My 42-year-old knees have become creaky lately. Nothing serious, just the every-day stiffness that starts showing up later in life. I often feel a twinge of pain getting out of bed in the morning, or sometimes after a long run. This past week those twinges gave me an excuse to do something I’d long been curious about: I visited an acupuncturist. I went, I have to say, as a bit of a skeptic.
MOST-ANCIENT ART Acupuncture—the insertion of fine, strategically placed needles in a person’s body—has been used as a medical treatment for at least 2,500 years. Along with the use of healing herbs, it makes up a cornerstone of traditional Chinese medicine. According to one legend, a Chinese warrior wounded by an arrow had felt no pain. An intrigued attendant was inspired to discover how other forms of puncturing or piercing might be used as an anesthetic. In time, acupuncture made its way into the ancient Chinese text Huang Di Nei Jing, or “Inner Classic of the Yellow Emperor,” the Chinese equivalent of Western medicine’s seminal Hippocratic corpus. Down through the ages, the subsequent texts and research added to, refined, and re-interpreted the basic ideas laid out in the Nei Jing.
As with most of those ideas, acupuncture evolved from the fundamental Chinese theory of Yin and Yang. The character for Yin described the shady side of a slope. It represents what are called feminine qualities: earth, passivity, darkness, inwardness, tranquility, realized fruition, completeness. Yang’s character, originally the sunny side of a slope, is associated with what are called male qualities: the heavens, light, heat, excitement, outwardness, the dynamic beginning of things. According to traditional Chinese medicine, the ever-present, complementary forces of Yin and Yang work in the human body as they do throughout the entire natural universe. Disease, illness, and pain are the result of an imbalance between the two forces. The goal of acupuncture is to restore the harmony of the Yin and the Yang.
All of which seemed to me a bit unscientific, until I came across some different language explaining the same principle in Ted Kaptchuk’s book The Web That Has No Weaver. The logic behind Chinese medicine, he writes, assumes that a part can be understood only in its relation to the whole. “Biomedicine, a more accurate name for Western medicine, is primarily concerned with isolable disease categories or agents of disease, which it zeroes in on, isolates, and tries to change, control, or destroy. The Western physician starts with a symptom, then searches for the underlying mechanism—a precise cause for a specific disease...The Chinese physician, in contrast, directs his or her attention to the complete physiological and psychological individual. All relevant information, including the symptom as well as the patient’s other general characteristics, is gathered and woven together until it forms what Chinese medicine calls a ‘pattern of disharmony’.… One does not ask What X is causing Y? but rather, What is the relationship between X and Y?”
BELOW THE SURFACE I find it appealing that thousands of years’ worth of observations have created an understanding about patterns of “harmony” and “disharmony” in the human body. And I believe in holistic approaches—it seems only natural to me, for instance, that diet and lifestyle and environment and exercise and stress and sleep all have something to do with how our bodies get sick and get well. Though I have to admit it was a stretch for me to understand how my kidney was connected to my creaky knees. But Jennie Cysyk explained the link during our meeting at the Acupuncture Center of Woodstock in Woodstock, Vermont, before she put the needles in me. She spent some of that time describing the Chinese notion of Qi (pronounced chee). She called it “vital life force energy,” and told me how it was both present in all parts of my body and how it flowed through my body along specific pathways called “meridians.” Ted Kaptchuk’s book calls that invisible lattice the “warp and woof” of human anatomy, the informational network that unifies all parts of the body. The Nei Jing says, “The meridians move the Qi and the Blood, regulate Yin and Yang, moisten the tendons and bones, benefit the joints.” There are a dozen or so major meridians and even several smaller ones. Acupuncture is based on the theory that pain and illness are a manifestation of a disharmony or an imbalance along the meridian pathways, and that specific points on the outside of a human body can be stimulated to correct or change the Qi flowing through them. As it happens, one of the major meridians, the kidney meridian, links to the knees.
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I was willing to go there in theory, and I willingly described my urinary habits and conditions to Cysyk, though I assumed that the years pounding my knees playing soccer in high school or the knee surgery I’d had from a baseball injury might have more to do with the pain I was feeling. Later, I read a column on an outdoor-sports Web site that made me think twice about simply blaming pain on “an injury.”
Writer James Swan had badly injured his shoulder while halibut fishing near Homer, Alaska. He wrote a column about treating his injury through acupuncture. “In traditional Chinese medicine,” he says, “an injury is seen as the result of multiple causality and a symptom of overall imbalance in Qi, caused by excessive or weak flows of Qi from or to internal organs.… From this perspective, when I was injured I was fighting seasickness, so my stomach meridian was weak. It was cold, and the choppy seas were somewhat frightening, causing weakness in the kidney meridian, as the kidneys are associated with fear. When you are frightened, your breathing shallows, producing less Qi, so the lung meridian would also be weaker. Accordingly, these external conditions made the shoulder weaker and injury more likely to occur.” He might have added that a pre-existing weakness in his shoulder may have predisposed him to seasickness, or to fear. To the traditional Chinese way of thinking, it’s all related.
ON PINS AND NEEDLES The acupuncture room in Cysyk’s office looked and felt exactly like rooms I’d seen before while getting massages—same massage table, soft light, vague, pleasant smell of incense or essential oils, and soothing music. I lay on the table with my pant legs rolled up past my knees, closed my eyes, and—honest—didn’t feel a thing as Cysyk gently tapped little needles into the tissue around my knees. Originally, acupuncture needles were fashioned from bone, horn, slivers of bamboo, and later, gold, bronze, tin, and silver. Today they’re made of stainless steel, in varying gauges, and generally about the thinness of a human hair. The best needles, Cysyk believes, are made in Japan. The ones she used on me were around an inch long, sterile, each in a tiny, disposable plastic sheathing. To insert them, she placed the sheath on a point along the desired meridian, and tapped her index finger against the top of the needle. The insertions she typically makes might be anywhere from a couple of millimeters to a half-inch or so deep. Depending on the procedure and practitioner, needles may be twisted, twirled, or even connected by tiny clamps to a low-voltage alternating current.
Of the 20 needles she put in me, I felt two of them, and only barely, and only briefly. I felt more the warming sensation when Cysyk heated the ends of some of those needles with a burning stick of mugwort, a process called moxibustion and intended to further stimulate the flow of Qi. After she inserted the needles, she had me lie on the table for about 15 minutes. I had a slight warm feeling in my knees and felt so relaxed I almost fell asleep.
Classical Chinese medical theory recognizes 365 acupuncture points on the surface meridians of the human body. Modern Western researchers have identified those same points as specific areas of lowered electromagnetic resistance. (They’re the same points, by the way, stimulated by acupressure—the same general idea without the needles.) Other scientific theories attempt to explain why acupuncture works. According to the “gate theory,” the stimulation from the needles “jams” or overloads the lower nerve bundles in the central nervous system, blocking other pain signals from reaching the brain. Another theory suggests that the needles send electrical impulses to the hypothalamic–pituitary system at the base of the brain, releasing enkephalins and endorphins, the body’s natural, potent pain-killing hormones. Acupuncture is believed to affect levels of serotonin in the brain, which in turn affects mood and energy. Acupuncture has been observed to decrease inflammation, increase circulation, and increase a body’s T-cell count, which in turn stimulates the immune system. The news is filled with celebrities and pro athletes using acupuncture to treat the affects of aging and injuries. The list of conditions that are said to respond to acupuncture include acne, anxiety, arthritis, and asthma—and those are only the ones listed under “A.”
COMING OUT WELL I felt light walking away. My 90-minute first treatment cost between the $60 and $100 that a visit typically costs. Depending on your condition, you might require one treatment like me, or you might need several visits.
The next morning I woke up and stepped out of bed, thought of my previous doubts, and felt not a twinge. As an uncomprehending agnostic would say, “There might be something to this.”
