How does acupuncture work?
Acupuncture is one modality of the entire system of Chinese Medicine. It is the one with which most Westerners are most familiar, but it is only part of a larger whole. Having developed in a relatively insular culture, Chinese Medicine has its own unique framework, language, and ‘lens’ through which it sees the human body as well as the natural world and the universe (and not necessarily at pains to differentiate among them philosophically or linguistically!)
So: the first step to doing (but certainly not to receiving) acupuncture is understanding it in this context. That is because it is based on the large perspective and principles of Chinese Medicine. Acupuncture textbooks, especially the Classics, of necessity speak the colorful, poetic, sometimes hokey-sounding language of this 3000 year old system. While it is incredibly complex and exacting – and accurate! – this language is no doubt partly responsible for Western suspicion as to acupuncture’s relevance medically speaking in modern times. But acupuncture textbooks don’t teach you where to put needles for ‘a headache’; they teach you where to put needles for any one of dozens of underlying patterns (with colorful, poetic unfamiliar names) that CAUSE your headache. The practitioner’s first job in doing acupuncture is to make correct diagnosis, and this is supremely important. You don’t want to treat the headache with a point combination meant for one pattern when a different pattern is responsible… it could become worse.
Diagnosis is made by
1.) Looking at the tongue – which is an incredible accurate map of the insides of your body. We look for things such as the shape, color, coat, cracks, size, moisture – and where all that is. Don’t brush your tongue please, before you go! An unbrushed tongue is easier to read.
2.)Taking your pulses – you have 9 on each wrist in the system I was taught. The practitioner will put three fingers along your wrist and stand there subtly pressing and moving his/her fingers for a couple of minutes to feel all of them
3.) Talking to you – asking you to describe your symptoms, asking for answers to seemingly random and unrelated stuff that to us, helps immensely in sorting out patterns quickly. Its incredible how often a patient will inadvertently describe an problem with a word-for-word quote in a 3000 year old Chinese Medical textbook – using the same colorful, poetic language. So, I always ask a lot of questions and listen carefully.
Once a diagnosis is made, thin, tiny needles (much much smaller than the ones that no one likes to see coming at them in a hospital!) are placed in the skin at specifically chosen points (the ‘point prescription’) on the body. They are not randomly placed but inserted along the meridians or channels which Chinese Medicine recognizes as traversing the body. These channels are as real to the Chinese as anything else: blood vessels, lymph pathways etc… and carry something as – but not more – important: Qi. Every human body, like everything else in the universe contains and is animated by Qi, which is often translated as ‘life force’ but in actuality has no literal translation. It is the motivating principle of a thing, and in the human body moves the blood and all the fluids, generates body heat, among other jobs… The idea with Chinese Medicine is that when you feel unwell, the Qi is either doing something it shouldn’t, or not doing something it should. The needles are inserted precisely to enter a particular channel at a particular point chosen specifically for its properties and indications – to manipulate the Qi in the channel and redirect it or benefit it in some other particular way. There are around 600 points (depending on how they’re counted) on the human body, and each one does from a couple to several things when it is needled. (This is why acupuncture school takes so long – learning all that is a real commitment!) To give a very basic example, again using the headache: a practitioner might use a point for pain, and then combine it with the ‘command point’ for the head – essentially telling the ‘pain’ part of the treatment to favor the head, since thats where the pain is…
Generally more than a couple of needles are placed, and some practitioners have been trained to use a specific ‘needle protocol’, meaning to use a certain number of needles (my school had a loose rule of 12) for every treatment. (The idea being that a really good practitioner could accomplish anything they needed to by the use of no more than 12 – or whatever – needles). But it all depends upon the prctitioner, the patient and what is needing to be accomplished. I often use more, especially for pain.
The needles may be in areas nowhere near you pain or problem, and that is because the channels cross and cover your whole body, and a needle may be put in another part of the affected channel due to the specific indications of that point and the chances that it will most benefit your problem despite not being nearest to it. Needles may also be put in other channels – usually several different channels, especially in internal medicine acupuncture – for the specific properties of a point there. Any given health complaint is likely to be seen in Chinese Medicine as arising from disharmonies – and/or disharmonious balance – in more than one channel and its related organ (needing channels can also affect the organ to which they are related).
The channels are named after the organs to which the are associated, and which are treated through them:
Lung, Large Intestine, Stomach,, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, Triple Burner (the organ with ‘function but no form’), Gall Bladder, Liver (there are actually several other channel too, not related to organs, but trying to keep this simple!)
Needling a channel can treat either problems within the channel itself, or problems in the organ system related to it. Sometimes, for complicated reasons, points for one organ system are located on a channel attached to another organ system. As things change, your treatment, and the points used will probably change too, because the patterns change. Different practioners might use different points too, but that doesn’t mean one is better than the other; in the same way Western doctors might favor one drug or treatment over another. If something worked well for you, let your practitioner know so he/she can repeat it.
The needles generally don’t hurt at all – many people don’t even know they’ve been put in. We like to say that if they do hurt, its about as much as having your hair pulled. Some are more intense, and I always ask before I do those, warning the patient that this particular point can be ‘zingy’ in case they’d rather refuse. Often during insertion or removal, the practitioner will move or manipulate the needles in some way, and this is to increase the desired effects.
Once the needles are in, you lay quietly generally alone either in a room or behind your own curtain; or, in a community acupuncture setting, in a recliner located in a darkened room with several other people quietly getting treatment. The time varies, but is generally 20 to 30 minutes. You may feel things going on in your body, may feel suddenly very relaxed (I’ve had people ask me if I’m putting drugs in the needles), or may feel a sensation around a specific needle itself such as heaviness, pressure, burning, tingling, or itching… this is called ‘da Qi’ and means ‘the Qi arrives’; the Qi is coming to the needle and responding to it – the treatment is working!
Then, the practitioner comes and removes the needles and you are done! For the next few hours you should not do anything that sends the Qi all crazy (OK, NOT a classic Chinese term!) such as exercise heavily, eat a big meal, have sex, drink alcohol, ride a roller coaster – you get the idea. You want the Qi to keep doing what the needles told it to do and not what a hyped-up external event tells it to do… Qi is effected by the environment a lot, so this is important.
When you first start treatment for a specific problem you will probably be advised to come more often, say once week. As you feel better (the Qi becomes re-habituated) treatments can be spread out to every two weeks or more, until eventually you are coming once a month or less for maintenance. I always suggest coming in every so often even once the problem is resolved just for a ‘tune up’. Since Chinese Medicine looks at underlying patterns. we love it when patients come in before they start feeling bad, so we can do a check-up, look at the patterns and such and work on correcting anything we see going on underneath before it manifests in an actual condition requiring more frequent and intense treatment.
Best of health!