acupuncture is touted for its power to treat pain, depression, and addiction. so what really happens when you get stuck?

Let’s start with the traditional Chinese explanation: The body contains as many as 20 invisible pathways, called meridians. Qi (pronounced chee), a form of energy, flows constantly through these pathways. When meridians are obstructed by poor diet, bad posture, or unhealthy habits, qi builds up in some places and is depleted in others, leading to illness and pain. Some 365 acupuncture points on the skin connect with the meridians. By gently inserting needles in a select few of these points, acupuncturists remove the obstructions and restore the flow of qi.

American medical researchers have not been able to link the meridians to the body’s network of blood vessels or any other observable system, nor can they tell exactly what qi might be. But imaging studies of the nervous system have shown that the insertion of needles triggers the flow of electromagnetic signals through the body. These signals, in turn, stimulate the release of natural painkillers and other substances that can help the body heal.

The World Health Organization recognizes acupuncture’s effectiveness against 28 common ailments. But in the United States, it is often used for these four:
pain: More than 60 percent of people who see acupuncturists are looking for pain relief — usually the kind that Western medicine cannot readily cure, says Lixing Lao, M.D., director of traditional Chinese medicine at the University of Maryland School of Medicine, in Baltimore. That includes back, neck, and arthritis pain, migraines, menstrual cramps, and carpal tunnel syndrome.
depression: In a small 1998 study at the University of Arizona of women with major depression, two-thirds of the subjects experienced a profound improvement after acupuncture, which is comparable to the effectiveness of psychotherapy or antidepressant drugs. Larger studies are now under way. “Acupuncture’s efficacy hasn’t been conclusively established,” says John J. B. Allen, the professor of psychology who led the Arizona study, “but in our trial many people showed quite a bit of benefit.”
addiction: Auricular acupuncture, which involves placing the needles in the outer ear, is being used at substance-abuse programs in the United States to treat addiction to cigarettes, alcohol, and drugs. Acupuncture alone has not been proved to end addictions, but studies suggest it can be beneficial when used along with counseling, 12-step programs (such as Alcoholics Anonymous), and medication. In one study published in the American Journal of Public Health, 40 percent of smokers who received acupuncture and also attended an educational program were able to quit for at least 18 months. Only 22 percent of those who took the classes but had placebo acupuncture were able to kick the habit for that long.
infertility: This has been one of the fastest-growing areas of treatment since the 2002 publication of a German study that found that more than 40 percent of women undergoing in vitro fertilization who received acupuncture became pregnant (compared with 26 percent of those without acupuncture). Doctors at the Center for Reproductive Medicine and Infertility (CRMI) at the New York–Presbyterian Weill Cornell Medical Center have observed that acupuncture can increase blood flow to the uterine wall, making it more receptive to an embryo. Still, Zev Rosenwaks, M.D., director of the CRMI, says that “while there are a great number of biological explanations for acupuncture’s benefits to fertility, there has yet to be a definitive clinical study.”

Most states require that acupuncturists be certified in order to practice. For certification, an acupuncturist must be trained in Oriental medicine, have studied human anatomy, and have passed an exam in acupuncture. To find out if a practitioner is certified, go to the website of the National Certification Commission for Acupuncture and Oriental Medicine: www.nccaom.org.

More than 7,500 physicians in the United States have had training in medical acupuncture. They are often a good choice for those who are leery of alternative medicine. You can find a list of them at the American Academy of Medical Acupuncture website: www.medicalacupuncture.org.

In addition to taking a medical history, acupuncturists ask about lifestyle. Questions may include: How strong is your appetite? How well are you sleeping? How much do you sweat? They observe your posture, listen to your voice, and assess your mood. They will examine your injury or condition but also take your pulse at several spots on your wrists to gauge your qi balance.

“A good acupuncturist must be a detective,” says Meg Richichi, an acupuncturist in New York City, “not someone who just puts needles in at prescribed points.”

Depending on the diagnosis and the practitioner’s preferred technique, anywhere from 1 to 30 needles may be used. They are usually inserted between an eighth of an inch and one inch deep, and most patients feel only a slight discomfort—a tingling feeling known as deqi (da-chee). The acupuncturist may twist the needles or flick them to increase deqi. The needles are typically left in for 20 to 35 minutes. Most people say they feel relaxed during treatment, and some even fall asleep, says Nancy Rakela, an acupuncturist in Berkeley, California.

One caveat for first-timers: Do not expect to feel significantly better after one treatment. Most practitioners see patients for four to six weeks — usually once a week, but two or three times if a condition is acute. “I like to definitely see results after six to eight treatments,” says Brian Carter, a San Diego acupuncturist.

The cost varies, but the initial visit will probably run from $90 to $140, and subsequent treatments from $60 to $90. Some insurers — Oxford Health Plans and Kaiser Permanente, for example — cover at least part of the expense.