Acupuncture originated in China about 2,500 years ago. The practice is based on the philosophy of yin and yang—two opposite forces that govern all aspects of life, including health. Ailments result from an imbalance of these two forces, which is caused by the disruption or blockage of energy, or chi, in the body.

Acupuncturists stimulate points along specific energy pathways, or meridians, to help chi flow freely. A body with balanced, free-flowing chi will be able to heal specific symptoms by itself. Thin metal needles are the most common means of stimulation, although massage, heat, lasers and magnets are also used.

Acupuncture did not become popular in the United States until Richard Nixon visited China in 1972, sparking widespread interest. Today, millions of Americans undergo acupuncture procedures every year, utilizing a combination of techniques developed in East Asian countries; such as China, Japan and Korea, where people often use both traditional and modern medicine to treat their illnesses.

While it is difficult to study, acupuncture is generally thought to be effective. It has been used to alleviate ailments such as nausea, dental pain, headaches, menstrual cramps, tennis elbow, fibromyalgia, osteoarthritis, lower back pain, carpal tunnel syndrome and asthma. It may also help patients fight addiction and aid stroke victims undergoing rehabilitation.

Common Types of Acupuncture

Traditional Chinese Acupuncture
Needles are used to activate specific points of the body that affect the flow of chi. When acupuncture was first developed, ivory and bone needles were used. As technology advanced, iron, silver and gold needles were developed. Today, practitioners of traditional Chinese acupuncture use stainless-steel needles about the width of one strand of hair.

Japanese Acupuncture
A slightly gentler method, Japanese acupuncture uses thinner and shorter needles than the Chinese style. There are two treatments: root and local. Root treatment addresses a patient's energy imbalance as a whole, while local treatment focuses on alleviating specific symptoms. Both root and local treatments can be performed at the same time.

Five-Element Acupuncture
The concept of yin and yang is also associated with the Chinese philosophy of the five elements: fire, earth, metal, water and wood. Nature and humans are linked in a cyclical pattern of creation and destruction symbolized by these elements. This belief colors Chinese history, philosophy and medicine. Five-element acupuncturists take a holistic approach to medicine, focusing on the chi and the balance of the five elements in the body. They believe that restoring the balance of elements will cause other symptoms to cure themselves.

Auricular Acupuncture
This method is performed solely on the 200 acupuncture points around the outer ear. Because acupuncture points are connected by energy pathways, each point around the ear is linked to other points around the body. It is thought that auricular acupuncture can have all the benefits of traditional acupuncture because stimulating points around the ear affects specific pathways, which in turn stimulate the body's flow of chi.

Korean Hand Acupuncture-Acupressure
Similar to auricular acupuncture, Korean hand acupuncture utilizes what Tae-Woo Yoo, a Korean physician, calls micro-meridians, which link to traditional meridians that flow throughout the body. Tae-Woo Yoo developed this form of acupuncture in 1971, mapping the micro-meridians of the hand and linking them to corresponding pathways. Treatment is isolated to the hand, but, as with auricular acupuncture, the overall effects are thought to be identical to traditional acupuncture performed on the body.

Trigger Point Acupuncture
A direct style of acupuncture, specific trigger points are used to relieve muscular tightness caused by injuries or bad posture, for example. Tight muscles are identified and a thin needle is used to probe the area, causing the muscles to twitch involuntarily, relieving tightness and, usually, symptoms.

Common Treatment Techniques

Moxibustion
Acupuncture points are stimulated with heat, specifically by burning the herb moxa, which comes from the mugwort plant. It is most useful around large blood vessels, eyes or ears, where acupuncture may be dangerous. There are two types: direct and indirect.

• Direct: A small ball of the herb, about the size of a grain of rice, is placed directly onto the skin and burned at an acupuncture point. In ancient times, the skin was allowed to blister and burn, but now it is more common to remove the burning moxa after the skin has become warmed.
• Indirect: A piece of moxa is crushed and wrapped in paper, like a cigar. It is lit and held close to the skin, stimulating the acupuncture point with heat and causing the skin to turn red. Indirect moxibustion can also be combined with acupuncture. The tip of the needle is wrapped in the herb and lit, heating the general area.

Acupressure
A quick fix for an office headache or for people who balk at the use of needles, acupressure is a Chinese massage that stimulates points along the body's meridians by using pressure. If possible, corresponding points on both sides of the body are stimulated at the same time. Firm pressure is applied using the fingers or thumbs. Pressure is either maintained for one to three minutes or applied at intervals of ten seconds.

Electroacupuncture
An electrical current is sent through the inserted acupuncture needles to stimulate the site. This has been tested on chemotherapy patients and was found to help treat nausea.

Chiropractic Acupuncture
Many chiropractors use acupuncture techniques on a daily basis, calling the practice "meridian therapy."

Cupping
This technique uses metal, wood or glass jars to create a partial vacuum against the skin, stimulating acupuncture points with suction.

Gua Sha
A solid object with a rounded edge, traditionally a soupspoon or coin, is firmly stroked across the skin, causing stagnated blood to rise to the surface. Organs and the immune system are thought to benefit from increased blood flow.

Herbology
Traditional Chinese medicine uses herbs to help balance yin and yang and facilitate energy flow. They are used for both long-term health and to cure specific symptoms.

Massage Therapy (Tuina or Anmo)
Chinese massage therapy differs from other forms of massage because of its integration of acupressure techniques. While using techniques like kneading, shaking, rocking, gliding and friction, pressure is applied to specific points believed to stimulate energy flow.

Naturopathic Medicine
Naturopathic medicine combines traditional therapies with modern medicine. Practitioners usually have a conventional medical background, but have also studied holistic healing techniques, including Chinese medicine and acupuncture.

Qi Gong
Translated as "breath work," Qi Gong manipulates the same energy fields stimulated by acupuncture, using breathing techniques and visualization instead of needles.

Credentials

M.D. (D.O. for Doctor of Osteopathy)
Medical Acupuncture Certification: American Board of Medical Acupuncture—The ABMA offers certification to physicians who, after medical school, complete a formal course of study that consists of 200 hours of acupuncture-specific study and training. The program must comply with regulations of the World Health Organization and the World Federation of Acupuncture and Moxibustion societies.

M.A. (also the M.A.O.M.—Masters in Acupuncture and Oriental Medicine)
The Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) is a specialized accrediting agency recognized by the U.S. Department of Education. The ACAOM establishes requirements for accredited masters programs. Each approved program must include a minimum of 4,000 hours of coursework, of which 1,200 hours must be completed at the doctorate level.

Certification
Every state has different licensing requirements. In most states, certification from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is required to obtain a license. The NCCAOM offers three routes to certification: formal education, apprenticeship or a combination of the two. Formal education entails schooling from institutions that meet NCCAOM standards and ACAOM requirements. An apprenticeship requires students to complete 4,000 hours of training, working with a credited program for three to six years. Certification can be obtained as well through a combination of both. To be certified, acupuncturists must also take four tests over two days: the foundation of oriental medicine, acupuncture techniques, point location and biomedicine.

The Acupuncture Society of America also offers four different levels of certification. Basic: 100 hours. Intermediate: 200 hours. Advanced: 300 hours. And Master: 400 to 500 hours. Certification takes about four months for every 100 hours. At the end of the course, completion of an exam is required for certification.

Last Reviewed: May 12, 2006
Last Reviewed By: Kirsten Vala