While many in the West consider acupuncture to be an "alternative" medical treatment, it has been practised for up to 5,000 years in China. It’s perhaps ironic then, that Samitivej hospital physiatrist Dr Chirapan Vinaikulpong finds that it’s her western patients who request acupuncture rather than her Thai patients. "This might be changing, but most of my Thai patients are afraid of needles. Europeans are afraid of chemicals."
Acupuncture is the insertion of very fine needles about one to two centimetres into the skin of the body to influence its health. It is first mentioned in the world’s oldest medical text, the Huang Di Nei Jing, which theorises that the body has an energy force, called qi (pronounced "chee"), running along twenty "meridians" or pathways. There are up to 2,000 spots where these meridians reach the surface of the skin; placing a needle on them will affect the qi that runs through them. Qi itself is influenced by the opposing forces of yin and yang, which represent positive and negative energy. Acupuncture is believed to keep the balance between yin and yang, so it allows the normal flow of qi throughout the body.
There is no scientific explanation of how acupuncture works, but a number of theories have been offered. One popular theory suggests that pain impulses are blocked via acupuncture from reaching the spinal cord or brain. Others variously suggest acupuncture releases narcotic-like chemicals, endorphins or neurotransmitting chemicals, such as seratonin and noradrenaline.
Since the 1970s, the World Health Organisation has recognised that acupuncture can help treat many ailments. These include neuromusculoskeletal conditions, such as arthritis, neuralgia, and neck/shoulder pain; psychological disorders such as depression; circulatory disorders such as hypertension; addictions; respiratory disorders, such as allergies and bronchitis; and gastrointestinal conditions. Since then it has been formally recognised in the US that acupuncture can help with even more afflictions, including carpal tunnel syndrome, asthma, migraines and menstrual cramps.
As a physiatrist, Dr Chiraporn treats mostly patients with neuromusculoskeletal problems. In her experience, she says acupuncture definitely has an anti-pain effect and that her patients usually request acupuncture when their medication starts to lose its effect. "But I have observed that acupuncture also regulates the recovery of musculo-skeletal problems. It works best when the problem is simple and acute, and there are no underlying mental problems."
However, Dr Chiraporn says that the effect of a treatment session does not last long. "It depends on the patient – in some, it lasts for two to three hours, in others up to a week." This is why traditionally, for chronic problems, patients were treated every day in China. "But this is difficult to achieve in Bangkok, so I usually recommend two to three sessions per week," she says. The length of a session depends upon the treatment, but usually involves the use of six to 10 needles.
There is no regulation of practitioners of acupuncture in Thailand, but the Shanghai University of Traditional Chinese Medicine has run a three-month course in Thailand since 1998, which some 120 to 150 Thai physicians have completed. Patients who want to ensure their practitioner has a qualification could check to see if they hold a certificate from that course as a minimum requirement.
"The entire concept of traditional Chinese medicine is that when you look at a local problem, you look at the whole too," Dr Chiraporn says. As such, acupuncture is not the complete solution to health problems. "Meditation, exercise and diet are also important. Acupuncture can combat some very painful symptoms, but it is also the duty of the patient to work to fix their problems."
Samitivej Hospital:381 6807
Department of Medical Services: 590 6127
Sirindhorn National Medical Rehabilitation Centre: 591 3569
Price depends on doctor
Bangkok General Hospital: 310 3011
Bt700 for first visit, Bt560 for second and further visits
Huay Chiaw Hospital: 223 1351
Bumrungrad Hospital: 667 1000
Bt100/pack of ten needles, then fee depends on doctor
Yan Hee General Hospital: 879-0300
Bt400 to 500