EXPERT
Jeff Rippey
Acupuncturist
- Saint Joseph, MO
- Colorado School of Traditional Chinese Medicine
- Accepting new patients
Why It's Hard To Tell Patients Where Needles Might Be Placed
I've been answering questions on this site for a couple of years now. There's been a recent trend towards acupressure questions which I addressed in my first blog post. Generally,...
Why It's Difficult to Answer Acupressure/Pressure Point Questions
As part of this site, patients have the capability of asking questions of practitioners and subject matter experts. Recently I’ve been seeing a lot of questions that take the...
Why is acupuncture so relaxing?
The human nervous system has multiple different divisions but for the purposes here, we need to consider the autonomic system. This is the part of the nervous system over which we don't usually exert too much conscious control. The autonomic system has 2 main sub-divisions: the sympathetic and the parasympathetic,
The sympathetic nervous system is sometimes described as the 'fight or flight' portion of the autonomic nervous system. The main neurotransmitter here is epinephrin/norepinephrin (adrenalin), and the system functions in such a way as to prepare the body to fight something or run away from it. Blood is diverted away from internal organs to the muscles of the limbs, blood pressure is increased, pupils are dilated along with a number of other physiological effects which function in the aggregate to either fight or flee.
The parasympathetic system, on the other hand, operates in opposition to the sympathetic. This system is usually referred to as the 'rest and digest' system and its main neurotransmitter is acetylcholine. When this system is activated blood is diverted from the limbs to the internal organs, pupils are constricted, gastrointestinal sphincters relax and a host of other physiological effects that put one in a more subdued mode.
What acupuncture does is force a person into a parasympathetic state.
Can acupuncture hit a nerve?
How does acupuncture stop pain?
Does acupuncture exert its effect solely due to biochemical changes? Probably not, since a good acupuncturist can often get immediate pain relief or reduction from the first few needles. There's not nearly enough time for a biochemical response to be stimulated, those molecules to travel to their site of action, bind receptors, and exert the effect.
Generally, we can talk about a short list of biochemical effects due to acupuncture:
1. Acupuncture promotes the production and release of endogenous opiate peptides. These are opiate like proteins your body produces naturally. Acupuncture increases their production and release which can have the effect of lowering pain.
2. Acupuncture regulates a set of neurotransmitters in the spinal cord and brain which are intimately involved in the propagation of pain signals. Basically, acupuncture makes it harder for these signals to move around.
3. Functional MRI studies have shown that acupuncture changes the way the brain processes pain signaling. In addition to thinning the pain out (opiate peptides) and slowing the signal down (neurotransmitters), acupuncture is changing the way the brain deals with pain signals that make it through.
4. Functional MRI studies also show that acupuncture increases binding sites in the brain for opiate peptides. We're changing the pain sensation by inducing the brain to produce more binding sites for opiate peptides which reduce pain sensations.
Is this the exhaustive list of everything acupuncture does in pain management? In my opinion, no. None of these changes or interactions accounts for how long the acupuncture pain relieving effect can last, nor do they explain how quickly pain relief can come on as a result of acupuncture.
Which is better acupuncture or acupressure?
Can acupuncture release trapped emotions?
The short answer to your question is, yes, acupuncture can often be very helpful in assisting a patient to process and release negative emotions which they may be holding. It can sometimes be a tricky process to manage for both the practitioner and the patient. The more information you can provide your practitioner, the better and easier the process will go.
How are acupuncture needles removed from your ear?
Seriously, though, there are a variety of ways to interact with auricular points not all of which involve needles. If I'm using needles on ear points, i prefer to use Korean hand needles which are much shorter/smaller than typical acupuncture needles. These are inserted either by hand or via a special tool for the insertion of Korean hand needles. Removal is usually by hand, with a pair of hemostats (kind of like small locking pliers), or a set of tweezers.
Occasionally, I'll use a pyonex needle on a patient's ear. These are very tiny needles on a circular, sticky backing - kind of like a circular bandaid. They can remain in place for several days and are usually peeled off by hand or with a pair of tweezers.
Lastly, there are ASP needles which are used to stimulate ear points. These are a barbed needle packaged inside an insertion device. They deform the ear cartilage around the barb which holds them in place. Eventually the cartilage will return to its regular configuration which usually pops the needle out. Otherwise these can be removed with tweezers.
The vast majority of the time, I use ear seeds on ear points. This is a small round seed on a sticky backing, and applies pressure to the ear point. These can also remain in place for up to several days and are typically removed by hand or with tweezers.
Can acupuncture help a clogged ear?
If it's a feeling of being clogged, you've visited an ENT and there's nothing in the ear canal, then, yes, acupuncture can often be helpful.
It's also important to keep in mind that the ear is connected to the throat via some very small canals. Just because you may be feeling something in the ear, doesn't always mean the problem is in the ear. I had a patient recently who came to me with ear pain and the problem turned out to be a fairly advanced cancer that had spread to the lymph nodes under the jaw/ear.
Cases like that are precisely why you need to involve practitioners of conventional and Chinese medicine in an integrative fashion.
What happens to your body after acupuncture?
First off - occasionally after the first treatment, but definitely after 3-4 treatments you should notice a decrease in your headaches. Sometimes this shows up as reduced episodes, sometimes as reduced pain levels, and sometimes both those things.
Acupuncture is placing your system in the 'rest and digest' mode (versus the 'fight or flight' mode). Some people will experience this as fatigue. Usually it doesn't last for more than a few hours post treatment and can be handled either will a light meal or a nap.
Because we're often forcing people out of the 'fight or flight' mode, reduced blood pressure is also very common. This can present as light-headedness and usually doesn't last for more than a few minutes after needles are removed.
There's a whole set of sensations which can accompany needle insertion and retention. Most of them are normal. I typically only get concerned if patients are still feeling a sharp or stabbing sensation around the needle after it has been in place for a few seconds. Make sure you're providing feedback to your provider and have uncomfortable needles either removed or re-positioned.
After the needles are removed, there can be an itching sensation around the needle site. This is a histamine reaction and is normal. Itch usually only lasts an hour or two after the needles are removed.
As far as biochemistry is concerned, there are a wide variety of effects that can occur as a result of acupuncture treatment. To be perfectly honest, the way western science applies study methodology it's almost impossible to know whether these effects occur as a result of any needling, needling in some location, needling in some locations for a particular health condition, or some other confluence of factors. The problem is that most western studies are built around the philosophical idea of reductionism and acupuncture/Chinese medicine are inherently holistic (i.e. not based on reductionism), and are rooted mostly in systems theory. It's sort of like trying to fit a round peg in a square hole....
Perhaps the simplest answer to your question, assuming you're seeing a board certified and state licensed acupuncturist, is 'nothing bad'.
Is acupressure good for neck pain?
How quickly does acupuncture work for back pain?
From the perspective of Chinese medicine, the sensation of pain is a symptom of something else that has gone off the rails somewhere. Classically, back pain can fall into one of three different diagnostic categories. In practice, I've seen a couple of other root causes on a fairly consistent basis. In all, that's somewhere between 3 and 5 different reasons why any given patient might experience pain.
Some of those reasons will respond faster to treatment than others and some patients respond faster to treatment than others.
I specialize in pain management. Pain conditions are probably 85-90% of my practice. There are two general things two keep in mind:
1. Statistically, there is somewhere around 5% of the population who simply do not respond to acupuncture - ever. It doesn't matter who they see or how many treatments they receive, acupuncture simply doesn't work for them. Of course, this means that 95% of the population will see some benefit to acupuncture treatment, so the odds are in any given patient's favor here.
2. Acupuncture is a cumulative treatment. Just like we often don't expect a single dose of antibiotic to clear up an infection, we shouldn't expect a single acupuncture treatment to resolve a pain problem. My rule of thumb is to give me 3 treatments. if the patient isn't experiencing some improvement by the 3rd treatment, either I'm missing something or they're in that 5% - usually it means that I'm missing something.
Is acupressure good for back pain?
How quickly does acupuncture work for migraines?
As for how quickly - there's no way to predict. There are several different root causes for headache in the Chinese diagnostic model. The differentiation is based on where the pain is felt, how the patient experiences that pain subjectively, where the headache starts, whether the pain moves and what other symptoms might be associated. Migraine usually falls into one of a couple different buckets and without seeing, diagnosing and treating you, I have no way to know which bucket your migraine experience falls into.
I specialize in pain management - including headache/migraine. I usually tell people that they should be noticing a decrease in episodes, pain levels, or both after 3-4 treatments.
Fatigue after acupuncture?
Generally, when someone experiences an unwanted effect or adverse event as a result of acupuncture, it means that something is not quite right with the Chinese diagnosis, the points chosen for treatment, or both.
You mentioned you're seeing a doctor, but it often matters whether or not this person is a doctor of acupuncture/Chinese medicine versus an MD/DO/DC who may be providing 'acupuncture-like' services under the scope of their existing license. Your provider should have an L.Ac. or R.Ac. credential and either a Dipl Ac or Dipl OM national board certification. If you're seeing an MD/DO, they should have an AAMA national certification. If your provider doesn't have either of these credentials and/or board certifications, they are likely not well trained in acupuncture or Chinese medicine. This matters because the Chinese diagnostic system is very different from conventional medicine. If you wouldn't expect your doctor to diagnose a broken bone without taking an x-ray, you shouldn't expect an acupuncturist to treat without diagnosing your problem using the Chinese diagnostic methods.
It sounds like you've spoken to your provider, which is usually my first suggestion in these types of cases. However, since this person seems a little dismissive of the idea that acupuncture is the source, I'd strongly suggest getting a second opinion from another licensed provider of acupuncture/Chinese medicine. You can go to NCCAOM.org and use their 'Find a Practitioner' lookup to get a list of board certified and state licensed acupuncturists in your area. Call around and see if you can find someone who will give you a free consult - this will let you lay out what's happening and maybe together you can get to the bottom of the situation and find some resolution.
How do you relieve pressure points in your feet?
Some other considerations: problems in the feet can sometimes be a reflection of issues elsewhere. Sometimes excess tension in the calf, hamstrings, glutes, or low back can exert pressure on the heel which will stretch the plantar fascia causing pain. Sometimes problems with tibialis anterior and the quadriceps in the thigh can cause issues around the big toe and medial arch. Footwear that is too tight or shoes that come to a point can cause Morton's neuroma.
Conversely, problems arising in the foot/ankle can reflect up the chain to affect the knee, low back, mid-back, or posterior shoulder. If you're experiencing any pain in these locations, it's possible the foot is the source of the issue.
There are far too many potential issues, some of which may not be directly related to the feet at all, to provide any sort of useful answer to this question.
If you're continually experiencing pain in your feet, I'd strongly suggest a few things:
1. Visit a podiatrist and have them evaluate the foot/feet. Acupuncture and Chinese medicine can be effective in a wide variety of conditions, but they're not the solution for ALL conditions. You need an evaluation from a specialist to rule in/rule out issues which may be structural and require surgical repair.
2. Take a good look at your footwear. Anything that is squeezing the toes together, putting excess pressure on the ball of the foot, or excessively elevating the heel is eventually going to cause pain. The foot is a very mechanically complex structure and a lot of modern footwear doesn't allow the foot to act like a foot. See if you can find someplace that will analyze your gait, foot strike, and toe off and make a recommendation as to optimal footwear for the way you move.
3. Visit a sports medicine certified acupuncturist or a physical therapist and have them evaluate the entire myofascial chain affecting the foot. They can then come up with a comprehensive treatment plan to help get everything back in to alignment and prevent further discomfort or deterioration. Sometimes a good athletic trainer is also helpful, especially if there are muscles mis-firing or otherwise in need of rehab.
Does acupuncture work on feet?
Acupuncture and Chinese medicine are built around a systems theory model of a living organism, not a reductionistic one. Just because the problem happens to be in the foot, it doesn't necessarily follow that the treatment will involve acupuncture on the feet or in the affected area. I most often treat foot issues with needles elsewhere on the body, and I've got a pretty good success rate with that approach.
Conversely, if the problem was something like acid reflux, neck pain, or frontal headache, I'd probably use points on the feet rather than points on the abdomen, head, or neck. Again, in my experience, this tends to work fairly well.
What are the pressure points in your foot?
Only considering the 6 primary channels that either start or end on the feet, there are roughly 33 acupuncture points. Depending on the acupuncture system and source material, we could probably add another 4-6 extraordinary points which puts us very near 40 recognized points on the feet. This does not account for anything that reflexology might add to the mix. In order to answer your question, I'd need a great deal more information.
Can acupuncture cure cataracts?
Because treating cataracts usually requires herbal medicine as well as acupuncture, patients need to make sure they're seeing a board certified and state licensed acupuncturist. Chiropractors (DC) and physical therapists (DPT) often offer 'acupuncture like' services under the scope of their existing licensure, and most states allow this. The problem is that DC's and DPT's are often either not trained at all in Chinese medicine or only receive a fraction of the training in Chinese medicine that an L.Ac. (licensed acupuncturist) has.
To find a local, board certified, acupuncturist, go to NCCAOM.org and use their "Find a Practitioner" lookup.
Can acupuncture help your vision?
Issues like diabetic retinopathy can be difficult, especially if the patient's blood sugar is not under control. Some types of congenital visual issues don't respond particularly well.
I've personally gotten good results for patients with wet macular degeneration, dry macular degeneration, retinopathy other than diabetic, glaucoma and cataract if it's caught early.
There are several health issues, and visual issues are among them, where it's in a patients' best interest to make sure they're seeing an actual board certified and state licensed acupuncturist, rather than a chiropractor or physical therapist who may have minimal training. To find a local board certified acupuncturist, you can use the "Find a Practitioner" lookup at NCCAOM.org.
Can acupuncture cure dry eyes?
While 'dry eyes' may constitute an entire disease state in conventional medicine, in Chinese medicine it's a symptom of something else going off the rails. So, the 'why' is important and will have a lot to do with whether and how quickly there is a response to treatment.
If your dry eyes are a symptom of allergy or a medication side effect, then acupuncture can probably help. There are a variety of other issues which can affect the eyes and cause dryness, so I'd suggest a visit to your eye doctor first.
Can acupuncture help with ear problems?
Acupuncture isn't going to do much for auditory nerve damage, congenital deafness. It's spotty in terms of helping age related hearing decline.
If you're interested in trying acupuncture for your issue and you've been to an ENT to rule out other, more serious issues, then go out to NCCAOM.org and use their "Find a Practitioner" lookup to get board certified providers in your area. Call a few of them and see if you can find someone who has a good track record with whatever your ear issue is.