Amanda Wilde (Host): The ancient art of acupuncture is steadily gaining popularity in Western medicine. Today, we're talking about acupuncture in the primary care setting with Dr. Jacklyn Lee, an Osteopathic Family Medicine physician at Skagit Regional Health. Welcome to Be Well, the podcast from Skagit Regional Health. I'm Amanda Wilde. Dr. Lee, thank you for being here. I called acupuncture an art, but is acupuncture an art or a science or a practice or a treatment or all of the above?

Jacklyn Lee, DO: It's a little bit of all of the above. It's a form of medical treatment that involves inserting a very thin needle at specific points in the body to promote healing. The needles that we use today are made of stainless steel and are usually very thin. It's thinner than a strand of hair. It originates from traditional Chinese medicine that believes pain and disease arise when there's a restriction in the flow of a person's energy known as chi.

And so by placing these needles at certain points to release the restriction, the flow can then be restored to achieve rebalance and health, but more relevant to modern times. And very interestingly, recent scientific studies have shown that acupuncture treatment for pain increases specific neurotransmitters in the brain that suppress pain perception. Very similar to how chronic pain medicine works.

Amanda Wilde (Host): Wow. So is acupuncture mainly used in Western medicine for pain relief or is it also a treatment that can?

Jacklyn Lee, DO: It can do both. Because sometimes when, after a patient gets acupuncture, they can get complete resolution of pain and that pain may never return. Sometimes it may return, but the interval or frequency really depends on the person.

Amanda Wilde (Host): Let's talk about all of this. Like walking through what an acupuncture session is like, but first of all, when is acupuncture helpful in the primary care setting?

Jacklyn Lee, DO: Acupuncture is used to treat various diseases and syndromes. The list is actually endless most commonly, however, it is used to treat various chronic. Disorders include chronic low back pain arthritis, fibromyalgia, complex regional pain syndrome, neuropathy, chronic migraine, even cancer related pain, but it can also actually be used for mood disorders, including depression, anxiety and PTSD. More interestingly infertility, even to flip a breached baby or to induce labor. It can also be helpful for smoking, alcohol, opiate dependence, sleep disorders and even for weight loss.

Amanda Wilde (Host): Wow. That's astonishing. So acupuncture can be targeted to certain conditions.

Jacklyn Lee, DO: Very much so.

Amanda Wilde (Host): Well, so let's get a feel for what an actual session is like. Can you walk us through it?

Jacklyn Lee, DO: Sure. Acupuncture treatment needs to be a very relaxing experience as it involves. Engaging and facilitating your energy. And so it is very important that you are comfortable during the entire session. So you should come wearing loose fitting clothes as some needles may need to be placed around your elbows or behind your knees. You are typically lying on your back or stomach, or sometimes seated. Typically, there is relaxing music in the background while the needles are placed and you should be in a very meditative state, by emptying your mind and focusing on your breathing. There are actually many different styles and techniques of acupuncture.

So even if you had tried acupuncture in the past and didn't find it helpful, it may still be worthwhile to try a different style or practitioner. I am largely trained in Kiiko Matsumoto style, which is a Japanese style of acupuncture and that uses a palpatory method to diagnose and determine which points to treat. I personally love the style because it provides immediate feedback while the treatment is being performed. I also have a special interest in auricular acupuncture which focuses on treating representative points in the years. I also like to incorporate electro acupuncture, dry needling and tiger warmer, which is a small apparatus used to warm specific acupuncture points.

Amanda Wilde (Host): So you have a lot of different acupuncture tools at your disposal. You mentioned immediate responses from some of these. You can know immediately if it's working, what do you see that lets you know the acupuncture is working?

Jacklyn Lee, DO: That's a very good question. There are some palpatory points in the body that I would kind of palpate for tightness and also tenderness. And after needling specific points to relieve that restriction, you can kind of immediately feel the tightness releasing or it'll become less tender. So you know that point is being effective.

Amanda Wilde (Host): Is there any downside to receiving acupuncture or is it all good?

Jacklyn Lee, DO: There are some common side effects, although very minor and rare. Sometimes people can have minor bleeding and bruising around the insertion site. You may also feel transient headache, nausea, dizziness or maybe a little achiness immediately after treatment as your body adjusts to the restricted energy flow, being restored all of a sudden. But what's also awesome about acupuncture is that there are almost no absolute contraindications. Of course, if you have a severe phobia of needles, I would not recommend it, although again, the needles we use are thinner than a strand of hair and you usually barely feel them going in most of the time.

We would also not want to needle any areas with active skin infection or skin breakdown. So that is also something to be mindful of. Otherwise, most people with cancer, seizure disorder, bleeding disorder, or those on blood thinner should still be able to receive it. But of course, based on their history and severity, it's a bit case by case.

Amanda Wilde (Host): So you shouldn't let a fear of needles really stop you because this is not like getting a shot. You said it's painless for the most part.

Jacklyn Lee, DO: Yes.

Amanda Wilde (Host): Now will insurance cover acupuncture treatment, or do I need a doctor's referral to get treatment? How does that work?

Jacklyn Lee, DO: That's a very good question. Most insurances do not require referral for acupuncture, but in terms of coverage, you really would have to follow up with your own insurance because every plan is different. However, Medicare just recently started to cover acupuncture for chronic low back pain only. And hopefully, this will open doors for more indications in the future.

Amanda Wilde (Host): Is there anything else you'd like to add about using acupuncture in the primary care setting?

Jacklyn Lee, DO: To seek acupuncture from a practicing physician is an added bonus because we would complement such therapy with conventional remedies and treatment, and we usually have a very comprehensive understanding of your medical history. And so, it may be beneficial to get acupuncture from a primary care physician or practicing physician like myself versus an acupuncturist, or general acupuncturist in the community.

Amanda Wilde (Host): Yeah, you have a huge well rounded view and thank you for an enlightening conversation about acupuncture. Dr. Lee, I really appreciate your time. Visit SkagitRegionalHealth.org to learn more. Thanks for listening to Be Well, the podcast from Skagit Regional Health. And if you found Be Well helpful, please share it on your social media platforms and check out the full podcast library for topics of interest to you.

I'm Amanda Wilde. And we'll talk again next time.