How to shop for top-notch acupuncture treatments

Back pain. Headaches. Allergies. Arthritis. Anxiety. Morning sickness. Acupuncture practitioners claim their centuries-old approach can successfully treat dozens of medical problems — with few side effects or risk of complications.

Many health care providers see acupuncture as a possible tool to battle the U.S. opioid epidemic. Recently, the American College of Physicians recommended using acupuncture as one of the first treatments for lower back pain, and the Joint Commission's "Pain Management Standards" now includes acupuncture as a non-pharmacological strategy for managing pain.

Western medicine proposes several theories on how acupuncture works. One premise: It releases the body's own painkillers, or endorphins. Another hypothesis, the Gate Control Theory of Pain, argues that the body shuts down pain receptors in response to acupuncture's needling.

In Eastern medical lingo, ailments are described in terms of an excess of or deficiency in yin or yang, forces that are connected and interdependent. Energy flows through the meridians or pathways of the body. These pathways connect via acupuncture points that relate to internal organs; acupuncture's specialized needle placements improve the flow of energy and promote healing.

Although there's much evidence that acupuncture often alleviates pain and successfully treats a range of symptoms and diseases, there's no clear answer as to whether acupuncture is a microneedle magic bullet. Many skeptics argue that any benefits of getting stuck probably derive from a placebo effect.

That's because it's difficult to test the efficacy of acupuncture. In double-blind studies, one group receives the conventional drug or treatment while another group receives a placebo. The problem is, there are no good placebo substitutes for acupuncture. Another problem in assessing acupuncture (and many other medical treatments) is that ailments often simply resolve themselves.

So maybe acupuncture's usually positive results are from a placebo effect. Or maybe all those needles somehow stimulate the body to heal itself or suppress pain. Or maybe getting yourself stuck works due to an as-yet-discovered process. If you are the patient, since it works, maybe you shouldn't overthink it.

After all, thousands of drugs and medical procedures are approved and prescribed to treat conditions at enormous cost every day, often without a precise understanding of why they work, or even whether they are effective at all compared to other approaches or doing nothing. Unlike acupuncture, often these approved and accepted treatments pose serious risks to patients who undergo treatment.

And it's clear that patients who try acupuncture love it. A recent study by American Specialty Health Inc. (ASH) surveyed 89,000 patients who received treatment for chronic pain. It found a vast majority (87 percent) of patients rated their acupuncturists favorably (9 or 10 on a 0-to-10 scale), somewhat more favorably than patients rated conventional health care providers (76 to 80 percent). Nearly all (99 percent) of the surveyed acupuncture patients rated their providers good or excellent, and almost none reported minor or serious adverse effects.

If you are looking for an acupuncturist, talk with your friends and physician for recommendations. The nonprofit Twin Cities Consumers' Checkbook and Checkbook.org regularly surveys local patients on their experiences with health care providers, including acupuncturists. For the next month, Checkbook is offering free access to its ratings of acupuncturists to StarTribune readers via this link: Checkbook.org/StarTribune/Acupuncture.

If the acupuncturist is a physician, look for certification by the American Board of Medical Acupuncture (ABMA) (www.dabma.org). Alternatively, consider a physician who is a member of the American Academy of Medical Acupuncture (www.medicalacupuncture.org).

If the acupuncturist is not a physician, check for certification by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) (www.nccaom.org). NCCAOM-certified acupuncturists can add "Dipl. Ac." after their names.

As there are many qualified acupuncturists, and since other consumers tend to be especially satisfied with them, pay attention to prices. Checkbook's undercover shoppers called a sample of area acupuncturists for their fees for private treatment of arthritic knee pain and were quoted prices ranging from $45 to $300 for an initial session. Checkbook's shoppers also asked about prices for community acupuncture, which is a growing trend. (Acupuncturists treat multiple patients in the same room.) Prices quoted to its undercover shoppers for community acupuncture were far lower than those for private sessions, ranging from $15 to $60 per session.

Twin Cities Consumers' Checkbook magazine and Checkbook.org is a nonprofit organization with a mission to help consumers get the best service and lowest prices. It is supported by consumers and takes no money from the service providers it evaluates. You can access Checkbook's ratings of area acupuncturists free of charge until March 5 at Checkbook.org/StarTribune/Acupuncture.