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The pandemic has inspired a number of interesting home experiments, from whipped coffee, to sourdough, to DIY hair-dyeing. Right around the time people started clearing grocery store shelves of yeast, virtual acupuncture started to become a thing, especially among regular acupuncture clients as well as people with renewed stress who wanted to add acupuncture to their wellness routines.

Even though some acupuncture facilities have opened back up with additional safety precautions, the Zoom acupuncture trend has continued, especially among people who are immunocompromised and confined to their homes while quarantining, or are in an area where acupuncture is not readily available. While there is a small percentage of practitioners who are giving patients tiny needles, called press tacks, to actually practice acupuncture on themselves, many are using the digital sessions to educate patients on the unique acupoints on their own bodies that can lead to optimal healing. This practice is known as acupressure.  

Traditionally, an in-person acupuncture treatment is designed to address concerns ranging from allergies to migraines to back pain. A practitioner will use a series of thin needles to stimulate various acupoints which may help improve the function of a certain system (like the digestive system). Most states require acupuncturists to either have a certification from or take a test by the National Certification Commission for Acupuncture and Oriental Medicine in order to be able to practice in any capacity.  

On a normal basis, research has found that acupuncture can help regulate immunity by reducing inflammation in the body. Evidence also shows that acupuncture may play an active role in treating depression by hitting acupoints that are thought to move stagnant energy out of the body. During a global pandemic, these health concerns are top of mind for many. 

But acupuncturists believe the practice of acupuncture is also unique to individuals and their specific ailments — for example, some may see an acupuncturist to alleviate stress, others to address a specific joint pain, or a combination of issues. “Each patient’s challenges and course of action is unique. I can treat the symptom with almost immediate alleviation of pain, but to heal, I have to know its root cause. To heal, I have to know you,” says Juhi Singh, licensed acupuncturist, Chinese herbalist, and founder of the Juhi-Ash Center in New York City. 

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When acupuncturists couldn’t see their clients in person back in March, they looked for ways to check in with them and their individual mental and physical health concerns. Zoom only seemed natural, since almost every other medical practitioner migrated to a video platform for telehealth appointments. For some patients, the virtual mind-body check-ins provided some semblance of structure during quarantine, says Gabriel Sher, director of acupuncture at ORA in New York City. 

Of course, Sher notes the common distractions of home (dogs that need to go outside, kids that pop in the room) don’t necessarily create the same pristine, calming environment as ORA, but the regularity of the practice is the important thing. ORA’s practitioners begin its virtual sessions with an in-depth assessment of the client’s diet, digestion, sleep habits, and emotional health, and guide them to use acupressure by pressing on certain acupoints five times an hour. They also supply patients, about half of whom were new to ORA during quarantine, with tools like ear seeds, which aren’t much larger than a peppercorn and can be adhered to various points on the ears, a hotspot for mental health connection, explains Sher. (Ear acupuncture is thought to be helpful because acupoints on the ears have been found to reach an area of the brain that regulates emotional response, according to research in the journal Medical Acupuncture.)    

Woven Bodies, a digital parenting support group and acupuncture practice, also implements acupressure with virtual clients. Sessions first start with a lengthy consultation of the patient’s health history before the practitioner talks through acupoints on the body to target, and helps the patient recognize and press on those points. 

Alexandra Garcia, a licensed doctor of acupuncture and Chinese medicine and co-founder of Woven Bodies, has found the virtual acupressure practice to be especially effective in labor and delivery settings; acupuncture’s ability to reduce the duration of labor and even alleviate pain is the subject of some studies. Because many hospitals and birthing centers have not been allowing additional people, like acupuncturists, in the delivery room due to COVID-19 restrictions, the designated support person (either the birthing partner or midwife) can step in, take the call, and help reach acupoints on the person giving birth. Even after the pandemic, Garcia anticipates continuing this virtual method for pregnant patients, so that the acupuncture practitioner isn’t disrupting the birthing environment. Virtual acupuncture is also a great tool for postpartum parents, when time is limited and it’s easier to hop on a telehealth call with a newborn in the house, Garcia adds. Plus, patients then have the agency over their own bodies and the knowledge to practice the acupressure techniques themselves on their own time. 

Other practices are giving patients even more agency. Steven Mavros, licensed practitioner of Chinese medicine and owner of Healing Arts Center of Philadelphia, decided to go virtual in March to keep patients’ routines with regular appointments. He has many fertility patients (acupuncture can be beneficial to some people trying to get pregnant, as it may increase blood flow to the ovaries, Mavros says) who may be on a strict IVF or insemination schedule and don’t want to waste valuable time. Lauren, a Healing Arts Center patient from Avondale, Penn., who got pregnant at the beginning of the pandemic, didn’t want to stop her regular treatment or risk being exposed to the virus with an in-person session due to her history of recurrent pregnancy loss. 

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For virtual sessions, Healing Arts Center mails out press tacks, which are tiny, sixth-tenths of a millimeter-sized needles, attached to what looks like a small, circular rubber bandage that patients can press into their skin. Patients with a previously booked telehealth session are only given enough press tacks to use during the time period of the telehealth sessions, under the supervision of a licensed acupuncturist, Mavros says. He specifically instructs patients to push the press tacks into a point far from a vein or artery. For example, to treat nausea, rather than the point  on the underside of the wrist, he instead advises patients to insert the press tacks on the top of the wrist,  to steer clear of any veins or tendons. And because of the size of the needle, you don’t actually feel it at all — it barely punctures the epidermis, the outermost layer of skin, he adds. Given how shallow the punctures are, there isn’t much risk for things to go haywire, he adds. 

“The only side effect that I could see is that maybe they put it up a millimeter or two off and it doesn’t have as much of an effect, or causes a small bruise.” This use of patient-administered press tacks hasn’t gone unchecked by the acupuncture community, though — and practitioners in certain states are not able to send them home with patients at all. 

“There are maybe some scenarios where I would like to use press tacks, but in New York state we’re not able to give these to clients for home use,” Garcia says. Out of an abundance of caution, she says she won’t supply a patient with something that would puncture their skin during a virtual session. “It’s not to say it’s not doable. I do have colleagues outside of New York who use press tacks,” says Garcia. “I think they are a great in-between, because they’re not quite full-on needles.” 

Juhi Singh says she would not give patients any kind of needles to take home under any circumstances. “I am aware of virtual practitioners using smaller needles adhered to rubber disks in a guided session, but I have not seen them, [so] I can’t say if the smaller needle has less potential for harm or even any potential for gain,” Singh says. “Acupuncture, in trained hands, is a medical skill, with a medical degree, administered under precise sterile conditions,” she adds. Instead of piercing the skin, she suggests working on acupoints with self-administered acupressure to be safe.   

Needles or no needles, it’s too early to say whether digital sessions are just as effective as an in-person practice, practitioners say, and more research on the benefits of virtual acupuncture still needs to be done.  Long-time Healing Arts Center client Steph, of Philadelphia, Penn., who uses the Zoom sessions as frequently as possible since she has Type I diabetes and is at higher risk for COVID-19 complications, says that the virtual sessions are almost as effective as being in person. “I don’t think it’s quite as impactful as the needles are smaller,” she says. While she appreciates the time set aside for meditation after the session, she feels as though her application, even if guided by a practitioner, naturally won’t be as precise as the practitioner’s exact placement of the needles.

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But these virtual appointments can allow patients space to touch base with their mental and physical health as well as adhere to a routine while the COVID-19 pandemic rages on. Stacy of Pitman, N.J., a patient at Healing Arts Center of Philadelphia, was newly diagnosed with anxiety and felt that the virtual treatment, specifically the press tacks, helped keep her anxiety under control. She pressed on the press tacks, which Mavros says can be comfortably left in the ears for a week for maximum efficacy, any time she started feeling anxious, and the feeling would start to dissipate, she says. 

Alexa, a patient at ORA in New York City, felt that the acupressure tools she learned in the virtual sessions were useful to learn more about what works for her own body. “I really didn’t know much about acupressure before, and now I know the points to focus on when I am nauseous or finding I need to focus. Additionally, I learned about some on my back for stress and muscle tension that my partner was able to help me with,” she says.

The important part of the practice is that the patients themselves are accessing those acupoints that studies show may provide healing for some ailments — even if it’s just screen to screen for now. “It shifts the emphasis from it being something where the responsibility is all in the practitioner’s hands, and from the needles being this magic thing,” Garcia says. “Instead we’re giving the tools to the patient, and they have to be tuned in to the work the body is trying to do.”

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