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The risks of acupuncture are low if you have a competent, certified acupuncture practitioner. Possible side effects and complications include:

• Soreness. After acupuncture, you might have soreness, minor bleeding or bruising at the needle sites.
• Organ injury. If the needles are pushed in too deeply, they could puncture an internal organ — particularly a lung. This is an extremely rare complication in the hands of an experienced practitioner.
• Infections. Licensed acupuncturists are required to use sterile, disposable needles. A reused needle could expose you to diseases, such as hepatitis.

Not everyone is a good candidate for acupuncture or for particular types of acupuncture. Conditions that may increase your risks of complications include:

• Bleeding disorders. Your chances of bleeding or bruising from the needles increase if you have a bleeding disorder or if you're taking blood thinners , such as warfarin (Coumadin), so let your acupuncturist know.
• Having a pacemaker. Acupuncture that involves applying mild electrical pulses to the needles can interfere with a pacemaker's operation.
• Being pregnant. Some types of acupuncture are thought to stimulate labor, which could result in a premature delivery.

No special preparation is required before acupuncture treatment.

Choosing a practitioner

If you're considering acupuncture, take the same steps you would to choose a doctor:

• Ask people you trust for recommendations.
• Check the practitioner's training and credentials. Most states require that nonphysician acupuncturists pass an exam conducted by the National Certification Commission for Acupuncture and Oriental Medicine.
• Interview the practitioner. Ask what's involved in the treatment, how likely it is to help your condition and how much it will cost.
• Find out whether your insurance covers the treatment.

Tell your doctor you're considering acupuncture. He or she may be able to tell you about the success rate of using acupuncture for your condition or recommend an acupuncture practitioner.

Each person who performs acupuncture has a unique style, often blending aspects of Eastern and Western approaches to medicine. To determine the type of acupuncture treatment that will help you the most, your practitioner may ask you about your symptoms, behaviors and lifestyle. He or she may also closely examine:

• The parts of your body that are painful
• The shape, coating and color of your tongue
• The color of your face
• The strength, rhythm and quality of the pulse in your wrist

This initial evaluation may take up to 60 minutes. Subsequent appointments usually take about a half-hour. A common treatment plan for a single complaint would typically involve one or two treatments a week. Number of treatments will depend on the condition being treated and its severity, but six to eight treatments are common.

During acupuncture

Acupuncture points are situated in all areas of the body. Sometimes the appropriate points are far removed from the area of your pain. Your acupuncture practitioner will tell you the general site of the planned treatment and if you need to remove any clothing. If appropriate, a gown, towel or sheet will be provided to preserve your modesty. You lie on a padded table for the treatment, which involves:

• Needle insertion. Acupuncture needles are very thin, so insertion usually causes little discomfort. Between five and 20 needles are used in a typical treatment. You may feel a mild aching sensation when a needle reaches the correct depth.
• Needle manipulation. Your practitioner may gently move or twirl the needles after placement or apply heat or mild electrical pulses to the needles.
• Needle removal. In most cases, the needles remain in place for 10 to 20 minutes while you lie still and relax. There is usually no discomfort when the needles are removed.

After acupuncture

Some people feel relaxed and others feel energized after an acupuncture treatment. But not everyone responds to acupuncture. If your symptoms don't begin to improve within a few weeks, acupuncture may not be right for you.

The benefits of acupuncture are sometimes difficult to measure, but many people find it helpful as a means to control a variety of painful conditions.

Several studies, however, indicate that some types of simulated acupuncture appear to work just as well as real acupuncture. There's also evidence that acupuncture works best in people who expect it to work.

Since acupuncture has few side effects, it may be worth a try if you're having trouble controlling pain with more-conventional methods.