Imitation is the Sincerest Form of Flattery

With National Acupuncture and Oriental Medicine Day coming up later this month (Oct 24th), I thought it an appropriate time to explain what goes into this practice.

My profession is being quietly hijacked by chiropractors, physical therapists, athletic trainers and other medical / health practitioners. And I am reading more and more articles about the pharmaceutical industry extracting the “active” parts of Chinese herbs to create and mass produce synthetic drugs. While it is fantastic that more people are interested in acupuncture and herbal medicine, this is a complex medicine, and people are going to increasingly be injured or sickened if it is not used correctly.

In light of this, I thought it would be helpful to clearly lay out the differences in training and practice along with the potential implications to the consumer.

There are many ways to practice acupuncture. The most rudimentary is to simply put a needle where it hurts… This is also known as “dry needling” or trigger point needling. Sometimes it helps; sometimes it aggravates the tissue. The crazy thing is that even this unsophisticated treatment is still relatively effective, which is why more and more types of practitioners want to use it.

Dry needling is a form of acupuncture. For physical therapists, it is also an insurance loop hole. The training involved to practice dry needling is a one weekend workshop. That’s it. One weekend.

Taken from the American Society of Acupuncture’s official position statement on dry needling – “As ‘dry needling’ is acupuncture, it presents the same inherent risks including but not limited to perforation of the lungs and other internal organs, nerve damage, and infection. Recent reports of serious and potentially life-threatening injuries associated with ‘dry needling’ include pneumothoraces and spinal cord injury. These and other injuries support the statement that ‘dry needling’ presents a substantial threat to public safety when performed without adequate education, training, and independent competency examination. Adequate training and competency testing are essential to public safety.”

A simple certification to take advantage of an insurance opportunity is far from the commitment required to fully practice this medicine. It takes several years to be recognized as competent in its country of origin, just as it takes years to become a licensed acupuncturist in this this country.

Unfortunately, many states leave it up to the consumer to delineate between who is aptly qualified and who is not. In the state of Illinois, it is illegal (beyond the scope of practice) for physical therapists to practice dry needling. Once again, the training for physical therapists is a weekend workshop. Most consumers do not know this. Physical therapists in this state continue to dry needle, and will often code it so that it will be covered by insurance. These practitioners should be reported to the Department of Professional Regulation.

Chiropractors can be “certified” to practice acupuncture. Their training is typically 200 hours. Medical doctors (MDs) can practice “medical acupuncture”. Their training is minimally 300 hours. My training to become a licensed acupuncturist and board certified herbalist was approximately 3000 total hours – 2000 classroom and 1000 clinical. In addition, I had to pass four board exams along with the “clean needle technique” written and practical exam confirming that I understood how to safely handle needles. Many medical doctors work with needles on a regular basis, but chiropractors and physical therapists do not.

Obviously, physical therapists, chiropractors, and medical doctors are well trained in their respective professions. They simply are not well trained in acupuncture or any aspect of Chinese medicine (herbal medicine, gua sha, cupping, or moxibustion).

One of the most common things that people say in their first acupuncture treatment is that they are surprised that I am not putting needles just in their area of pain. My standard answer is that points have many functions, and some of the best places to treat the knee, for example, are nowhere near the knee….

In school we were taught the “standard TCM” protocols for virtually any ailment under the sun. They involve treating the area of concern (dry needling) along with other supporting “constitutional” and “master / command” points that have particular functions. For example, the point ST36 / Zusanli (just below the knee) is the command point for digestion. Additionally, it treats depression, shortness of breath, dizziness, fatigue, etc. It also might be an effective trigger point for anterior leg, ankle, or big toe pain. It is what I refer to as a “big point”.

We memorized and were tested again and again on the channels, point locations, and point functions. We were taught and tested on how to safely needle different structures of the body and the contraindications for various conditions. The acupuncture, Chinese medical theory, biomedicine, eastern nutrition, and herbal medicine education was a 36 month full time (year-round) program.

I graduated, passed the board exams, started practicing, and quickly realized that there was still a lot to learn. I started taking continuing education courses to help improve outcomes, and learned that what we are taught in school is just scratching the surface of what I need to know to be successful in practice. This is a 5000(ish) year old medicine that was largely passed down from generation to generation through apprenticeship.

Throughout history, acupuncturists and herbalists in China and across Asia would hold their own theories, point protocols, and formula modifications close to the vest. Fortunately for you and me, this medicine has now spread throughout the world, and there are many brilliant people decoding and teaching these “secrets”…. Additionally, as Western medicine continues to decode the intricacies of the human body, we are learning more about why acupuncture works. It is a fascinating study.

This is a truly amazing medicine. I am so grateful to have the opportunity to study and practice it everyday. My hope is that more people in the next generation will start this journey when they are younger, as their initial career path. I hope that they will continue to move this medicine forward. It is left up to them, and to you, the consumer, whether this medicine will continue to be taught and practiced as a complete study, or if all different types of practitioners will simply “stick a needle where it hurts” and hope for the best.

The American Society of Acupuncturists position on dry needling can be found here. More information about our lobbying efforts can be found here.

As always, please don’t hesitate to ask questions. I love the simplicity and complexity of this medicine and I will continue to learn and share with you.

Be well – Jana

Jana Bricker
L.Ac., Dipl. Ac., Dipl. OM, MSOM, BS Nutrition
Apex Acupuncture and Wellness, Ltd.
514 N. Western Ave. | Suite B
Lake Forest, IL 60045