Acupuncture is a form of complementary therapy that involves inserting very thin needles into the body. Practitioners insert needles at different locations and depths to treat different health issues. Acupuncture can help relieve pain and treat a range of other complaints. However, the exact way in which it works remains unclear. Some people believe it works by balancing vital energy, while others believe it has a neurological effect. In this article, we detail what acupuncture is, how it may work, and what the practice’s benefits and risks are. TCM explains that health is the result of a harmonious balance of the complementary extremes of yin and yang of the life force known as Qi, pronounced “chi.” Advocates believe that illness is the consequence of an imbalance of these forces. According to TCM, Qi flows through meridians, or pathways, in the human body. These meridians and energy flows are accessible through 361 acupuncture points in the body. Inserting needles into these points with appropriate combinations will bring the energy flow back into balance. A 2017 review suggests that many acupuncture points are at sites where stimulation can affect the activity of multiple sensory neurons. These sites are also known as receptive fields. The physical stimulation of needle insertion at these sites may affect pain processing in the central nervous system and muscles and increase blood flow to certain parts of the body. A 2018 meta-analysis of acupuncture’s effect on chronic pain found that the practice can provide pain relief benefits distinguishable from placebo. However, the exact mechanism by which acupuncture works is not clear. All therapies come with both risks and benefits. A person should always seek medical advice before undertaking any therapy. Possible risks of acupuncture are the following:
The Food and Drug Administration (FDA) regulates acupuncture needles as medical devices. Their manufacture and labeling need to meet certain standards. The needles must be sterile, nontoxic, and labeled “for one use only” by a licensed practitioner. As with any complementary therapy, it is advisable to use acupuncture alongside conventional treatments in cases of chronic or severe conditions. Acupuncture is a common complementary therapy that can help people manage many different conditions. Benefits of acupuncture include the following:
The National Center for Complementary and Integrative Health (NCCIH) advises people not to use acupuncture as a replacement for conventional medical help. An acupuncturist will examine a person and assess their condition, insert one or more thin, sterile needles, and offer advice. Individuals will typically sit or lie down during the procedure. The acupuncturist should use single-use, disposable, sterile needles. People may feel a very brief stinging or tingling sensation upon needle insertion. They may then experience a dull ache at the base of the needle. Typically, the needles will stay in place for 20–60 minutes, although this will vary depending on the procedure. In some practices, the acupuncturist will sometimes heat needles after insertion. The number of treatments a person will need depends on their individual case. Someone with a chronic condition may need one or two treatments per week over several months. An acute health issue typically improves after 8–12 sessions. Acupuncture is a complementary therapy and should not take the place of doctor-recommended treatments. Before undergoing acupuncture to treat chronic pain or other conditions, a person should seek advice from a primary care physician. In some U.S. states, acupuncturists themselves can be primary care physicians. Acupuncture is a traditional complementary therapy that has a historic origin in China. It involves inserting small needles to stimulate specific parts of the body and its neural network. Studies show that acupuncture can help manage chronic pain, OA, headaches, and migraine. Acupuncture carries little risk of side effects, and practitioners must carry a license to perform acupuncture procedures. nevertheless, osteopathic manipulative techniques can act as a complementary or alternative therapy in the management and treatment of many conditions. From: Integrative Medicine for Children, 2009 What Is It? Osteopathic medicine is one of two fully licensed comprehensive systems of medical care in the United States. Practitioners of osteopathic medicine are identified by the letters "DO" while allopathic physicians are identified by the initials "MD." Osteopathic medicine emphasizes the relationship between all organ systems of the body, including the musculoskeletal system (your bones and muscles) and the function of your entire body. Osteopathic physicians are licensed to prescribe medication and perform surgery. Although more than 60 percent are primary care physicians, DOs practice in all branches and specialties of medicine and have the same rights and responsibilities as MDs. The popularity of osteopathic medicine has grown in recent years. According to the American Association of Colleges of Osteopathic Medicine, the number of graduates of colleges of osteopathic medicine more than doubled in the past decade. And the American Osteopathic Association reports that there are currently more than 77,000 DOs in this country, making up about 7 percent of all physicians. You'll find DOs in local hospitals, private practices, community health clinics, academic medical centers and military hospitals—anywhere you expect to find a physician. So, if DOs are fully licensed physicians, what sets them apart from MDs? It is mostly in their approach to a medical or surgical problem. The approach is rooted in their philosophy. DOs take a holistic approach to medicine; this means they focus on the total person, not just the particular symptom, illness or disease. DOs believe that all the systems in your body—including the musculoskeletal system—operate in an integrated way. Problems with one system can affect the others. Perhaps the most significant difference between DOs and MDs is that DOs consider the role of the musculoskeletal system in relationship to symptoms and illness. They have special training in recognizing and correcting structural problems through various manual techniques called osteopathic manipulative treatment (OMT), which are used primarily for diagnosing and treating musculoskeletal problems. Given this concern with muscle and bone, it's not surprising that you will find many DOs in sports medicine and physical medicine and rehabilitation. How It Got Started Andrew Taylor Still, an MD, considered to be the father of osteopathic medicine, developed the discipline in 1874 after becoming disillusioned with how medicine was being practiced. A Civil War surgeon, Dr. Still was appalled by the ineffectiveness of traditional medical treatment. Later, he watched three of his children die from meningitis, despite medical treatment. Dr. Still was particularly distressed by the use of drugs of this era. Many, such as arsenic and mercury compounds, he considered useless and even harmful. He focused on health, believing that the human body has the ability to heal itself. You could say he was an early proponent of "wellness"—now a common term among health care professionals. He identified the musculoskeletal system as an essential element of health and advocated preventive medicine, exercise and nutrition. DOs and MDs: Many Similarities In many ways, most DOs are almost indistinguishable from conventional MDs. The primary difference is philosophical and the types of diagnostic and treatment modalities that can be employed in medical care. Throughout their training, DOs are taught to treat the whole person. While many incorporate manipulative techniques within contemporary medical practices, you might not see a huge difference between a visit to a DO and a visit to an MD. It's not surprising that there's so much common ground. MDs have increasingly embraced a whole-person (holistic) approach to medicine—for instance, recognizing the effect of stress on physical health. Meanwhile, DOs have embraced the diagnostic and therapeutic approaches used by MDs, including the use of medication. The vast majority of DOs will use the same medical and surgical therapies as well as medications similar to an MD. All states license DOs, and some have separate licensing boards. In states without separate boards, DOs are licensed through the same process as MDs. Either way, all physicians (both DOs and MDs) must be approved by a state medical board exam to be licensed. Both DOs and MDs attend three to four years of medical school, and applicants to both generally have a four-year undergraduate degree. After medical school, both DOs and MDs can choose to pursue a specialty, such as psychiatry, surgery, or obstetrics and gynecology, which involves a four- to six-year postgraduate training program. You can go to a doctor of osteopathic medicine (DO) for any condition that would lead you to seek out an allopathic MD. Finding an osteopathic physician is just as easy, but you must seek them out. Insurance companies cover visits to a DO just as they cover visits to an MD. So if you are on a health plan, look for DOs on your preferred provider list. (Medicare and Medicaid also pay for DO visits.) You can ask for referrals from other health care professionals, or go to the American Osteopathic Association's website (www.osteopathic.org), where you will find a list of state associations that can refer you to a DO in your area. Your visit will proceed like any other appointment with a health care professional. The doctor or an associate will take your medical history. Some advocates of osteopathic medicine say that, because of their holistic orientation, DOs may spend a bit more time with patients, probing into lifestyle issues and their relationship to the overall physical condition. The osteopathic difference is the total holistic approach to caring for a patient. Each patient's experience is what counts. But no matter how much time is spent in the DO's office, you may find a greater emphasis on your overall well-being and lifestyle than on just the complaint that brought you into the office. Once a detailed history is assessed, a physical exam is performed just like it would be in an MD's office. Of course, the nature of the exam depends on the reason for your visit. With some DOs, you may notice one significant difference: a focus on your body's structure in relationship to its function. The DO will assess your posture by asking you to stand, walk, sit and lie down. As you perform these tasks, the DO is observing your movements, structure of the spine and muscles and the balance of your body. As part of osteopathic manipulative treatment (OMT), an osteopathic physician will conduct a hands-on examination. This involves evaluating your back and limbs, checking joints for pain or limited mobility and testing your muscles, tendons and ligaments for tenderness. The DO also will assess your reflexes, flexibility and muscle strength. These techniques help your doctor detect various abnormalities, including restrictions in range-of-motion, structural irregularities and changes in tissue textures. Moreover, these techniques give an added dimension when trying to narrow down the cause of your ailment or concern. Musculoskeletal disorders sometimes mimic other conditions and, accordingly, OMT may help your DO make a more accurate diagnosis and appropriate targeted treatment. Depending on the results of the exam, you may need other tests, including radiologic studies and/or lab studies, which the DO will order. Women's Health DOs have a long-standing commitment to women's health. In fact, Dr. Still was one of the first to admit women to medical school on a regular basis. Today, about half of the total enrollees in osteopathic medical schools are women. The American College of Osteopathic Obstetricians and Gynecologists was established in 1934, nearly two decades before the allopathic American College of Obstetrics and Gynecologists. To find an osteopathic OB/GYN in your area, call 800-875-6360 or visit the website at www.acoog.org. Osteopathic physicians, or DOs, can be seen for almost any condition, but a visit may be especially appropriate for musculoskeletal disorders, such as:
DOs may use osteopathic manipulative techniques (OMTs) to diagnose and treat these types of musculoskeletal problems. While OMT is generally used for musculoskeletal problems, it's also used to relieve other conditions, including:
Osteopathic principles stress the body's own natural healing powers, the importance of the musculoskeletal system to the general well-being of the entire body and the interconnectedness of all the body's systems. It is a holistic approach, looking at the entire patient, not just the disorder. DOs believe that OMT loosens lymph node congestion and increases the circulation of natural antibodies, thus boosting the immune system. OMT may also relax muscles, relieve pain, reduce stress, promote circulation, improve posture, stimulate the nervous system and increase joint mobility. Studies are in progress to help explain how OMT works on these conditions. One possible explanation for some of OMT's benefits is that it increases circulation and the release of endorphins. Release of these endorphins could lead to an increased feeling of well-being and a higher tolerance for pain. OMT has also been used to ease the pain of labor and delivery, in part by improving a woman's posture and by helping pregnant women use their body mechanics effectively during delivery to reduce the time they spend pushing. Moreover, OMT is drug-free, an important consideration for pregnant women. A few DOs specialize in cranial sacral osteopathic techniques, in which OMT is applied specifically to the bones, membranes and ligaments of your skull and tailbone with gentle, rhythmic pressure to affect your entire well-being. It is often used for migraines and other forms of chronic pain. Cranial sacral therapy is not used as a primary treatment modality in bone cancer, bone or joint infection, a protruding disk or spinal-fusion surgery. After a physical exam, your DO will decide on and develop a course of treatment with you. In most cases, it may be similar to that provided by an MD. For instance, in the case of a respiratory infection, you might receive antibiotics. But you may also receive osteopathic manipulative techniques than can improve the function of your lungs and rib cage. Your DO may also suggest an exercise program and dietary changes that can improve your particular condition. As necessary, an osteopathic physician may refer you to a different osteopathic or allopathic specialist when you need surgical or specialty care. Depending on your condition and your DO's initial approach to health care, he or she may use some of the many OMT techniques to relieve misalignments, improve joint mobility and treat other structural problems. These techniques include soft-tissue manipulation, counter-strain, high-velocity/low-amplitude joint and spine manipulation, cranial sacral, muscle energy and many more, each of which is intended to correct misalignments of the musculoskeletal system and to relax muscles. It may feel like a massage or a chiropractic manipulation but it is distinctly different. The difference is that osteopathic medicine is a complete system of medicine, and if medications or additional medical services are needed to complement your treatment, your DO is either able to provide them to you or refer you to a specialist. Afterward, you may feel very relaxed. You may even experience a tingling sensation where the manipulations were performed. If you feel a little sore, don't worry—soreness can be a normal reaction. But if the pain lingers, talk to your DO. Your DO may suggest various stretching exercises for you to do at home to further complement the OMT, as well as lifestyle changes to improve your condition long term. If you are receiving OMT, there will be follow-up visits scheduled as needed. Otherwise, it's just like visiting any other primary health care professional—you'll visit when you are ill and come in for regular check-ups to prevent illness and promote health. Your first visit may last up to an hour; subsequent ones may last about 20 minutes, depending on the reason for your visit. The cost will be comparable with the cost of a visit to an MD, and insurance coverage is comparable as well.
Review the following Questions to Ask about osteopathic medicine so you're prepared to discuss this health care option with your health care professional.
For information and support on Osteopathic Medicine, please see the recommended organizations listed below. American Association of Colleges of Osteopathic Medicine (AACOM) Phone: 301-968-4100 American Osteopathic Association (AOA) Email: National Center for Complementary and Alternative Medicine Email: Texas Osteopathic Medical Association Phone: 512-708-8662 |