Texan Magazine
By Dr. Justin Phillips, LAc.
Academic Dean and Director of Clinics at Texas Health and Science University
“I’m afraid of needles, except acupuncture needles.” – Actress Catherine O’Hara
Acupuncture is easily accessible these days. Yet, despite the growing number of insurance companies that now include acupuncture treatments in their healthcare plans, mainstream acceptance remains low due to confusion and popular misconceptions about what it is and isn’t. I’ve treated skeptical patients whose initial mental image of acupuncture was of a doomed soul so full of needles as to resemble a metal porcupine getting ready to meet their final fate should they fall off a treatment table. Then there are the fantastical action movie tropes. Plucky heroes who magically paralyze foes with a single, well-placed acupuncture needle. I’ve practiced acupuncture for years and have yet to meet an acupuncturist capable of such a gravity-defying feat. All of this creates fear and mysticism around acupuncture, which is undeserved by this ancient healthcare field dedicated to healing and relieving pain. The terrible irony of it all is that for people for whom acupuncture should be one of the first stops for a healthier life, it is often the last (if at all).
Acupuncture, and all of the modalities of East Asian Medicine (EAM) such as cupping, herbal medicine, and electro-acupuncture, are ideal early intervention methods. They’ve been shown in numerous clinical trials to have minimal side effects and few adverse outcomes.
It is effective for many conditions such as pain management, insomnia, thyroid issues, poor digestion and even day-to-day stress. And with a growing number of insurance companies covering acupuncture treatments – Blue Cross, the Veterans Administration, Aetna, United, and even Medicare – these interventions are ever more affordable and available.
Despite this, estimates by the National Institutes of Health suggest only ten percent of Americans use acupuncture as a part of their medical care. There are countless reasons for this disparity between usage and the value of care. In a world with climbing medical costs and plummeting medical access, acupuncture can be delivered in a pinch by a trained practitioner. It’s often done on treatment tables, but also in massage chairs, zero gravity chairs, and sometimes yoga mats.
One of my former professors used to carry a pack of acupuncture needles in his pocket. They were sealed and sterile, but he had them in case he came across someone in need. That’s forever stuck with me. I may not always carry needles in my pocket, but the message behind his simple gesture remains clear.
Of course, the current methods of acupuncture delivery are a far cry from a stranger on the street with a pocket full of filiform needles.
A wonderful thing about EAM is that there is a provider and a clinical environment for almost everyone. Today, most acupuncture clinics have embraced a spa-like aesthetic – soft music, calm décor, and sometimes even heated treatment tables. While some acupuncturists like me are old-school purists who use just needles and herbs, others include essential oils and sound therapy in their treatments. But for patients that want a quicker and often more cost-conscious way to get regular health maintenance, there is community-style acupuncture where they share a treatment space, usually partitioned with cushions or screens and a single practitioner. Regardless of the setting, the most critical aspect about acupuncture is that its power is in the needles. Those can go almost anywhere, and often with minimal cost. To be clear, acupuncture is a long-established medical science, developed over the course of three thousand years.
It is true that for much of its history, acupuncture lacked access to many of the modern methods of scientific testing that we have today; for instance, MRIs, X-rays, and complete blood counts. Nevertheless, their methods were still predominantly evidence based. Just as Louis Pasteur and Antoine Bechamp debated germ theory and terrain theory in the mid-1800s, there were rival schools of thought in EAM. While EAM’s disputes were not settled under a microscope, they were settled in an equally significant arena, patient outcomes. EAM and its modalities persisted as a dominant form of medicine in a large part of the world for centuries because it worked, and the refinement of the most effective, safest way to deliver that medicine was the science of the time. In 2002, the World Health Organization conducted a sweeping study on the effectiveness of acupuncture and found that it could help with a wide variety of disorders. This study was repeated in 2016, with additional conditions and disorders included in the list. For many in medical research, the question is no longer “does acupuncture work” but “how does acupuncture work.” Even more importantly to the clinicians that benefit from the research is, “how can we fit it into our treatment plans.” One of the big challenges facing EAM right now is how to best answer those questions. This is because a lot of the methods developed for modern medical research were designed around pharmaceuticals, where a single chemical component can be easily isolated for testing. It is much harder to isolate the effects of acupuncture and EAM, particularly when the system has been conceived to work holistically rather than as individual treatment components.
Then there is the challenge of the double-blind placebo-controlled clinical, which is considered by many to be the gold standard for clinical testing.
Unfortunately, it is very difficult to double-blind acupuncture research. In clinical research, a double-blind trial means there are at least two groups of test subjects. One that receives the actual treatment, usually a pill in modern medical research, and the other that gets a placebo, typically a sugar pill. The “blinding” is that no one, not the patients nor the doctors, know who is getting the treatment and who is getting the sugar pill. This way no one can cheat and fudge the answers. The challenge is how to perform the above in acupuncture.
Not only is it hard to convince someone you’ve inserted a needle into their body, it is virtually impossible to convince a clinician they have performed an acupuncture treatment if they haven’t. This has created a space in which the nay-sayers and detractors of complementary medicine have challenged the validity of EAM as “unscientific,” which has further muddied the waters for many of the patients that might benefit from these therapies. The truth is, despite the challenges of doing research on acupuncture, we have been able to begin answering some of the biggest questions, especially those that address how acupuncture benefits the body and why it creates the effects that it does.
—————-We know that acupuncture reduces inflammation, both locally and throughout the body. Inflammation is one of the major causes of disease, both pain and metabolic.————-
Acupuncture can reduce inflammation by stimulating the body’s natural healing responses through a little bit of medical sleight-of-hand.
The needles, small as they are, are a foreign object under the skin and the body reacts to them as if they were an injury; a response of management and healing. The medical sleight-of-hand is that the needles, which are thinner than the average human hair, don’t actually cause any injury at all. So, by the time the body martials its recuperative efforts, there is no damage to fix. But because the human body is tight-fisted in its use of resources, the energy already spent to manage the suspected injury isn’t going to go to waste. Instead, the body uses those healing resources to repair old chronic damage long ignored like a knee that gets creaky in cold weather, or to reduce low grade inflammation and issues caused by things like repetitive stress. Acupuncture has also been shown to regulate the nervous system.
Most of us living in this crazy, frenetic world of ours feel like we’re constantly running away from a pack of wolves. This chronic, low-grade stress governed by our fight-or-flight sympathetic nervous system isn’t very healthy. Running away from a pack of wolves doesn’t give you time to do things like sleep, heal, or digest your food so your body decreases those functions. The long-term health impact of that is catastrophic and leads to everything from insomnia, acid-reflux, and hypothyroidism. Acupuncture calms down fight-or-flight and helps put us back in a rest-and-digest state. In other words, acupuncture holds the wolves at bay.
Even more importantly, some recent and very promising research suggests that through a process called neuroplasticity, acupuncture might even help retrain your brain so that it understands that the wolves aren’t there at all. What all of this means is that acupuncture can get you healthy and keep you that way. Especially if you get treatment early, while most of the issues you are still dealing with are inflammation and bad digestion rather than COPD and cancer. Isn’t it dangerous to let someone stick needles in your body? Any medical procedure can be dangerous if it isn’t performed by a skilled, highly-trained practitioner. But just like other health-care professionals, acupuncturists go through a lot of training before being certified to practice. Acupuncturists receive nearly three thousand hours of training over the course of three to three and a half years of graduate school. Almost a third of those hours are in hands-on, supervised clinical practice where they refine and perfect their skills. Some even go beyond this and do up to two years of extra study to earn a doctoral degree and receive additional specialty training. In other words, acupuncturists have advanced academic degrees, pass rigorous national board exams, and get licensed by the same state medical boards that licensed your medical doctor.
The bottom line is that acupuncture works and is safe. Still, the question I get asked most frequently as a doctor of acupuncture, and the one that’s likely been lurking in the back of your mind while reading this article, is: “Does acupuncture hurt?” The short answer is no. The longer answer is that sometimes a patient might experience a very brief pinch as the needle is first inserted, similar to a mild bug-bite. In many cases the patient doesn’t feel anything at all. Even if there is a little pinch, this typically passes quickly and the rest of the treatment is without discomfort. About sixty percent of my patients fall asleep during treatment and describe it as the best sleep they get.
If anything, receiving an acupuncture treatment might feel a little odd for a couple of reasons. First, your body is reacting to the presence of non-damaging foreign objects, which isn’t a sensation most of us spend a lot of time dealing with. The second, and maybe more important reason that acupuncture might feel strange is that for the first time in perhaps a long time, you aren’t running away from an imaginary predator. As counter-intuitive as it sounds, for many people it feels strange to be relaxed, and in that relaxed state to experience our body as something other than a source of low-grade discomfort. Frankly, that seems like a good weird to feel. In the 21st century, acupuncture isn’t just on the fringe of medicine anymore; it’s everywhere. Baylor Scott & White hospitals now employ acupuncturists at many of their facilities. The VA hires acupuncturists as well as contracting with outside providers and even acupuncture schools to provide care for veterans. The MD Anderson Cancer Center has hosted multiple symposia on integrative cancer care where acupuncture and herbal medicine were front and center.
Texas Health and Science University, the school where I teach and practice, is pursuing academic partnerships with several institutions of higher learning, including St. Edwards University, Texas State University and Sam Houston State University’s College of Osteopathic Medicine. We’re also developing professional relationships with other healthcare providers, such as the VA, Integral Care in Travis County, and SLEW Cancer Wellness Center in San Antonio. Whatever your needs, there are a few things that are consistent in all of these models that are worth repeating. Acupuncture is safe. Acupuncture is comfortable. Acupuncture works.
If you’re not yet convinced, speak with an acupuncturist. I love to answer questions and there are few things I am more passionate about than effective and accessible medicine. I’ll talk your ear off, but don’t worry; if you pick up a bit of tinnitus from all the chit-chat, acupuncture can fix that, too. And I might just have a packet of needles in my pocket.
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Austin-based Texas Health and Science University offers an accredited master’s degree in acupuncture and is currently developing a doctoral degree program in this rapidly growing field. It operates a satellite location in San Antonio that features the only academic acupuncture program in the city as well as professional and student intern treatment clinics.
