Jeff Rippey

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.

To be honest, I had to look up acupressure mats because I've never heard of them. After checking a few out, here's what I can say: something like this is most likely safe and I can't speak to effectiveness.

Contrary to popular belief, acupuncture points are not in fixed locations. The actual position of the point varies from person to person and even varies on the same person from day to day. There's no way to guarantee the stimulation from the mat will be delivered to a location that will be useful to you given your issue.

Given that the mats aren't all that expensive, it might be worth a try to see if you can get any relief. Your best bet, however, would probably be to see an actual practitioner of Chinese medicine and have them do an assessment and treatment for your back pain. If you have a problem with needles, just let them know - while needles get the fastest, longest lasting results (at least in my experience), we do have other options for treating pain that don't rely on needles.

Unless you're in California, I'd suggest you start with the "Find a Practitioner" directory at NCCAOM.org. This will give you a list of board certified and state licensed acupuncturists in your area.

Unlike the western conception of it, acupuncture is actually composed of multiple different systems. One of those systems is referred to as auricular or ear acupuncture. In this system, the entire body is mapped on to the ear and points on the ear alone can be used to treat issues in the entire body.

There are a few ways we utilize ear points: very small needles, tacks and seeds. The needles we use in the ear are quite small and are inserted and removed during the course of your office visit - in other words, you don't typically leave the office with any needles still in your ear.

Tacks are also very small. They're inserted in the office but, unlike most needles, you wear them home and can leave them in for a few days.

Then we have seeds. These are exactly what they sound like: it's a seed from a plant in the Vaccaria family (cow herb or prairie carnation). The seed is stuck on a small band-aid like square of adhesive and is applied to points on the ear. Similar to tacks, patients can wear the seeds for a few days before removing them. They can be very effective for pain patients because the seed can be squeezed to relieve a pain flare up. Unlike tacks or needles, seeds are non-invasive - they do not break the skin, they simply apply pressure to a point in the ear.

Good question. We've had several well designed studies, particularly this one from Germany (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4479426/), showing acupuncture does a good job of providing relief from seasonal allergies. Unfortunately, this is one of those places where the exact mechanism of action is still largely unknown.

The German study referenced above hinted at the fact that acupuncture may be regulating certain cytokines and reducing IgE. Cytokine is kind of a catch all term for substances secreted by the immune system. IgE is an anti-body produced by the immune system and is typically elevated in people who suffer from seasonal allergy.

Since allergy and allergic reaction are, more or less, an out of control or out of proportion immune response, it appears that acupuncture is somehow calming the immune system so the response is more moderate.

Acupuncture performed by a state licensed graduate of Chinese medical school is generally safe and can be very effective in the treatment of a wide variety of health issues - including allergies.

The first question is: why do you have back pain? Not all pain has the same cause and some causes are more easily treated with one style of medicine vs another.

If you haven't already, I'd suggest seeing your MD and having some x-rays/CT/MRI done to see if imaging can shed any light on the cause.

Both acupuncture and chiropractic may be able to help. Sometimes the combination is better than either method alone. If you do decide to try acupuncture, please make sure you're seeing someone who attended Chinese medical school and is licensed in your state as an acupuncturist.

How a practitioner of Chinese medicine would treat knee pain is going to depend on a lot of different variables. Broadly speaking, you are going to encounter to kinds of practitioners:

1. Those who will treat locally by placing needles in or around the knee.
2. Those who will treat distally by putting needles in other parts of the body.

Both methods can be very effective.

If you're asking how would acupuncture relieve knee pain, that's a bit more complicated. Acupuncture in pain patients appears to be doing two things:

1. Regulating a set of neurotransmitters which are responsible for the transmission of pain signals in the central nervous system.

2. Altering the way pain information is processed in the brain.

Good question. In studies acupuncture has been shown to have a dose dependent effect. What this means is, to a point, more treatments will give superior/longer lasting results.

With pain patients, a lot depends on how long you've been experiencing the pain and how severe the pain currently is. A typical course of therapy might be 5-7 treatments spaced 1 week apart followed by increasing the time between treatments until some maintenance interval is found which gives you sufficient pain relief.

The maintenance interval is mostly an individual thing. I've had patients whose interval was monthly and patients who came to see me twice a year after we got their issue under control.

When you start seeing an acupuncturist, expect a little up and down in your pain levels as you progress. Typically my patients experience a sharp reduction in pain after the first or second treatment. This initial reduction will last a day or two and then the pain returns. Each subsequent treatment reduces the pain a little more and/or extends the time for which the pain is either relieved or reduced. When the patient can go 5-7 days with either no or minimal pain, then we start to space the treatments out.

Generally speaking, no, acupuncture doesn't hurt. Some points can be more tender than others and you might feel a slight pinching sensation in initial insertion of the needle. If this occurs, it should fade within seconds.

This is a great question. Having a western diagnosis in hand can sometimes be useful when visiting someone who practices Chinese medicine, but it's not necessary. The Chinese diagnostic model is very different from conventional medicine and, frankly, the case as you've described it is perfect for acupuncture/Chinese medicine. Because we diagnose in a different way, we can often identify the root cause of an issue even though conventional diagnosis can't pinpoint the problem. If I were you, I'd start with the "Find a Practitioner" link at NCCAOM.org. Get a list of board certified practitioners in your area and see if you can find someone who specializes in pain management.

Yes, acupuncture will probably help. You're still fairly close in time to the injury, and the sooner you start treatment the better your long term results will be.