Acupuncture is a treatment that consists in pricking the patient with a
special needle. It developed in China about 2,000 years ago. Today
there is also a modern version of acupuncture which explains the
treatment in scientific terms.
What are the differences between traditional and modern
The differences are mainly at the level of theory - ideas about what is
going on when one inserts an acupuncture needle into a patient.
Traditional Chinese acupuncture uses a complicated system of ancient
ideas that are not easy for most of us to understand or accept today.
The modern version does not use these ancient ideas and this makes it
easier for health professionals to learn and use. Many doctors,
physiotherapists, osteopaths, chiropractors, nurses, and podiatrists
today offer acupuncture to their patients, and the British Medical
Acupuncture Society has over 2000 members.
There are also practical differences.
Modern acupuncturists do not use traditional diagnostic methods such
as the pulse or the appearance of the tongue.
Many, though not all, modern acupuncturists leave the needles in
place for quite a short time: often about two minutes or even less.
Many, though not all, modern acupuncturists use only a few needles,
perhaps four and sometimes only one! Surprising though this may seem,
experience shows that doing acupuncture this way is quite as effective
as using a lot of needles and leaving them in for longer and is less
likely to have unwanted effects.
Which is better, modern or traditional?
Both versions are
probably equally effective in some cases, since both use needles. The
traditional version is more difficult and time-consuming to perform but
there is little if any scientific evidence to show that it gives better
results or can treat a wider range of conditions than does the modern
version. Modernists have introduced new techniques to acupuncture, some
of which, such as electro-acupuncture, have been taken up by
How does it work?
A lot of research on this question has been done in recent years. Much
still remains to be discovered, but today we can say that there is a
plausible scientific basis for the treatment, at least in its modern
form. Here is a summary of the main topics that have been studied.
There are changes in the tissues at the site of needle insertion
which are thought to speed up healing of injuries and recovery from
The modern understanding of pain is that it depends on complex
patterns of activity in the spinal cord and brain. There is good
evidence that acupuncture can alter these patterns and so reduce the
intensity of pain or its unpleasantness.
Much musculoskeletal pain seems to be due to what are called trigger
points in the muscles and other tissues. Needling these can
inactivate the trigger points, and so to relieve pain and increase the
range of movement.
What diseases can be helped by acupuncture?
It isn't possible to give a complete list, partly because a lot depends
on the reaction of the individual patient. Some people are much better
subjects than others, and some don't respond at all.
In general, acupuncture is good for pain, especially pain in the muscles
and joints (including some kinds of arthritis). It can also help in a
range of other disorders, including headaches and migraine, some
allergies, painful periods, and ulcerative colitis.
Does it hurt?
Acupuncture is usually not pain-free. However, it is no more painful
than an ordinary injection or blood test and in many cases it is less
painful than these. As a rule it is necessary to produce a little pain
to achieve an improvement but some people feel nothing at all. Oddly
enough, you may even find that acupuncture makes you feel relaxed and
happy. If this happens it probably means that you are a good
acupuncture subject and are likely to benefit from this form of
treatment. (If it doesn't happen to you, however, that is not a bad
sign; you may do well anyway.)
Can it cause any harm?
Acupuncture carries the same risks as any other medical procedure
involving needles, such as damage to internal organs or other structures,
though this is rare. To put it in perspective, the risk of harm
occurring as the result of acupuncture is probably less than the risk of
taking aspirin or an anti-inflammatory drug for arthritis (these drugs
can cause bleeding and other problems). This assumes, of course, that
the acupuncture is performed by someone with an adequate knowledge of
anatomy and medicine.
Sometimes a small bruise appears where the needle was inserted. This
isn't serious; it just means that a little vein was broken by the
needle. There is no need to do anything about it; it will go away by
This list does not exhaust all the effects that have been
reported but it does summarize the commonest ones. If you have any
particular anxieties about the treatment you should discuss them with
the person who is going to treat you.
May I be worse after acupuncture?
You may find that your
symptoms become temporarily worse for a short time after acupuncture.
This is called an aggravation. Tell the person who is treating you
about this next time you come; it may be possible to avoid the
aggravation in future by treating you more lightly, with fewer needles
or for a shorter time. But some people will get a mild aggravation every
time they have acupuncture. They generally feel it is worth accepting this
for the sake of the pain relief which follows.
As well as a temporary worsening of your symptoms (aggravation), you
might have pain after acupuncture that is unconnected with your original
complaint, although this is rare. It may be due to damage to a small
nerve and is not totally preventable; it does not necessarily mean
that the acupuncture has been done incorrectly. Pain of this kind will
usually pass off within a day or two.
Can acupuncture transmit AIDS or hepatitis?
No, because all the needles are disposed of after use. There is
therefore no possibility that infection could be transmitted.
Is it safe to drive after acupuncture?
Some degree of drowsiness after acupuncture is fairly common. This may
make driving or operating machinery unwise, so you should
generally not drive yourself home after treatment, particularly on the
first occasion. Sometimes drowsiness does not occur after the first
treatment but does occur on a subsequent occasion, and it is also
possible for drowsiness to occur later in the day, some
hours after treatment. If you have had acupuncture you should
therefore be cautious about driving for the rest of the day and should
be prepared for your reflexes to be slower than normal.
How soon will I notice an improvement?
You may have partial or even complete relief as soon as the
needle is put in but this is exceptional. Most people find that improvement
takes longer to appear - sometimes later the same day, or
perhaps up to two or three days later.
How many treatments will I require?
Sometimes one treatment is
enough but this is unusual. Most people require a course of roughly 3
to 6 treatments.
How frequent are the treatments
For chronic (long-term) problems like arthritis you may
be asked to come back after a week or so. Acute problems (those that have
started recently, such as a sprain) may be treated more frequently at
first, although probably not more often than twice a week.
How soon will I know if it is working?
Generally speaking, there should be at least some effect after two or
three treatments. If nothing at all happens you are probably not going
to respond to this form of treatment. You should never be asked to book
in for a fixed number of treatments in advance, since the course of
treatment is always unpredictable.
Will the effect be the same each time I am treated?
You may find that the effects of treatment vary from time to time. One
treatment may help a lot, the next less or even not at all. Don't worry
too much about this; provided there is a long-term trend towards
improvement all is in order.
Will acupuncture cure me completely?
acupuncture doesn't 'cure' diseases although it can give good relief,
especially for pain. It is best thought of as a form of symptom relief.
At the same time, if a disease is capable of recovering by itself it is
possible that acupuncture can tip the balance towards recovery.
Will I need further treatment after the first course?
In many cases an occasional 'top-up' treatment is needed to maintain
improvement. As a rule only one treatment is required for this, even if
the initial course was longer. Patients appear to have individual
patterns of response which remain pretty constant. For example, you may
find that it always takes 24 hours before you notice an improvement. And
the duration of improvement - 8 weeks, 12 weeks, or whatever - is also
fairly constant for a given patient.
Should I stop my conventional treatment?
You shouldn't stop any prescribed medication before
discussing it with your doctor; doing so could be dangerous.
"Over-the-counter" treatments can be stopped (discuss this with your
acupuncturist), but remember that if you are taking medicine to relieve
pain and stop abruptly you may get worse. You may think
this is caused by the acupuncture although it isn't. It may well be
possible to reduce or even stop pain-relieving medicine later but do
But I don't actually believe in it!
Belief doesn't matter. In fact, the best results are often seen in
people who didn't expect it to work! Provided you are willing to have
the treatment it may work.
I'm pregnant. Is it safe to have acupuncture?
Ideally, all kinds of treatment are best avoided in pregnancy, but
acupuncture is probably safer than most drugs and a recent review of
adverse events in pregnancy has been reassuring. If you are pregnant you
should tell your acupuncturist in case any modification of treatment is
required. Acupuncture appears to work quite well for nausea and vomiting in the
early months of pregnancy and for back pain in later pregnancy.
What if I'm a blood donor?
Discuss this with your acupuncturist. You can be given a letter to show
to the blood donor authorities, explaining that you have had acupuncture
from a regulated health professional who uses single-use disposable
needles. This will usually allow you to give blood.
I still have questions. Where can I find more information?