Frequently Asked Questions
Welcome to the Maryland Acupuncture Society page for information about acupuncture. This page is designed for potential or current acupuncture clients, or anyone interested in general information about the practice of acupuncture. This information is organized as a series of questions (Q) and answers (A), known on many web sites as FAQ, which stands for Frequently Asked Questions. To see an answer to one the questions listed below, click on the question.
What is Acupuncture?
Acupuncture is part of a broad system of Traditional Chinese Medical Arts, which also includes:
- Chinese Herbal Medicine,
- Tui Na (Chinese Massage),
- Therapeutic Movement (including Tai Chi and Qi Gong),
- Chinese Dietary Therapy and
- Feng Shui (geomancy)
These healing systems all have their roots in Ancient China and have developed through approximately 3,500 years of Chinese civilization. Traditional Chinese Medical Arts account for roughly 40% of all medical care given in China today.
In the last three decades acupuncture has become increasingly popular in the United States. According to the 2002 National Health Interview Survey–the largest and most comprehensive survey of complementary and alternative medicine (CAM) used by American adults to date–an estimated 8.2 million U.S. adults had ever used acupuncture, and an estimated 2.1 million U.S. adults had used acupuncture in the previous year for the treatment of a variety of conditions, and as a complementary and health promoting therapy. Currently there are 46 accredited acupuncture schools in the United States, and roughly 12-14,000 licensed acupuncturists practicing this medical art.
How Does Acupuncture Work?
Acupuncture is based on the understanding that a network of vessels called meridians runs through the body. Something the Chinese call Qi (pronounced ‘chee’) circulates through the meridians. Qi is most commonly translated as ‘Energy.’ It can also be understood as everything that circulates in the body. Qi can be as immaterial as spirit, energy or nerve impulse, and as material as blood, lymph and other body fluids. There are twelve main meridians that traverse the surface of the body and connect internally to the Qi of organs, glands and other anatomical structures and physiological systems.
Traditional Chinese Medicine defines perfect health as a state of physical, mental, emotional, and spiritual balance. All illness and disease are fundamentally due to imbalance on any level. Acupuncture balances the Qi, and everything the Qi contacts, by manipulating designated points on the meridians (acupuncture points) with various techniques including the superficial insertion of acupuncture needles, and/or the application of heat or pressure. There are more than three hundred of these acupuncture points on the twelve main meridians, and each has a specific effect on the network of Qi in the body.
What about the Needles?
The needles used for acupuncture bear little resemblance to the hollow bored variety used with hypodermic syringes. Acupuncture needles are solid and extremely thin, about the thickness of a cat’s whisker. Made of high quality, surgical grade stainless steel, the needles are pre-sterilized, individually packaged, and disposed of after every use.
During treatment, most needles are inserted just beneath the surface of the skin. Although sensations vary from person to person, most patients report little or no discomfort. Some experience a mild sense of heaviness or electricity in the area of insertion. Most patients find acupuncture very relaxing and many fall asleep during treatment.
In addition to needles, once an acupuncturist understands an individual’s condition, a number of other tools and techniques are used to offer appropriate therapy. The tools and techniques of a well-trained acupuncturist can include:
- Moxibustion: Moxibustion shares equal status with needling in terms of its therapeutic significance. Moxa is another name for the herb Artemesia Vulgaris, or Mugwort. Burning moxa for therapeutic effect is called Moxabustion. There are many different techniques of moxibustion and many different grades of moxa. Moxa can be applied directly on acupuncture points in everything from tiny, rice grain sized pieces to thumb sized cones. Moxa is also commonly applied indirectly by burning cherry-sized balls affixed to the tops of needles (the warming needle technique) or by passing the lit end of a cigar-sized moxa stick above the surface of the skin.
- Blood Moving: Blood moving approaches include the application of suction cups to specific areas of the body (cupping), the use of dermal frictioning (gua sha), and bloodletting (encourging the release of 1-2 drops of blood from an acupuncture point using a diabetic stick type needle.) These techniques break up chronic blood congestion in surface capillaries, improve microcirculation and can be dramatically effective in resolving certain pain conditions. They can also be important in the resolution of high fevers and respiratory conditions.
- Bodywork: Today all physical techniques are grouped under the term Asian Bodywork Therapy (ABT). Traditional Chinese massage is called Tui Na. Sometimes it goes by the name of an earlier version, Amma. Other ABT approaches include Shiatsu, Jin Shin, Thai bodywork, Chi Nei Tsang, or acupressure.
- Polarity Devices: Magnets, pellets of copper and zinc, silver and gold, and various copper cords, rings and chains with special built-in diodes are used to establish an electromagnetic gradient along meridians and between acupuncture points.
- Frequency Approaches: Frequencies of sound and light are applied to acupuncture points usually via tuning forks or beams of color light.
Are there different Styles of Acupuncture?
Yes. Although a comprehensive set of core principles form the basis of the full system of Chinese Medicine, there are many styles and substyles within the practice of acupuncture itself. This is because Acupuncture has evolved over thousands of years and over a vast geographical area (all of the nations of East Asia and beyond). It has been subjected to many different cultural, political and scientific influences. The end result is a diverse medical tradition that lives today in numerous interpretations and regional variations.
No style is “better” than another. Where the different styles of acupuncture vary is in the emphasis they place on different treatment principles and systems. The general goal of all acupuncturists is the promotion, maintenance and restoration of health and the prevention of illness.
Examples of various acupuncture styles include:
- ‘Family’ Style or Generational Acupuncture: Numerous lineage-based Chinese styles typically handed down through apprenticeship training.
- ‘TCM’ or ‘8-Principle’ Acupuncture combined with Herbology: TCM is the official Chinese state sponsored style of Traditional Chinese Medicine. TCM is taught in most medical schools in the People’s Republic of China since 1949, and most certification examinations in the United States today are based on this system.
- Barefoot Doctor Acupuncture: An abbreviated style of acupuncture with a first aid approach to public health developed in China in the 1950’s.
- Five Element Acupuncture: A style that emphasizes the strength of an individual’s unique constitution to overcome and prevent illness. Five Element Acupuncture is represented in mainland China, Taiwan, Vietnam, and Europe, and derived mainly from Japanese acupuncture traditions.
- Japanese Acupuncture: Examples include Meridian Therapy, Abdominal (a.k.a. Hara-based) systems, and Moxibustion-based styles.
- Korean Constitutional Acupuncture: Examples include Korean constitutional acupuncture traditions and Korean hand acupuncture traditions.
- Auriculotherapy: Based on the understanding that the entire body is represented in the ear, and can be treated with ear points, examples include Chinese, French (Nogier) and synthesis systems (Terry Oleson).
What about Chinese Herbs?
As part of the broad system of Traditional Chinese Medical Arts, Chinese herbal Medicine, like acupuncture, is effective for a wide range of complaints. Chinese Herbal Medicine is probably most renowned in the west for it’s effects on skin disease, gynecology, digestive complaints, respiratory conditions, allergies, disorders of the immune system, pain, psychological problems, and addiction.
Chinese Herbal Medicine can be employed by people of any age or constitution. Children and pregnant women can be, and commonly are, cared for by Chinese Herbal Medicine. Chinese herbal medicines are mainly plant based, but some preparations include minerals or animal products. They can be packaged as powders, pastes, lotions, tablets, or teas depending on the herb and its intended use.
Different herbs have different properties and can balance particular parts of the body. Herbs can act on the body as powerfully as pharmaceutical drugs and should be treated with the same caution and respect. However, adverse reactions to Chinese herbs are extremely rare and are negligible when compared to those commonly produced by pharmaceutical drugs.
The State of Maryland currently does not require any particular training or certification to practice Chinese Herbal Medicine. However, guidelines from the Accreditation Commission for Acupuncture and Oriental Medicine recommend that for safe and effective practice, herb certificate training programs for Master of Acupuncture students and practitioners be a minimum of 660 hours of training, including 210 hours of clinical experience. Please ask your herbalist about his or her qualifications.
Who can benefit from Acupuncture? What does it help?
The World Health Organization recognizes the ability of acupuncture and Oriental medicine to treat nearly four dozen common ailments, including:
- neuromusculoskeletal conditions (such as arthritis, neuralgia, insomnia, dizziness, back/neck/shoulder pain, migraine headaches);
- emotional and psychological disorders (such as depression and anxiety, stress, and eating disorders);
- circulatory disorders (such as hypertension, angina pectoris, arteriosclerosis and anemia);
- addictions to alcohol, nicotine and other drugs;
- respiratory disorders (such as asthma, emphysema, sinusitis, allergies and bronchitis);
- gastrointestinal conditions (such as food allergies, ulcers, chronic diarrhea, constipation, indigestion, intestinal weakness, anorexia and gastritis);
- gynecological problems (such as irregular, heavy or painful menstruation, PMS, and infertility); and
- urogenital disorders (such as stress incontinence, UTI’s and sexual dysfunction in men and women).
Acupuncture is a health promoting preventative therapy that benefits body, mind, and spirit, and is also helpful for complaints that lack an easily determined medical cause. Anyone who has chronic symptoms or illnesses, a lifestyle that places great demands on vitality and well being, and is committed to improving quality of life can benefit from acupuncture.
Patients often report that they:
- are sick less often and recover more quickly,
- have increased vitality and stamina,
- have richer, more harmonious relationships,
- have a fuller sense of well being and purpose in life,
- see reductions in long- term healthcare costs,
- have become active participants in their own wellness.
Is Acupuncture safe?
Unlike drug and other therapies, adverse side effects of Acupuncture are extremely uncommon. About 15% of acupuncture patients experience a temporary exacerbation of their condition or minor flare-ups of old conditions following their first few treatments. This is well documented and not a concern. In fact, these ‘healing reactions’ are a normal part of getting better. They are typically short-lived and are usually followed by significant improvement.
The incidence of truly adverse reactions to acupuncture when it is provided by properly trained professionals has been repeatedly documented to be extremely minuscule. The American National Institutes of Health (NIH) concluded in 1997 that
“one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions”. http://consensus.nih.gov/1997/1997Acupuncture107html.htm
Furthermore, the ‘side effects’ of acupuncture are usually things ‘you want’ rather than things you ‘don’t want’. This is precisely because the whole person is the focus of treatment, not just the specific symptom.
For example, a woman may come to an acupuncture clinic primarily for the treatment of chronic sinus pain. The practitioner provides a treatment that attends not only to the sinus pain as a symptom but also to the patient’s central imbalances and disharmonies discovered during assessment. After several treatments, the patient notes that not only has sinus pain improved, but sleep is better and the peri-menopausal hot flashes she had been experiencing have mostly disappeared. This is not an unusual scenario.
What is the relationship between Acupuncture and Conventional Medical Care?
Acupuncture is a holistic form of treatment concerned with many levels of functioning. Acupuncture is complementary to Western medicine. Acupuncture is not a replacement for conventional medical treatment. People who are under a physician’s care should not alter medications or other therapies without first consulting their physician.
How do I find a qualified Acupuncturist?
Acupuncture is now a licensed medical profession in over forty states plus the District of Columbia. The abbreviation L.Ac. (Licensed Acupuncturist) signifies official state licensure has been granted to practice acupuncture in that state. In order to grant licensure, most U.S. states require graduation from a program that is accredited by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) or that has candidacy status.
Currently, master’s level training is considered the nationally recognized entry level standard for the purposes of ensuring safe and effective practice. The abbreviation M.Ac. (Master of Acupuncture) from an ACAOM accredited school signifies the completion of extensive (3-4 years, with a miniumum1,905 credit hours, including at least 660 hours of clinical experience) post-secondary acupuncture training. This level of training qualifies the practitioner to treat a full range of health issues including chronic and acute disease, chronic and acute pain, internal medicine according to Oriental medical theory, rehabilitation, and prevention.
In addition, many states require passage of the national certification exam administered by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) to be eligible for state licensure. The abbreviation Dipl.Ac. (Diplomate in Acupuncture) signifies passage of this exam.
Medical Doctors (M.D.s), Osteopaths (D.O.s), Naturopaths (N.D.s), Chiropractors (D.C.s), and other healthcare practioners may use acupuncture as an adjunctive therapy to their primary practice with a total of 300 or less hours of training. This level of training is appropriate as first aid for pain and basic ailments. The terms Medical Acupuncture, Naturopathic Acupuncture, and Chiropractic Acupuncture may be used to designate completion of adjunctive acupuncture training for these professions.
What can I expect when I visit an acupuncturist?
Your first visit can last for up to two hours. During this time you will have the opportunity to speak at length about your reasons for seeking acupuncture and the benefits you wish to attain with treatment. Your health history will be reviewed and a physical exam, including tongue and pulse examination, will be conducted.
Since traditional Chinese medicine takes a more holistic approach to patient care than Western medicine, you may be asked questions that appear unimportant (questions about your sleep habits, your ability to tolerate heat or cold, your dietary habits, your mood, etc.) but are actually vital to the type of care you will receive. Using all of the information obtained during the history and physical exam, the practitioner will then determine a diagnosis and treatment plan.
Needles, moxa, and other techniques may or may not be used during the initial visit. Subsequent treatment sessions last for approximately 30-60 minutes. The results that can be expected and the length of treatment required will depend on the severity of the disease, it’s duration and the general health of the patient.
Initially, bi-weekly or weekly sessions may be recommended. As you start to improve, frequency of treatment is reduced accordingly. Treatment is always advisable at the change of seasons and during times of particular stress or upset. These visits provide the opportunity to correct imbalances as they occur.
How much does Acupuncture cost?
Initial consultations typically range between $90-$150. Regular treatment usually costs between $60-$85 per session depending on the facility, location, and experience of the practitioner.
Will insurance pay?
Acupuncture is one of the Complementary Alternative Medicine (CAM) therapies that are more commonly covered by insurance. Currently an increasing number of plans are providing for acupuncture treatment. However, you should check with your insurer before you start treatment to see whether acupuncture will be covered for your condition and, if so, to what extent. Some insurance plans require preauthorization for acupuncture. Your acupuncturist may or may not submit your claim for you, but at the very least can provide the necessary documentation for you to submit.
How Do I Renew My Maryland License?
Clink here to apply for license renewal.
Please note that if you fail to renew your license on time you may be considered practicing without a license and may be charged in violation of the Maryland Acupuncture Practice Act.
A late renewal means that you have sent in your renewal application within a 30-day grace period after the expiration date of your license. If you file a late renewal, you will be required to pay a $100 late fee. Please remember that a late renewal only applies if you submit your application and fee within 30 days after the expiration date. After that period, you will be required to reinstate your license.
Maryland Continuing Education Hours Requirements
(1) A licensee applying for renewal shall complete 30 hours of relevant continuing education during the 2-year period preceding the expiration of the license which include the following:
(a) At least 20 hours in formally organized programs which are relevant to the practice of acupuncture and Oriental medicine and are approved by the Board or sponsored by, but not limited to, the following organizations and their member organizations:
(i) American Academy of Medical Acupuncture;
(ii) American Association of Acupuncture and Oriental Medicine (AAAOM);
(iii) Council of Colleges of Acupuncture and Oriental Medicine (CCAOM);
(iv) Colleges and universities accredited by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM);
(v) National Commission for the Certification of Acupuncture and Oriental Medicine (NCCAOM);
(vi) Society for Acupuncture Research; or
(vii) The National Acupuncture Detoxification Association;
(b) Not more than 10 hours of formally organized training programs in Western science and medical practices, medical ethics, medical research, or cardiopulmonary resuscitation which are relevant to the practice of acupuncture and are sponsored by, but not limited to, organizations listed in §F(1)(a) of this regulation and the following organizations:
(i) World Health Organization (WHO);
(ii) National Institutes of Health (NIH);
(iii) American Medical Association (AMA); (iv) American Nurses Association (ANA); (v) American Psychiatric Association (APA);
(vi) Red Cross;
(vii) Local colleges; or (viii) Local hospitals;
(c) Not more than 10 hours of training in approved programs which will assist a licensee to carry out the licensee’s professional responsibilities, including, but not limited to:
(i) Management courses for a school administrator;
(ii) Foreign language training for translators of relevant texts;
(iii) Educational methodology for teachers of acupuncture;
(d) Not more than 10 hours teaching acupuncture and related Asian medical therapies in an accredited school or in a program approved for acupuncture continuing education;
(e) Not more than 7 hours of pro bono work as outlined in §F(3) of this regulation; or
(f) Not more than 7 hours in published writing or articles in acupuncture and Asian medicine that are:
(i) Peer-reviewed research or peer-reviewed clinically relevant articles in acupuncture and Oriental medicine; and
(ii) Limited to 4 hours per article.
(2) Pro Bono Work.
(a) Pro bono work shall earn 1 credit hour for each 3 hours of pro bono activity up to a maximum of 7 credit hours per renewal cycle.
(b) Pro bono work shall be for the provision of acupuncture services provided through an organization offering humanitarian services such as, but not limited to:
(i) Domestic or international victims in an emergency situation or disaster area;
(ii) Low income or underserved areas or populations;
(iii) Special needs populations; or
(iv) United States military personnel.
(c) Upon completion of the pro bono work, the licensee shall obtain from the facility written documentation of completion of pro bono hours including:
(i) The name of the facility;
(ii) The address where the pro bono work was provided;
(iii) The type of work that was done;
(iv) The number of hours of actual work provided for which the licensee desires credit hours; and
(v) A statement guaranteeing that the work provided no financial benefit to licensee.
(3) Licensees shall maintain the documentation of their continuing education credits for 4 years from the date of their acupuncture renewal.
(4) If requested by the Board, a licensee shall provide proof of continuing education attendance by providing documentation of:
(a) Name of the program;
(b) Date of the program;
(c) Number of continuing education hours earned; and (d) Name of the sponsoring organization.
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What is the ASA?
The American Society of Acupuncturists (ASA) is your primary national level professional association. It coordinates activities at the national level, including working with a lobbyist in Washington D.C. to represent the profession, holding national conventions, and offering national level opportunities for student and licensed practitioner involvement. http://www.asacu.org/.
What is CCAOM?
The Council of Colleges of Acupuncture and Oriental Medicine (CCAOM) is a 501(c)(6) voluntary membership association for acupuncture schools and programs in the U.S. Established in 1982, the Council’s primary mission is to advance AOM by promoting educational excellence in the field. Currently the Council consists of 53 acupuncture schools. As a requirement of membership, all of the Council’s member schools have obtained either full accreditation or accreditation candidacy status with the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), the national organization recognized by the U.S. Department of Education to accredit AOM schools and programs in the U.S. The Council administers a national needle safety course known as the Clean Needle Technique Course. http://www.ccaom.org/
Recommended reading: http://www.ccaom.org/downloads/PaperOfLixinHuang.pdf
What is ACAOM?
The Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) is the national accrediting agency recognized by the U.S. Department of Education to accredit Master’s-level programs in the acupuncture and Oriental medicine profession. As an independent body, ACAOM accredits first professional Master’s degree and professional Master’s level certificate and diploma programs in acupuncture and first professional Master’s degree and professional Master’s level certificate and diploma programs in Oriental medicine with a concentration in both acupuncture and herbal therapies. The Commission fosters excellence in acupuncture and Oriental medicine education by establishing policies and standards that govern the accreditation process for acupuncture and Oriental medicine programs. Currently, ACAOM has over 60 schools and colleges with accredited or candidacy status with the Commission. http://www.acaom.org
Recommended reading: http://www.ccaom.org/downloads/PaperOfLixinHuang.pdf
What is NCCAOM?
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), was established in 1982 as a non-profit organization currently operating under Section 501(c)(6) of the Internal Revenue Code. The mission of the NCCAOM is to establish, assess, and promote recognized standards of competence and safety in acupuncture and Oriental medicine for the protection and benefit of the public. There are currently over 14,000 active Diplomates practicing under NCCAOM certifications in Acupuncture, Oriental Medicine, Chinese Herbology and Asian Bodywork Therapy. In year 2017, NCCAOM celebrated its 35th anniversary. http://www.nccaom.org/about/about.html