Jeff Rippey

The answer to your question has a lot to do with why you're experiencing fertility issues in the first place. Not everyone experiences this issue for the same reason and it's not always solely the female partner who needs some level of treatment.

The first place any couple needs to start is with a reproductive health workup for both partners. Men can experience issues with sperm health, sperm counts, etc. For women the issues can range from hormonal to structural. Before deciding on a treatment plan, patients need to understand where the issues lie.

The other complicating factor is whether or not a patient is already using or has already tried conventional fertility treatments. This can range from hormonal adjustment designed to promote ovulation all the way to procedures like IUI or IVF.

The thing most fertility patients do not want to hear is that acupuncture and Chinese medicine are not quick fixes. Patients are generally looking at 3 months of treatment, sometimes more.

If there are fertility issues, both partners have had a workup, and the decision is to move forward with only acupuncture/Chinese medicine, I'd say 3-6 months of treatment at a minimum.

If the patient is combining acupuncture/Chinese medicine with more conventional treatment, I'd still say to start acupuncture 2-3 months ahead of any pharmaceuticals or procedures. There is some science that shows an acupuncture session just before and just after IVF can increase the odds of successful implantation, but most practitioners of Chinese medicine are going to want to set a baseline for you and that means a few weeks of treatment prior to the IVF procedure.

Fertility and fertility issues are an area where patients not only want an actual board certified, state licensed acupuncturist, but this person should also have an ABORM (American Board of Oriental Reproductive Medicine) certification. These will be people who attended and graduated from an accredited school of Chinese medicine and then continued their education specifically for fertility issues. ABORM.org has a practitioner lookup function on their website, I'd suggest starting there.

Since there aren't many licensed acupuncturists nationwide, and fewer still with an ABORM certification, a board certified state licensed acupuncturist with a solid track record in fertility would also probably help. To find someone like this you can use NCCAOM.org's 'Find a Practitioner' lookup.

Where I wouldn't necessarily expect great results is with any other provider who is offering 'acupuncture-like' services under the scope of some other license. These are people who often have minimal to no actual training in Chinese medicine. If you wouldn't expect a family doctor to fix a neurological issue, you shouldn't expect a chiropractor to be all that effective as an acupuncturist.

The science shows that acupuncture can help with fertility issues. A lot will depend on why a person is experiencing a fertility problem. I typically suggest that both partners start with a complete reproductive health workup. Issues can present on both the male and female side and be due to things ranging from hormonal to structural. You want to know where you're starting.

Fertility is one of those areas where patients need to make sure they're seeing a board certified, state licensed acupuncturist rather than a provider who is offering 'acupuncture-like' services under the scope of some other practice license (like a chiropractor or physical therapist). It can also be helpful to see someone who specializes in reproductive medicine. NCCAOM.org has a 'Find a Practitioner' lookup that allows patients to find local board certified providers. If you want someone who specializes in reproductive medicine, go to ABORM.org and use their 'Find a Practitioner' lookup.

In a medical context, 'cure', is a tricky word - technically it's an FDA regulated word. No treatment can claim to 'cure' anything unless the FDA says it can, and the FDA does not make any statements or claims regarding acupuncture or Chinese medicine's ability to 'cure' male infertility. So let's change the phrasing a bit - can acupuncture help male infertility?

The answer is maybe. Much will depend on why a patient is experiencing the problem. For male infertility there can be hormonal issues, structural problems, diet and lifestyle have been shown to have a effect on sperm quality, and there is a laundry list of other potential issues.

Any man experiencing fertility problems should first get a reproductive health workup. This will tell us whether there are identifiable issues and what those issues are. Having this information guides treatment choices. For some issues acupuncture and Chinese medicine will not be at the top of the list, for other issues they might, and sometimes patients will get the biggest effect by combining acupuncture with conventional treatment.

Fertility is one of those areas where patients need to make sure they're seeing a board certified, state licensed acupuncturist rather than a provider who is offering 'acupuncture-like' services under the scope of some other practice license (like a chiropractor or physical therapist). It can also be helpful to see someone who specializes in reproductive medicine. NCCAOM.org has a 'Find a Practitioner' lookup that allows patients to find local board certified providers. If you want someone who specializes in reproductive medicine, go to ABORM.org and use their 'Find a Practitioner' lookup.

There is some evidence that acupuncture can be useful in the treatment of traumatic brain injury (TBI). So I'd say, yes, acupuncture could probably help with a concussion - particularly if there are residual issues like headache.

When dealing with a more serious issue like TBI, it's important to make sure you're seeing a provider who is fully trained in Chinese medicine rather than someone who read a few books or has attended a couple of seminars. Your provider should have an NCCAOM national board accreditation and either an L.Ac. or R.Ac. state credential. To find providers like this in your area, you can use the 'Find a Practitioner' lookup at NCCAOM.org.

For mild to moderate hypertension, studies show that acupuncture is usually just as effective as pharmaceuticals. For more severe hypertension, you'd want to combine acupuncture with pharmaceuticals.

Please make sure your provider has an NCCAOM national board certification and either an L.Ac. or R.Ac. state credential. Without these, you have no way of knowing their base training in Chinese medicine. To find a board certified provider in your area, you can use the 'Find a Practitioner' lookup at NCCAOM.org.

As long as the carpal tunnel is fairly localized and only affecting the wrist/hand, yes, acupuncture can usually help to resolve the issue. If this is a severe case where the forearm or entire arm are now involved, acupuncture might help some, but the patient is most likely looking at a surgical fix.

Please make sure your acupuncture provider has an NCCAOM national board certification and either an L.Ac. or R.Ac. state credential. Without these things, you have no way of knowing their base level of training - which in the US can range from very little to quite a lot. To find a board certified provider in your area, you can use the 'Find a Practitioner' lookup at NCCAOM.org.

Without knowing what your issue actually is, it's hard to say whether or not you might expect immediate improvement. I'm a pain management specialist and most acupuncture questions typically revolve around a pain issue, so I'm going to assume that's what we're dealing with here.

I'm also going to assume you're planning to see a board certified, state licensed acupuncturist rather than a chiropractor or physical therapist who may have minimal to no training in Chinese medicine.

Those assumptions out of the way, I can tell you that that vast majority of my pain patients *usually* experience some reduction of the pain on their first treatment. This reduction normally lasts 24-48 hours and then the pain will start to come back. For those that don't experience a reduction on the first treatment, things are typically trending downward by the second or third.

That all being said, there's about 5% of the population who, for whatever reason, don't respond to acupuncture. It doesn't matter who they see or how many times they go. If a patient makes it to the third treatment and they're still not experiencing any change in their pain, it means either they're in that 5% or I don't have a good handle on what's going on. Honestly, usually it's that I don't have a good handle on what's going on.

If you need to locate a board certified, state licensed provider, you can use the 'Find a Practitioner' lookup at NCCAOM.org

Usually, yes. Be prepared to attend at least 3 treatments.

Also, make sure your provider is actually trained and credentialed as an acupuncturist. At a minimum, they should have an NCCAOM national board certification and an L.Ac. or R.Ac. state practice license. To find people like this, you can use the 'Find a Practitioner' lookup at NCCAOM.org.

I'm a nationally board certified, state licensed, doctor of acupuncture who specializes in pain management. Here's my typical timeline:

Patients usually get at least a 50% reduction in pain on the first treatment. This reduction lasts for 24-48 hours and then the pain starts to come back and/or moves.

Each subsequent treatment adds a day or two to how long the pain reduction or elimination persists such that by treatment 4 or 5 the patient doesn't require weekly treatment. Then we start skipping weeks, spreading the treatments out until either the pain resolves and doesn't come back or we find some interval where the pain stays mostly under control.

Treatment intervals can vary. For some people a treatment every 4-6 weeks will keep things under control. Other people may only come in 2-3 times per year.

There is about 5% of the population who never respond to acupuncture. There can be a variety of reasons for this, but my general rule of thumb is: if a patient has been to 3 treatments, spaced one week apart, and isn't experiencing any change, it's unlikely they will experience a change with acupuncture.

The other wild-card here is that there are providers in the US offering 'acupuncture-like' services under the scope of some other practice license. Depending on the state this can be people like chiropractors, physical therapists, and, occasionally, MD/DO or nurses. Most of these folks have never attended school for Chinese medicine, many have less than 100 hours of training and no supervised practice in an educational setting. Some of them can be pretty good, many of them are simply reading points out of a book. Patients have no way of knowing the good practitioners from the bad in this case.

As a consumer, you're looking for one or more of the following:

1. If your acupuncture provider is an MD/DO, they should have an ABMA board certification. Without this, in most states, they could literally have woken up that morning and decided to be an acupuncturist for the day. In other words - they could be completely untrained in acupuncture.

2. Any other provider should have a national board certification from NCCAOM and either an L.Ac. or R.Ac. state credential. Without this, you have no way of knowing what their base training level is.

To find NCCAOM credentialed providers, go to NCCAOM.org and use their 'Find a Practitioner' lookup.

I, and I'm sure other acupuncturists, get questions like this a lot. The problem here is that, as phrased, the question is essentially unanswerable. There is no one point or set of points that might always be utilized in knee pain - or any other pain for that matter.

From a channel perspective, there are 6 primary and 4 extraordinary channels crossing the knee. These all run in different locations and, if a channel pathology is at the root of the problem, an acupuncturist would need to be able to differentiate which channel is primarily affected. We do this two ways: 1. We'd need to know precisely where on/in the knee the patient is experiencing pain - is it medial, lateral, posterior, anterior, does it radiate or is it fixed, how does the patient experience the pain (sharp, dull, burning, electrical)? We'd also need to know what other symptoms the patient might be experiencing, even if it doesn't seem like those symptoms would be related to knee pain. 2. Sometimes joint pain is related to an internal organ pathology - in the case of the knee, the Chinese model would include things like kidney and spleen. In order to differentiate between these causes, again, a lot more information would be required.

Secondly, there are multiple systems of acupuncture that providers practice and they don't all approach problems like joint pain the same way. Some practitioners will put needles in the local area and some won't. Even if the patient provided their entire symptom list, along with a detailed anatomic picture of where they're experiencing the pain, there is no guarantee that any other provider would choose to utilize the points I might pick. Sometimes this means one of us will get a better result versus the other. Sometimes this means we both might get the same result for a patient's issue.

For people who've never tried acupuncture, it can relieve a bit of the anxiety of the unknown to have some idea where the needles might be placed before the appointment. I appreciate this fact because I've been there. Here's what I suggest - go to NCCAOM.org, use their 'Find a Practitioner' lookup and get a list of local board certified providers. Call around and see if any of them offer a free introductory consult. Usually this will be something like 30 minutes. Go in and talk to a few, let them see what your issue is, and get a feel for how each one might treat the problem.

Just about any provider would need a lot more information before being able to supply a reasonable answer to this question. There are a variety of issues which may affect the kidney - some of them can be addressed with acupuncture, some of them are best addressed with a combination of acupuncture and conventional medicine, and some are best addressed with conventional medicine alone. Without knowing what's wrong, I can't tell you what bucket you fall into.

If we're talking about chronic kidney stones - acupuncture, diet modification, and herbal medicine can sometimes help a great deal.

If we're talking about low filtration rates (either eGFR out of rage or high serum creatinine), then sometimes a combination of Chinese and conventional medicine are the best bet.

If we're talking about something like adrenal fatigue, acupuncture and herbs can sometimes be as effective as conventional treatment.

If we're talking about polycystic kidney disease, acupuncture can sometimes help but, again, you'll want to combine conventional medication.

If we're talking about a decline in kidney function such that the patient is now on dialysis or there's cancer involved, we're now starting to move into an area where acupuncture and Chinese medicine are going to have declining benefit relative to conventional medicine.

Any stone larger than about 5mm is too big to pass through the ureters to the bladder. Acupuncture isn't going to reduce the size of a stone if you have one that's too large. Surgery or lithotripsy is your best bet in this case. Passing a stone smaller than 5mm is intensely painful. Acupuncture can help with the pain as well as any nausea that might result. Fluid intake is the best thing to keep the stone moving. Chinese herbal medicine and dietary modification can help prevent stones forming in the first place - this is where you really want to be, especially if you've had one stone already.

I couldn't say whether or not acupressure is good for knee pain - I almost never use pressure techniques. The reason I don't use them is because in terms of patient comfort, time to pain relief, and duration of pain relief acupressure is a distant second to acupuncture (using needles).

Unless the patient is one of those rare people who pass out when any needle breaks the skin, acupuncture is going to work better, faster, be more comfortable and the results will persist longer.

This is a great question and somewhat goes to a kind of systemic problem we have here in the US around acupuncture delivery. When we look at acupuncture delivery in a country like China, we typically see patients receiving acupuncture several times per week for a week or two at which point the patient is reevaluated to determine whether or not more treatment is necessary. They can do that because almost everyone in China is open to acupuncture and it's a first line treatment for many issues. Chinese acupuncture providers are seeing lots of patients; they can have lower fees and still make a living - not to mention in China medicine is socialized, so the government is footing a chunk of the bill.

In the US though, most patients don't immediately think of acupuncture when they have a problem and usually they come to us last rather than first. Since acupuncturists aren't seeing the same patient numbers, they have to charge more in order to make a living. So the model we've adopted in the west is built around one treatment per week.

Setting aside the money issue, what works best? To be honest, when patients are experiencing severe or extreme symptoms, multiple treatments per week, at least in my experience, often provides superior results. I treat mostly pain conditions and my general rule of thumb is: if a patient's pain is routinely above 7-8 on a 10 point scale, I prefer to start with 2-3 treatments per week for one to two weeks. After that we can usually drop back to one treatment per week and continue making progress.

If I were working with you, I'd probably group your symptoms into two buckets:

1. Fatigue and weakness
2. Tinnitus

I'd then suggest working on the fatigue and weakness first as, in my experience, these tend to respond faster to acupuncture than tinnitus. If your experience of fatigue and weakness seems severe or extreme (and it kinda does), then 2 treatments per week for a couple of weeks might be what you need to get some traction on these issues.

Tinnitus is a problem that, again in my experience, doesn't respond as quickly to acupuncture. I wouldn't try doubling down on treatments expecting a faster resolution on this particular problem.

What I wouldn't expect (and, in my opinion, what few US acupuncturists should expect) is for you to pay full price for each treatment and come in for more than one session per week indefinitely. There should be a clearly articulated end-goal for multiple sessions per week and your provider should have a solid plan for getting to that goal and then ramping down to a different treatment interval.

I don't know if acupressure can help with thyroid issues, I don't use much acupressure in my practice. In comparison to acupuncture (using needles), acupressure is a distant 2nd in terms of time to relief from symptoms, duration of relief from symptoms, and overall patient comfort during the treatment.

Can acupuncture help with thyroid issues? Usually, yes. A lot is going to depend on what, exactly, is the issue with the patient's thyroid. There are a range of potential problems, and a variety of different treatment methods which may be intermixed in order to get the best result for the patient.

I'd suggest going to NCCAOM.org, clicking on their 'Find a Practitioner' link and locating a board certified, state licensed acupuncturist near you.

Honestly, I've not had much success treating vitiligo with acupuncture. However, I do know some other acupuncturists who claim to have provided successful treatment.

I suggest you start with NCCAOM.org's 'Find a Practitioner' link. Get contact information for a few board certified providers near you and then call around to see what their success rates are with this issue.

Acupuncture can sometimes be effective for varicose veins. It will most likely help a great deal if there is pain involved. It may help resolve the varicosities themselves, but usually bleeding is much more effective.

The varicosities themselves should not be bled, but there is often superficial venous congestion (so-called 'spider veins') that presents with varicose veins. These spider veins can be bled and this often helps to reduce the venous pressure in the low leg and provide relief.

Most acupuncturists are trained in bleeding techniques. Unfortunately, not everyone continues this practice. Some states also restrict the performance of this particular technique.

My best suggestion is to use the 'Find a Practitioner' link at NCCAOM.org and locate some local providers. Call around, explain your situation, and see if any of them will perform a bleeding treatment for you. Again - please make sure that they're not planning to bleed the varicose veins themselves.

Assuming you're seeing an actual board certified and state licensed acupuncturist, yes, acupuncture can be quite helpful throughout a pregnancy.

In the early trimesters acupuncture can help to manage nausea. In later trimesters acupuncture can help with low back/pelvic pain. Also, consider acupuncture if you happen to catch a cold while pregnant - most cold medications will be out of the question and acupuncture can help from a symptom perspective.


Pregnancy is one of those cases where it's fairly important to make sure you're seeing a provider who attended and graduated from a school of Chinese medicine rather than a chiropractor, PT, or physician who may have minimal to no actual training in Chinese medicine.

The classics of Chinese medicine have a short list of points which are contraindicated in pregnancy. These points are thought to be too 'stimulating' and have the potential to bring on uterine contraction and cause miscarriage. Poorly trained providers are often unaware of this prohibition and don't know which points to avoid. In addition, some of these points are go-to points for problems like nausea and low back pain. Again, poorly trained providers don't know how to treat these issues when the go-to points are off the table.

You want a provider with either a Dipl Ac or a Dipl OM national board certification and an L.Ac. or R.Ac. state credential. For pregnancy issues, you may also want to seek out someone who has an ABORM (American Board of Oriental Reproductive Medicine) qualification. To find local L.Ac./R.Ac. you can use the 'Find a Practitioner' link at NCCAOM.org. To find an ABORM certified provider you can go to ABORM.org.

If you're looking at acupuncture to help manage things like first trimester nausea or low back pain in later trimesters, once a week should be sufficient.

For acupuncture during pregnancy it's very important that you see an actual board certified and state licensed acupuncturist rather than a chiropractor, PT, or physician who may be offering 'acupuncture-like' services under the scope of some other medical license. There are points which should be avoided in pregnancy and minimally trained providers often aren't aware of this fact.

You want a provider with either a Dipl Ac or a Dipl OM national board certification and an L.Ac. or R.Ac. state credential. For pregnancy issues, you may also want to seek out someone who has an ABORM (American Board of Oriental Reproductive Medicine) qualification. To find local L.Ac./R.Ac. you can use the 'Find a Practitioner' link at NCCAOM.org. To find an ABORM certified provider you can go to ABORM.org.

The theoretical answer to your question is maybe. The classics of Chinese medicine lay out a set of points that are not to be used at any stage during a pregnancy. These points are thought to be too stimulating or too strongly 'descending' and are also thought to stimulate uterine contraction. There have been a few modern studies of these points in a pregnancy context and, so far, the 'science' does not support the classical Chinese position. My own position is to give the classics their due. After all, almost everything else they mention works in a clinical context. A board certified and state licensed acupuncturist will be well aware of which points to avoid. Any other provider offering 'acupuncture-like' services under the scope of some other license may not.