Acupuncture, as practiced in contemporary times, involves the insertion of very thin, single use, sterile needles at various points on the body in order to effect a therapeutic change in a person’s health status. It is one technique within a family of therapeutic approaches based on the philosophy, observations and experiences of practitioners in ancient China. Although variations of clinical practice have evolved with the spread of acupuncture-based therapeutics across Asia, into Japan, Europe, and more recently, the Americas, all acupuncture practice styles are grounded in the principles set forth in the surviving Classical Chinese Medical texts.
In addition to needle insertion, healing techniques include massage, herbal preparations that are taken orally or applied topically, and the application of heat (moxibustion) to specific acupuncture points and regions of the body. Electrical stimulation of inserted needles is included in some practices. Recommendations may also be made concerning nutrition, exercise, other lifestyle considerations, meditation or spiritual practices.
The healing arts may be generally described as practices that promote improved healing, better health, and personal happiness. They are often defined as stress reducing therapies that engage the patient’s creativity e.g. through music, dance, drawing or literary expression. Patients often find that acupuncture treatments themselves calm and reduce the perceived physiological effects of stress, thus clearing a path for improved self-care, visualizing a positive change in their life circumstances, and healing. Therefore, the goals of a healing arts practice can overlap with the global goals that individuals bring to the acupuncture office, especially after an initial acute painful condition has been ameliorated.
Point selection is most important in determining the number of points to be treated. And that depends upon the diagnostic impression, physical examination and patient response. The number of points selected for treatment will therefore vary. Typical in my practice would be treating from one to 16 points over the course of a several-step, 45-50 minute treatment that often includes an opportunity for quiet rest or meditation, and as a final step, perhaps a form of massage (Tui-na). My preference is to use the fewest possible points (10 or less), but sometimes there are special indications that require more.
It is not necessary to insert needles through the skin in order to effect a therapeutic change. Other techniques to work with an acupuncture point and channel include massaging the point or body area, placing a specialized Tei-shin needle on the skin but not through it, warming the point or area with moxibustion, applying magnets, electricity, and/or using a medical grade laser light to painlessly but effectively stimulate a point. All these modalities are available in my practice.
My preferred diagnostic and treatment style is predominantly in the Japanese acupuncture tradition. Based on my patient’s story and physical examination, I will insert the most slender needles possible, with a gentle and mindful technique. In contrast to a Classical Chinese approach, I rarely manipulate the inserted needle to obtain an immediate patient-perceived sensation of what is called the Qi response. Rather, I set the needle into the point, and then allow time for the needle to interact with point (and the nervous system) in a gentle manner. Meditation is sometimes suggested to augment this phenomenon. Some needles are felt during insertion, some not.
In my approach to treatment, I have found that anything beyond a mild sensation associated with needle insertion and/or retention is distracting for patients, and therefore not therapeutic. This is not to state that there will be no sensation, but the overall treatment should be comfortable, indeed relaxing, even though a person may experience a sensation of movement or change during the session. However, people differ in what they perceive at any one point, and during any one treatment. Perceived sensations may range from little or no sensation, to feeling changes both locally and distal to the treatment point. Paradoxically, sometimes the points where the needle almost effortlessly slides in can be the more sensitive for the patient. That sensation should soon pass within less than a minute, but if that is not the case, I remove that needle and find alternatives to achieve our goals.
Importantly, for some people, any needle insertion through the skin is too strong a stimulus, resulting in immediate local pain and a flare in their presenting symptoms. A trial treating a minimal number of points with non-insertion techniques (e.g. using laser light, magnets, Tei-shin needle) can be tried. On rare occasions, even non-insertion techniques are too strong and ultimately not helpful. In these situations, it is best to try non-acupuncture therapies, with referral to other healing arts practitioners.
Because there are many acupuncture styles and practitioners with varying backgrounds and techniques of patient care, it may be worthwhile to seek out a practitioner who will take a different approach from your initial acupuncturist. I would suggest a phone conversation prior to making your first appointment, wherein you can describe your previous experience and reason for seeking another trial of acupuncture. If you do decide to try again, I would suggest a limited and gentle trial, with a conservatively drawn goal. Please keep in mind the point made above: that for some people, any needle insertion or point treatment is too strong a stimulus, and alternatives should be considered.
Yes, but there can be complications, ranging from the cosmetic (minor bruising) to the very rare but serious (puncture of a vital organ or structure). This topic has been extensively reviewed and published. As a global statement, yes, acupuncture treatment by a properly trained, competent and careful practitioner is safe, but not without risk of somewhat more common transient and minor complications such as: bruising, local pain, a flare in the presenting symptom, faintness, anxiety or an unexpected emotional reaction, nausea or excessive fatigue. Very rarely, a serious complication such as puncture of the lung or a nerve is reported. Skin infection is rare. Single use sterile needles are the standard of care for placement though the skin. Therefore, the risk of acquiring a blood-borne infection such as hepatitis is effectively nil. The Consent for Acupuncture Treatment that you sign prior to treatment should list possible complications (as does the Consent document I use). It is important that all your questions concerning safety are clearly and satisfactorily answered before treatment starts.
Is there contemporary scientific evidence that acupuncture has measurable clinical benefit in humans?
This is an area of vigorous debate, and the published literature is voluminous. Very generally, on the side for positive human clinical benefit are data from small to moderately sized clinical reports and investigations, as well as the anecdotal reports, observations and experiences of patients. On the opposite side, taken as a whole, are published data that do not support the global conclusion of clear clinical benefit for acupuncture treatment when acupuncture is evaluated using data from well-controlled and properly powered studies that constitute “gold standard evidence” in contemporary scientific medicine. There are some recent exceptions: e.g. a recently published neuroimaging study showing both an acupuncture-provoked change in brain information processing pathways linked to a measured beneficial change in patient outcome [see: Resources menu for a link to this material], but as a generalization and on the whole, the two data sources are not in agreement.
My personal approach is to acknowledge this difference, but to emphasize that, in my office-based practice, individual patient experience after a trial of acupuncture treatment, in conjunction with other recommendations for health and healing, is the most valuable measure of benefit. If my patient has a positive experience with perceived benefit, then for that individual, treatment has been helpful.
This is interesting, because my many years of clinical practice as an academic physician were devoted to the care of pediatric patients, specifically children with complex underlying medical disorders who required anesthetic and/or intensive care, or who had difficult-to-manage painful conditions. But now my office-based acupuncture practice is primarily an adult one. Some seek symptomatic relief from chronic, often painful conditions; or for help managing the side effects of the necessary medications or treatments prescribed by their primary and specialty care physicians. Additional reasons for seeking care have included immune dysfunction disorders, respiratory diseases, stress management or more emotional issues, back or joint pain, muscle or bladder spasms, gastrointestinal, neurological and/or musculoskeletal conditions. Individuals undergoing chemotherapy or other cancer treatment sometimes find acupuncture helpful as a supportive therapy to mitigate fatigue, peripheral neuropathy and/or the mental fogginess that might accompany their treatment. Others come in for general supportive care, using acupuncture as one of their balancing and health maintenance strategies. Caregivers come in for supportive care as they manage the illnesses of their loved one.
Yes. There are several ways to work with the acupuncture points that do not require needles inserted through the skin. Laser light, specialized massage, Tei-shin and other surface treatments are comfortable and can be helpful. Treatments are shorter (about 30 minutes). Outcomes vary, and my experience is that acupuncture-based treatment is best considered supportive of the care plan recommended by the primary care and specialty pediatric providers.
My background in acupuncture includes earning a Masters Degree in Acupuncture from the New England School of Acupuncture (NESA; Watertown, MA: 1996); completing the 300-hour course in Structural Acupuncture sponsored by the Harvard Medical School (HMS) Department of Continuing Medical Education (Boston: 2015); and most recently a 12-month Japanese acupuncture course at Tri-State College of Acupuncture (TSCA; New York: 2017). Acupuncture has been a component of my medical practice throughout my years in academic medicine as a pediatric anesthesiologist, critical care and pain medicine provider. I have been in the private practice of acupuncture since 2013.
We are fortunate in the greater Philadelphia area to have many excellent acupuncturists who are graduates of schools and colleges of acupuncture, Oriental medicine, or medical training programs in China, including practitioners with specialized expertise in fertility or musculoskeletal problems. There are also a modest number of physicians that have completed 300 basic hours of acupuncture education through courses specifically for physicians. My background includes the rigorous and highly supervised clinical practice of an excellent acupuncture degree program (New England School of Acupuncture), the specialized structural treatment protocols of the Structural Acupuncture Course at the Harvard Medical School, and the comprehensive material with supervised clinical practice of the Tri-State College of Acupuncture Japanese acupuncture course. My acupuncture practice is also very much informed by my knowledge of general medicine and several years of neuroscience research. I enjoy complexity and the challenge of trying to understand the underlying basis for the symptoms or health problems of those who seek my care. I draw on all aspects of my background and experience as I seek that understanding, and offer a plan of treatment.
Yes. The building itself is wheelchair accessible through a side entrance, with elevator service to all floors. Access to my two treatment rooms is through wide doorways; and each room has a powered treatment table to facilitate safe access and specialized positioning needs. Importantly however, an adult capable of assisting with position changes should accompany individuals who need such assistance. Bathrooms are in a stairwell, but there is a wheelchair accessible one on the ground level.
Initial inquiries can be initiated by email: firstname.lastname@example.org. Alternatively, a voice message can be left though Google voice: 646-397-0267. Please allow 24 hours for a response, although most inquiries are responded to in less time. My preference is to have a brief phone conversation with potential new patients before we agree on an initial appointment.
This is typically a 90-minute visit that will include a review of your reason for seeking a trial of acupuncture, your medical and general health status, discussion of what an acupuncture treatment entails, obtaining your written consent for treatment, an acupuncture-specific physical exam, and an initial treatment addressing your primary complaint, especially if pain is the reason for coming in for care. I typically recommend a trial of 3-5 treatments (sometimes longer for a more complex problem) to see if the treatments are helpful. Subsequent sessions of 45-70 minutes are typically more treatment–focused.
My office is in the Medical Tower building located just off Rittenhouse Square in Center City Philadelphia. The address: 255 South 17th Street, Philadelphia PA 19103. SEPTA service is nearby. Street parking is challenging but can be found. Pay parking lots are in the area.
Payment in full is due at the time of service. Payment by cash, check, FLEX account and major credit cards (not corporate) is accepted. I do not participate in any third party or insurance plans, but will provide you with a Super Bill specifying an ICD-10 diagnosis and treatment codes.