Acupuncture has come to the fore in the West only in the last thirty years or so, however it can be traced back over three thousand years in China. Several approaches have been developed over that time, but all are aimed at the treatment of the full range of physical, mental and spiritual problems.

Theory
Traditional Chinese Medicine recognises a 'vital energy flow' (qi, ki, or chi) through the body. Areas of high concentration are referred to as 'meridians' or 'channels' but this energy is considered to permeate all areas of the body. For full health, this energy flow should be perfectly balanced with no areas of excess or deficiency. The energy flow can be manipulated by the insertion of fine needles into 'acupuncture points' on the body.

Diagnosis
A holistic approach! Practitioners will ask questions, look, listen, use their sense of smell and sense of touch, feeling for tender points and a number of different pulses. To give you an idea of the detail, when checking pulse they feel for six different ones and consider rate, width, strength, quality and rhythm in each case.

Treatment
For a condition such as ME/CFS, particularly if it is long-standing, you can expect to attend many sessions. Generally a session will last around half an hour, the basic form of treatment involving the insertion of (once-only, disposable) needles into the skin, and sometimes moxabustion (the burning of a herb on or close to the skin). During treatment a patient may feel no more than a dull ache or a tingling, although sometimes there are feelings such as light headaches, nausea or vomiting; very rarely a patient may faint during treatment. It is important to tell the practitioner if you are (or think you may be) pregnant, as some acupuncture points should be avoided during pregnancy.

Acupuncture methods

• Traditional Chinese Medicine
  TCM is the form taught and practised in China today. The needles are inserted quite deeply and may be left in place for 20 minutes or so, occasionally the therapist twirling, lifting and thrusting them as required.
• 5 Element Acupuncture
  Diagnosis is aided by palpation of the lower abdomen, and needles are inserted at a superficial level (the acupuncture points are different from those of TCM). The '5 Elements' refer to fire, water, metal, wood and earth which in Chinese Medicine characterise movement of energy.
• Stems and Branches
  Includes consideration of energy flow together with Chinese astrology
• Trigger Point / Myofascial
  Palpation of myofascial layers of tissue in certain energetic zones of the face and body, and then insertion of needles.
• Auricular
  Needles are inserted in the ear since it is thought this mirrors the whole human body. Auricular acupuncture is sometimes used alongside TCM acupuncture.
• Electroacupuncture
  The needles are stimulated electrically, a dc current being passed between pairs of needles in an effort to move blocked qi to relieve pain.

Effectiveness
We are aware of very little in the way of double-blind placebo-controlled trials involving people with ME/CFS, however anecdotally it appears acupuncture can help some people in varying degrees - from mild to significant improvement (although, as always, there are some who react adversely). A recent review of acupuncture trials and their effectiveness for people with ME/CFS showed only short term benefit in some trials and no benefit in others.

Practitioners
In the UK the British Acupuncture Council sets professional, ethical and training standards of a high level. is a nationwide group of family doctors and hospital specialists who practise acupuncture alongside more conventional techniques. The BMAS believes that acupuncture has an important role to play in health care today, and that it is vital to put forward a balanced case in order that informed opinion can encourage its use.