Jeff Rippey

Yes, acupuncture can be a good choice in the treatment of depression. Several studies have shown that acupuncture matches the effectiveness of drugs like Prozac in mild to moderate depression. There are also studies showing acupuncture plus therapy gives better results than either acupuncture or therapy alone.

If you're not in CA, go to NCCAOM.org and use their "Find a Practitioner" look up. Get a list of practitioners in your area and then call around to see if anyone will make a house-call. Sometimes we do and that might be a better fit for your friend initially.

Acupuncture can probably help with your pain issue. The area where we have the best evidence of acupuncture's effectiveness is in chronic and acute pain. I've worked with lots of hand/wrist pain patients and I'm usually able to get good results for them.

If you're not in CA, go to NCCAOM.org and use their "Find a Practitioner" lookup to get some providers close to you.

Good question. Unfortunately, the answer is: it depends. How long you've had the migraines, how long they've been a daily occurrence, whether or not there is a hormonal component or a lifestyle component all influence how a practitioner of Chinese medicine will diagnose and treat and also influence how many treatments you might need.

A general rule of thumb that I give to my migraine patients when we start treatment is: if something about your migraines (frequency, severity) doesn't change for the better in 3-5 treatments (at one treatment per week), we may need to re-think our approach.

Acupuncture can be fairly effective in mild to moderate depression. Here's a link to a study showing acupuncture is at least as effective as a typical antidepressant:

https://www.scientificamerican.com/article/can-acupuncture-treat-depression/?redirect=1

Be prepared to give acupuncture 3-5 treatments and please ensure you're seeing a state licensed acupuncturist. To find someone in your area, assuming you're not in California, you can start at NCCAOM.org and go to their 'Find a Practitioner' page.

Yes, acupuncture can probably help with your migraines. I have a handful of migraine patients and I'm usually able to get them to a place where their migraines are under control and don't exert as big an impact on their quality of life.

Be prepared to commit to weekly treatment for somewhere in the neighborhood of 3-5 weeks.

Also, please make sure you see a state licensed and board certified acupuncturist. If you're not in California, a good place to start is the 'Find a Practitioner' page at NCCAOM.org.

I'm a little confused by your question: have you and your husband been trying to get pregnant and are experiencing difficulty, or are you considering trying to get pregnant and want to use Chinese medicine just in case?

Assuming no underlying health issues for either one of you, I'd probably suggest starting acupuncture for both of you at the end of your period. I'd go once a week, this will give you roughly 2 treatments prior to ovulation. I'd continue acupuncture, for both partners, at once a week for the next 2-3 weeks and then see what happens.

If you have menstrual irregularity, abnormally long or short cycles or abnormally painful menstruation, then all bets are off and you might need more intensive treatment to normalize your cycle before getting in to the work of fertility enhancement. Things might also get complicated if you've been on long term hormonal birth control (pills, implants, Mirena IUD, etc.)

It's also worthwhile to have your husband tested for sperm count, quality and so on. This will give you a head start on things if you do encounter issues getting pregnant.

No, it's not typical for a patient to experience headaches after an acupuncture treatment. There's a lot that could be going on here and without a great deal more information here's the best advice I can offer: talk to your provider and let them know what you're now experiencing. Hopefully the feedback will give them the information they need to adjust your treatment so this doesn't happen again.

Yes, acupuncture can be very effective for migraine. I've had several migraine patients over the years and usually the combination of acupuncture and diet modification brings things well under control.

This is a question I get a lot: how long is it going to take for acupuncture to work for some condition? Unfortunately, there isn't really a single answer. Chinese medicine considers the human system as an integrated whole. Each person is unique and the treatments are individualized. This makes it difficult to pin down an exact number of treatments.

Diagnostically, Chinese medicine works a little different from conventional medicine. For anxiety, there are a couple of different root causes and some root causes are easier to treat than others. It sometimes helps to envision your health issue like an iceberg. The part of the ice floating above the water is the symptom you experience. The part of the ice below the water is everything leading up to the symptom you experience. To make the symptom go away, we also have to address what's hidden under the water, and there's often way more stuff that's submerged.

That being said, you should notice some improvement by your 3rd treatment (assuming weekly sessions). The idea with Chinese medicine is not to have you coming in once a week for the rest of your natural life. What we're trying to do is find a maintenance interval that works such that your symptoms are either eliminated or reduced to such a degree that they don't interfere with your life. Sometimes an acupuncturist can resolve your issue in 5 or 7 treatments, and sometimes an acupuncturist gets things under control in 5 or 7 treatments and then sees you monthly for a few months to make sure everything is going ok.

Good question. Yes, studies have shown that for mild to moderate depression acupuncture is almost always at least as effective as SSRI drugs (things like Prozac, Paxil or Zoloft).

The how is a little tricky. Let's start with the SSRI drugs. If you look at a patient information leaflet for one of these drugs and check out the mechanism of action section you'll see that we don't really understand how these substances work. We know that, in many cases, they do and we're willing to tolerate the side-effects to achieve the beneficial result of the drug.

Acupuncture in depression is in a somewhat similar boat. We don't have a clear mechanism of action. We do have some good ideas about what's going on: promotion of the parasympathetic (rest and digest) nervous system as well as effects on the GABA system in the brain. Does this account for the entire effect? We aren't sure. What we do know is: as I mentioned above, acupuncture is almost always at least as effective as the SSRI drugs when tested head-to-head in mild to moderate depression.

The advantage goes to acupuncture because it has a very low risk/side-effect/adverse event profile. All other things being equal acupuncture, performed by a licensed acupuncturist who graduated from Chinese medical school, is fairly safe. Another consideration: in the long run, acupuncture is likely to be more cost effective as well.

Essentially, we're comparing two things: we don't have a clear understanding of why either one achieves the effect it achieves, but we're pretty sure both things achieve the effect we want. One thing has a long laundry list of potential negative effects and, over time, can be very expensive. The other thing has a much shorter list of potential negative effects and over time is cheaper.

You're probably going to get as many answers to this question as there are acupuncturists on this board. From a scientific perspective acupuncture has been shown to:

1. regulate sensory/pain transmitters in the spinal cord and brain.
2. re-map areas of the pre-frontal cortex responsible for processing pain signals.
3. regulate leptin, ghrelin, cholecystokinin, insulin and blood sugar.
4. influence muscle tonicity at various points on or in the body - often in areas distant from where needles were inserted.
5. promote the parasympathetic side of the autonomic nervous system.
6. promote the GABA system in the brain.
7. regulate immune response.
8. stimulate the release of endogenous opiate peptides.
9. up-regulate opiate receptors in the brain.
10. have a homeostatic effect on blood pressure.

Plus a whole laundry list of other things that are escaping my memory at the moment. So, it's not that we don't know acupuncture has measurable effects in the body. It's also pretty clear that acupuncture is not dependent on placebo - there have been several studies over the last few years demonstrating this fact. We also know that when we test acupuncture head-to-head against pharmaceuticals for certain conditions, acupuncture is almost always at least as effective as the drug, sometimes more effective.

Your question is what got me in to Chinese medicine in the first place: what's going on? After studying for almost 20 years, I have a hypothesis - it's an idea that many practitioners of Chinese medicine share and it has to do with how the body grows and develops as an integrated whole. In a nutshell, we think the needles are tapping in to a bioelectric system that runs on the order of micro or pico amps which follows the fascial planes/connective tissues in the body and serves to integrate everything such that every cell knows both where it is and what it's supposed to be doing. There's quite a bit of circumstantial evidence, from a wide variety of researchers, going all the way back to the late 19th century, that this could be the case.

Without writing an entire book on the subject, this is what I think is being stimulated in the body when acupuncture needles are utilized.

Acupuncture can most likely help with your anxiety. About 20% of my practice are anxiety patients and I'm usually able to get good results for them.

Because of the way Chinese medicine views the body and body function, it is not limited to only physical issues. I've worked with depression, PTSD and a variety of other issues that conventional medicine typically considers psychological or psychiatric.

It's a lot easier to list the things you wouldn't want to treat using acupuncture:

1. Acute, life threatening infection - bacterial, viral or fungal.
2. Severe, life threatening trauma - think car accident or heart attack.
3. Joint degradation to the point that replacement is necessary. Acupuncture can still help manage the pain/discomfort but there is a point of no return with joint issues and once a patient has crossed that line, replacement is the best option.
4. Cancer. Acupuncture can manage chemotherapy side effects, but it's not going to cure cancer.

For almost any other condition, whether physical or not, acupuncture can have benefit.

Acupuncture can usually help patients lower their blood pressure. A lot depends on why your pressure is elevated and sometimes it takes a few treatments to get your pressure down and keep it down.

This is a good question. There are a couple of things here:

1. A single acupuncture treatment is unlikely to help a patient with any condition. Sometimes we're able to hit the nail on the head straight out of the gate and correct an issue with a single treatment. Most of the time you're looking at more like 5-7 treatments with incremental gains after each one. With a condition like anemia, there's no way to know what's happening after a single treatment. Red blood cells have, roughly, a 90 day lifespan and it takes time for your body to manufacture more.

2. A great deal is going to depend on why you have anemia. There are several different models from the perspective of conventional medicine for why a person might be anemic. I'd suggest you start with your primary care physician, have some blood tests run and see if you can figure out what's the root cause. It could be something relatively simple like a B12 or iron deficiency in your diet or it could be something more troubling like a bone marrow issue. It will help you make a more informed decision as to treatment options if you have some good ideas as to why you're experiencing the problem. Knowing where the issue is from a biomedical standpoint will also help your acupuncturist figure out how they're going to treat the problem.

To answer your more general question: yes, acupuncture actually works. We've had lots of excellent studies in the last 10 years or so which tell us:

1. Acupuncture is dose dependent - this means, to a point, more treatments yield better results.

2. Acupuncture is not placebo.

3. When compared head to head against pharmaceuticals for the same condition, acupuncture is usually at least as effective as the drug.

All this being said, for the best results please make sure you're seeing someone who graduated from a Chinese medical school and is licensed as an acupuncturist in your state.

The answer somewhat depends on where/why you're considering electroacupuncture and the comfort level of your Chinese medicine practitioner. If you're wanting to use electrical stimulation to help manage jaw/tooth pain, some practitioners may be willing to do it and some won't.

I've used electrical stimulation quite successfully over metallic implants (knees, hips, plates used to repair fractures, etc.). There's no hard and fast contraindication just because you have metal components in your mandible.

Make sure you're having the procedure done by a board certified, state licensed acupuncturist (in other words: someone who went to Chinese medical school) and everything should be fine.

You've asked a great question, the problem is: the list of conditions which may be successfully treated with acupuncture is quite long. If I tried to type it all out here, I'd be sure to miss something. Instead, I like to list the conditions or occasions where acupuncture is not a good choice - it's much shorter.

Chinese medicine and acupuncture are not good choices if:

1. You have a severe, life threatening infection - either bacterial or viral. In this case, you need antibiotics and, potentially, hospital support.

2. You've been shot, stabbed, in a car accident, run over by a train or have otherwise sustained catastrophic physical damage. Conventional medicine excels in the preservation of life under these circumstances, go see a Chinese medicine practitioner after the doctors and surgeons have put you back together.

3. You have severe joint degradation to the point where you're in constant pain and every doctor you talk to says you need joint replacement. In these cases, Chinese medicine and acupuncture can help to manage your pain until you can get the joint replaced, but if the cartilage is gone, you're bone on bone and it's unlikely Chinese medicine is going to reverse the damage. Again, this is a case where you should probably have the surgery, then see a practitioner of Chinese medicine to help the healing time and rehab.

4. You have cancer. Chinese medicine has been shown in several studies to help manage the side-effects of chemotherapy - particularly pain, nausea and fatigue. Chinese medicine probably won't do anything for the cancer itself. My position on this is admittedly conservative, I know lots of other practitioners who will take on cancer patients that have stopped chemo and aren't seeing an oncologist. My personal rule is: I don't take cancer patients unless they're also see an oncologist and the oncologist is aware the patient is seeking my help.

For almost any other health condition, Chinese medicine and acupuncture can help. Acupuncture in particular, because we aren't introducing any substances in to the body, integrates quite well with conventional medicine. Studies often show the combination of acupuncture with pharmaceuticals gives better results than either method alone. Studies have also shown that acupuncture is almost always at least as good (sometimes better) as a pharmaceutical when tested head to head in a variety of conditions.

In order to get the best possible results, you need to make sure you're seeing a board certified and state licensed acupuncturist (in other words: someone who went to Chinese medical school and specializes in the practice of Chinese medicine).

Yes, acupuncture can be very successful in the treatment of anxiety. Probably 20% of my practice is anxiety related. Chinese medicine has a few different root causes for anxiety, and some respond more quickly to treatment than others. You'll want to give Chinese medicine 4-5 treatments to really get a feel for how well it's going to work in your particular case.

It's also important to note that some cases of anxiety have a lifestyle component. If this is the case for you, you'll get much better results from treatment if you're open to making lifestyle changes as well.

For the best results, please make sure you're seeing a board certified and state licensed practitioner. if you're outside of CA, you can use the "Find a Practitioner" lookup at NCCAOM.org. You can also Google your state's acupuncture association to find someone local to you.

Yes, acupuncture will probably be able to help with your arthritis pain. It might take a few visits, but generally within 3-5 treatments most folks start to experience pain relief.

Generally, no, acupuncture does not hurt. That doesn't mean you might not feel a few of the needles on initial insertion, but after a second or two there shouldn't be any sharp pain.

There are some very common needle sensations that are often confused for pain. Sometimes folks might feel a mild electrical type sensation that propagates up or down from where the needle is inserted, you might also feel a dull throbbing ache around the needle or a mild distending sensation around the needle (somewhat like someone is blowing a balloon up under the skin around the needle). These are all normal and, as long as they're not so intense as to be distracting, are actually desirable during treatment.

Generally speaking acupuncturists have two approaches:

1. Local treatment. In this case, the pain is in your neck so the acupuncturist may insert needles in or around the painful area in your neck.

2. Distal treatment. In this case, even though the pain may be in your neck, the acupuncturist will put needles in other body locations. For neck pain, wrists and ankles are often used.

Either method can be very effective, people sometimes have a hard time understanding why a needle in their ankle reduces their neck pain though.