Jeff Rippey

Yes, acupuncture can help with chronic knee pain. I work with knee issues quite a bit and usually get a good response.

There are more than a few studies showing acupuncture's anti-inflammatory effects, so, yes, acupuncture can function to reduce inflammation in the body.

Short answer is: yes, acupuncture can help loosen your tight neck muscles.

There are a variety of different approaches an acupuncturist might take. Some will treat distally (no needles in your neck), some might treat locally (needles in your neck) and some will use both distant and local needles.

What points might be utilized are going to depend on where, precisely, you're experiencing the pain, what the pain feels like to you, whether or not the pain radiates, whether or not the pain you're experiencing is in fact radiating from somewhere else, if there is a time of day you predominantly experience the pain or if there's a time of day the pain is at its worst, whether or not the weather has any effect on the pain and whether hold/cold or pressure/no pressure makes the pain worse or better.

Pain is not simple to diagnose or treat and Chinese medicine does not use treatment "protocols". Treatments are individualized for each patient. Without actually seeing and diagnosing you, it's impossible to say where you could press and get relief.

Treatment frequency for migraine depends a lot on the severity and frequency of the headaches. If your migraines are extremely painful and happen several times per week, you might need to be seen 2-3 times a week for a couple of weeks to bring the episodes under control. After that, you might be looking at weekly treatments for another 4-5 weeks.

If your migraines are less frequent or more mild, you might be able to start with weekly treatment.

I work quite a bit with migraine patients and my general rule of thumb is: patient's should notice a change in frequency, severity or both after about 3 treatments.

In my opinion, there aren't many similarities.

Chiropractors are looking at the body through the lens of the spine and the spinal nerve roots. They're adjusting the spinal motion segments in order to relieve pressure on the nerve roots to address some issue. Usually it's back pain, but the spinal nerve roots go on to provide ennervation to all body structures so, theoretically, there are a wide variety of issues that could potentially be addressed (assuming an impinged nerve was the root cause). Usually, chiropractors are well trained in nutrition too and their entire scope of practice varies from state to state.

Those of us who practice Chinese medicine, on the other hand, are using a completely different lens through which we view the body and disease/dysfunction. Like chiropractors, and many other providers of more "natural" treatment, we're using holism as our base - in other words we look at the human body as an interconnected whole. We depart somewhat from other providers because we also consider the human as being embedded in their environment, so there are environmental influences/factors which we also consider. In general, the Chinese diagnostic model is very different from both the conventional system and the systems in use by other holistic/natural medicine providers. It would take a great deal more space to fully explain this. Chinese diagnostics are not simple, there aren't any short explanations and to get the most out of Chinese herbs and acupuncture, there's a certain level of skill one must develop (which generally takes more than just a few weekends).

Basically, chiropractic and Chinese medicine are two completely different skill sets which take time (years usually) and concentrated effort to develop. The theoretical under-pinnings of both systems are completely different and the Chinese system has the added twist of coming from a completely different cultural context that had a completely different view of science and nature. In particular, the Chinese diagnostic model and the Chinese view of the etiology and pathogenesis of disease requires one to step outside of the usual western material-reductionistic paradigm.

Short answer: yes, acupuncture is safe on a weekly basis. It's the general treatment interval in the US for most issues.

Slightly longer answer: in China acupuncture is often done daily or every other day. When I did a clinical rotation in a Beijing hospital, there were in patients who were receiving acupuncture twice a day for the duration of their stay.

It's hard to say how long the effects of one treatment might persist. It depends on a variety of factors which are not easy to predict.

In general, acupuncture has a dose dependency. The easiest way to think about this is through an analogy with conventional medicine. When you have an infection and the doctor puts you on an antibiotic, it's usually not just one pill. There's a week or two of therapy which is required to clear up the infection. If a patient stops the antibiotic too early, the infection can return and might become resistant to the first antibiotic used. This is why patients are almost always instructed to take the antibiotic until it's completely gone no matter how much better they're feeling.

A single acupuncture treatment is a lot like taking just one dose of antibiotic.

There's a course of therapy required in order to receive the full benefit of the treatment. According to some of the better studies we have, in pain management, that number tends to be in the neighborhood of 8 treatments. Some acupuncturists might be able to get results in fewer and some might take more.

Is it possible to hit the nail on the head and have a one-and-done acupuncture treatment? Yes, I've had it happen a few times - it's not the norm though.

For headaches, I typically tell people that after 3 treatments, spaced one week apart, they should start noticing a change in headache frequency, severity or both.

For an adult with no other underlying issues, yes, scalp acupuncture is very safe.

If you've had any kind of brain surgery where part of the skull is either missing or has been replaced with metal or plastic, make sure your acupuncturist knows.

I don't generally recommend any after-care for my patients. Normally I tell them to go about their day as usual. You might check with your provider to make sure they don't have any specific instructions.

Chinese medicine, practiced well, doesn't have set treatment "protocols." We're looking at the body in a completely different way relative to conventional medicine and part of that difference is the realization that two patients can be experiencing the same or similar symptoms for entirely different underlying reasons. We want to treat the underlying reason, not the symptom. Even though two people might have back pain or headache, they won't necessarily receive the same treatment.

On top of this, there are multiple different systems of acupuncture: modern Chinese, classical Chinese, Korean, Japanese, local treatment methods, distant treatment methods. All, properly applied, can be effective, but they all focus on different aspects of the medicine, have different theories about how points are applied and, sometimes, have completely different points and point locations.

This can be a tough question to answer. Sometimes acupuncturists try to promote the procedure as "painless" which isn't technically true. Some points can be a little more sensitive, particularly on initial insertion of the needle.

In addition to this, there are several sensations which can occur, usually thought to be desirable, which can be confused for pain or discomfort by a first-time patient. These include: a dull ache or dull throbbing at the needle site, a short lived pins and needles sensation that propagates up or down from the needle, or a mild distending sensation around the needle. All these sensations should go away once the needles are removed.

The other thing that makes this question complicated is: there are a variety of other medical providers who can often legally provide an "acupuncture-like" service using acupuncture needles but who are often very ill-trained. Patients who see one of these providers can sometimes complain of painful after-effects that might have been avoided had they seen a licensed acupuncturist instead.

Lastly, I'm not sure if you're asking in the hypothetical, i.e. "I'm thinking of trying acupuncture and I want to know if the needles should hurt." Or if you're asking relative to a particular event, i.e. "I recently had acupuncture and now there's pain where some of the needles were. Is this normal?"

If it's the first case, some needles might pinch a bit on initial insertion, but that sensation should fade away rapidly. If the needle is still sharp and stabby feeling after a few seconds, you should speak up and have that needle removed or re-positioned.

If it's the second case, no, that's not normal. Your first step should be to contact whatever provider performed acupuncture on you and tell them what's going on. They may have a solution or may be able to point you in a good direction.

For the best results and the safest treatment, please make sure you're seeing a provider who is licensed as an acupuncturist in your state. If you're not in CA, they should also carry an NCCAOM board certification in acupuncture or oriental medicine. Do not be afraid to ask for these credentials and if your provider doesn't have them, find someone who does. A good resource for finding local licensed acupuncturists is the "Find a Practitioner" lookup at NCCAOM.org.

You don't necessarily have to rest after an acupuncture treatment. I normally advise my patients just to go about the rest of their day as usual.

Acupuncture can sometimes induce fatigue. If you feel like resting and have the time, taking a short nap isn't going to hurt anything. If you find you're constantly fatigued after an acupuncture treatment, you might try eating a small meal either just before or just after treatment.

There are too many variables to provide a hard and fast number for how quickly acupuncture will work in a condition like migraine. Some patients respond more quickly than others, some acupuncturists are better with pain conditions than others.

I work a lot with pain and migraine. My usual advice is that we should be seeing a reduction in headache severity, headache frequency or both in 3 or 4 treatments. A full course of therapy might be something like 6-8 treatments.

Here's a good analogy: when the doctor prescribes antibiotics for an infection, do you take only one dose? No, there's a course of therapy required and if you quit too early, the infection isn't wiped out.

Acupuncture works the same way, one treatment is roughly equivalent to a dose of medication. You need a course of therapy in order to realize the full effect.

Yes, acupuncture can be done daily. In most studies from China we see a course of therapy being 10 or 12 treatments delivered over the course of 10 to 12 days (one treatment per day). When I did a clinical rotation in China, some of the inpatients in the hospital were receiving acupuncture twice a day.

In the US, largely for financial reasons, we've adopted more of a weekly model. Either way can work and if your condition is fairly severe it's not uncommon for a practitioner to suggest more frequent treatment/fewer days between treatments up front.

Acupuncture and Chinese medicine sit on top of an entirely different model for how the body works. Part of this model recognizes the uniqueness of each individual patient - not everyone experiences a health issue for the same reason even if the outward manifestation of that problem appears the same or similar.

On top of this, there are multiple different systems of acupuncture which different practitioners might be utilizing in their treatments.

All of which is a long winded way of saying there's no set "protocol" for an acupuncture treatment. Where the needles go is going to depend on what system of acupuncture your provider practices and what your individual diagnosis ends up being.

If you are already pregnant and wanting to utilize acupuncture to help manage aches, pains or first trimester nausea and vomiting, yes, it can be an excellent treatment choice and extremely safe.

In this case, it's fairly critical that you see a provider who is licensed as an acupuncturist in your state. Make sure the person you see attended and graduated from a school of Chinese medicine, carries a state practice license for acupuncture and, if you're not in CA, they should also be NCCAOM board certified.

The reason this is important is classically in Chinese medicine there are acupuncture points which are contraindicated in pregnancy - these points are theorized to cause miscarriage. A trained practitioner of Chinese medicine will know these points and know to avoid them when treating a pregnant woman. Other providers may not "believe" in the classical information and may attempt to use one of more of these points anyway.

Fertility is an area I don't really work in, so I had to go look up some information for you. It appears as though the answer is a tentative "yes". Here's a link to a site with some information specific to acupuncture, fertility and egg quality:

https://www.ccrmivf.com/news-events/acupuncture-fertility/

When it comes to fertility issues, there are two things which can be critical to achieving good results:

1. You need to see a provider who attended a school of Chinese medicine and is licensed in your state as an acupuncturist. Not everyone who offers "acupuncture" attended a Chinese medicine school - make sure you ask and make sure the person is licensed as an acupuncturist and not providing "acupuncture like" services under some other kind of practice license (like a chiropractor or a physical therapist).

2. You need to see a licensed acupuncturist who specializes in fertility issues. It's a common specialty and if you're in or near any kind of a large city, there should be at least one and possibly several licensed acupuncturists who only or primarily work with fertility patients.

If you need help finding a local provider and you're not in CA, you can use the "Find a Practitioner" look up at NCCAOM.org.

The question of how often you should receive acupuncture for a pain condition like migraine is directly tied to how severe or frequent your headaches are.

For patients with severe pain or frequent headache (headaches 3 or more times per week), I like to start with 2-3 visits per week. Generally we only have to do this for a week or maybe two and then the pain and/or frequency comes down enough that we can go to weekly treatments.

We might stay at weekly for another 2-3 weeks and then we'll start spreading things out to find the appropriate maintenance interval for that person.

If your headaches aren't that severe or frequent, you can probably start with weekly treatments. Expect to receive at least 3 treatments, on a weekly basis, before you start noticing changes.

Yes, acupuncture can work quite well for anxiety. In fact there's a recent study that shows acupuncture outperforming alprazolam (Xanax) for anxiety.

I see quite a few anxiety patients and I've been able to help most of them.

For the best results, please make sure you're seeing a provider who is licensed as an acupuncturist in your state. If you're not in CA, you can use the "Find a Practitioner" lookup at NCCAOM.org to get a list of people local to you.