Jeff Rippey

A lot will depend on why you're having chronic knee pain. Sometimes, yes, a series of acupuncture treatments can resolve the pain. In other cases, a series of treatments will reduce the pain and some level of maintenance may also be required for a patient to remain relatively pain free.

A lot is going to depend on why you're experiencing hand pain. If you haven't done so already, having some x-rays taken and getting evaluated by your primary care provider should be your first step. If the imaging and evaluation doesn't identify the problem or the problem is identified but conventional medicine doesn't offer much in terms of resolving the issue then, yes, acupuncture can often provide relief.

A lot is going to depend on why you're experiencing spinal pain. If you haven't done so already, go to your primary care and at least have some x-rays taken. Depending on what the x-rays do or don't show, an MRI might also be in the cards.

If the imaging doesn't provide a concrete diagnosis or the imaging does provide a diagnosis but conventional medicine doesn't offer much in terms of a resolution to the issue then, yes, acupuncture can often help.

Unfortunately, it's hard to give a concrete answer to the "how many sessions" question. Chinese medicine is an individualized system - this means that Chinese medicine recognizes that not everyone experiences a symptom like back pain for the same reason and not everyone responds to treatment at the same rate.

Some very generalized numbers for you: studies show, across all types of pain, an average number of total treatments in the 8-10 range. Keep in mind this is a population average, there will be people who respond in fewer than 8 treatments and people who require greater than 10.

On top of this, there is roughly a 5% non-response rate at the population level. This means that about 5% of the population do not respond to acupuncture at all. We don't know why this happens and the only way to know if you're in the 5% who don't respond is to try acupuncture. Of course, this also means there is a 95% chance acupuncture will work for any given person.

My general rule of thumb for pain patients is to come for three treatments spaced one week apart. If the patient isn't noticing a difference by the 3rd treatment then either I'm not understanding the problem well enough to apply the correct treatment, or they're in the 5% who aren't going to respond.

It depends on what's causing your neck pain. It would be a good idea to start with your primary care provider and get some imaging done. X-rays and/or an MRI might show what's causing the pain which will give a starting point for treatment.

Unfortunately, tinnitus is extremely difficult to treat. I can count on the fingers of one hand the number of tinnitus cases I've seen respond to acupuncture.

I've had quite a few patients who've tried a variety of remedies ranging from vitamins to herbal medicines - almost none of them have seen any significant improvement.

I don't want to dissuade you from trying anything (so long as what you're trying is safe), but it's rare to see things work.

If you haven't seen anyone yet, I'd start with your primary care provider and get some x-rays. Depending on what the x-rays show, you may have a variety of options.

Sometimes a referral for physical therapy is warranted. In some cases a chiropractor might help. Acupuncture has an excellent track record in the treatment of chronic back pain. Conventional pain management can sometimes provide relief. Lastly, some issues rise to the level of surgical intervention. Sometimes it takes more than one provider from the above list.

There are some headache causes that would need to be ruled out (e.g. cancer or other tumor/growth). Assuming you've already been down that road, yes, acupuncture can be an excellent treatment for chronic headache and/or migraine.

Assuming you've ruled out other potential causes (medications, lung infection, tumor/cancer/growth in lung), yes, acupuncture can often help chronic cough.

Acupuncture is an excellent treatment choice for most kinds of pain, including chronic leg pain.

Assuming you've had an upper GI scope and ruled out other, potentially more serious causes, yes, acupuncture can generally help chronic stomach pain.

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

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.