Does Acupuncture Hurt?
We have found that typically patients are surprised by how little it hurts. Many people feel little to no discomfort and it is common for patients to fall asleep during treatment. The only discomfort is normally with the initial insertion of the needle when it breaks the skin (if there is continued discomfort the needle can be adjusted or removed).
Acupuncture uses filiform, stainless steel, single use, sterile needles that are mostly no thicker than a human hair. Acupuncture needles are different from hypodermic needles. Hypodermic needles for shots and blood drawing are much thicker (as many as 40 acupuncture needles can fit in the tip of a hypodermic needle) and hollow.
In the end, your comfort is paramount to the healing process, so we invite you to come in, handle the needles and ask questions. If you are still uncomfortable, we can use other noninvasive techniques like acupressure, Chinese herbal medicine, magnets, moxibustion and diode chains to affect healing.
How Many Treatments Will I Need?
This question depends entirely on the type of condition being treated and how long the problem has existed. For a twenty year old (whose natural healing abilities are at their peak) who has just sprained his or her ankle, treatment can yield immediate results with a reduction of swelling and pain, increased range of motion and dramatically decreased recovery time. Even in this situation, however, Acupuncture and Oriental Medicine (AOM) is not a panacea.
The body is the only thing that can actually heal itself, and that process takes time. AOM helps balance the body and its energies so that the healing process is optimal. For chronic issues (pain, digestive disorders, depression, etc.) that have developed over a number of years, the answer is far less clear. The disease process develops its own inertia and it will sometimes take time to halt, then reverse this inertia (akin to turning a large ship and getting it going in the right direction). Additionally, the body will often push things that it cannot deal with into a state of latency (kind of putting a lid on things) until circumstances will allow it to properly deal with the issue. The problem with this is that our modern lifestyles often do not give our bodies the opportunity to slow down and deal with things. Thus a small crick in the back can become a debilitating pain issue that needs to be managed with pain killers and limitations on one’s activities. AOM can “pop the lid” on these latent issues and sometimes things will get worse before they get better.
With all of this in mind, typically you should expect to see a change in your symptoms within four to six treatments. At Princeton Acupuncture and Oriental Medicine, after your initial intake, we will present you with a written Report of Findings and a treatment plan indicating the frequency of visits and number of visits that we recommend for your specific problem. The treatment plan typically includes a decreasing frequency of visits at targeted intervals over the course of the treatment (for example from once a week, to once every two weeks, etc.) until you are coming in on a “maintenance” schedule (typically five to twelve times a year). At the targeted dates for frequency reduction (or at any time you request) we will perform a brief reevaluation, discuss your progress and a decision regarding the course of your treatment will be made, together.
Is Acupuncture Safe?
The U.S. Food and Drug Administration (FDA) approved acupuncture needles for use by licensed practitioners in 1996. The FDA requires that sterile, nontoxic needles be used and that they be labeled for single use by qualified practitioners only. Relatively few complications from the use of acupuncture have been reported to the FDA in light of the millions of people treated each year and the tens of millions of acupuncture needles used. Occasional complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. Our clinic uses only single use, sterilized needles that are properly disposed of after use.
People with cardiac pacemakers, infusion pumps, or other electrical devices should avoid electroacupuncture. Please tell us if you use one of these devices. There are certain areas of the body and certain treatments that should be avoided in pregnant women. Please advise us if you are pregnant or trying become pregnant.
A survey by Ernst et al. of over 400 patients receiving over 3500 acupuncture treatments found that the most common adverse effects from acupuncture were:
- Minor bleeding after removal of the needles, seen in roughly 3% of patients. (Holding a cotton ball for about one minute over the site of puncture is usually sufficient to stop the bleeding.)
- Hematoma, seen in about 2% of patients, which manifests as bruises. These go away after a few days.
- Dizziness, seen in about 1% of patients. Some patients have a conscious or unconscious fear of needles which can produce dizziness and other symptoms of anxiety. Patients are usually treated lying down in order to reduce the likelihood of injury if the patient faints.
The survey concluded: “Acupuncture has adverse effects, like any therapeutic approach. If it is used according to established safety rules, and carefully, at appropriate anatomic regions, it is a safe treatment method.”
Safety compared with other treatments:
Commenting on the relative safety of acupuncture compared with other treatments, the National Institute for Health consensus panel stated that “adverse side effects of acupuncture are extremely low and often lower than conventional treatments.” They also stated: “the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. For example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow… are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments.”
In a Japanese survey of 55,291 acupuncture treatments given over five years by 73 acupuncturists, 99.8% of them were performed with no significant minor adverse effects and zero major adverse incidents (Hitoshi Yamashita, Bac, Hiroshi Tsukayama, BA, Yasuo Tanno, MD, PhD. Kazushi Nishijo, PhD, JAMA). Two combined studies in the UK of 66,229 acupuncture treatments yielded only 134 minor adverse events. (British Medical Journal 2001 Sep 1). A total of 121,520 treatments with acupuncture therapy were given with no major adverse incidents (for comparison, a single such event would have indicated a 0.0008% incidence).
Does Health Insurance Cover Acupuncture?
More and more health insurance companies are providing coverage for acupuncture. This is because studies of acupuncture have shown that acupuncture is safe and effective (and as a bonus to the insurance companies, it is inexpensive!). This is great for consumers, giving them more options and for some, an option that finally works for them.
There are, however, some drawbacks. It is estimated that approximately forty cents of every dollar that is billed to a health insurance company goes to collecting the money in a modern medical practice. This additional work has to be done by either the health care practitioner or additional staff. If the practitioner does this additional work, it means less time for the patients and if the practitioner hires additional staff, it means seeing several patients an hour to support the additional staff. The end result is that you, the patient, tend to spend more time with a nurse and less time with your doctor, the person who is best qualified to care for your health.
At Princeton Acupuncture and Oriental Medicine, we believe that the interaction between the practitioner and the patient is vital and necessary to the healing process. During a treatment that lasts between an hour and an hour and a half, your practitioner will actually be with you for up to forty minutes and sometimes longer. You will normally be treated on your front or back (sometimes both) and adjunctive therapies like moxibustion, gua sha and cupping will be performed, as necessary, at no additional charge.
We prefer to spend our time on you, our patient, and your health and well being. We have therefore made the decision at Princeton Acupuncture and Oriental Medicine to not process invoices through insurance companies. We will, however, give you an invoice with the proper codes and information so that you can submit it to your insurance company. If your insurance company reimburses, either partially or wholly, for acupuncture, you will be reimbursed directly from your insurance company. This enables us to provide you with the highest quality care that concentrates on what is most important, you and your health and well-being. Here are some questions to ask when you call your insurance company to find out if your plan covers acupuncture:
- Do I have acupuncture benefits?
- Do the benefits cover my condition? (some plans are very restrictive covering a very narrow range of conditions, some cover conditions like pain, but only in certain locations, it is important to ask this because while acupuncture may be covered, your condition may not be)
- What is my deductible and has it been met?
- How many sessions per calendar year does my plan cover?
- How much does my plan cover for an out of network provider?
- What is the coverage amount per session?
- Do I need a letter of medical necessity and who can provide one if necessary?
Are There Any Side Effects?
One side effect that causes a concern with patients is that the original symptoms will sometimes worsen for a few days after an acupuncture treatment. This is sometimes referred to as the “Law of Cure”. Your body has its own innate wisdom and when it is dealing with something that it cannot handle, it will often shunt the problem to an area of the body that can contain the problem until it is ready to deal with it. The result of this can be pain and illness. Now why would the body “create” pain and illness? Possibly because what it is dealing with is worse than the pain or illness that you are suffering from. Say you hurt your arm, your body tells you not to use that arm with not so subtle pain signals so that the body can heal itself. In a similar fashion, if you have chronic pain or some illness, your body is sending you a signal to maybe slow down, get rid of some stress, eat better or in some cases get help from someone who is trained to heal. Again, the body has its own innate wisdom, we just have to learn to listen to it.
Sometimes other general changes in appetite, sleep, bowel or urination patterns, or emotional state may be triggered. These should not cause concern, as they are simply indications that the acupuncture is starting to work. Acupuncture can be seen as a smoothing out of blocked Qi that is stuck in areas of your body. When a garden hose gets a kink in it, the water stops flowing. When you straighten the hose, the built up pressure makes the water burst out in the beginning. This is what can happen when you first have acupuncture.
It is also common with the first one or two treatments to have a sensation of deep relaxation or even mild disorientation immediately following the treatment. These effects normally wear off within 24-48 hours.
A few people have reported more serious reactions, such as dizziness, sweatiness, or nausea, according to a November 1999 issue of the Archives of Family Medicine. There have even been some cases reported where patients lose consciousness. These problems are extremely rare, however, and normally clear up on their own within a few minutes, without lasting harm to the patient.
Please discuss what you have been experiencing with us. Your comfort is a priority. The more you communicate with your practitioner, the more they will be able to help you.