For Patients

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Q: What is qi?
A: Qi (pronounced “chee”) is based on the ancient Chinese theory of the flow of energy. Qi and blood (xue) flow through distinct meridians or pathways that cover and fill the body, somewhat like the nerves and blood vessels. Open meridians are essential for optimal health.
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Q: How does acupuncture work?
A: Acupuncture treatment is rendered based on an Oriental medical diagnosis that includes an assessment of pulse quality, shape and color of the tongue, medical history and whole body evaluation. Following the diagnosis, acupuncture points are chosen on the body along acupuncture meridians, or pathways. Needle stimulation of these points increases the body’s healing energy or qi. The body has approximately one thousand acupuncture points.

Qi circulates throughout the body within the meridians, which also are related to the internal organs. Qi surfaces to the skin level at specific points. Good health depends on the smooth flow of qi. When the flow of qi is blocked due to trauma, poor diet, medications, stress, hereditary conditions, environmental factors, or excessive emotional issues, the system is disrupted. Illness is then generated. In accordance with ancient theory, acupuncture allows qi to flow to areas where it is deficient and away from areas where it is in excess. In this way, acupuncture regulates and restores a harmonious energetic balance in the body. There is a Chinese saying, “There is no pain if there is free flow; if there is pain, there is no free flow.”
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Q: How deeply are the needles inserted and what health benefits can I expect to be achieved?
A: Needle size and insertion depth depend upon the nature of the problem. Depths can be from 0.2 to 3 inches. Also taken into consideration are: the patient’s size, age, and constitution. Scientific research has discovered that acupuncture points show a variety of unique bioelectric properties. Stimulation of acupuncture points cause definite physiological reactions affecting brain activity, such as releasing pain-killing endorphins, influencing blood pressure, enhancing the immune system, balancing the sympathetic and parasympathetic nervous systems and enhancing the endocrine system. Most of all, acupuncture stimulates the body’s natural ability to heal itself, regain homeostasis, and maintain its relationship with nature.
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Q: Is there medicine on the needle?
A: No. It is the needle itself that initiates physiological changes and stimulates the movement of qi to cause a corrective change in the body.
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Q: Is acupuncture painful and what will I feel during a treatment?
A: At the time the needle is inserted, some may feel soreness or slight pain. Others may feel nothing. Common qi sensations around the needle include: tingling, electrical sensations that may travel above or below the needle, or a sense of swelling at the insertion site. Stimulation of needles can be done manually, or by attaching electrodes that transmit a weak current. Some people are energized by treatment, while others feel relaxed.^[1]

It is important to seek treatment from a qualified acupuncture practitioner to ensure proper needle placement and stimulation. In any case, if you experience discomfort during or after the treatment, it is usually mild and short term. Because the purpose of acupuncture is to balance your body, there are no long-term negative side effects. On the contrary, relaxation and a sense of well-being often occur during and after treatment. Often patients become so relaxed that they sleep during treatment.
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Q: Are the needles sterile?
A: Almost all acupuncturists use needles that are pre-sterilized, non-toxic and disposable. Communication of disease through acupuncture has not been an issue in the U.S., a record few other health care professions can claim.

The U.S. Food and Drug Administration (FDA) approved acupuncture needles for use by licensed practitioners in 1996. The FDA requires manufacturers of acupuncture needles to label them for single use only.

Relatively few complications from the use of acupuncture have been reported to the FDA when considering the millions of people treated each year and the number of acupuncture needles used.^[2]
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Q: What is involved in herbal treatment/therapy?
A: Beyond understanding acupuncture, the public is quite curious about the Chinese herbal aspect of Oriental medicine. Chinese herbal medicine consists mainly of vegetable sources, leaves, flowers, twigs, stems, roots, tubers, rhizomes, and bark. In addition, there are animal and mineral products used on occasion when necessary. Most acupuncturists use herbal medicine in raw, powder, and pill form. Raw herbs take some cooking and may taste strong or undesirable. There is a saying in Chinese, “bitter mouth, good medicine.” Herbal pills may be prescribed instead of raw herbs for less severe conditions. Likewise, herbal medicines are rapidly increasing in economic importance, with the U.S. claiming over $60 million in world market herbal sales, including raw materials.^[3]

In China, herbal medicine has traditionally been the most fundamental method of treatment. Medicinal herbal formulas are dispensed to each patient based upon the patient’s individual constitution and current medical condition. Unlike western herbs, Chinese herbs are used in very specific combinations, as opposed to singular herbs. An herbal formula may be comprised of as many as 15 herbs, all having specific purposes within the formula. These herbal formulas, like acupuncture, work to unlock the qi, to nourish, and to repair the organs.
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Q: How is diagnosis and treatment ascertained through Oriental medicine?
A: Before providing acupuncture treatment or prescribing herbs, an Oriental medical doctor must take an assessment of your body by using diagnostic methods such as: asking you questions about your medical history, reviewing western medical findings, looking at your tongue, feeling your pulse at your wrists, palpating your abdomen and meridians along the body, checking the appearance, texture, color and temperature of your skin, assessing how your voice sounds, evaluating your gait, facial diagnosis, and also several other diagnostic techniques particular to the style of the doctor’s practice. Soon after, he or she will come up with an Oriental medical diagnosis, which is quite different than a western medical diagnosis. Then, they will treat you accordingly based upon their assessment. Because of the fluid and ever changing nature of the human body, an Oriental medical diagnosis and treatment protocol can change as well.
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Q: What is yin-yang and its relationship to acupuncture?
A: All aspects of our existence can be explained and understood in terms of yin-yang as it represents the two most general categories into which everything is divided. As it relates to acupuncture, it is used as a means of observing the way energy moves and manifests in the body.

Symbolically viewed as polar opposites, yin is dark, and yang is bright; yin is cold, and yang is hot; yin is passive, and yang is active; yin is female, and yang is male; yin is rest and yang is activity. The changes to yin-yang always move in relationship to each other. The ideal is for each to exist in harmony with the other. Thus, acupuncture seeks to create a balance of yin and yang that is essential to health. A deficiency of either principle can manifest as disease, and in extreme cases of imbalance, death.
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Q: What is the length of an acupuncture treatment?
A: Individual treatments will vary in length from 20 minutes to one hour.
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Q: How many treatments will I require?
A: Each patient is unique and responds to acupuncture differently, so the number and frequency of treatments will vary from patient to patient.

The number of treatments needed to address a specific health concern depends upon the duration, severity, and nature of your complaint. You may need only a single treatment for an acute condition or a series of five to fifteen treatments may resolve many chronic problems. Your body constitution, severity of problem, and the length of time that you have been sick, will all play a part in this. Since acupuncture addresses the health of the whole body, there are many people that seek regular acupuncture treatment to maintain good health and as a preventative measure.
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Q: What is the cornerstone of Oriental medicine?
A: In one of the oldest medical books in the world, the Huang Di Nei Jing (The Yellow Emperor’s Book of Internal Medicine), it explains that acupuncture should be used to treat disease before you get sick. In fact, the Nei Jing was one of the first medical texts to introduce the concept of prevention. Everyone has a tendency toward weakness somewhere in his or her body. With regular acupuncture treatments, the weakened systems are strengthened, so problems occur less frequently. When they do occur, recovery is much quicker. Thus, the prevention of disease is the cornerstone of Oriental medicine.
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Q: What types of illness does acupuncture treat?
A: A partial list includes:

• Musculoskeletal: Neck Pain, Shoulder Pain, Tennis Elbow, Carpal Tunnel, Back Pain, Knee Pain, Sciatica Foot Pain, Sports Injuries
• Neurological/Nervous System: Headache, Insomnia, Stroke, Stress Disorders, Bell’s Palsy, Hyperthyroidism, High Blood Pressure, Neuralgia Epilepsy
• Gynecological: Fertility (Male/Female), Menstrual Pain, PMS, Menopause, Pregnancy, Cysts
• Respiratory: Asthma, Cough, Sore Throat, Common Cold, Hay Fever, Other Diverse Allergies
• Gastrointestinal: Constipation, Diarrhea, Acid Reflux, Nausea, Stomach Pain, Poor Digestion
• Others: Heart Disorders, High/Low Blood Pressure, Chronic Fatigue, Impact Cancer Treatment, Men’s Health Issues, Addiction, Accident Related Injuries, Anxiety & Depression, Skin Disorders.

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Q: What is the educational level of acupuncturists?
A: To qualify for licensure in California, a practitioner must qualify for and pass the California Acupuncture Board (CAB) licensure examination. To qualify to sit for the CAB exam, a student must complete a 3000-hour master degree level program at a CAB-approved school or demonstrate equivalent training.

A listing of the CAB approved schools, along with contact information can be found on the CAB website.
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Q: How are acupuncturists licensed in California?
A: The State of California leads the nation in the field of acupuncture. In 1978, we became the first state to license qualified practitioners as primary care providers. Following graduation from a CAB approved school, qualifying candidates must pass a comprehensive state-licensing exam.

The acupuncturist is required to post a current valid license in a conspicuous location in their office. The status of an acupuncturist’s license can be obtained from the California Acupuncture Board website at: www.acupuncture.ca.gov. As of 2004, California has licensed more than 9,000 acupuncturists (L.Ac.’s). Our state constitutes nearly half of the licensed acupuncturists in the country, and exceeds by more than four times the number of licensed acupuncturists in the state of New York. (As of July of 2003, New York had 2089 licensed acupuncturists, representing the second largest state in their number of licensed acupuncturists.^[4]) As of the date of this report, the total of all licensees from other states (excluding California) was 12,828. 10 States accept California reciprocity, and 11 states do not yet regulate acupuncture.^[5]
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Q: Do medical doctors practice acupuncture?
A: The term used for the practice of acupuncture by medical doctors is “medical acupuncture”. The consumer should be aware that unless medical acupuncturists carry the designation of L.Ac., they are not licensed through the California Acupuncture Board. As such, their training in Oriental medicine and acupuncture may most likely be significantly less.
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Q: What is the difference in training between L.Ac.’s (acupuncturist’s licensed by the California Acupuncture Board) and medical acupuncturists?
A: A California L.Ac. is required to take at least 805 hours of didactic training in acupuncture and Oriental medicine theory, 450 hours of herbal medicine, and have 950 hours of clinical experience out of the total of 3,000 hours of graduate study.^[6]In contrast, MDs certified in “medical acupuncture” by the American Board of Medical Acupuncture are required to take only 200 hours of didactic training in acupuncture and 100 hours of clinical training.

Do not rely on an Oriental medical diagnosis of disease by an acupuncture practitioner who does not have substantial Oriental medical training. Because an individual is a medical doctor, it does not automatically mean that he or she has also had Oriental medical training.

If you have received a diagnosis from a doctor and have had little or no success using conventional medicine, you may wish to ask your doctor whether acupuncture might help.^[7]
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Q: Is there an increasing trend toward integrative medicine? Can patients address health issues collaboratively with their acupuncturist and MD?
A: Increasingly, acupuncture is complementing conventional therapies. For example, doctors may combine acupuncture and drugs to control surgery- related pain in their patients.^[8] By providing both acupuncture and certain conventional anesthetic drugs, some doctors have found it possible to achieve a state of complete pain relief for some patients.^[9] They also have found that using acupuncture lowers the need for conventional pain-killing drugs and thus reduces the risk of side effects for patients who take the drugs.^{[10], [11]}

Your right to ask. Your right to know. Your right to choose: As a consumer, it is your right to ask your acupuncturist regarding their level of training in acupuncture and Oriental medicine. Based upon the knowledge you gain, it is your right to choose the level of qualifications you prefer for the type of treatment you are seeking.
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Q: Is the use of acupuncture and alternative medicine increasing in the U.S.?
A: In November 1997, the National Institutes of Health (NIH) convened a panel of 12 distinguished physicians and scientists to review the history, licensing, practice and current status of clinical research on the effectiveness of acupuncture. The result was the first formal endorsement of acupuncture by the NIH, stating, “There is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value.” The panel urged health professionals to consider acupuncture, particularly integrating its use with conventional medicine after a thorough medical workup.^[12]

The panel determined that evidence for relief of post-operative pain and nausea associated with pregnancy or chemotherapy is clear-cut. Other conditions, including stroke, headache and chronic low back pain, were listed as benefiting from acupuncture. The panel also noted that acupuncture appears to be effective in relieving common disorders such as menstrual cramps, muscle pain, carpal tunnel syndrome, addiction and asthma. They also recognized that acupuncture treatment can result in a reduction in the amount of pain medication or anesthesia that might otherwise be required.

Acupuncture has been cited by the World Health Organization (WHO) to treat over 43 conditions.^[13] 

Beth Israel Deaconess Medical Center, Boston, Mass reported: visits to practitioners and the use of alternative therapies increased 47% between 1990 and 1997. The research was conducted via telephone interviews in 1990 (1,539 adults) and 1997 (2,055).^[14]

• A 47% increase in alternative medicine represented an estimated 427 million visits to practitioners in 1990, increasing to 629 million in 1997 – exceeding total visits to all primary care physicians in the U. S. (396 million in 1997).^[15]
• An estimated 83 million American adults (more than 4 out of 10) used some form of alternative medical treatment last year.^[16]
• An estimated $27 billion, most of it not reimbursed by insurance, was spent on alternative treatment in 1997.^[17]
• Types of Treatment: 42% comprised of treatment of existing illnesses and 58% for prevention and health maintenance. These are two areas that traditional western medicine doesn’t adequately address.^[18] “It is the beginning of acceptance of some forms of alternative medicine into mainstream medicine in the US,” said George Lundberg. “Acceptance the good old fashioned way – by merit.”^[19] According to an August 2001 study published in the Annals of Internal Medicine which investigated the use of acupuncture, herbal medicines, yoga, massage and other complementary medicines:^[20]
• Americans, regardless of age, are relying on at least one of 20 different therapies studied.
• Across all age groups studied, of those that tried alternative therapy, 50% continued to use it 20 years later.
• The study authors write: “These responses imply that alternative therapies are perceived to be a force to be reckoned with for some time to come.”

Researchers at the University of Maryland in Baltimore, with the support of the Office of Alternative Medicine (OAM), [OAM is the National Center for Complementary and Alternative Medicine (NCCAM) predecessor], conducted a randomized controlled clinical trial and found that patients treated with acupuncture after dental surgery had less intense pain than patients who received a placebo.^[21] Scientists at the university also found that older people with osteoarthritis experienced significantly more pain relief after using conventional drugs and acupuncture together than those using conventional therapy alone.

OAM also funded several preliminary studies on acupuncture that have shown promising results in such diverse conditions as: decreases in depressive episodes, improvement in attention deficit hyperactivity disorder, and reduced rate of breech births. Researchers reporting in the November 11, 1998, issue of the Journal of the American Medical Association conducted a randomized controlled clinical trial using moxibustion for breech births. They found that moxibustion applied to 130 pregnant women presenting breech significantly increased the number of normal headfirst births.
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