What conditions can be treated with acupuncture?
In theory, any health condition can be treated with acupuncture. However, to be considered effective in modern western medicine, a treatment must meet certain conventional standards. Many of these conventions are different than the standards that developed in the culture of Traditional Chinese Medicine. In recent years, TCM treatments are gradually being documented according to Western Medicine conventions so that more Western-trained medical professionals are comfortable with reviewing and recommending them. The most widely used reference of conditions that have been evaluated according to western medicine conventions was compiled by the World Health Organization (WHO).
What is acupuncture?
“Acupuncture” means the medical procedure of inserting needles through the skin or mucous membrane, with or without electrical stimulation applied, at one or more specific points, without the injection or withdrawal of any substance, to affect a therapeutic and/or analgesic response in a patient, with the intent to stimulate the neuroendocrine system (Ref 1).
In TCM, disease or health problems are an imbalance in the primary force in life, called “Qi” or “Chi” (pronounced chee), which flows in meridians (pathways or channels). To restore the balance, we influence the flow of Qi by stimulating points along meridians by inserting needles or applying heat (moxibustion), pressure (acupressure),electrical currents (electroacupuncture), laser (laser acupuncture), etc.
How do I choose an Acupuncturist or TCM doctor?
Most people are referred to an acupuncturist or TCM doctor by someone who knows the practitioner already, either an acquaintance or a health practitioner. Note that a TCM practitioner or TCM doctor usually has training in the full range of TCM theory and practice including basic treatments of Acupuncture, Moxibustion, Cupping, Herbal Medicine, and Tuina (acupressure). Some practitioners specialize in just one of these disciplines, but will still have the background in TCM diagnosis, treatment principles and differentiation. An Acupuncturist practices acupuncture and may or may not have training in TCM theory and other practices.
If you do not have a referral, there are several things that may help you decide.
- In a few locations, some practitioners have advanced training and experience in specific areas; these people will usually advertise such training. In Canada, the majority of practitioners are general practitioners, rather than specialists. Even if you have a very specific concern, most TCM doctors and many acupuncturists may be able to address it, at least initially.
- Some health professionals such as physicians, dentists, physiotherapists and chiropractors have taken specific acupuncture training to complement their principal practice [see next section], and may be able to provide very specific treatment if they already know your health history.
- In five provinces, acupuncturists must be licensed by a government or government-designated body [see next section]. In two provinces, TCM practitioners must be licensed. These designations tell you that the practitioner has met minimum standards of competence and that they must continually advance their professional ability through continuing education. In other provinces, some practitioners voluntarily undertake licensing exams and requirements. Be careful to distinguish the designations of “R.Ac.” or “L.Ac.” [see next section] from non-regulatory organization designations.
- Your own experience may be the final way to choose. You should feel comfortable with your practitioner. Every practitioner has their own approach and may emphasize different aspects or have different techniques in communication, assessment, and treatment. Many practitioners will consult with other practitioners or health professionals, and even refer you to someone. It may take several treatments before you notice any improvement in your condition; if there is no improvement after regular treatment for six months, your practitioner should refer you elsewhere, or try a different approach.
How are Acupuncturists licensed?
In Alberta, BC, Ontario, Quebec, and Newfoundland, an “Acupuncturist” must meet government standards in training and professional exams. They must also maintain their license registration annually. Registered or Licensed acupuncturists can write “R.Ac.” or “L.Ac.” after their name. Other health professionals such as physicians, dentists, physiotherapists and chiropractors might use acupuncture according to their professions’ codes but are not “Acupuncturists” unless they meet government requirements.
In Saskatchewan, there is no government acupuncture legislation (2024), so in theory, anyone can practice without any qualifications. In reality, it is difficult to run an acupuncture practice with no training at all. Most practitioners have been screened by some organization at some time in their career. The difference between practitioners is often in the standards and requirements of their screening organization.
Are there side-effects or risks from acupuncture?
Needling produces potential contact with blood. The risk of blood-borne diseases requires advance protection. The main way to eliminate infection risk is with pre-sterilized needles. We use only single-use disposable needles made of stainless steel or surgical stainless steel, pre-sterilized with ethylene oxide. When there is risk of bleeding, we use standard disinfection, prevention and control precautions and procedures.
Acupuncture may produce temporary discomfort or sensations such as pricking, distention, small bruises, slight bleeding, mild electric shock-like sensations, local warmth or cold, or sensation of numbness, tingling or movement under the skin. These are normal, and usually subside a few moments after the needle is in, or soon after withdrawing it. If bruising occurs, it usually subsides in 2 to 3 days.
Contact your practitioner if any uncomfortable sensations worsen, or have not decreased after a few days. Do not hesitate to contact your practitioner or physician if you have any concerns about the treatment you received.
In some cases, symptoms might worsen before noticeable improvement begins. This may last two to five treatments. To avoid this possibility, some patients may choose to work only on temporary relief at first rather treating the underlying conditions.
A survey of 1100 practitioners (Ref 3) listed adverse events encountered per practitioner year (py). Those commonly due to acupuncture include fainting (1 per 7 pys), nausea, vomiting, and increased pain. Serious adverse events included pneumothorax (1 per 12 pys) and convulsions (1 per 11 pys). Although the data may underestimate frequency, there seem to be significantly fewer adverse reactions in TCM than in Western medicine.
Does acupuncture feel like getting a needle?
Getting a needle at the doctor’s office is a very different than acupuncture needling. Hypodermic needles are hollow with a sharp cutting end. They cut through skin and blood vessels to inject or remove fluid. Cutting hurts because these tissues have many nerves that react to painful stimulation. Also, blood that leaks from the vessels cannot drain away quickly (called a bruise) which puts pressure on the surrounding tissues causing more discomfort.
Acupuncture needles are different. They are slightly rounded to push past blood vessels instead of cutting through them. They rarely cause bleeding, and are generally 2 to 3 times thinner than hypodermic needles. Acupuncture needles usually cause much less feeling than regular needles. Many people don’t even feel them go in. Click here to learn more about Does it hurt?
In some cases, the practitioner may stimulate or manipulate the needles to produce a strong sensation, which is usually uncomfortable for a very brief moment. The practitioner may describe the sensation to you in advance so that you are less startled (although some people prefer not to be told). This stimulation is usually required in very serious conditions, or in conditions that can be improved rapidly with strong treatment.
How long does an acupuncture treatment take?
Treatments may last 10-20 minutes or as long as 90 minutes depending on the practitioner and the condition. Most treatments are 45-60 minutes. Treatment for acute conditions, like muscle sprain, sudden headache, etc., usually take less time than for chronic problems.
References
1 The Medical Profession Act, 1981 (Sask). THE SASKATCHEWAN GAZETTE, PART I, No. 31 Volume 92 REGINA, FRIDAY, AUGUST 2, 1996
2 Ernst E, A. White. 1999. Acupuncture: a scientific appraisal. Oxford: Butterworth Heinemann.
3 Barrett B, D Kiefer and D Rabago. 1999. Assessing the risks and benefits of herbal medicine: an overview of scientific evidence. Alternative Therapies 5(4):40-49.