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Chat Gets to the Point of Acupuncture

Posted: February 26, 2016
NorthBay Healthcare is engaging with the community in a big way through social media, thanks to #NBDocTalk, the every other week live Facebook chats.

The Feb. 24 chat on acupuncture with physician Sandra Skates, D.O. saw the greatest response so far, with dozens of questions posed by NorthBay’s Facebook followers. The half-hour chat ended up lasting 45 minutes as followers not only tuned in to see the answers to their original questions but posted follow-up inquiries.

Dr. Skates explained acupuncture and its uses in treating anxiety, neuropathy, chronic sinus infections, back and neck pain, and a host of other health issues.

“Back pain is the most common reason that people come to me for acupuncture. Acupuncture cannot cure arthritis or degenerative discs but many of my patients have been able to decrease medications, increase activities and find relief from their back and neck pain, even radiating pain to the arms or legs,” she noted in one reply.

She also cautioned that it is not a cure-all.

“I always tell my patients that medical acupuncture is not ‘snake oil’ or a magic wand,” she
noted. “It may be a successful standalone treatment or be part of a whole treatment regimen. It works very well for some people and conditions and not at all for other people and conditions.”

Some asked about whether insurance covers acupuncture, and skates notes that Western Health Advantage and many other providers do, however, Medicare does not.

“I encourage you to contact your insurance provider. The more demand from patients, the
more likely insurance is to cover acupuncture in the future,” she said.

#NBDocTalk is held every other Wednesday with a different NorthBay Healthcare doctor answering questions on various health issues. The full discussion with Skates can be viewed on the NorthBay Facebook page at Facebook.com/NorthBayHealthcare.

Here is an edited transcript of the chat:

Q: Will this work for anxiety?

Dr. Skates: It can work for anxiety. It works better if the anxiety is mild to moderate, more recent and not related to deep seated medical or other psychological problems. Often acupuncture is a piece of a whole functional medicine program for anxiety.

Q:  Will this work for neuropathy, specifically in the feet?

Dr Skates: The longer time the neuropathy has been going on, the more difficult it is to treat. Neuropathy that arises for no reason or related to long term medical problems like diabetes is the most difficult to treat. However acupuncture can reduce symptoms. I have the most success with treating chemotherapy or radiation induced neuropathy that is less than a year old.

Neuropathy, for those who are not familiar with it, is a disease of the nerves. It most commonly occurs in the feet. Symptoms include a feeling of tightness, numbness, sometimes heat and pain. People will sometimes say it feels like they have socks on that are too tight. It can occur with diabetes. It can occur and not be associated with other medical illnesses. It is often a side effect of chemotherapy and/or radiation treatment for cancer of any kind.

Q: Will this work for chronic sinus infections or for plantar fasciitis

Dr.  Skates: Actually it can work for most. In my office I use a combination of Osteopathic Manipulative Medicine and Medical Acupuncture for these problems. As with anything if there are serious underlying problems acupuncture is not as successful.

I always tell my patients that Medical Acupuncture is not "snake oil" or a magic wand. It may be a successful standalone treatment or be part of a whole treatment regimen. It works very well for some people and conditions and not at all for other people and conditions.

Q: How about hyper pigmentation on face?

Dr Skates: I have no experience with using it for hyper or hypopigmentation anywhere in the body, nor have I read any articles about this application.

Q: How about neck pain?

Dr. Skates: I use it successfully every day in patients with neck pain.

Q: Will it work for IBS and constipation?

Dr Skates: Irritable Bowel Syndrome and chronic constipation are often treated with acupuncture. I usually look at certain structural issues along with diet and bowel flora along with using acupuncture

Q: How about an over active bladder?

Dr. Skates: Yes indeed. It may decrease or relieve symptoms of overactive bladder. There are so many factors involved in overactive bladder that it may take multiple treatments before lasting changes are made.

Q: Will it work for weight loss, ADHD and back pain? What's the youngest age that could benefit from acupuncture?

Dr. Skates: Acupuncture is widely used for weight loss. I do not treat people for weight loss, however.

I do not have much experience with treating ADHD, however I have colleagues in Medical Acupuncture that are using it -- successfully

Back pain is the most common reason that people come to me for acupuncture. Acupuncture cannot cure arthritis or degenerative discs but many of my patients have been able to decrease medications, increase activities and find relief from their back and neck pain, even radiating pain to the arms or legs.

One of my colleagues first exposure to acupuncture was using an instrument to gently tap acupuncture points on his premature baby girl in the neonatal ICU. Any age can be treated. Usually children are treated using smaller and fewer needles. children also often respond to electrical stimulation or beads on the ears without using body needles.

Q: Do you practice cupping and what is it good for?

Dr. Skates: Yes I practice cupping. In Chinese Medicine Qi and blood cannot be separated. Many pain and medical disorders are related to congested or "congealed" QI. cupping uses suction to bring blood to the surface, thereby diffusing QI and blood and relieving the congestion. I use glass cups. A cotton ball is dipped in alcohol and clipped a hemostat. The cotton is lighted on fire. The cotton ball is briefly "swept" in the inside of the cup to burn up the oxygen, creating a vacuum. Then the cup is place on the skin and "voila". Scraping or gua sha works similarly using an instrument that is scraped across the skin.

Q: Will it help with a chronic loss of smell? Is it covered by WHA insurance?

Dr. Skates: It depends on the cause of the loss of smell. I have not had any patients come to me with this problem.
Yes it is covered by WHA.

Q:  Will it work on post-surgery pain and does Medicare cover it?

Dr. Skates: I can't make guarantees but many causes of post-surgical pain can be aided or relieved with medical acupuncture .

No, Medicare does not even recognize the billing codes for acupuncture. However in the past year there are some Medicare Secondary Insurances that cover acupuncture. It would be up to you to check with your insurance carrier. Most of the time Medicare is billed for an office visit and the patient has an out of pocket payment for the acupuncture part of the visit.

Q: Would AARP cover it?

Dr. Skates: I do not currently have any patients with AARP insurance that covers acupuncture. I encourage you to contact your insurance provider. The more demand from patients the more likely insurance is to cover acupuncture in the future.

Q: How about bursitis in the shoulder area?

Dr. Skates: Yes, depending on the actual problem and extent of damage to the structure of the shoulder.

Q: How well does manipulation work with acupuncture?

Dr. Skates: The two work excellently together!. Most of the time they are not performed on the same visit but I have many patients on which I use a combination of the two.
I do Osteopathic Manipulative Medicine, which involves hands on evaluation and treatment of pretty much every structure in the body. The technique used can be very, very gentle or fairly aggressive depending on the problem and the particular patient being treated.

Q:  It's the 'aggressive' bit that I'd like more data on.

Dr. Skates: Well. Sometimes areas that need Manipulation are tender so there can be pain. I do sometimes use techniques that make noise, similar to what people think of as chiropractic treatment (although most say it's nothing like being at the chiropractor) and sometimes I put the body in some positions that most people would not assume during their usual daily activities.

Q: What benefit is the electronic connection with acupuncture and how do you decide to use it?

Dr. Skates: There are several techniques for pain management that were developed by physicians in the US and Canada that use electricity in varying frequencies to stimulate release of pain relieve neurotransmitters. In the "energetic" part of the acupuncture treatment, it is used to move Qi through the meridians, add Qi to the system or disperse congested Qi.

Qi translates roughly to Energy .

Q: Does it hurt?

Dr. Skates: The needles are very small and do not damage the tissue as they are inserted. Thus there can be a small amount of pain during needle insertion. Some people are more sensitive than others. Any pain should last no more than a split second to a few seconds then go away. Most patients are surprised when the needles are removed because they didn't realize how many there were.

Q: You covered Medicare and WHA. But do other insurance carriers cover acupuncture?

Dr. Skates: Many do but not all. Some who cover it limit the number of visits allowed per year. We encourage everyone to check with their insurance carrier before scheduling an acupuncture appointment so that they don't end up with an unexpected bill.