Acupuncture Today

The article explores the potential of curcumin, a natural polyphenolic substance extracted from turmeric, to reduce Delayed-Onset Muscle Soreness (DOMS) and support athletic recovery. DOMS is caused by microscopic muscle fiber tears and subsequent inflammation, involving the release of reactive oxygen species and inflammatory markers like COX-1 and COX-2. Curcumin demonstrates promising anti-inflammatory and antioxidant effects by suppressing inflammatory markers, including NF-B, IL-6, TNF-ɑ, and specifically COX-2, thereby reducing muscle damage. Studies detailing optimal timing and dosage have varied, showing significant DOMS reduction when curcumin was ingested before and after exercise, with recommended dosages ranging from 150 mg to 1,500 mg daily, often broken into multiple doses. However, practitioners must acknowledge that curcumin is not risk-free. Individual variability in tolerance, absorption, and metabolism is significant, and side effects like gastrointestinal issues are common. Furthermore, curcumin acts as an iron chelator and can reduce the effectiveness of certain drugs, such as tamoxifen. To enhance effectiveness, curcumin is often combined with piperine (from black pepper), which can increase its bioavailability by 20-fold. The goal remains achieving the maximum therapeutic benefit with the fewest side effects, requiring practitioners to start with low doses and carefully monitor patient response.

This article discusses the management of Lyme disease using modern herbal formulas that effectively target the pathogen (Borrelia burgdorferi) while restoring constitutional balance. Because historical TCM classics lack direct instruction on Lyme, practitioners must utilize "borrowed knowledge" by applying insights from similar spirochete-caused disorders, such as syphilis and leptospirosis. Herbs effective against those ailments—including jinyinhua, banlangen, huangqin, and tufuling—have proven useful for Lyme disease. Additionally, the author integrated the Native American botanical desert parsley (Lomatium dissectum), which acts to "outthrust" deeply embedded pathogens, mirroring the TCM concept of "releasing the exterior". Clinical use of Lomatium often provoked a detox reaction, followed by measurable symptomatic improvement. The core strategy emphasizes multi-targeted, synergistic herbal combinations to modulate inflammation, support detoxification, and aid immune response. Recent research further validates this approach by highlighting the effectiveness of both Eastern and Western herbs, such as black walnut husks, qinghao, and Cryptolepis, which also possess documented antiparasitic properties useful for addressing common tick-borne co-infections like Babesia and Bartonella. Managing Lyme disease remains a significant clinical challenge, demanding a nuanced, integrative approach that bridges conventional and traditional healing systems.

This article summarizes a study evaluating Electroacupuncture (EA) as a synergistic adjunct therapy for Non-Small-Cell Lung Cancer (NSCLC), particularly addressing complications arising from chemotherapy, such as resistance, bone marrow suppression, and immunosuppression. The research, conducted using an NSCLC mouse model, combined EA applied at Zusanli (ST 36) and Sanyinjiao (SP 6) with the chemotherapy drug cisplatin. The findings were robust: EA combined with low-dose cisplatin significantly reduced tumor volume by 76%, marking superior tumor suppression compared to cisplatin alone (45% reduction). Mechanistically, EA enhanced the anti-tumor immune response by upregulating immune-related genes and increasing the infiltration of anti-tumor immune cells, including CD8+ T cells and M1 macrophages. Critically, EA provided substantial protection against chemotherapy-induced toxicity by safeguarding bone marrow hematopoiesis, enhancing progenitor cell function, and increasing peripheral leukocytes. The study identified the PACAP-PAC1 pathway as a potential underlying mechanism for EA’s immunomodulatory and hematopoietic benefits. These results strongly suggest that EA, utilized at ST 36 and SP 6, serves as a safe and highly practical adjuvant in the clinical management of NSCLC, enhancing treatment response while minimizing debilitating toxicity.

Dry needling is rapidly becoming a mainstream treatment for musculoskeletal pain, but the acupuncture profession faces a crisis as physical therapists (PTs) increasingly adopt this technique. With PTs significantly outnumbering acupuncturists and only requiring minimal training (as little as 20-80 hours), acupuncturists risk becoming irrelevant in this fastest-growing area of pain relief. The article asserts that licensed acupuncturists are the most qualified providers, possessing thousands of hours of training in needle techniques, anatomy, and safety—far surpassing the limited coursework of other professionals. Historically, the profession missed opportunities to claim this trigger-point needling space, allowing others to step in. The current challenge is not to debate ownership, but to actively claim leadership by enhancing professional messaging. The author notes that patients choose providers who communicate clearly; PTs successfully explain the treatment in relatable terms, while acupuncturists often rely on complex, esoteric language. To reclaim their expertise, acupuncturists must unify and integrate specific dry needling methodologies—which focus distinctly on trigger point etiology and neuromuscular dysfunction beyond simple ah shi needling—into their training and practice. By using clear language and proactively marketing their advanced needling skills, the profession can solidify its position as the gold standard in therapeutic needling.

This article highlights the critical, often overlooked, role of the Seven Affects (anger, joy, worry, sorrow, thought, fear, and fright) as instigators of chronic disease, or "long disease," a concept typically centered on external factors like the Six Excesses. Emotional states, when sustained at an abnormal intensity and duration, cause internal damage by directly damaging internal organs and disrupting the flow of qi, blood, yin, and yang. Specific connections are detailed, such as anger damaging the liver, worry/sorrow harming the lungs, and fear damaging the kidneys. The impact of this emotional imbalance is pervasive; for instance, chronic fear during a viral infection can undermine the efficacy of both acupuncture and herbal treatments, resulting in temporary or subpar outcomes often misattributed to a "wrong diagnosis". Practitioners are urged to prioritize keeping the Seven Affects in mind when developing treatment protocols for long disease. The author recommends using the concept of "emotional atmosphere" to educate patients, helping them understand that continuous stress or emotional distress (allostatic load) directly contributes to lingering disease states and poor recovery. By educating and inspiring patients using the Seven Affects framework, practitioners empower patients to actively contribute to their own healing, recognizing that compassionate presence and sincere listening are equally as vital as the physical treatments provided.

The article provides essential guidance for acupuncturists navigating the complex landscape of insurance billing, dispelling the common myth that licensing requires credentialing to bill insurance. Many insurance plans cover acupuncture out-of-network, meaning providers can bill without enrollment, with true HMO-style plans being the primary exception. The fundamental decision is strategic: does network participation enhance value or merely limit income, considering that no insurance plan pays in-network providers more? In-Network participation offers significant benefits, including increased patient volume due to lower out-of-pocket costs, predictable reimbursement, and free marketing via insurer directories. However, these benefits come with pitfalls, such as lower contracted rates, higher administrative burdens (credentialing, preauthorizations), care restrictions, and audit risk. Conversely, Out-of-Network participation allows for higher fee flexibility and greater clinical autonomy, but typically results in reduced visibility, unpredictable payments, and increased need for patient collections. The author suggests a hybrid approach—joining select strong regional networks while remaining out-of-network for others—as a balance between maximizing patient access and revenue. Ultimately, the choice must be a strategic one based on local market factors, administrative capacity, and long-term financial goals. Crucially, practitioners maintain control and can withdraw from a network later if it no longer serves their practice goals.

The article highlights the critical, often overlooked, need for continued care for oncology patients after they achieve "NED" (No Evidence of Disease) and complete their acute treatment. Upon entering remission and ringing the ceremonial bell, many patients feel a pervasive sense of anxiety and depression as the consistent support from their primary oncology team sharply decreases. Cancer is recognized as deeply traumatic, and patients subsequently face ongoing physical challenges like lymphedema and brain fog, coupled with psychological implications, including chronic dread and fear of recurrence. The author argues that acupuncturists are uniquely positioned to serve as the bridge for patients transitioning from acute treatment to post-oncology care, as the cadence of traditional Chinese medicine (TCM) support does not necessarily decrease. Post-treatment, practitioners must conduct a thorough re-evaluation, acknowledging that patients often embark on long-term adjuvant therapies (like tamoxifen) that introduce new side effects, effectively creating a new primary diagnosis. A trauma-informed care approach is recommended, emphasizing validation, predictability, and empathetic listening to normalize the patient’s experience. Practitioners should maintain a vetted list of specialized referral professionals (therapists, dietitians, lymphatic drainage specialists) to aid patient reintegration. By supporting this vulnerable population, acupuncturists fulfill a tremendous clinical need and gain the attention of doctors increasingly seeking complementary medicine referrals.

Acupuncture is an ancient therapy characterized by a rapidly expanding scientific basis, increasingly integrated into U.S. healthcare systems despite persistent barriers in reimbursement and professional recognition. This segment details the robust research evidence concerning acupuncture’s mechanisms of action, particularly in pain management. At the local level, needle insertion generates immediate tissue effects by engaging connective tissue mechanotransduction; fibroblasts respond to mechanical signaling, altering inflammation and blood flow. Centrally, acupuncture is widely recognized for its influence on endogenous opioids (ß-endorphins, enkephalins), which correlates directly with rapid and sustained analgesia. Functional neuroimaging studies confirm that authentic needling not only activates the somatosensory cortex but also consistently deactivates affective and limbic brain regions like the amygdala, making it effective for addressing pain comorbid with anxiety and depression. Furthermore, auricular acupuncture engages vagal pathways to regulate autonomic function, beneficial for cardiovascular and gastrointestinal issues. Clinically, large meta-analyses provide robust support for acupuncture in chronic musculoskeletal pain, headache, and osteoarthritis, showing that it is not merely a short-term intervention but a durable therapy that can reduce long-term healthcare utilization. Acupuncturists must utilize this scientific language to educate patients and colleagues, strengthening their practices and advocating for greater integration into mainstream healthcare.

This intriguing article proposes that the biting patterns of female mosquitoes may not be random but could, in fact, provide an observable biological demonstration of the subtle energy maps, or meridians, long recorded in East Asian medicine. The author suggests that mosquitoes, driven by evolutionary precision, seek not only blood but also qi—the vital energy of the body. Mosquitoes are known to be attracted to biochemical markers of energy and metabolism, specifically relying on ATP (adenosine triphosphate) as a phagostimulant to initiate feeding. This concept is linked to modern research showing physiological correlates for meridians and acupoints. Studies indicate that acupoints have high concentrations of mast cells, which release ATP upon stimulation, and elevated levels of ATP and CO2 are found along meridians, suggesting high metabolic activity. A chemical analogy is drawn between the TCM concept of zhen qi (air and food energy) and the formula for cellular respiration (producing ATP and CO2). The hypothesis suggests that when a mosquito bites, it inadvertently stimulates these mast cell clusters along the meridians, releasing the very ATP that encourages feeding. If this is the case, mosquito bite patterns are selective, guided by the biochemical signatures of qi. Further research correlating bite distribution with acupuncture meridians could help illuminate the material basis of qi.

This article explores the valuable role of acupuncture as a supportive therapy during In vitro fertilization with embryo transfer (IVF-ET), demonstrating its ability to enhance success rates and increase the chances of pregnancy. From a modern biomedical perspective, acupuncture administered before and during the IVF cycle helps regulate the hypothalamic-pituitary-ovarian axis, promote hormonal balance, improve blood flow to the uterus and ovaries, and reduce psychological stress by inhibiting sympathetic activity. Frequently used acupoints in IVF support, typically located in the lower abdomen and middle to lower back, correspond anatomically with the innervation of the reproductive organs (T11–L2 and S2–S4 spinal nerves), suggesting a neurological basis for their synergistic effects. From a Traditional Chinese Medicine (TCM) view, treatment aligns with the Kidney-Tian Gui-Chong-Ren-Uterus axis, focusing on nourishing kidney essence and regulating menstruation. Optimal timing is key, suggesting pre-cycle treatment starting one to three months before IVF. Furthermore, research indicates that acupuncture performed specifically on the day of ET can significantly improve clinical pregnancy rates, especially in freeze-thaw cycles, and a higher pre-ET dosage is linked to increased live birth rates. By integrating both physiological and energetic aspects, acupuncture offers a holistic, evidence-informed approach to optimizing fertility.

The article focuses on the significance of the BackInAction randomized clinical trial, published in JAMA Network Open, which evaluated the use of acupuncture for Chronic Low Back Pain (CLBP) in adults aged 65 and older. This trial was a direct response to a call by the Centers for Medicare & Medicaid Services to inform coverage decisions regarding acupuncture reimbursement for older adults. The study enrolled 800 seniors with CLBP, assigning them to one of three groups: usual medical care only, standard acupuncture, or enhanced acupuncture (which included maintenance sessions). The acupuncture protocols balanced scientific rigor with real-world practice flexibility, utilizing core points along with individualized point selection. Key takeaways showed that both acupuncture groups experienced greater and more durable reductions in disability (measured by RMDQ scores) and pain compared to the usual care group over six and 12 months. Adverse events were extremely rare, underscoring the safety of acupuncture for seniors. The article highlights the importance of these robust findings, noting they add considerable weight to the legislative effort to pass the Acupuncture for Our Seniors Act. Currently, while Medicare covers acupuncture for CLBP, it does not recognize licensed acupuncturists as Medicare providers, making these results crucial for advancing professional recognition.

This research highlight offers compelling scientific support for using fire needling (FN) acupuncture as a treatment for knee osteoarthritis (OA), focusing on both pain relief and crucial cartilage protection. A study conducted on rats with induced OA (MIA model) found that the FN group, treated at common knee acupoints like Xuehai (SP 10) and Zusanli (ST 36), demonstrated significant post-treatment improvements. Assessments using micro-CT and histology confirmed improved bone structure and density. Critically, the treatment inhibited cartilage degeneration, supported by enhanced OARSI scores. Mechanistically, FN acupuncture reduced key pro-inflammatory proteins (MMP9 and MMP13) while increasing beneficial Type II collagen (COL2). Furthermore, improvements were observed in synovial inflammation and subchondral bone structure. Behavioral tests confirmed these findings, showing enhanced weight-bearing ability and improved pain thresholds. The study concludes that FN acupuncture provides a scientific basis for this traditional technique, making it a valuable therapeutic option for managing painful and often recalcitrant joint disorders.

The modern healthcare landscape is driving acupuncturists away from the traditional fee-for-service model toward appealing alternatives like concierge and direct-pay care. These models offer stability and reduce the administrative burden associated with insurance processing, facilitating more individualized patient care. Key differences exist: direct-pay uses an all-inclusive membership fee, while concierge uses a membership fee but often continues to bill insurance. Adopting a mixed model structure, particularly concierge, introduces complexity regarding compliance with state and federal laws. A major point of confusion is HIPAA compliance. HIPAA applies only to "covered entities" who electronically transmit health information during standard transactions with insurers. Acupuncturists who strictly avoid these transactions are typically exempt. However, this exemption is lost if a practice handles Protected Health Information (PHI) or uses a mixed payor base. The article strongly recommends that all providers comply with HIPAA to satisfy state consumer and data privacy laws. Acupuncturists contemplating a practice transition must consult a licensed healthcare attorney and a HIPAA/IT compliance consultant for guidance.

This article provides an in-depth look at three involuntary facial motor disorders: blepharospasm, hemifacial spasm, and facial tics. Blepharospasm involves bilateral, forceful closure of the eyelids (orbicularis oculi muscles), often triggered by stress, and usually stops during sleep. Hemifacial spasm is unilateral twitching, commonly caused by vascular compression of the facial nerve (cranial nerve VII), which uniquely, can persist during sleep. Facial tics are sudden, repetitive, non-rhythmic movements linked to stress or anxiety, and typically disappear during sleep. Western medical treatments include botulinum toxin (Botox) injections, muscle relaxants, or microvascular decompression surgery for persistent hemifacial spasm. From a Traditional Chinese Medicine (TCM) perspective, these conditions are often attributed to patterns of liver wind, qi and blood stagnation, or internal imbalances affecting the meridians. TCM treatment, utilizing acupuncture, facial motor points, and scalp acupuncture, offers a holistic approach designed to calm the nervous system, smooth the flow of qi, and address the root imbalance affecting the face and spirit.

The Department of Veterans Affairs (VA) is making a significant stride toward improving U.S. veterans' access to integrative care, including acupuncture, through the rollout of external provider scheduling (EPS). This new cloud-based tool modernizes VA scheduling and drastically simplifies community care coordination. EPS allows VA schedulers to book approved appointments directly into a community provider's system in real time, which includes referral numbers. This streamlined process reduces the administrative burden on practitioners by eliminating delays from phone calls and faxes. The service is provided at no cost to the provider, integrates with over 150 electronic health record (EHR) systems, and ensures patient record security by not accessing or storing files. Importantly, providers retain full control over the appointment slots shared with the VA. A mandatory requirement for acupuncturists seeking VA credentialing is active NCCAOM board certification, ensuring veterans receive care from providers meeting the highest national standards. The NCCAOM and the American Society of Acupuncturists (ASA) are encouraging all qualified providers to explore participation to expand access to safe and effective care for those who have served.

This article serves as an essential guide for acupuncturists venturing into home visits, a crucial service for patients who are homebound due to injury, illness, or incapacitation. Providing safe and effective care outside the clinic demands meticulous preparation. Before the visit, practitioners must handle logistics, asking about crucial in-home factors like parking, pets, firearms, or smoking. All required paperwork, including consent to treat forms, must be completed beforehand. For both personal and vehicle safety, general emergency gear must be carried, and HIPAA compliance is non-negotiable; charts must be secured in a closed or locked container or on a password-protected device during transport. The acupuncture travel kit itself must be stored in an impervious container, containing only individually wrapped needles and a travel sharps container. Critically, the author advises against using moxa during home visits due to fire hazards, especially if the patient is on oxygen. Once in the home, professional boundaries are maintained by always knocking, introducing oneself, and confirming patient identity to build trust. Practitioners should also adopt the clean bag technique used by nurses and remain flexible when coordinating care with other members of the patient’s medical team.

This installment in the "Spirits of the Points" series delves into the spiritual and emotional uses of Stomach meridian points ST 36 through ST 40, specifically addressing imbalances in the earth element. ST 36 (Leg Three Miles) is a powerful point for instilling energy, endurance, and the spiritual will needed to endure an arduous situation, particularly when a patient is close to giving up. ST 37 (Upper Great Void) and ST 39 (Lower Great Void) both treat emptiness and weakness, with ST 37 targeting upper-body deficiency, mental frailty, and an inability to receive inspiration. ST 39 focuses on the lower body, digestive functions, and lack of motivation. ST 38 (Branch Opening) helps the "droopy, malnourished, unstable" patient absorb vitality from heaven and earth, restoring curiosity and appetite. Most profoundly, ST 40 (Abundant Splendor) addresses deep, spirit-level hunger in patients who perceive scarcity, feel perpetually unsatisfied, or cannot recognize the richness and bounty of their lives, helping to restore an internal sense of gratitude and fullness.

This article provides crucial clinical insights regarding the formation and management of vesicles (fluid-filled blisters) following cupping therapy, a skin response less common than ecchymosis but requiring proper clinical discernment. A case study involved a patient who developed multiple small, clear vesicles within 24 hours after moderate-to-strong stationary silicone cupping along the Bladder Meridian, which resolved spontaneously. Biomedically, vesicles are caused by excessive negative pressure that mechanically separates the epidermal and dermal layers, leading to the accumulation of plasma and lymphatic fluid. From a Traditional Chinese Medicine (TCM) viewpoint, this phenomenon might signify the successful externalization of dampness or toxic heat, or alternatively, indicate that the treatment intensity surpassed the patient's constitutional tolerance. Practitioners should counsel patients beforehand to mitigate anxiety. Key risk factors include high negative pressure, prolonged retention time, and sensitive skin. Management protocols prioritize maintaining skin integrity, advising patients not to rupture the blisters, monitoring for secondary infection, and adjusting subsequent treatments by reducing pressure or duration.

This article shines a light on the alarming ocular complication associated with GLP-1 receptor agonists (such as semaglutide and liraglutide): Non-arteritic Anterior Ischemic Optic Neuropathy (NAION). NAION is a serious condition causing sudden vision loss due to reduced blood flow and optic nerve damage. Troubling research indicates that semaglutide may approximately double the risk of NAION. Given the massive projected use of these weight loss drugs, the article warns that thousands of individuals could face NAION-related blindness. The underlying cause involves vascular dysregulation and optic nerve ischemia. Acupuncturists are urged to remain vigilant and counsel patients, particularly those with diabetes or hypertension, about this risk. Acupuncture is presented as a promising and viable therapeutic intervention for NAION. Controlled trials demonstrate its ability to improve vision outcomes in ischemic optic neuropathy by enhancing microcirculation, neuroprotection, and modulation of vascular tone. Specific local and distal acupoints are frequently used, including UB 1 (Jingming) and GB 20 (Fengchi), to promote ocular blood flow and nerve regeneration. Acupuncture offers a cost-effective solution with a low side effect profile for managing these associated ocular vascular insufficiencies.

This article explores the complexities faced by herbalists in applying foundational Traditional Chinese Medicine (TCM) principles to intricate modern illnesses like Lyme disease, caused by Borrelia burgdorferi. Lyme often progresses to debilitating chronic or post-treatment Lyme disease syndrome (PTLDS), affecting the neurological, digestive, and joint systems. While Western antibiotics are effective early on, chronic cases often respond poorly or require additional support due to digestive sensitivity. A skillfully crafted TCM formula must utilize Emperor, Deputy, Assistant, and Envoy herbs to simultaneously target the pathogen and holistically support the body by modulating immunity and improving detoxification. TCM diagnosis often reveals patterns like spleen/stomach disharmony (fatigue) or liver/kidney imbalances (joint pain). The author emphasizes that strict pattern differentiation sometimes lacks the pathogen specificity needed for complex infectious diseases. Therefore, effective modern formula creation must integrate insights from Western medical science and pathophysiology alongside classical principles to safely and effectively address the persistent challenges of chronic Lyme.