结束语 (Concluding Remarks)

This will be my last post in the acupuncture series.  I've learned a lot about acupuncture and traditional Chinese medicine and I have a new respect for both.  Though perspectives on what acupuncture is actually doing may be different in Eastern and Western medicine, I'm certain it is effective at treating some disorders.  Whether Qi is energy flowing in meridian lines, vital substances moving through vessels, or nerve signals connected by the fascia plane network, there is something going on that is responsible for undeniable results in various studies.  

Even if acupuncture is a placebo effect, it is a powerful one and takes full advantage of the mind-body connection to produce results that can be felt even by a skeptic like myself.  Just the relaxation experienced during acupuncture (regardless of whether the feeling is produced by the environment of the clinic or the actual procedure) is beneficial enough to warrant its use to treat stress related issues and disorders.  I would recommend acupuncture to anyone that suffers from chronic pain, stress, or anxiety, especially if Western approaches have failed to offer successful treatment.

I have to keep one thing in my mind as I'm concluding this experience: in my limited time studying acupuncture, I have learned that Eastern medicine is a much more holistic approach to healing and treatment and that acupuncture is only a very small part of a true Eastern medical treatment.  All the studies on acupuncture's effectiveness were limited to only acupuncture, meaning that despite the conclusion that acupuncture is only effective at treating a few disorders in a limited spectrum, it is quite possible that a holistic Eastern approach incorporating acupuncture as part of the treatment is just as effective as the Western approach in treating any disorder.  This is something I hope to be able to continue to explore in the future.

Placebos and Acupuncture

As I researched, I ran into several studies involving discussions about acupuncture's effectiveness being nothing more than a placebo effect. Many studies use what is called "sham acupuncture" in determining the effectiveness of acupuncture treatments. Sham acupuncture is done in a variety of ways, but typically it is the use of an acupuncture needle placed in incorrect or non-acupuncture points. Marcus (2010) conducted a survey of various studies in acupuncture pain reduction for osteoarthritis and back pain. Each was conducted by comparing traditional treatments with the use of sham acupuncture to act as a placebo. In the ten studies, only two reported strong evidence that traditional acupuncture was more effective than sham acupuncture; the interesting finding, however, was in almost all the studies, sham acupuncture was still better than no treatment.

This opens an interesting debate. After these findings, there is some support that claims that all acupuncture is merely a placebo effect. Colquhoun and Novella (2013) do not take long to state their stance in their article titled "Acupuncture is a Theatrical Placebo." They proclaim that if sham acupuncture is just as effective as traditional acupuncture, then it must be a placebo effect. Lundeberg, Lund, Naslund, and Thomas (2008) claim that sham acupuncture is not inert and therefore cannot be considered a placebo. Because most sham acupuncture still involves some sort of needle insertion, they claim that it still has a physiological, and psychological effect. Follow up studies confirmed this (Moffet, 2009) and made special mention that needles placed in non-points seemed to have the greatest effect (rating the same as traditional acupuncture in13 out of 22 studies). Instead of pointing at a placebo effect, this would call into question the current theoretical basis for acupuncture practices, as traditional acupuncture points were as effective as non-points in a majority of studies.

Personally, I'm not sure what side to take. From my small amount of research on dry needlers, I remember that their version of acupuncture tended to be effective even though they had little training and didn't always use traditional acupuncture points. I would also think there's some possibility that some of the practitioners in these studies didn't hit the correct acupuncture points in the treatment (or hit actual points in the sham condition). I remember feeling somewhat skeptical when Paula had told me that she just had to "feel" for the points and they could be in slightly different locations in different people. But I also have to take my own experience into account. I went in with an open mind, but a healthy amount of doubt as well and I felt some real effects from the treatment. It makes me wonder if I fell victim to a placebo effect or if it would have had the same effect no matter where the needles had been placed.

Works Cited

Colquhoun, D., & Novella, S. (2013). Acupuncture Is Theatrical Placebo. Anesthesia & Analgesia, 116(6), 1360-3.

Lundeberg, T., Lund, I., Näslund, J., & Thomas, M. (2008). The Emperors sham - wrong assumption that sham needling is sham. Acupunct Med, 26(4), 239-42.

Marcus, D. (2010, November). Is Acupuncture for Pain a Placebo Treatment? The Rheumatologist. Retrieved April 4, 2015, from http://www.the-rheumatologist.org/details/article/873613/Is_Acupuncture_for_Pain_a_Placebo_Treatment.html

Moffet, H. H. (2009, March). Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials. J Altern Complement Med, 15(3), 213-6. doi:10.1089/acm.2008.0356

Western Perspectives

As mentioned in previous weeks, acupuncture has been proven to provide some pain relief, reduction of inflammation, and other minor health benefits. There are few arguments against acupuncturist effectiveness in these areas from Western medicine. However, traditional Chinese medicine (TCM) makes claims as to how and why acupuncture works and these explanations of meridians and Qi flow do not align well with Western medicine. So to resolve this confusion, I sought to explore why acupuncture works from a Western perspective.

Takayama, Watanabe, Kusuyama, Nagase, Seki, Nakazawa, and Yaegashi (2012) found that acupuncture increases blood flow, which has a variety of positive health benefits. Tests were run using various acupressure points and increases in blood flow where seen in the traditionally associated body systems. Acupuncture effected the sympathetic tone in these areas, which caused blood vessels to constrict and dilate, changing blood flow to certain areas.

Acupuncture has been used to manipulate levels of endorphin, epinephrine, norepinephrine, serotonin, and dopamine. The increasing some of these chemicals has strong pain relief effects and can also help combat withdrawal symptoms and decrease addiction cravings (Cabýoglu, Ergene, & Tan, 2006). Various acupuncture sites can act as triggers to manipulate chemical release.

Langevin and Yandow (2002) found an interest correlation between acupuncture points and fascia planes in the body. The fascia planes form a network that closely resembles the meridian lines than are used in acupuncture. Nerves within these planes could explain how the clinical effects of acupuncture work, especially in the case of anti-inflammatory effects.

Other TCM concepts that are needed for acupuncture can also be understood in terms of Western medicine (Cheng, 2013). Most acupuncture points have high concentrations of nerve endings and connective tissue, highlighting the importance of these spots over other points in western medical terms. Qi is often explained in terms of nerve signals or the transportation of neurotransmitters and other chemicals. Even the balance of yin and yang can be seen in terms of Western medicine, as it closely relates to the homeostasis between the sympathetic and parasympathetic nervous systems.

It seems the connection between the mechanics of Western and Eastern medicine is closer than I previously believed. All of the studied effects also work together to improve general health and reduce stress -- two things that alone could account for other claimed benefits of acupuncture. Though acupuncture and its related concepts make up only a small part of TCM, it’s interesting to see how much the two very different systems of medicine align with each other.

Works Cited

Cabýoglu, M. T., Ergene, N., & Tan, U. (2006). The mechanism of acupuncture and clinical applications. Int J Neurosci, 116(2), 115-25.

Cheng, K. J. (2013). Neurobiological Mechanisms of Acupuncture for Some Common Illnesses: A Clinician's Perspective. Journal of Acupuncture and Meridian Studies, 7(3), 105-14.

Langevin, H. M., & Yandow, J. A. (2002). Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec, 269, 257-65.

Takayama, S., Watanabe, M., Kusuyama, H., Nagase, S., Seki, T., Nakazawa, T., & Yaegashi, N. (2012). Evaluation of the Effects of Acupuncture on Blood Flow in Humans with Ultrasound Color Doppler Imaging. Evidence-Based Complementary and Alternative Medicine : eCAM, 2012, 513638. doi:10.1155/2012/513638

 

Effectiveness of Acupuncture

Ever since acupuncture gained popularity in the United States and Europe, there have been countless studies as to its effectiveness (or lack thereof) for treating everything from common aches to cancer. Studies have been performed with various methods and the results have been just as varied. I've spent weeks trying to find articles, but for each I find, there’s another that has results counter to the first. In order to retain any semblance of sanity searching for an unbiased view, I've turned to examining a few meta-analyses instead.

The biggest collection of literature and research is acupuncture for various pain treatments. One of the most cited and largest studies was done by Vickers et al. (2012), which looks into the effectiveness of using acupuncture for chronic pain conditions (specifically back and neck pain, osteoarthritis, chronic headache, and shoulder pain). The meta-analysis was conducted on 29 different randomized controlled trials consisting of 17,922 patients. In all trials, acupuncture showed significantly greater effectiveness over sham acupuncture and other types of controls (though it was noted that sham acupuncture had some effectiveness over no acupuncture -- something to explore on another day). All pain conditions were equally affected.

Madsen, Gøtzsche, Hróbjartsson (2009) conducted a meta-analysis with 13 trials, and though they found some evidence of acupuncture having a "small analgesic effect," they found the data regarding the effectiveness of sham acupuncture (used as a control in many of the trials) to be troublesome. In some of the trials they found sham acupuncture to be greatly effective and in other trials, not effective at all. This brings doubt onto the traditional foundational knowledge behind acupuncture and whether the effect is more physiological or psychological.

A 2014 study conducted by Manyanga, et al. compared traditional acupuncture to sham acupuncture, no treatment, and usual care in a meta-analysis of 12 trials (1763 participants). They found that, though acupuncture seemed to be effective, its effects varied widely between trials. The duration of the effectiveness and magnitude of the effects were not consistent between trials.

Another area that acupuncture has had some success is for smoking cessation. White, Resch, and Ernst (1999) found that while acupuncture was successful for smoking cessation over wait-list controls, it was not superior to sham acupuncture and though various techniques were tried in all the trials, no particular technique was superior. The study made mention that the effects were non-specific and it’s possible they could be related more to motivation than a physiological effect of the acupuncture.

Though most of these studies found that acupuncture was effective, they also found inconsistencies and a curious correlation between sham treatments and effectiveness. I've decided that I'll look further into this link next week.

Works Cited

Madsen, M. V., Gøtzsche, P. C., & Hróbjartsson, A. (2009). Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ, 338.

Manyanga, T., Froese, M., Zarychanski, R., Abou-Setta, A., Friesen, C., Tennenhouse, M., & Shay, B. L. (2014). Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine, 14. doi:10.1186/1472-6882-14-312

Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., Linde, K. (2012). Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Arch Intern Med, 172(19), 1444-53. doi:10.1001/archinternmed.2012.3654

White, A. R., Resch, K.-L., & Ernst, E. (1999). A meta-analysis of acupuncture techniques for smoking cessation. Tob Control, 8(4), 393--7. doi:10.1136/tc.8.4.393

 

Eastern Perspectives

A page of the Huangdi Nejing

Now that we have reviewed a history of acupuncture, how exactly do the historical texts explain acupuncture and related concepts in traditional Chinese medicine (TCM)? To look into this question, I delved into the Huangdi Neijing (the Suwen and parts of the Lingshu) myself to see what I could unravel from the original text. I by no means am an expert, but translations and notes of the original text have helped me pick out basics of the practice.

Qi is one of the most basic concepts in TCM, yet one of the hardest to translate into a Western equivalent. Though it’s commonly and incorrectly understood to be some type of energy, it’s often used in TCM associated with states of matter. It can be represented in various forms, some seeming to be tangible (such as vital fluids or breath) and others essential as essence of a function. It is the flow and transformation of Qi that is most important in TCM, as the Qi requires balance in form and function and needs to flow equally into, throughout, and from all the body's systems.

As part of the balance, TCM employs the concepts of yin and yang and the five elements. The yin and yang represent balance through dialectic relationship in all things. If the yin is solid, then the yang is fluid and air; if the yin produces then yang is what is filled. Each is in balance and in opposition, but take away one and the other would not exist. Often it is an imbalance in this system of opposition that causes many of the illnesses in TCM: at its very basic level, most ailments are caused by an excess or lack of vital flow, developed through overproduction, underproduction, overfilling, blockage, or environmental effects.

The five Chinese elements also play a role, as Qi flows through the body in various states, each with elemental qualities. Elements must be in balance, so that there is not too much heat, cold, or dampness. Again, it’s a state of equilibrium and balance that is required and if one element becomes overpowering, it manifests in the form of an illness. For example, in the Neijing it states, "When wind and heat have harmed a person, then his nine orifices are shut and blocked. When fog and dampness have caused a disease, then a shade on the eyes obscures vision." There's also a balance between the elements and seasons as well. For example, it’s said in the Neijing that being exposed to the winter's cold causes a warmth disease as your body tries to produce heat for balance (i.e. you get feverish).

TCM also uses a system of organs, though the organs are similar to the ones presented in western medicine, but often their functions are different. For example, the Neijing says that the qi of the kidneys nourishes the bones and keeps the body strong. If the kidneys are weak, a person will grow tired and their bones will become brittle. Each organ is associated with yin or yang and each has an associated element as well. Qi flows through each, being stored, transformed, and transported throughout the body in many forms and for many functions. Each yin organ works with a yang, and each fits within a system of Qi flow. From what I understand, the actual thought behind the way the organs and Qi work are very similar to what we believe in Western medicine. Qi is taken in with food and air through the body (through organs like the lungs), transformed into other forms, and is used inside the body in various ways, and then eventually leaves as waste.

An image showing the channels in the hand

Now the interesting thing I found was that there is no system of meridians mentioned in the Suwen. There is reference to jing mai and lou mai, which are seen as a system of vessels that transport vital fluid within the body (like blood and forms of qi), but their descriptions in the Suwen (along with other types of small vessels) more accurately describe the circulatory system rather than some abstract system of energy flow. There are also some references in the Suwen describing early forms of acupuncture as being more akin to medieval bloodletting practices than modern acupuncture.

I had issues finding a copy of the Lingshu that wasn't completely turned into a modern textbook for acupuncture, but did manage to find partial copies that had been more or less directly translated. From what I saw, the Lingshu was more or less a diagnostic tool for every known illness. Once the cause of an illness was discovered a treatment could begin. For example, some types of fever were seen as both an excess of yang energy causing a heating of the exterior and insufficiency of yin, causing a heating of the interior. The recommended acupuncture points were a series meant to restore yin and cool inside, while causing sweating to release yang energy and cool the body.

Works Cited

The Yellow Emperor's Classic of Medicine. (1995). (M. Ni, Trans.) Boston: Shambhala.

 

Dry Needling, a Origin Story

After reflecting on my previous post about dry needlers, I felt the need to explore the subject further. From the few websites I had scanned in the process of seeing what type of training was available, it seemed like dry needling had been a treatment before acupuncture started gaining ground in the 1970's. I was interested to see if dry needling had evolved from acupuncture, as a western counterpoint to acupuncture, or from somewhere else entirely. As it turns out, it’s the latter.

As noted by Brav and Sigmond (1941), common treatment for various types of pain such as sciatica was to inject an anesthetic solution into the nerve and surrounding tissue. Many different types of solutions had been tried and amazingly, it was observed that just about any substance injected had the same effect. Taking a cue from acupuncture, Brav and Sigmond set up an experiment with three groups of participants: a group that would receive the standard injection of anesthetic novocaine, a ground that would receive an injection of saline, and a group that would have a needle inserted but receive no injection. Though the novocaine group reported the greatest pain relief, the "dry needle" group was close behind in second place.

Other researchers followed up on the experiment, posting their own reports that contained results agreeing with Brav and Sigmond's conclusion (Levine, Gormley, & Fields, 1976; Moral, 2010; Paulett, 1947; Travell & Rinzler, 1952). Though dry needling did not immediately become a mainstream treatment, the research continued to evolve and the practice gained exponential growth in the early 2000's (Legge, 2014). Though it shares much in common with acupuncture (and it has grown by riding piggyback on acupuncture's growing popularity), its practitioners typically use western explanations of nerve and muscular trigger point therapy rather than using terms related to Qi or meridians.

Works Cited

Brav, E. A., & Sigmond, H. (1941). The local and regional injection treatment of low back pain and sciatica. Ann Int Med, 15, 840-52.

Legge, D. (2014). A History of Dry Needling. Journal of Musculoskeletal Pain, 22(3), 301-7. doi:10.3109/10582452.2014.883041

Levine, J., Gormley, J., & Fields, H. (1976). Observations on the analgesic effects of needle puncture. Pain, 2, 149-59.

Moral, O. (2010). Dry needling treatments for myofascial trigger points. Journal of Musculoskeletal Pain, 18, 411-6.

Paulett, J. (1947). Low back pain. Lancet, 2, 272-6.

Travell, J., & Rinzler, S. (1952). The myofascial genesis of pain. Postgrad Med, 11, 425-34.

 

A Short History of Acupuncture

There’s controversy as to exactly when and where acupuncture was first practiced. It has been theorized that sharpened bones found as early as 6000 BCE in China were first used for acupuncture, but without any accompanying documentation, their actual purpose cannot be conclusively determined (White & Ernst, 2004). The first mention of acupuncture in any documentation was in the Huangdi Neijing (also seen as Haung Di Nej Jing), or The Yellow Emperor’s Classic of Internal Medicine, which thought to have been recorded sometime between fourth century BCE and second century CE (The Yellow Emperor's Classic of Medicine, 1995). This further complicates the issue of the origin of acupuncture as The Yellow Emperor is more of a legendary figure in Chinese history, but supposedly reigned sometime in the second or third millennium BCE. This being the case, most agree that the Neijing was likely compiled over several centuries (White & Ernst, 2004).

A page from Zhenjiu Jiayi Jing

The Neijing contains two books: the first is the Suwen (or Su Wen), which contains information on the fundamental nature of Chinese medicine, and the Lingshu (or Ling Shu), which is basically a technical manual on acupuncture and other Chinese medical practices. In 260 CE, another manual, called the Zhenjiu Jiayi Jing (A Classic of Acupuncture and Moxibustion) was compiled and is the first known manual exclusively dedicated to the practice of acupuncture. The Zhenjiu Jiayi Jing clearly outlined all the acupuncture points and their purposes, and increased the known points to 349 from the 295 which were listed in the Neijing (Ma, 2000). However, it was the Zhenjiu Dacheng (The Great Compendium of Acupuncture and Moxibustion) published during the Ming Dynasty (1368-1644) that forms the basis of the modern practice of acupuncture (White & Ernst, 2004).

Reston's article as it appeared in the New York Times

Acupuncture spread to surrounding countries around sixth century CE, coming to Korea and Japan first. Jesuit missionaries took the knowledge back with them to Europe and the practice began in France sometime in the sixteenth century CE, spreading into the rest of Europe afterwards. Though the popularity of the practiced in Europe waxed and waned through several centuries, acupuncture did not see common practice in the United States until the 1970’s. In 1971 a member of the US press corps named James Reston received treatments in China and published an article about his experience in the New York Times (White & Ernst, 2004). After the article, acupuncture began to gain popularity in the United States.

Works Cited

Ma, K.-W. (2000). Acupuncture: its place in the history of Chinese medicine. Acupuncture in Medicine, 18(2), 88-99. doi:10.1136/aim.18.2.88

The Yellow Emperor's Classic of Medicine. (1995). (M. Ni, Trans.) Boston: Shambhala.

White, A., & Ernst, E. (2004). A brief history of acupuncture. Rheumatology , 43(5), 662-663. doi:10.1093/rheumatology/keg005

The Dry Needlers

During my appointments, Paula has talked to me about several subjects, including details about the acupuncture profession in general. Looking back on some of these chats made me want to explore a few of these topics in greater detail.

Image from doctorgetwell.org

One of the things Paula has mentioned more than once was the threat the acupuncture industry faced from what she called “dry needlers.” Apparently, dry needling is a practice some physical therapist and chiropractors use that is similar to acupuncture, but typically has far less training and expertise. By taking only a class or two over a few days, a chiropractor or physical therapist can start offering dry needling and many may advertise it as acupuncture since it is a far more recognizable name. She said her training consisted of 4,000 hours of classes and practice while most dry needlers consider themselves trained over a weekend. As she explained, she wouldn't attempt to take a weekend course on physical therapy and start taking physical therapy patients, so why would it be OK the other way around?

According to Paula, these practitioners often cause injury or other harm to patients and no only give true acupuncturists a bad name, but also cause government agencies to crack down on the practice by increasing regulations.

I was curious, so I did some quick internet searches to see if I could get a feeling of how other practitioners felt about the practice. Looking at sites from WISCA and a funny (but mocking) video, I could see that other acupuncturists share Paula's disdain for dry needling. What I was even more surprised to find was a physical therapy education company (www.kinetacore.com) offering a three day "level one" training for dry needling, claiming that "Successful completion of the Level One Dry Needling course will provide you with skills and knowledge to begin utilizing the treatment immediately" -- pretty much confirming exactly what Paula had told me.

Long Term Effects

It's been a week and the cupping marks have finally disappeared. Overall I cannot say that I really feel much different than I did when I started treatments, but looking back, there were definite analgesic to the first treatment. They only lasted a few days, but it’s rare I have enough relief to consider myself "pain free" for any amount of time, even with Western medicine.

The second treatment had some minor relief, but nothing close to the first. And the cupping did even less. So I can say with some certainty, acupuncture does seem to be effective in treating nerve pain and it’s possible with repeated treatments it could have a lasting effect.

The only other effect I noticed from all the treatments (more so the first two than the last) was a nice sense of calm and relaxation, both during and after the treatments. However, I could not say whether this was attributed to the treatments themselves, the scented oils used, or the atmosphere of the clinic. From my experiences, acupuncture could also be used for stress and stress-related illnesses, which could explain why it seems to have a positive effect on so many different types of aliments. In the coming weeks, I'm going to delve into the history of acupuncture, try to get an idea of how it works from both an Eastern and Western perspective, and review some of the literature and research available that speaks to its effectiveness as a medical treatment.

3rd Treatment

Today we didn't actually do any acupuncture -- at least not with any needles. Today's treatment was biomagnetic cupping. It is much like the cupping that I had experienced in previous visits (as in use of a glass cup which is applied with suction), but each cup had a charge. Also instead of just two cups, thirteen cups were used and arranged in a line on my back. Paula told me that they help align and balance minerals inside the body and can help restore the flow of energies.

The procedure did not exactly hurt, but it didn't feel very pleasant. Unlike the acupuncture (which was calming) and the cupping done previously (which felt like a massage), biomagnetic cupping was uncomfortable and I was glad when the twenty minute period of "waiting" was done.

Afterwards, my back looked like I was attacked by an octopus.  The marks left by the cupping burned a little but did not have much continuing pain or discomfort.  Unlike the acupuncture appointments, I did not really have a sense of calm afterwards.

Though I searched, I could not really feel any lasting effect from the cupping (other than the marks of course), but maybe it was more subtle than I realized. Either way, this marks my third treatment in three weeks and now I need to focus on what (if any) lasting effect the treatments have had and start to dig into what the scientific community has to say about acupuncture and other practices in Chinese medicine.

2nd Treatment

I went to my second appointment today. From my last appointment I did have some relief from the pain in my fingers and thumb on a near daily basis and had no lower back pain at all, despite working outside quite a bit over the weekend.

Other than what Paula had told me from the last appointment, I still didn’t know much about acupuncture. I’ve purposely avoided seeking out too much information so I can have a better subjective experience during my first few appointments. However, I wanted to know a little more of what was going on, so I asked Paula for a slightly deeper explanation of the theory behind acupuncture. Paula says that energy (called Qi) follows through conduits (meridians) throughout the body. There are 12 standard meridians, each one flows through one of the 12 zang-fu organs. The zang organs (associated with yin) are considered to be “solid” organs that produce various substances for the body. The fu organs (yang) are hollow and responsible for consuming, metabolism, and elimination. Each zang organ is paired with a fu organ, so the flow of energy goes up for the yin meridians and then back down through the yang meridians. As long as the pressure remains balanced between the two pairs, everything is fine and the body is healthy. However, when the flow gets disrupted or blocked, symptoms began to manifest. Deficiencies can cause issues as well as excesses.

The needles used in acupuncture are applied to specific points along each meridian and each needle helps unclog and increase the flow of energy. The treatment helps balance the flow and eliminate various issues. The actual practice is far more complicated than just sticking needles in points, so this is a very simplified explanation, but it’s the best one I can come up with from my limited experience and knowledge so far.

In order to better show me what she was explaining earlier, Paula used a quite a few “optional” points so I can get the full experience. By the end of the session I was feeling like I might appear as a porcupine and this time the treatment wasn't quite as pain free as the first. There were needles placed in a few areas with high amounts of sensory nerves and despite the thinness of the needle, I felt them.

The sensation of the needles is odd however; once she was finished inserting them all, any discomfort started to fade and as I sat waiting (part of any sessions is a 10-15 minute quiet time in which the needles stay in and you are supposed to relax) I could almost drift off to sleep.  Other than feeling relaxed, I tried to detect some other sensations, but I didn't really notice anything else in particular that I could identify.

Four hours later, I feel much the way that I did after the first session. I am relaxed and feel less pain than I normally do in my hands, but I'm not sure what else I'm supposed to feel. I can say for certain that it’s doing something for pain, but past that I'm not sure.

1st Treatment

I just got back from my first acupuncture treatment. Paula has me loaded down with notes, pamphlets, and diagrams but I think it'll take me a bit of time to digest it all so I'm just going to focus on the treatment for now.

I have had chronic lower back pain with sciatica and peripheral neuropathy for some time, so I thought they would be a good thing to experiment with for my first acupuncture experience. Paula explained that these issues were caused by problems along the kidney and bladder meridian (meridians are always paired) and so she used a treatment that used acupressure points along those lines.

I am not sure what I was expecting as a result of the treatment, but the effect was not immediately apparent. The treatment itself was surprisingly relaxing (for something that requires needles to be stuck into your body) and caused very little pain. During the treatment I became acutely aware of my body -- my breathing, heartbeat, and blood flow seemed more apparent than normal. After the acupuncture, she also did some cupping therapy, moving the cups around to create a massage-like effect. It felt great, like a massage that got directly into the muscles underneath my skin (which sounds really creepy now that I write it, but the feeling was wonderful).

The most pronounced effect was a relaxed calm that I experienced immediately after (and which I still have an hour and a half later as I write this). My fingers and hands also feel less pain than normal and my back feels great (though a good massage will do that too). Of course, this may just be in my head, but I am realizing the physical manifestation of what I expected to happen may be part of the point of the mind/body experience too. Paula says the full effect may not be apparent immediately, so I hope to have more to report on the actual feelings a bit later.

The plan is to go through three treatments. Paula says three treatments should be enough to get the full experience and afterwards I'll be able to make a judgement on what acupuncture can do.

I Found Someone to Stick Me with Needles

I expected that acupuncture would be an easier practice to involve myself in because I knew of local practitioners in Auburn and Columbus (the two cities where I spend the most time).  After researching and calling around, I finally decided I would start with PaulaLord, L. Ac. (www.acupunctureforsouthernliving.com) who was licensed and had an office in Auburn.

We have only spoken over the phone, but I explained to Paula that the acupuncture was for a class and the treatments would help me explore the mind/body aspects of the practice. She's eager to help me, letting me know that she had extensive training and education and would have no issues explaining how and why acupuncture worked (details that she was excited to share since most clients are not interested). I'll meet her to discuss more in person later.

I also made the promise to myself that I would take a holistic approach to the experience, as most practitioners I spoke with or researched suggested that the acupuncture itself was only part of the experience and was commonly combined with elements of meditation, herbal medicine, and other practices. I also thought that combining elements of other practices into the experience may enhance the overall effect.

Decisions, Decisions...

After much internal debate, I've finally decided what I wanted to explore as part of my mind/body practice. But before I reveal it, I wanted to look at what I didn't choose -- and why.

I have a full time job, am taking a full time doctoral class load, have three kids, and commute an average of three hours a day to work and school. I was afraid that a few of the practices would not fit into my schedule, and after looking into class times at local spots for yoga and tai chi, my fears were confirmed. Though I could attempt a study through DVD's or streaming video, I really wanted to be led by an experienced guide; but nothing structured like a class was going to possibly fit into my life.

A few of these practices I considered to be really out there, and I was afraid the amount of skeptic baggage I would approach the practice with might dampen the experience. This included suggested practices for the assignment like reiki, johrei, and tapping. I have a lot of doubts about the effectiveness of these practices and wanted to try something more familiar (yet something I've never actually done). I was also a bit worried because I thought it might be more difficult to find practitioners to help me explore these practices. I had not seen any advertisements or offices for either of these, so I wasn't sure if they would even be accessible to me.

I also excluded hypnosis and belly dancing for a combination of reasons. I'm not comfortable with either practice (I don't like to feel out of control, as I fear I would with hypnosis and I'm not in the physical shape for any sort of dancing) and I also saw a combination of a few earlier mentioned factors as well.

I finally settled on acupuncture. Acupuncture is something that has fascinated me for a while, and though I've never tried it before, it’s a treatment that has been suggested to me by my doctor to treat neuropathy and back pain. The fact that it's been recommended by a Western doctor gives it some credibility to me and I assumed I would be able to make appointments that would work around my many other obligations. I had seen several businesses that advertised as acupuncturists around Auburn (where I live) and Columbus (where I work), so I did not think finding a practitioner would be an issue.