Jeff Rippey

Acupuncture is an excellent treatment for most any kind of pain, including ankle pain.

When it comes to acupuncture, answering the "how" question is very tricky. Taken as a whole, Chinese medicine is coming at the body and health issues from the standpoint of systems theory. Conventional science/medicine is coming at the body and health issues largely from the standpoint of reductionism.

Systems theory and reductionism represent one of those few times where either one is correct or the other is - they cannot both be right at the same time. There are ideas in systems theory, mainly the concept of emergence, that stand in direct contradiction to reductionism. Emergent properties are properties that appear when systems are brought into interaction and those properties are completely unpredicted by the action of either system in isolation (the whole is greater than the sum of its parts). Reductionism, on the other hand, claims that complex systems can be decomposed to component parts and understood as the simple interaction of those pieces (the whole is only the sum of its parts).

The reality is that systems theory provides superior answers to our questions in most contexts. Why medicine has not yet caught up with everyone else is an open question.

And herein lies the issue: we're trying to understand a medical system that is built on systems theory by using reductionism. It's a square peg-round hole problem. To put it more simply - we aren't even asking the right questions yet in most acupuncture studies (we're not asking the right questions in most biological studies if I'm being honest).

The honest answer is: no one knows what the "how" of acupuncture is, no one has really asked that question or looked at it in a fundamental way. We could talk about neurotransmitters and down-regulation of the central nervous system, but that's only one level deep. How is it that a handful of solid, stainless steel needles should exert those effects? We don't know, we aren't even asking that question. In reality, in the reductionistic model, that question doesn't make sense.

Here's the thing, though, we have a lot of drugs - FDA approved drugs - on the market that we do not know how, exactly, they work. Almost all antidepressants, some anti-anxiolytics, most anti-psychotics, and many others. So, if you were to treat your anxiety with prescription meds, it's even odds whether or not we understand how those drugs are exerting their action.

Just because we don't understand exactly how something works doesn't mean we can't observe it working and use it as a solution to the problem.

Potentially, a lot of things could improve chronic back pain.

Without knowing location, cause, severity, what you've already tried and how that worked, it's very difficult to provide specific advice. Here are some things you can think about trying:

1. Acupuncture has a very good track record in chronic pain including chronic back pain.

2. Depending on what, exactly, is going on, chiropractic can sometimes help.

3. Physical therapy can sometimes improve low back pain.

4. Massage can sometimes make things better.

5. Exercise, particularly exercises that target the core muscles, can sometimes provide pain relief by stabilizing the structure. In tandem with this, I'd suggest correcting any postural issues.

6. Injections like epidural or steroids can sometimes improve pain. Keep in mind that studies show steroid injections for pain are providing short term pain relief at the expense of the long term viability of the joint. Steroids appear to speed up joint degradation and will cause more pain in the long run.

Sometimes it takes more than one thing from the above list in order to improve the situation.

If you haven't done so already, it's worth getting some imaging (xray/CT/MRI) so any provider understands exactly what's going on with the spine.

My general rule of thumb on exercise is so long as we're not dealing with a broken bone or a muscle/ligament/tendon/connective tissue tear, exercise after treatment is fine. I sometimes ask people to bring it down a notch for a couple of days post treatment, but otherwise I like to have people performing their normal activities.

Sometimes, yes, acupuncture can help with this type of muscle spasm.

There's not enough information provided in this format to answer your question. Treatment in Chinese medicine is individualized - while a generic category may be enough for a western MD (and this is an arguable position), it's not enough for someone practicing acupuncture. I'd need to know where the pain is, how you experience it, how the pain started, how long you've had it, a bunch of other details around the pain, and a lot of background on your general health.

There are some statistics I can throw at you though. First off, acupuncture has about a 5% non-response rate. In plain english this means about 5% of the population receive no benefit from acupuncture. We don't know why this is the case, and there's no test anyone can give you to determine if you're in that 5%. You have to try acupuncture and see what happens. The upside is there is a 95% chance acupuncture will work just fine for you.

Second, we do have some general statistical information around number of treatments required across pain conditions. The average appears to be somewhere between 8 and 10. Please keep in mind, this is an *average*. That means some people responded in fewer than 8 treatments and some people required greater than 10. Again, there is no way to predict in advance where you might end up.

In addition to these two points, there is one more thing to keep in mind. In my experience, folks inside the 95% who respond to acupuncture tend to vary in terms of how fast they respond. I've had people get relief in as few as 1 treatment and I've had people who took 2 or 3 treatments before they experienced any change. If you decide to try acupuncture, you need to be able to commit to at least 3 sessions. Going one time then deciding it didn't work isn't really trying acupuncture.

Usually, yes, acupuncture can help with insomnia.

It's not so much the system of acupuncture as it is how well trained the practitioner is.

Unless you happen to be in one of the handful of states that have large numbers of acupuncturists, you'll likely only find folks who practice so-called "TCM" or "Traditional Chinese Medicine". We could argue for hours regarding how "traditional" this system really is, but that's neither here nor there.

For your purposes, can a TCM practitioner help with your sciatica? The answer is, yes, most likely they'll be able to at least make you more comfortable.

Usually, yes, acupuncture can help relieve bloat.

Unfortunately, each individual responds at their own pace. When it comes to acupuncture, some people respond quickly, some slowly, and some not at all. The only way to figure out which of these groups you might fall into is to try acupuncture and see what happens.

Acupuncture needles are solid. We aren't introducing any substances to the body nor are we taking anything out. Yes, you can have alcohol after a treatment.

My rule of thumb for pain patients is twice a week treatment if the pain is consistently over 8/10 on a pain scale. Once the pain comes down, we will drop the frequency to once per week.

If the pain is consistently less than 8/10, then one treatment per week is usually sufficient to get pain levels headed down.

There are very few things that would create a contraindication for acupuncture. As long as you don't have hemophilia or some other bleeding disorder, yes, you can receive acupuncture for your low back pain. Pain management is one place where the science is virtually overwhelming in terms of acupuncture's effectiveness versus placebo and it's effectiveness versus standard treatment.

It depends on what's causing the earache. Your first stop should be an ENT to rule out infection and to see if the cause of the problem can be determined.

If the ache is due to nerve entrapment or muscle tension then acupuncture can be a very good choice for treatment.

Potentially, a few things. Diet and exercise have a pretty good track record in improving chronic fatigue. It might be worthwhile to have some food allergy testing done - I've had a few cases where removing food items causing sensitivity made a dramatic improvement to fatigue cases.

Acupuncture and Chinese herbal medicine have a pretty good track record in this space. You're going to want to make sure you're seeing an actual licensed acupuncturist rather than someone providing "acupuncture like" services under the scope of some other license. Go to NCCAOM.org and use their "Find a Practitioner" link.

Conventional medicine can sometimes help, particularly if the fatigue is the result of long term symptoms from some other infection (like COVID or Lyme). Blood tests would the the initial step here to see if the original pathogen can be identified.

Acupuncture is an excellent treatment choice for all kinds of chronic pain, including neck pain. Neck pain is probably the second most common type of pain I deal with on a regular basis.

I see and hear questions like this often. For folks who've never had acupuncture and are nervous about the needles, it's a question that makes a lot of sense. Unfortunately, it's a question that cannot be answered.

The problem is two-fold:

1. Chinese medicine uses an entirely different diagnostic method that is looking at your entire system, not just one part. Health issues that are considered one thing in conventional medicine often have multiple potential causes in Chinese medicine. Without evaluating and diagnosing you, I have no idea why *you* are experiencing depression. Since treatment hangs on the diagnosis and I haven't diagnosed you, I can't tell you how I'd treat.

2. There are multiple different systems of acupuncture, not everyone practices the same way, and there's no general script or method for issues like in conventional medicine. Even assuming I had enough information to diagnose, there is no guarantee that a different acupuncturist would use my approach. Therefore, any needle locations I listed would be useless to you unless you're coming to see me.

Like I said, this is a question I get a lot, and I understand where it comes from. There's no reason that the average person should understand anything about the details of Chinese medicine. What I usually suggest for people in your position is to call around to several acupuncturists in your area and see which ones offer a free consult. Meet with a few and get an idea how they practice, where they're likely to place needles, and how many needles they're likely to use. Then make an appointment with the practitioner that made you the most comfortable.

Please make sure you're seeing a board certified, state licensed acupuncturist. A chiropractor or physical therapist is NOT the same thing (a PT in particular would be way out of scope treating an issue like this. In other words in a very gray area legally). To find licensed acupuncturists in your area you can go to NCCAOM.org and use their "Find a Practitioner" lookup.

What can be done is going to be dependent on why, exactly, you are experiencing low back pain. If you haven't done so yet, I'd stop by your primary care provider and at least have some x-rays taken. Depending on what imaging shows, you may have several options. If this is acute low back pain, you didn't experience any recent trauma to the area, and you've never had low back pain before, it's entirely likely that the pain will go away on its own over the next week or so. Use heat on the area and keep things moving. To prevent a recurrence, you can try strengthening your core with something like yoga or calisthenics.
If this is acute pain that has persisted for several weeks or more chronic pain without any complicating factors, then things like acupuncture, chiropractic, or physical therapy can help alleviate the issue. Keep in mind that it may take multiple modalities (i.e. acupuncture and chiropractic) and multiple treatment sessions. If your primary care is concerned at all about what they see in the image, you may be looking at a neurological consult and, potentially, surgery.

Sure. Exercise is an excellent way to get blood pressure back down to more of a normal range. Acupuncture has a good track record in this space. Some herbs are pretty good at normalizing pressure. What's going to work best for you is going to be dependent on how high your blood pressure currently is, how long it has been that way, and what other complicating factors you might have (pre-existing heart disease, family history of stroke, etc.) .Sometimes it makes more sense to start folks on prescription medication to get the pressure down quickly and then transition to more of a long-term solution.

With a lot of caveats, sometimes, yes. I treat a lot of migraine patients and, for those who respond to acupuncture, I'm usually able to get them into a much better space in terms of episodes and severity.