Acupuncture? Well, I know it involves needles — lots of them.” Most people today know a little about acupuncture. They’ve heard of its ancient origins in China. But how does it work? It’s likely that many are puzzled as to what happens in acupuncture. Lucinda Fecteau, current president of the New Hampshire Association for Acupuncture and Oriental Medicine (www.nhaaom.org), describes acupuncture as “a method of promoting the body’s innate healing processes through insertion of sterile stainless steel surgical needles into precise acupuncture points.” The needles are manipulated by the hand or by electrical stimulation. Fecteau is dually licensed and board certified in Occupational Therapy and Oriental medicine. She maintains a practice in integrative medicine and acupuncture in Nashua. According to Chinese medical teaching, the body is a dynamically balanced system of organs connected by the flow of Qi (energy) within 12 main pathways called meridians. Illness results from the imbalance of Qi through the meridians. Needling selected combinations of acupuncture points restores the balance of Qi. Energy flows and stimulates the body’s innate healing abilities. The meridians, or energy pathways, are not the same as the body’s neurological system. Meridians cannot be seen or isolated, as a nerve or blood vessel could be. Their reality is demonstrated by the effectiveness of treatment. But Western thinking typically expects concrete evidence and in recent years, such evidence has been documented. There is a growing body of research that attests to the biomedical effects of acupuncture. Imaging studies (MRI) have demonstrated that needling certain points changes blood flow in the brain. Needling creates a neurological impact by stimulating release of endorphins that inhibit the perception of pain. Acupuncture can stimulate the adrenal glands to produce natural steroids, deactivate trigger points or affect the functioning of the gastrointestinal system. The World Health Organization has identified more than 40 conditions, says Fecteau, for which acupuncture has been proven through controlled clinical trials to be an effective treatment. These include neurological problems (migraine, sciatica, for example), musculoskeletal, digestive, respiratory, gynecological and emotional conditions. The list includes certain conditions of infancy as well. Non-needling techniques are used for infants and children. Fecteau explains, as in Western medicine, that treatment begins with the practitioner asking the patient about presenting problems and also about sleep patterns, nutrition, prior illness, lifestyle, medications taken and other relevant information. This guides the choice of acupuncture points. As treatment progresses, other conditions may become evident. “Treatment is usually not long term,” says Fecteau. “Once or twice a week, for two to four weeks, would be typical, though a chronic condition might take longer.” During the process she teaches a patient strategies for maintaining good health. This may include nutritional counseling, exercise and meditation. She notes that in China, acupuncture is considered preventive medicine. It is not emergency medicine and is not suited for crisis treatment. Acupuncture is gaining acceptance in the medical community. It is now offered at New Hampshire hospitals — Elliot, Exeter and St. Joseph’s to name a few — as well as nationally recognized facilities like Memorial Sloan-Kettering Cancer Center and Dana-Farber. It is also gaining credibility in the treatment of addictions. The 1997 National Institute of Health Consensus Statement on acupuncture stated that acupuncture can be part of a comprehensive management program in treatment of addictions. One misperception about acupuncture that Fecteau has heard is that one has to believe in it or it doesn’t work. “This is not true,” she says, “though as with any treatment, a positive attitude and a feeling of confidence often lead to a better outcome.” A few New Hampshire physicians include acupuncture in their practices. Dr. David Nagel of Concord Orthopedics specializes in pain management. Acupuncture fits into pain management procedures, he says, as part of a total approach. About 10 years ago he took the training program of the American Academy of Medical Acupuncture and began using acupuncture to relieve muscle pain. He has 10 to 20 acupuncture patients but no longer takes new patients, saying that he can’t commit to the two visits a week for several weeks that acupuncture requires. Medical acupuncture differs from traditional acupuncture. It is based on neuro-physiology. “I do not believe in the reality of Qi or meridians,” he says. “But there is much that is good about the Chinese model. I still use some of this approach. It’s a bit of a mystery, but it is effective for some people.” He is pleased to see that several major medical schools and centers are expanding opportunities in complementary medicine. Fecteau also welcomes the growing interest in complementary medicine She is, however, concerned that as acceptance grows, there will be practitioners who have not had adequate training. “When practiced improperly,” she says, “acupuncture can lead to infections, punctured organs, internal bleeding and nerve damage.” Dr. Nagel also expressed concern about training. Fecteau suggests that prospective patients ask the provider if she or he has graduated from an accredited program. Completion of an accredited acupuncture program is three years. Certification in Oriental medicine requires four years of study. Acupuncture, though an ancient practice, is still evolving, says Fecteau. NH While few insurance companies in N.H. reimburse for acupuncture treatment, according to NHAAOC, you should contact your insurer directly to find out if it is covered under your plan. Medicare/Medicaid: Medicare and Medicaid do not cover acupuncture treatment. Self-Pay: Acupuncture treatments typically range in cost from about $40-$125 per 1-1-1/2 hour visit. Flexible Spending Accounts and Medical Savings Accounts: These accounts, often available through your employer and made up of your own pre-tax dollars, usually reimburse for acupuncture treatment. Speak to your employer about how to use this benefit.