• For carpal tunnel syndrome? In 1997 a National Institute of Health statement said acupuncture was a promising treatment, but later research said proof is scant.
• For fibromyalgia? Some scientific literature says the treatment shows potential to help, but a 2003 assessment by the Agency for Healthcare Research and Quality concluded that the evidence was insufficient.
• For headache/migraine? A 2009 review found that acupuncture may help relieve tension headaches. However, two large trials that looked at acupuncture for migraines found no difference between actual and simulated acupuncture.
• For menstrual cramps? Two literature reviews have suggested that acupuncture may help with pain from menstrual cramps, but the research is limited.
• For low-back pain? According to the American Pain Society and the American College of Physicians in 2007, acupuncture is a therapy physicians can use when patients with chronic low-back pain do not respond to conventional treatment. But a large clinical trial reported in 2009 found that actual acupuncture and simulated acupuncture were equally effective -- and both were more effective than conventional treatment -- for relieving chronic low-back pain.
• For neck pain? Studies of acupuncture for chronic neck pain have found that acupuncture provided better pain relief than some simulated treatments.
• For osteoarthritis/knee pain? Acupuncture appears to be effective for osteoarthritis, particularly in the area of knee pain.
• For postoperative dental pain? Although recent data on acupuncture for postoperative dental pain are scant, literature reviews based on earlier evidence have identified acupuncture as a promising treatment for dental pain, especially following tooth extraction.
Source: National Institute of Health, Acupuncture for Pain review
• 120 in Tennessee
• 12 in Chattanooga
On Thursday afternoons the Yin Yang House on Frazier Avenue is full of people looking for a last resort.
As a Chinese lullaby plays in the background, about 10 people wait in line for treatment in the same room where other patients are being treated. Thin, silver acupuncture needles hang from people's hands and knees and feet; they protrude from foreheads.
A wiry man with cancer holds his head between his hands while his wife rubs his back. There is a young woman with migraines and painful monthly periods, a 40-something man with back troubles.
Jennifer Rintelman, 29, comes every week hoping the tiny needles will stimulate her body to get pregnant. She has been trying for three years. The owner of the Yin Yang House, Chad Dupuis, has a wall of baby pictures that Rintelman said represent his success stories. She stares at them for hope.
"I have been coming for a year. He says he is surprised I am not pregnant yet," she said. "My husband comes now for headaches and knee pain."
Chronic conditions such as migraines, fibromyalgia and back pain can wear people thin over time. So when medications don't work or threaten addiction or when side effects get worse, people are willing to try just about anything.
That's where acupuncture comes in.
A traditional Chinese medicine and one of the oldest healing practices in the world, acupuncture has mixed reviews. Some research shows it works. Sometimes a placebo works better, depending on the condition, according to the National Institute of Health. At the end of the day, the verdict is still out, and more research needs to be done.
"Overall, it can be very difficult to compare acupuncture research results from study to study and to draw conclusions from the cumulative body of evidence," a NIH overview of acupuncture states.
But practitioners say they can offer relief for everything from allergies to depression and especially pain. The ancient treatment has a fierce following, one that continues to grow in Chattanooga by word of mouth. Many who pay out of pocket for weekly sessions -- because most insurance won't cover it -- swear it works even though they and their acupuncturists don't know exactly why.
Nancy Wiley, 74, started taking acupuncture years ago when she saw an acupuncturist on a local television show.
"I thought, 'Why not?'" she said.
She said the needles are so small and sharp that they don't hurt when the acupuncturist taps them in with his fingers. Over time she has been treated for arthritis and shingles and acupuncture has kept her out of the doctor's office, she said.
"It is something I count on," she said. "I believe in it."
Brett Moldenhauer, who owns the Chattanooga Institute for Acupuncture and Wellness and directs the Tennessee Acupuncture Counsel, has privileges to practice acupuncture on Erlanger hospital patients who have just had surgery or are in acute pain. He said his client base has jumped from 15 to 45 patients in the last decade.
"Skepticism about it has fallen away," he said.
Western medical research is still studying how acupuncture could work to alleviate pain. One theory is that it stimulates blood flow and "activates opioid systems in the brain that respond to pain," according to the NIH.
Moldenhauer and others explain it this way to those desperate for an alternative solution. There are two forces in the body, the yin and the yang. The yin is the cold, slow and passive. The yang is hot, excited and active. When the balance is thrown off, disease creeps in, and the "qi," or vital energy, is blocked.
Prodding some of 2,000 points in the body along the 14 to 20 main channels can unblock the "qi."
The Tennessee Department of Health licenses acupuncturists through a board and monitors them. Practitioners typically have a master's level degree in Chinese medicine from an accredited school and between 1,400 and 2,000 hours of training in acupuncture. They also must pass a nation certification exam, Moldenhauer said.
Pro athletes and Olympic athletes who have used acupuncture to heal injuries and improve performance have made it popular in sports medicine. Moldenhauer is the acupuncturist for the Chattanooga Football Club and said he will treat the U.S. track and field team training for the Olympic trials next week.
An NIH report notes that, since 2002, acupuncture use has increased by more than a 1 million individuals in the United States to more than 3.1 million adults and 150,000 children.
The Yin Yang House in North Chattanooga fits in 58 to 80 people per week. Four years ago, Dupuis started holding community clinics that allowed people to get shorter acupuncture sessions for between $20 and $45. The typical hourlong treatment costs $70.
Sometimes the wait is hours long.
Some insurers do reimburse people for the service, but many don't. BlueCross BlueShield of Tennessee does not cover acupuncture in its standard fully insured plans because it is considered an alternative medicine, said Kelly Allen, a spokesperson for BlueCross. However, they do allow it as an elective under self-funded plans and offer discounts.
Chiropractic work, considered a manipulative therapy, is covered under standard plans, she said.
Trevor Haines, a martial arts teacher in Chattanooga, goes to acupuncture regularly for overall wellness and pain issues from training.
"So far so good," he said. "It works pretty well for the Chinese. Plus, it's a shorter line than the doctor."
Contact staff writer Joan Garrett at email@example.com or 423-757-6601. Follow her on Twitter at @JoanGarrettCTFP.