Expert: Tamsen Staniford, L.Ac. - 9/27/2009

Question
I have suffered with chronic pain due to nerve damage either in the C2 area of the spinal cord or in the occipital nerve for more than 7 years. Currently I am using pain meds to help take the edge off the pain located on the right side of my head,neck, and face. My neurosurgeon has offered that I speak to a ac. dr. in his office. Before I go,I am hoping to find out if I,m wasting my and the drs. time. Can an ac. dr. really help eliminate the pain? Approx. how many visits would it take? Are the areas numbed before the needles are inserted? As you can tell I am concerned. I am currently on Medicare and this procedure is not covered. If it has been known to help I do not care for the expense. I am just tired of hurting and really do not want to add any unnecessary pain to my body. Thanks, Tina

Answer
Tina,

With chronic pain of that length, the condition does become more difficult to change.  What that means is that if the acupuncture is going to help you, it will likely take longer to do so than if you had received the acupuncture closer to the time the damage occurred.  Nerve pain can be difficult to treat in general because there are multiple layers to the pain process.  The damage itself causes pain, and the brain adds another layer of interpretation of that pain.  From the Oriental Medicine perspective, pain is caused by a blockage of normal qi flow.  (Qi is the life force that normally flows throughout the body providing vitality and nourishment to every body structure.)  If that blockage has occurred because of a physical trauma, the blockage is harder to correct.
Having said all that, at this point you have nothing to loose and everything to gain from trying a form of treatment that has shown improvement in nerve pain for some people.  
As for the specifics of an acupuncture treatment itself, the needle insertion depth depends on a few factors.  Japanese Meridian Therapy acupuncture works with needle insertions of only a few millimeters, while Traditional Chinese or Korean acupuncture inserts to typical depths of 1/2 to 1 inch; less for shallow areas like the forehead or wrists and more for deep areas like the hip joint or the buttocks.  Scalp acupuncture is sometimes used for nerve pain and in that case the needles are usually threaded shallowly along for an inch or more.  Acupuncture is typically painless with sensations ranging from poking, pinching, itching, pressure, change in local temperature, numbness or nothing at all.  
Your reaction to the acupuncture is a little unpredictable so I can't give you an idea of how many visits it would take you to see improvement.  Commonly, people get some level of relief right away that lasts for a few days.  Over the course of multiple treatments the relief increases in strength and duration.  The specifics depend on the condition itself, the overall health of your body and mental/emotional aspect, and your dietary and lifestyle habits.  A poor lifestyle will win out against acupuncture every time.  The practitioner you see will be able to do an in depth Oriental medicine diagnosis and give you a better idea of how it will work for you.
Other modalities besides acupuncture are also common for many Oriental Medical practitioners, including tui na (specialized Chinese Medical Massage), herbal remedies, acupressure or electro-stimulation at the needle insertion sites (which is mild and hardly felt).  Another option altogether is to seek out a Medical Qi Gong practitioner.  They work with the qi the same way that acupuncture does, but without the use of needles.  
Most importantly, I want you to make sure you talk to the ac. dr. in the neurosurgeon's office about their training and qualifications.  You would do best to work with someone that has been trained in Traditional Chinese/Oriental Medicine, rather than a doctor who has had some training in acupuncture.  Acupuncture is simply the technique of inserting needles, and Medical Acupuncture is a westernized form of that technique that does not take Chinese/Oriental medical theory into account and requires a significantly lower amount of training.  While Medical Acupuncture has been shown to work, your condition would be better treated from someone well trained in Oriental Medical diagnosis and treatment.  Depending on what state you are in, the qualifications and certification/licensure for such a practitioner varies.  Make sure your practitioner received training at an accredited Oriental Medicine program, which typically takes 3-5 years and results in a Master's degree or above in the US, and has been certified or licensed properly for your area.
Also, keep in mind that every practitioner is different even if they perform the same function (just like any dentist, doctor, massage therapist, etc...)  If the first one you work with doesn't fit your needs, keep trying until you find one that does.
Good luck to you!