Last year Duke anesthesiologists combined data from 15 small clinical trials and found that using acupuncture before and during surgery significantly reduces pain -- and the amount of potent painkillers needed -- for patients after the surgery is over.

In a growing number of medical communities, this practice of inserting hair-thin, stainless-steel needles into the skin at specific locations is being embraced for treatment of conditions beyond pain and nausea, such as endometriosis, digestive concerns, chronic insomnia, and infertility.

HealthLine wanted to know more about the nuts and bolts of this Eastern-medicine tool that’s making its way into Western medical toolboxes. We asked Janet Shaffer, the acupuncturist at Duke Integrative Medicine, to share her thoughts about:

When to go: “We encourage people to come in as soon as you feel a little achy, as soon as you notice daily changes such as calves that cramp, feet that don’t tolerate walking the mall, or that you aren’t able to eat your favorite foods or are living on Tums. Getting things balanced early on makes a huge difference.

“Some people come in and don’t have anything wrong; they’re just looking for an official timeout. It’s a very deep rest for some people.”

When not to go: “I think there is a misconception that acupuncture can be magically useful for weight loss. Acupuncture can be helpful in facilitating weight-loss by preventing pain during exercise or kick-starting sluggish digestion. But I don’t recommend it for weight loss unless a specific weight-loss program is also in place.”

How acupuncturists are trained: “We go to school for three to four years to study the theories of Eastern medicine. You can think of Eastern medicine as mixing the body’s symphony on a soundboard; we learn about how to orchestrate that symphony properly. We learn what’s an appropriate mix for someone who’s 80 versus someone who’s 16, and how different constitutions and body types have different preferences and different [symptoms and medical complaints]. Then we learn acupuncture points and how to combine acupuncture with herbal therapies. Finally we learn how to match Eastern diagnosis and treatment with Western diagnosis and treatment.”

About those sticking points: “It’s almost unfortunate that we call them needles. They’re metal and they have a point, but they’re so small….Most people are pleasantly surprised how easy and painless acupuncture is. The patient’s whole experience is: You have a little chat with the acupuncturist and then sack out for a 25-minute nap.”

What the Qi?

So just how does acupuncture work? You can take your answer in occidental or oriental terms:

Western medicine says that insertion of needles stimulates the body’s nervous system to release chemicals that change the feeling of pain and influence the body’s internal regulating system.

Eastern medicine says that the insertion of needles restores the regular flow of energy called qi (pronounced chee), stimulating the body’s natural healing abilities.

The National Institutes of Health has issued a consensus statement that acupuncture has proven value for treating pain, nausea, and vomiting, and researchers are looking with promise at its use for asthma, menstrual cramps, and osteoarthritis. Duke Integrative Medicine’s Janet Shaffer says it’s like a reboot to your body’s system. “Your mind and your body have complete instructions on how to run -- they’ve been on this project for a long time. Acupuncture is like having a staff meeting to get everyone back on the same page.

“People naturally have a brilliant ability to heal,” says Shaffer. “Sometimes we forget that.”