitivity such as what can occur with some neurological disorders.
Blood letting is a ancient practice belonging to many of the world’s first cultures. It is also thought to be one of the original practices that gave rise to the concept in Chinese Medicine of ridding the channel of stagnant energy.
Today the practice is still taught to acupuncturists who study Traditional Chinese Medicine and can be highly effective for reducing the severity of certain conditions. In particular, any condition that is seen to have a great deal of heat such as fever, heat stroke or itchy and angry rashes, letting a few drops of blood from certain points can be highly effective for reducing the intensity.
For those interested in treating varicose veins or spider veins, releasing the pooled blood from the sight is effective for reducing pain, discolouration, as well as the prominence of the vein. The standard treatment consists of piercing the vein with a very fine lancet and squeezing out the old blood. The blood that is released from varicose or spider veins is usually viscous and very dark in colour due to having less oxygen and minimal circulation. For more productive results, a pressurised glass cup can also be placed over the area.
While blood letting does not rid the body of the compromised veins, it helps to reduce the build up of pressure and may delay the need for surgery.
Is acupuncture safe?
At a glance…
As a form of medicine, acupuncture is very safe when delivered by a qualified and experienced acupuncturist. Please be sure to enquire before you receive acupuncture that your practitioner has the correct qualification and is registered with the Australian Health Practitioner Regulation Agency (AHPRA).
Sterilised, single-use surgical stainless steel needles are used in every acupuncture treatment.
Following an acupuncture treatment, it is possible however uncommon that you may experience tenderness, minor bleeding or bruising at the needle site as a result of puncturing the skin. While all efforts are made to prevent this, sometimes this is unavoidable. It is possible that you may feel light-headed or dizzy after a treatment, emotional, calm or content.
If glass cupping or Gua Sha is used, bruising marks may be left on the skin for several days up to a week depending on the strength of the treatment. These marks are often only aesthetic and do not feel like regular bruising.
On a deeper level…
Quite often, the circumstances you hear about of patients ending up in severe pain or with punctured organs are in fact NOT caused by acupuncturists, but rather other physicians that use acupuncture needles in their treatments and do not have the level of skill or training required.
This is as a result of a lack of regulation on the supply of acupuncture needles and the ease by which certain physicians are able to complete a dry needling course in Australia. For more information about dry needling, please click on the “What is the difference between acupuncture and dry needling?” tab.
Today acupuncture and Chinese Medicine are one of the 14 registered health professions under AHPRA. As of July 1st 2012, all acupuncturists and Chinese Medicine doctors must be registered under the national registration and accreditation scheme with the Chinese Medicine Board of Australia and meet the Board’s Registration Standards, in order to practise in Australia.
In order to become an acupuncturist in Australia, you must have completed a Bachelor of Health Science majoring in Acupuncture. This is a 4 year degree, that in it’s most recent course review as offered by Endeavour College of Natural Health, has students perform no less than –
80 hours of point location
120 hours of therapeutics
550 hours of supervised clinic practice
This is only the practical component of the entire bachelor degree that we must complete before we may graduated and be registered with AHPRA. This means that as an acupuncturist in Australia, our knowledge of the anatomical structures of the body when it comes to needling is of the highest standard. For your own safety, please be sure to enquire before you receive acupuncture that your practitioner has the correct qualification and is registered with AHPRA.
Does acupuncture hurt?
Does it hurt?
Acupuncture can elicit a wide range of sensations and generally the insertion and stimulation of the acupuncture needle is not supposed to be painful. Everyone’s body is different however, as is their perception of physical sensations and pain. As acupuncturists, we do our best to make the experience as comfortable as possible, however a person’s experience of pain can depend on their individual pain threshold, what we are treating and in which area. If you have a fear of needles or a very low pain threshold, I make sure to spend the time to guide you through the process with deep breathing, and most of the time, people generally find the experience to be enjoyable after they overcome the fear of the first needle.
The acupuncture needle
Before having acupuncture, a common thing for people to say is that they don’t like needles or they think that it may hurt because they are comparing it to a needle at the doctor’s. The usual gauge of an acupuncture needle is 0.2 – 0.25mm in diameter which is incredibly thin. Compare this to the average gauge of a hypodermic needle generally used to draw blood which is around 0.8mm (aver 3 times the thickness). It may seem small, however this is a big difference when we are talking about piercing the skin.
The other great difference between the two types of needles is that hypodermic needles are hollow so that they can inject or draw out fluids. This means that the needle literally cuts through the flesh and vein walls in order to reach its target. Acupuncture needles are labelled ‘filiform’, meaning thread-like, and have a rocket-tipped point that separates the flesh rather than cutting it. This means that more of the surrounding structures remain in tact and the usual pain response is not elicited.
This is why for most part, the piercing of the acupuncture needle could be compared more to a mosquito bite rather than a needle. This is also why most of the time there can be little to no bleeding when the needle is removed.
What does it feel like?
The sensation of acupuncture may differ for each person, however what we are aiming for at the point of insertion can be dullness, pressure or heaviness; warmth or other changes in temperature; tingling or sensations of numbness. This is the sensation known as the ‘De Qi’ or ‘Qi’ response that we are aiming for and is part of your body’s natural response to the needle.
You may also experience sensations that travel from the point of insertion along the acupuncture meridians to other parts of the body as the channel is activated. These may be electrical in sensation due to activation of the nerves or nervous tissue in the area and is a completely normal and safe response to acupuncture. It is also quite common to feel a sense of calm, relaxation, or even a kind of ‘high’ after a session of acupuncture.
Overall the experience is NOT meant to make you feel too uncomfortable, and if you are experiencing pain or discomfort of any kind during an acupuncture session, you should notify your practitioner straight away so they can adjust or remove the needle. In saying this, we are literally piercing the body’s skin with a sharp object, so of course, a completely pain-free experience can not be entirely guaranteed. Some people are more reactive to this than others and a wide range of sensations may occur from strong stimulation of the point, to feeling nothing at all.
After the needle is inserted, acupuncturists stimulate the needle with certain techniques depending on what the condition may require. These techniques usually involve either up and down motions or rotating motions. These motions stimulate the tissues under the skin and activates what we refer to as the ‘De qi’ response which lets us know that the point is ‘activated’. This can be felt as warmth, heaviness, pressure, dullness, or tingling. This response is due to the activation of C fibres beneath the skin which is what is to believed to be one of the mechanisms of action for how acupuncture works.
When your body registers pain or noxious sensations in the external environment, it does so via the use of A-Delta nerve fibres which rapidly transmit localised pain to the brain to make you aware that that part of the body may be in danger. It is the built-in defense mechanism in your skin which covers your entire body. Beyond this protective layer in the muscles and organs, C fibres are then responsible for transmitting sensations. C fibres transmit signals as diffuse, dull pain and they travel at a much slower rate and so our perception of pain in these regions is considerably different to that of the surface of our skin. This is the reason why after the initial prick of the skin, acupuncture does not necessarily hurt so much as it does elicit a dull, heavy, or warm sensation.
What is the difference between acupuncture and dry needling?
Dry needling or myofascial trigger point therapy is the practice of releasing nodules within the muscles known as trigger points in order to treat pain associated with injuries.
It is called dry needling because unlike the purpose of a hypodermic needle, there is is no exchange of fluids in our out of the needle point. This term has been used as a way to disguise what is actually one of the many techniques used by acupuncturists, so that it can be taught to and used by practitioners who are not.
On July 1st 2012 in Australia, the term ‘Acupuncturist ‘ became a protected title when all accredited acupuncture practitioners became registered under the Australian Health Practitioner Regulation Agency (AHPRA) along with other nationally registered health professions such as medical practitioners, nurses, dentists and pharmacists etc. This now meant people without the adequate skill or training would not meet the strict requirements of the Chinese Medicine Board of Australia under AHPRA, and could not call themselves acupuncturists.
Practitioners in other fields can still undertake short courses in training to use the exact same needles as used by acupuncturists but without anywhere near the same amount of training. This can often lead to adverse reactions when points are overstimulated or attempts are made to release trigger points when it is not even necessary, or worse still, piercing of vital organs due to inadequate knowledge of human anatomy in relation to needling sites on the surface of the skin.
Acupuncture is very safe when administered by a well-trained practitioner. Complications and serious injury are not a result of acupuncture, but that of poorly trained practitioners with inadequate training and practice.
In order to become an acupuncturist in Australia, you must have completed a Bachelor of Health Science majoring in Acupuncture. This is a 4 year course, that in its most recent course review as offered by Endeavour College of Natural Health, has students perform 120 hours of practical needling classes before we are even allowed to treat a member of the public, and then a further 550 hours of training in a supervised student clinic. Only after this are we accepted by AHPRA as competent practitioners before you come to see us in our practice.
The top search results that appear when you search for a dry needling courses in Brisbane displays courses that may take you up to 2 weeks or just 12 hours to complete before being able to perform dry needling on the public.
One course boasts, “You’ll be practicing within 30 minutes of arriving at your course”, and then 12 hours of practice later, you are all set to treat your patients.
This is available for anyone who holds an accreditation in the following fields:
Remedial massage therapist
Granted these practitioners are registered professionals in their own field, however in my opinion, it takes more than 12 hours or even 2 weeks to gain an understanding of the dexterity and sensitivity required to wield a needle in such a way as to gain optimum therapeutic effects with little pain or discomfort. Trigger point release is just one of the many techniques that acupuncturists are qualified to treat as well as taking into consideration the root cause of the problem in order to determine the best treatment approach.
So if you are seeking pain relief, do yourself a favour and search for your local acupuncturist. We cover “dry needling” and every other needle technique you can think of to obtain the best results for what your body needs.