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Is acupuncture for you?

APR 2013

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The latest research says this traditional Chinese healing practice is worth a try for chronic pain.

For chronic pain in the muscles and joints—lower back pain and arthritis are among the most common tormenters in men—the standard approach usually includes anti-inflammatory medications, physical therapy, appropriate exercise or stretching, and rest. But when usual care fails to get the job done, acupuncture is an increasingly attractive option.

Men with chronic pain may find relief in acupuncture that conventional medicine did not provide—and it is safe. "I think the benefit of acupuncture is clear, and the complications and potential adverse effects of acupuncture are low compared with medication," says Dr. Lucy Chen, a board-certified anesthesiologist, specialist in pain medicine, and practicing acupuncturist at Harvard-affiliated Massachusetts General Hospital.

How does it work?

Acupuncturists insert hair-thin needles into the skin at points on the body. It is virtually painless when done by an experienced practitioner. Inserting the needles is thought to correct imbalances in the flow of energy in the body, called qi (pronounced "chee"). In Western scientific terms, Dr. Chen explains, "the effect of acupuncture is to adjust our body's neurotransmitters, hormone levels, or immune system."

Science has put acupuncture to the test on a wide variety of conditions, including chronic pain. The results have been mixed. But a recent study in Archives of Internal Medicine added to the evidence that acupuncture provides real relief from common forms of pain.

The researchers pooled the results of 29 past studies involving nearly 18,000 participants. Overall, acupuncture relieved pain by about 50%, which is comparable to the relief that many people get from conventional care, such as pain medication. That means that if a man rated his pain at the start as 60 on a scale zero to 100, acupuncture dropped it to 30, compared with people who did not have acupuncture.

The study is not the last word on the issue, but it is one of the best quality studies to date and has made an impression. "The question here is whether acupuncture is worthwhile to try," says Dr. Donald Levy, medical director of the Osher Clinical Center at Harvard-affiliated Brigham and Women's Hospital, where doctors combine conventional and alternative medical approaches. "I think there is evidence to support that recommendation."

Who can acupuncture help?

Many who seek acupuncture have already tried conventional options. "Many of my acupuncture patients have been through medical treatments, injections, and other procedures," Dr. Chen says. "When they fail to benefit from these approaches, they seek alternative treatment."

But for new pain, the local acupuncturist should not always be your first stop. "I highly recommend patients have a clear diagnosis of what is causing their pain to rule out serious medical conditions that should be treated right away, and then you can seek alternative therapies," Dr. Chen says.

For example, lower back pain could be from a muscle injury or from a herniated or "slipped" spinal disk. In the early and most painful "acute" stage, these pain-makers often respond well to acupuncture, Dr. Chen says. Even if the pain stems from a mechanical problem—such as narrowing of the spinal canal or osteoarthritis in a joint—acupuncture might still alleviate the painful symptoms even though it doesn't fix the underlying cause.

Is it safe?

Harms from acupuncture are rare. "It is unlikely that you will get harmed if it's done by an experienced acupuncturist," Dr. Chen says. The infrequently reported risks include being infected by inadequately sterilized needles or contact with the acupuncturist's hands. An incompetent acupuncturist could insert the needle too deeply. "If you research the literature on the harms of acupuncture, they are remarkably infrequent," Dr. Levy says.

Acupuncture user tips

How often do you need it? Dr. Chen recommends that new acupuncture seekers plan on weekly treatments until they start to see a benefit, then gradually lengthen the time until the next visit. Many people choose monthly treatment.

What does it cost? The typical cost of acupuncture ranges from $65 to $125 per session. Private insurers usually don't pay for it, nor do Medicare or Medicaid. A handful of plans may reimburse for physician-acupuncturists.

Where do you get it? Before visiting any acupuncturist, ask your doctor to recommend a trusted provider. Online, you can search for a trained acupuncturist at the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) at http://www.nccaom.org or (904) 598-1005.