John Aguilar, Jr, DAOM, EAMP, Dipl OM (NCCAOM)
Doctor of Acupuncture and Chinese Medicine
Practitioner, Bastyr Center for Natural Health, Seattle, WA
Adjunct Faculty/Lecturer, Northwestern Health Sciences University
Adjunct/Clinical Faculty, Bastyr University
The short answer:
"A therapeutic modality rooted in unique Chinese medical diagnosis and treatment concepts that consists of the insertion of fine, sterile needles into very specific points on the body, followed by skilled manipulation, for the purposes of effecting the functioning of the body or mind."
The long answer is quite a bit longer. I've broken down a discussion into four areas:
1. Aspects of treatment
2. Acupuncture Point Selection
3. Side Effects
4. Acupuncture Points
1. Aspects of Treatment
The practice of acupuncture, as a specific Chinese medical modality, extends far beyond the mere insertion of acupuncture needles into acupuncture points. Every aspect of the acupuncture treatment process contributes to the end effect.
Below is list of the basic aspects of an acupuncture treatment that the practitioner must take into account.
A) Gauge (thickness) of the needle - Typically 32-38 gauge needles are used (compared with the needles used in hospital settings which are normally 12-18 gauge - the smaller the number the larger the needle).
B) Specific acupuncture point chosen - There are hundreds of distinct acupuncture points on the human body.
C) The order of needle insertion - The order in which the points are stimulated affects the nature of the treatment.
D) Angle of needle insertion - Acupuncture points lay on acupuncture channels, aka 'meridians'. These channels have a specific direction of flow. Whether the needle is inserted against or with this flow greatly influences the affect that needle will have.
E) Depth of needle insertion - Points are spherical with discernable depths. The depth at which the needle is inserted and manipulated alters the effect of the treatment.
F) Whether needles are inserted and removed with the patient's inhalation or exhalation - Breathing is an active influence on the movement of energy through the body. What specific stage of breathing the patient is in when the needle is inserted and removed changes what the effect that needle will have.
G) Attainment of specific sensation, referred to as 'de qi' - This sensation must be felt by the practitioner, as it is the concrete indication that the needle has contacted the acupuncture channel and flow of energy. It is after attaining this sensation that the practitioner then skillfully manipulates the needle to have specific effect on that acupuncture point.
H) The specific technique employed on the needle by the practitioner - This is generally where the most emphasis is placed, second only to the choosing which points to use. Techniques include small amplitude lifting and thrusting of the needle, twisting and rotating of the needle, breathing, and the practitioner's specific mental intent ('yi').
I) Length of needle retention - The amount of time the needles are left in thie body after manipulation influences the overall effect of the treament. In modern times, the needles are generally left in the body, or 'retained', for 10-20 minutes. Note - classically, needle retention was not required for treatment effect. There are some modern practitioners who follow such classic techniques and do not retain needles.
J) The specific order in which the needles are removed - This order can influence the net effect of the treatment.
K) The specific technique used to remove the needle - Needles can be removed rapidly or slowly. The point may be immediately covered after removal of the needle, or not. The sensation of 'de qi' can re-attained and held during or just before removal, or not. All of these alter the effect the treatment.
3. Acupuncture Point Selection
The selection of acupuncture points for a given patient's specific condition can be a highly complex process. Contrary to popular belief, acupuncture points do not have single, isolatable physiological effects. Points do not 'do' something, nor are they 'good' for certain issues. As could be surmised from the above review of the aspects of the treatment, points have a wide range of tendencies. The specific effect to manifest is dependent not solely upon the point chosen, but rather on a long list of contextual contributors (all of which
also have non-reducible tendencies of action).
In the formal educational process of acupuncturists, many 'point prescriptions' are taught and memorized by students. Though these have reliably predictable effects, when properly matched with the patient's disease pattern, they are ultimately used merely as 'a good place to begin' in choosing what acupuncture points to use in any given treatment.
Importantly, the known actions and functions of points are based on Chinese medical concepts of health, illness, disease, pathology, pathophysiology, etc. No clinically useful prediction of a point's effect can be made based upon the Western scientific models of chemistry, biology, and so forth. Over time, as theories are proposed, tested, and refined through clinical use, this ability will be (is being) developed.
3. Side Effects
Side effects of acupuncture are minimal in frequency and severity.
Though not truly a side effect, there are often sensations associated with the insertion and manipulation of the needle. With insertion, a slight prick may be felt. Some areas of the body are more sensitive than others, and certain illnesses increase the sensitivity of the acupuncture points to needling.
Following insertion, during the needle manipulation phase of treatment, it is a positive therapeutic indicator when the patient experiences any number of sensations, including:
- dull ache or throb
- mild electrical feeling, possibly radiating to other areas of the body
- warmth at site of needle insertion
Additionally, perhaps 1 in 10 needles will result in very minor bleeding (rarely more than a drop or two), and 1 in 12 will leave a minor bruise at the site of needle insertion.
Rarely (I have never personally witnessed it), the patient will pass out with insertion of the first needle. Patients are most often laying down, and if not they are sitting, making these very easily managed.
4. Acupuncture Points
The exact number of acupuncture points depends in the source and style of the practice. Varying Oriental medical systems incorporate different points. Classically, 365 points were described on the acupuncture channels, with dozens of others laying off channels.
Points are located all over the body, literally. Hands and feet, arms and legs, torso, chest, back, and the head all have points on them.