8 biggest questions about acupuncture therapy, answered

Americans aren’t huge fans of needles, generally speaking. So is there any hope of acupuncture catching on here in the same way as gentler Eastern practices like yoga and massage? According to a 2012 survey, 3.5 million Americans have tried acupuncture, up from 2.1 million in 2002. If that trend continues, acupuncture will soon enter the mainstream.

Acupuncture is the practice of inserting small needles into the superficial layers of skin to treat pain and illness. Needles are placed along pathways called meridians, which are said to produce strong reactions when stimulated. Although needles can deter the squeamish, they may also contribute to the therapy’s aura of effectiveness. Like the sting of alcohol on a scrape, the sensation and overall experience of acupuncture gives you confidence that it’s working.

Scientists struggle to explain how acupuncture works in anatomical terms. The needles are placed too shallowly to directly stimulate nerves or muscles. And yet some patients experience real, measurable benefits, from physical changes to improved immune response. Doctors and alternative practitioners alike agree that acupuncture somehow unlocks the body’s own potential for healing.

We spoke with licensed acupuncturist Nancy Byrne, MS, who practices in Manhattan. Below she explains which conditions respond best to acupuncture and what happens at a typical appointment.

Q: How did you become an acupuncturist?

A: My own chronic pain led me to it. I saw many doctors and tried pharmaceutical solutions, and nothing was helping. My nutritionist planted the seed. She told me, “If this doesn’t help, try acupuncture.”

There’s a lot of theory and clinical science behind the practice. Some people think you can take a couple of weekend classes and call yourself an acupuncturist. But many of us go to school year-round for three or four years, taking thousands of hours’ worth of courses in Eastern and Western science.  After all, we need to understand when a patient really needs to see a medical doctor. That’s not usually a problem, though, because we’re typically the end of the line, after mainstream medicine has failed to help.

Q: What happens at the first appointment?

A: A typical visit lasts 45 to 60 minutes. The first is longer, about 90 minutes. I’ll do an intake interview, where I listen to the person's medical history and gather less formal clues to what’s happening with them. For instance, people will say, “I don’t know if this helps but…” Those moments can give me a huge amount of information.

I’m also observing. I take the pulse on both sides and look at the tongue. The tongue is the beginning of the digestive tract, so it reveals a lot of what’s going on internally. If energy is moving backward ― as with nausea or reflux ― it’ll show up on the tongue.

Also, the tongue is a kind of map of the body. Sometimes, I’ll tell someone what I’m seeing on their tongue ― evidence of poor sleep or pain ― and they’ll say, “Yes! I forgot to tell you that.”

Q: Everyone wants to know if the needles hurt.

A: People should know that acupuncture needles are very different from other needles. I hate needles. But acupuncture needles are very thin, flexible and hollow.

Does it hurt? It depends on the person. Some people don’t feel them at all. Others may feel a little prick or a zap of energy. But you’re just as likely to feel a sense of calm or bliss traveling along the path of the needles. And some people just fall asleep.

I always tell patients to let me know how a needle feels. My job is to decipher if it’s a beneficial sensation of energy or if tissue is being irritated or overstimulated. When someone tells me a needle is very uncomfortable, I’ll take it out and move it. The patient always has the final word.

Q: What else should people be prepared for?

A: Acupuncture is one arm of Traditional Chinese Medicine, which encompasses other areas of wellness. So your acupuncturist may also give you nutritional suggestions. This advice is different from what a registered dietician might give. Or you may get herbs to take in pill form*, which can change from week to week. At times, I’ll give clients different techniques to use at home: visualizations, breath work, simple yoga moves or tips for self-massage with a ball.

*Check with your doctor before taking any herbs, which can interact with prescription and over-the-counter medications.

Q: Here’s the million dollar question: How does acupuncture work?

A: We’re looking for patterns rather than treating single symptoms. Acupuncture channels are like a web that covers the body. The Heart channel or pattern, for example, is related to sleep, depression, anxiety and acid reflux. If people check a lot of those boxes, I know what I’m treating.

Beyond that, there are several schools of thought. Some acupuncturists treat locally, other treat up and down the same “highway,” or meridian.

Very recently, Western doctors have been excited about a newly discovered organ called the interstitium, described as these fluid-filled spaces between tissues all over the body. That’s exactly how I’ve been explaining to clients where the acupuncture points are found! I love when ancient medicine and modern science intersect.

Q: Some people who are curious about acupuncture may also be somewhat skeptical ― is that a problem?

A: There’s nothing wrong with being skeptical. In Western society, we are raised to ask questions and look for evidence. Plus, sometimes a person comes in because a friend or loved one pushed them to give it a try. Maybe they’re even a little defensive about it. Later on, I’ve heard the same person say, “I love it! I’m addicted!”

Skepticism doesn’t get in the way of the benefit. But it does help to come in with a sense of curiosity. And I’ve noticed that the people who benefit the most tend to be more in touch with their bodies, have a higher level of self-awareness and a strong desire to get better faster.

Learn more about how your mood affects your recovery from illness and injury.

Q: What sort of health conditions do people most often come in for?

A: Acute and chronic pain both respond well to acupuncture, sometimes very quickly. With acute pain, you may feel 80% relief after one treatment, and some people feel 100% better. Getting to the bottom of chronic pain is an ongoing process over multiple sessions. And some people come in for one thing, such as sleep problems, and discover another benefit that keeps them coming back, like relief from anxiety.

Find out more about anxiety and other mood disorders.

Acupuncture pairs nicely with other forms of medicine. It’s often used during cancer treatment to help with nausea. And it’s good for complex conditions that confuse medical doctors, like autoimmune problems.

Q: Do you see acupuncture playing more of a role in health care in the future?

A: We are facing two great epidemics: chronic pain and opioid addiction. Acupuncture can help on different levels ― by preventing addiction through treating pain, and by helping people deal with withdrawal as they wean off drugs. We have the means. There’s an army of acupuncturists ready and waiting.

Call your health insurance provider to find out if your plan covers acupuncture for your condition. Aetna, for instance, may cover it for nausea and pain when administered by a physician. Aetna also offers discounts for additional conditions not covered by insurance. You can use your HSA/FSA for acupuncture regardless of whether insurance covers the treatment.