Jeff Rippey

Acupuncture is an excellent choice for managing all sorts of pain, including neuropathy and diabetic neuropathy. I've done quite a bit of work with both kinds of neuropathy patients and usually get excellent results. It might take 3 to 5 treatments to bring things under control, so be prepared to commit to a few sessions. For the best results, please make sure you're seeing an NCCAOM board certified acupuncturist. If your doctor hasn't already recommended someone, you can visit the "Find a Practitioner" link at NCCAOM.org to get a practitioner local to you.

First, I'd suggest you both visit your primary care MD and make sure there are no physiological issues in play like low sperm count, poor sperm quality, blocked fallopian tubes, etc. Once this is out of the way, you're in a much better position to decide how you'd like to proceed.

Whether there are underlying issues or not, acupuncture and Chinese medicine have a pretty good track record when it comes to fertility. It's best if you both receive treatment, unless you're fairly sure that one or the other of you has some underlying issue - which is why I opened with the suggestion to see your MD.

There really isn't a "best time". If you're experiencing menstrual issues as well (pain, cramping, and so on), it's can be a good idea to start treatment just after your period. This will give you three to four sessions before your next period, and provide a way you can judge if the treatments are changing anything. Unfortunately, for women, sometimes it takes a cycle or two for the body to catch up with the acupuncture.

For the best results, please make sure you're seeing an NCCAOM board certified acupuncturist. You can find someone local to you by visiting the "Find a Practitioner" section at NCCAOM.org. There are acupuncturists who specialize in fertility treatments, so you might ask your ob/gyn or call around and see if there's a fertility specialist near you.

First off, I'm glad to hear your doctor is making this recommendation. Acupuncture has beneficial effect in a wide variety of health conditions beyond just pain management.

Cardiovascular disease is a tricky one to explain because there are so many facets that could be discussed; from high blood pressure to arterial plaques to angina and so on. Acupuncture's effects in each case are probably due to different mechanisms, some of which are not well understood currently.

Acupuncture has pretty consistently shown that it promotes the parasympathetic side of the autonomic nervous system. The parasympathetic is the so-called "rest and digest" mode (as opposed to the "fight or flight" or sympathetic side). This gives us a level of stress reduction along with dilating the blood vessels. A larger pipe leads to reduced pressure and this is one of the ways acupuncture reduces high blood pressure.

Acupuncture has also been shown to increase blood levels of nitric oxide (NO). This is a fairly potent vasodilator (again, larger pipe) and can also lead to decreased blood pressure as well as decreased angina (chest pain).

There are studies showing acupuncture can exert a cardio-protective effect. The mechanism here isn't clear, but we see lowered levels of cardiac enzymes in patients treated with acupuncture prior to heart surgery. Cardiac enzymes in the blood is one of the ways we know the heart has been damaged. Typically in heart surgery we expect to see a lot of cardiac enzymes in the blood after the procedure. For some reason, with acupuncture prior to the operation, we don't see a lot of cardiac enzymes in the blood so acupuncture might be doing something to protect the heart cells.

Acupuncture can also be used to help regulate irregular heart beat (arrhythmia). Some studies show acupuncture having similar effect to pharmaceuticals in this regard. Again, the mechanism isn't clear.

Since it has come up a couple times here, there are a lot of cases, in both Chinese and conventional medicine, where the mechanism of action isn't clear. In fact, there are a lot of FDA approved drugs on the market whose mechanism of action either isn't known at all or isn't fully understood. We make decisions based on efficacy and safety - does it do what it claims and are there any serious side-effects? In acupuncture's case the answer is typically, yes, it does what it claims and no, there generally aren't any serious side-effects. So, just because we don't understand how it works, sometimes it's enough to know that it does work and it works safely.

All of which brings me to my final point: to get the best and safest result, you need to make sure you're seeing an NCCAOM board certified acupuncturist. If your doctor doesn't have a few acupuncturists that he/she recommends, go to NCCAOM.org and use their "Find a Practitioner" link to locate someone local to you.

How long a session lasts depends on whether it's an initial intake, followup treatment or community acupuncture session.

I'm just going to give you some generalities here, whatever provider you're seeing may be slightly different. That being said, an initial intake usually runs 90 minutes and will include treatment time (i.e. time on the table with needles inserted to treat whatever your complaint may be). A followup treatment usually runs 60 minutes with a few questions up front to determine how the previous treatment worked and what has changed for you followed by treatment time. A community session typically runs 20-30 minutes after a very short set of questions/diagnoses.

Different practitioners may vary from these times slightly, but what I've outlined above is fairly typical.

How many treatments is this going to take? - is a common question practitioners of Chinese medicine often receive. The answer can vary depending on what is being treated, how long that condition has been present, how well any given patient adopts diet/lifestyle suggestions and, to be honest, how skilled/experienced the practitioner happens to be.

It sounds like you've already taken the first big step by addressing your diet. Assuming no underlying health/metabolic issues, I'd think something in the range of 7-10 acupuncture treatments spaced at one treatment per week would probably assist in getting you where you want to be weight wise.

For the best results, make sure you're seeing an NCCAOM board certified acupuncturist. To find someone local to you, go to NCCAOM.org and click the "Find a Practitioner" link.

Great question, there are potential risks and complications to receiving acupuncture treatment. Whoever is providing this service to you should have spelled everything out and, ideally, had you sign an acupuncture informed consent form that lays everything out in writing.

With that statement out of the way, generally speaking acupuncture is very safe. In increasing order of severity (and decreasing order of probability), here's what could possibly go wrong:

1. Local bruising/itching at the needle site. Itch is probably the most common adverse event and usually resolves in an hour or two. Bruising is probably the second most common and usually resolves in a couple of days.

2. Sharp pain around the needle site. Typically this means we're a little close to a nerve or capillary bed. Often times, repositioning the needle will make this pain go away. It's important to provide feedback to your provider (and important for providers to solicit this feedback). If you experience sharp pain on needle insertion that does not go away after a couple seconds, tell your acupuncturist and have them either move or remove that needle.

3. Sharp pain that does not subside when the needle is repositioned or removed. This is a little more serious and may mean the needle has nicked a larger nerve. Sometimes this can take a couple days to clear up.

4. Organ puncture, including tension pneumothorax. Organ puncture only occurs when needling over the abdomen (front or back). Pneumothorax only occurs when needling over the lungs (front or back). Of the two, pneumothorax is the more serious. Basically what has happened is the needle was pushed too deep and invaded the pleural/lung space allowing air from the outside to get in. This is a potentially life-threatening condition and requires immediate ER attention. Symptoms of a pneumothorax are: chest pain/tightness, painful cough, shortness of breath. If you experience any of these symptoms after receiving acupuncture over the chest or at the top part of the shoulder, go directly to the ER.

There is a 5th issue which very, very rarely pops up and that is infection. Almost all US acupuncturists use single-use disposable needles. This mean the needle is used once and then thrown away, reducing the possibility of cross-contamination between patients. Additionally, NCCAOM board certified acupuncturists are required to obtain a Clean Needle Technique (CNT) certification prior to receiving their board certification and state licensure. CNT spells out all the requirements for maintaining a clean space for the practice of acupuncture. Receiving this certification consists of being trained in school, attending a seminar, taking a written test and then taking a practical exam where an exam proctor looks over your shoulder while you're inserting and removing needles to ensure you're doing so in a safe and clean manner. Since the implementation of these guidelines and certifications, there have been very few instances of infection due to cross-contamination.

In my experience, the first adverse event happens quite a lot. Itch is probably the single biggest piece of feedback I receive from patients after a treatment.

The second event happens a fair amount, but getting feedback and repositioning or removing needles takes care of the problem and I've never had someone not schedule or re-schedule with me because the needles were too painful.

I've never had the 3rd, 4th or 5th adverse events occur while providing a treatment. To be honest, I've never heard of a board certified acupuncturist causing the 3rd or 4th issue. The only acupuncture cross-contamination case I'm familiar with comes from Canada in the 1980's.

Which brings me to my last point. Throughout this answer I've referenced NCCAOM board certified acupuncturists. These are folks who attended at least 3 years of Chinese medical school, sat for multiple board exams, acquired CNT certification and are state licensed as providers of Chinese medicine. Unfortunately, these aren't the only folks who offer treatment using solid acupuncture needles. There are other providers in the system who offer acupuncture-like services with a fraction the training and, in my opinion, you are rolling the dice with these providers.

To find an NCCAOM board certified acupuncturist close to you, go to NCCAOM.org and use their "Find a Practitioner" look up. Making sure your provider carries an NCCAOM board certification, CNT certification and state practice license will greatly minimize the probability you'll experience a serious adverse event.

First off, there are very few therapies of any sort that will help him quit smoking if he's not ready to quit smoking. In other words: there aren't really any treatments which will force him to do something he otherwise doesn't want to do.

That being said, what acupuncture does is help manage cravings. Typically when treating addictions we use a set of 5 needles in the ear. These needles appear to be stimulating the GABA system in the brain. This system is responsible for chilling things out in the central nervous system which is why it can be effective for helping people quit addictive substances.

If this is a route you decide to try, in order to get the best possible result you will want to take him to either an NCCAOM board certified acupuncturist. To find someone local to you, check out the "Find a Practitioner" link at NCCAOM.org. Or you can find an Auricular Detox Specialist near you by contacting the folks at acudetox.com (info@acudetox.com).

Different acupuncturists practice in different ways and use different systems of acupuncture, so I can't really speak for everyone. What I can say is: in my clinic if back and shoulder pain along with hand/finger pain due to arthritis were your chief complaints, then I'd find a way to treat both in the same session.

Short version: yes, both your issues could be treated at the same time.

Generally speaking, acupuncture is safe throughout pregnancy. We have techniques for helping women get pregnant, manage pain and other issues during pregnancy, we even have techniques for helping to turn breech presentation at the end of pregnancy.

There are a few acupuncture points which are classically contraindicated in pregnancy, but any well trained, NCCAOM board certified acupuncturist will be very familiar with points to avoid. To find a board certified acupuncturist near you, go to the "Find a Practitioner" link at NCCAOM.org.

A lot of folks: acupuncturists, MDs, other researchers and so on are starting to come to the idea that acupuncture should probably be recommended for everyone. The focus of Chinese medicine is more towards prevention, which is something we talk a lot about in the west, but never make any substantive movement towards.

Why should a woman use acupuncture if she's trying to get pregnant? It's a good question, particularly if the woman and her partner have no other fertility issues. I'm going to take a stab at answering the question, hopefully without resorting to any 'woowoo' terminology, we may just have to wander around the barn a bit to get there.

In recent years, we've started to realize that stress may be sitting at the root of a lot of modern disease conditions. In the west we have a very high stress 24x7 lifestyle where people are working a lot, spending a lot of time indoors, spending a lot of time sitting, spending a lot of time in front of a screen (computer, TV, tablet, phone). We have long commutes in heavy traffic. We have poor diets. We have a lot of exposure to environmental toxins. We get little exercise. None of this is particularly healthy, no matter how we attempt to rationalize it.

This stress activates our 'fight or flight' mode which is the sympathetic side of the autonomic nervous system. Activation of the sympathetic system leads to increased cortisol levels, higher incidence of high blood pressure, more headache/migraine, more digestive complaints, reduced immunity and a host of other potential effects. Why this all happens is a relatively simple function of how the sympathetic nervous system is designed to work. It's just that our bodies were never intended to be in this mode all the time.

Acting in opposition to the sympathetic system is the parasympathetic side of the autonomic nervous system. The parasympathetic system is the so-called 'rest and digest' mode. Here, the body relaxes, blood is diverted to the internal organs for nourishment, blood pressure drops, muscle tension is released. This is where our bodies were designed to spend most of their time.

Enter acupuncture. One of the things most acupuncture studies consistently show is acupuncture's ability to promote the parasympathetic 'rest and digest' mode over the sympathetic 'fight or flight' mode. In other words, acupuncture encourages your body to enter a state where better nourishment is going to be derived from your food and that nourishment is going to be better distributed to your internal organs.

From the perspective of fertility, being able to maintain a healthy balance between sympathetic and parasympathetic can sometimes make the difference between getting pregnant and not. We've all heard stories of the couple who are trying and trying and trying to get pregnant. Eventually, they tire of the grind and decide to just chill out for a few months before trying again and bam, pregnant. Stress can have a tremendous effect on our overall health, probably more than we think and in more ways than we currently recognize. Anything that helps to manage stress can increase fertility.

And, of course, if a woman is in the unfortunate position where she's having to consider IVF or other fertility treatments, acupuncture has a really strong track record with plenty of studies currently available showing efficacy.

To get the most out of any acupuncture treatment, please make sure you're seeing an NCCAOM board certified acupuncturist. You can start with the "Find a Practitioner" directory at NCCAOM.org to find someone local to you. If you're just looking for stress relief and have no underlying fertility issues, any acupuncturist will do the trick. If you have some sort of fertility issue, you will want to find an acupuncturist who specializes in this area.

I treat folks for dental pain all the time. If you haven't already, I'd strongly suggest having a dentist take a look. You may be dealing with a cracked tooth or a cavity in which case, you're eventually going to need to have work done.
Acupuncture can definitely help manage any pain/discomfort in the meantime.

If you have dental anxiety, acupuncture can also help. If this is the case, I'd suggest scheduling an acupuncture appointment either the same day (ideal) or 24 hours prior to your dental appointment.

Explaining how it works is a little more complicated. From the perspective of biochemistry, acupuncture appears to be affecting a set of neurotransmitters which have a lot to do with the transmission of pain signals in the brain and spinal cord. There is also evidence that acupuncture is changing the way the pre-frontal cortex in the brain processes pain signals coming from the body.

Generally, for tooth/mouth pain, I'll use points on the hands and feet.

For the best results, please make sure you're seeing an NCCAOM board certified acupuncturist. You can go to the "Find a Practitioner" page at NCCAOM.org to get a list of folks local to you.

Acupuncture can help improve circulation as well as help moderate blood pressure (either too high or too low).

Studies involving acupuncture have pretty consistently shown that it is, at least in part, stimulating the parasympathetic part of the autonomic nervous system. This is part of the nervous system that acts in opposition to the "fight or flight" side.

There are a lot of potential effects which can result from activating the parasympathetic system and one of them has to do with relaxing blood vessels. This allows blood to flow more freely contributing to increased circulation.

If you decide to try acupuncture, please make sure you're seeing an NCCAOM board certified acupuncturist. You can start with the "Find a Practitioner" link at NCCAOM.org to find someone local to you.

This is a very complicated issue/question and in the interest of full disclosure, I'm an extremely biased source when it comes to the subject of dry needling.

Are there people out there who provide dry needling services who are quite good at what they do? Certainly. The problem is: there are no national certifying agencies, no course curriculum guidelines, very few hours of training required and no required continuing education. In essence, there's no quality control and, in my opinion, you're rolling the dice when you allow someone to treat you using solid needles who doesn't carry some sort of nationally recognized board certification.

The American Medical Association's position is: dry needling is acupuncture and those providers who offer the service need to have substantially similar training, certification and continuing education requirements as acupuncturists. As I noted above, usually they do not have these qualifications.

Generally speaking, dry needling is targeting so-called "trigger points". The thing about trigger points is: they have a very narrow set of diagnostic criteria. A trigger point is defined as a point of highest tension in a muscle that, when pressed, creates a radiating pain pattern characteristic of that location on that muscle. If it doesn't fit that definition, even if the point is tender, it's not a trigger point and may or may not benefit from having a needle stuck in it. Most folks offering dry needling are flexing the definition somewhat and will simply needle any point that is painful when pressed, regardless of whether the pain radiates in a characteristic way.

The other issue is: your back pain may or may not be related to muscular issues/trigger points. If your back pain is trigger point related, then this type of treatment can sometimes help. If your back pain is not trigger point related, then this type of treatment is usually a waste of your time and money.

An acupuncturist who specializes in musculoskeletal treatments/pain management can locate and treat using trigger points (if they are part of the problem) and they can also address other, non trigger point, issues which may be causing your discomfort/pain. Generally an acupuncturist is going to have much more experience using needles to address problems like this, your experience will be more comfortable (dry needling tends to be very painful) and you're less likely to be injured by the needling process. Back treatment can be tricky, especially if needles are required over the lung/chest cavity. There is a risk of tension pneumothorax due to a needle penetrating the pleural cavity. This is extremely painful and can be life-threatening. It can happen to anyone who is using needles over the chest, but it tends to happen more often with providers who have sub-standard training and then attempt to dry needle.

The question you have to ask yourself is: do I want someone who qualified for, took and passed a set of nationally recognized board exams after taking thousands of hours of class work and having several hundred supervised treatment hours under their belt treating me OR do I want someone who took a weekend seminar, maybe inserted a handful needles under supervision and has no national qualification to perform the procedure in question?

You could also think about it like this: if you found out you had a brain tumor would you let your kids' pediatrician operate on it just because they had an interest in neurosurgery or would you try to find a board certified neurosurgeon to do the work?

Ultimately it's the same question. Do I want a board certified specialist or am I willing to roll the dice with just any old provider?

I suggest starting with the "Find a Practitioner" page at NCCAOM.org. Get a list of credentialed acupuncturists in your area and call around to see if you can find someone who specializes either in pain management or musculoskeletal acupuncture. In my opinion this will give you the best possible result and the safest, most comfortable treatment experience.

I had a patient ask me about these once before, so I've done a little research already.

Here's what I know: sometimes daith piercings work and sometimes they don't.

Often folks will think that the reason the piercing works to relieve migraines is because of auricular acupuncture and how the body maps on to the ear for this particular modality. I've compared the daith location to common auricular acupuncture systems and I can't see any reason, from a pure acupuncture/Chinese medicine perspective, for why it would work. In other words: there's nothing about the location of a daith piercing that would compel me to use it via acupuncture to treat migraine. Other acupuncturists have made the same comparison and arrived at a similar opinion.

That being said, I've spoken to people who've gotten a daith piercing and it has made a difference for them. The body is a very complicated landscape and no one has the last word on how everything goes together.

Here's what I'd do if I were you: if you haven't tried it already, give regular acupuncture a shot. I typically get excellent results for headache, including migraine, with needles in the body. If you give acupuncture 4 or 5 treatments and you're not responding (either a decrease in migraine occurrence or a decrease in migraine pain levels), then you can always give the daith a go.

If you decide to try acupuncture, for the best results you need to make sure you're seeing an NCCAOM board certified acupuncturist. Start with the "Find a Practitioner" page at NCCAOM.org to find some folks local to you.

Acupuncture can be an excellent treatment choice for dealing with pain (of any type) and fatigue. It also partners well with conventional pharmaceuticals because we're not adding any substances to the body and thus there is a very low risk for adverse event due to interactions.

Acupuncture can also, sometimes, help to regulate an out of control immune response which can lead to a reduction in symptoms overall.

For best results, you want to make sure you're seeing an NCCAOM nationally board certified acupuncturist. You can start with the "Find a Practitioner" page at NCCAOM.org to find someone local to you.

There are several studies out showing acupuncture's effectiveness in helping against cold and flu. What seems to be happening is: acupuncture is increasing T-cell count. T-cells are immune cells produced in the thymus which target and destroy bacterial and viral invaders.

How acupuncture does this is still an open question.

Whenever we consider acupuncture and Chinese medicine we have to remember this system is using a slightly different way of thinking about the human body and how it works. Reductionism does not play the same role in Chinese medical and scientific thought as it does in the west. Acupuncturists are looking at things more whole-istically; rather than focusing on one organ which may have a problem, we're looking at relationships between systems.

At the same time, unless we want to take the position "Crouching Tiger, Hidden Dragon" was a documentary, we must recognize that the ancient peoples who left us this system were looking at the same human bodies and the same disease processes we look at today. They were simply describing things using the best language they had available. Unfortunately, that language was ancient Chinese - which no one today outside of scholars of ancient China can really read and which does not translate well in to English. This poor translation combines with a poor cultural understanding and gives rise to the quasi-mystical approach many western acupuncturists tend to adopt. In reality, the history of Chinese medicine, from very ancient times to present, is about replacing superstition and mysticism with something we today would call more "evidence based".

Great question, I've been getting this one a lot recently in personal conversations. There are, in my opinion, 4 times when acupuncture is not a suitable treatment:

1. A patient has a life-threatening, acute infection - either bacterial or viral. In this case they are far better served with antibiotics/hospitalization.

2. A patient has experienced severe, life-threatening trauma - like a car accident or gunshot wound. Conventional medicine excels at the preservation of life in the face of catastrophic damage.

3. A patient has cancer. Chinese medicine can help a person in this condition better tolerate chemotherapy, but it's unlikely that Chinese medicine alone is going to resolve the issue.

4. A patient has joint pain whose cause is severe degradation of the joint itself. In this case, essentially, the joint has degraded to the point that every provider a person consults is telling them they need to consider joint replacement/fusion. In this case acupuncture can help to manage the pain, but it's unlikely to restore the joint to proper function.

Acupuncture's great, and under-utilized in my opinion, strength lies in the fact that it integrates very well with conventional treatments. There are usually no substances involved, the needles are solid (we aren't injecting anything) so there's very little concern of creating an adverse event via interaction with pharmaceuticals.

Even though Chinese medicine isn't a good choice for dealing with the 4 issues I've described above, it can play a role in after-care in all cases.

Acupuncture can work quite well for hypertension. If you're taking any prescription medication to help manage your blood pressure, make sure your doctor is aware you are going to try acupuncture. When acupuncture starts to bring your blood pressure down, you're going to need your physician to alter the dose of your medication. Otherwise you run the risk of ending up with blood pressure that's too low.

Please make sure you're seeing an NCCAOM nationally board certified and state licensed acupuncturist. If you need to find someone with these credentials local to you, start with the "Find a Practitioner" page at NCCAOM.org.

Acupuncture is generally an excellent choice for dealing with the pain of fibromyalgia. I've worked with several fibromyalgia patients and usually get good results for them.

How acupuncture works in this condition is still, largely, an open question. We know acupuncture is regulating several neurotransmitters in the spinal cord and brain which have to do with pain sensation. Acupuncture also appears to be changing parts of the brain's pre-frontal cortex. This brain area has a lot to do with how pain information is processed.

For the best results you're going to need to do two things:

1. Make sure you're seeing an NCCAOM board certified acupuncturist. You can start with the "Find a Practitioner" page at NCCAOM.org to find someone local.

2. Acupuncture is a dose-dependent front-loaded process. This means you're going to need to commit to several (probably 3-5) treatments up front. Usually we space these a week apart, but if your pain is severe your acupuncturist may suggest more frequently to start.

I'm so sorry this happened to you. I'm going to make a couple of suggestions:

1. Follow up with the initial provider. Let them know what you're experiencing and see what they think.

2. Make an appointment with your primary care doctor and get a neurologist referral (or make an appointment with a neurologist).

I suspect a nerve in your forearm was either damaged or irritated during this process. How long it might take to heal is going to be a tricky thing to figure out without a lot more information. Please make sure you're seeing an NCCAOM board certified and state licensed acupuncturist when receiving acupuncture treatments. There are a lot of people out there right now who are trying to cash in on acupuncture's popularity and they're not necessarily well trained.