A 70-year-old retired physician with chronic back pain endured numerous surgeries with little relief. A member of his church in Macomb, Illinois, who had experienced similar pain told him about an alternative therapy that had worked wonders for her: acupuncture.

Eager to seek relief from the aching, though not debilitating pain, the physician decided to give acupuncture a try.

That such an experienced physician would try the technique shows just how much ground the practice of acupuncture is gaining in the world of modern medicine.

The benefits of Chinese acupuncture have been documented for 2,000 years, and recent evidence indicates acupuncture may be even older.

"Something that has been around this long, I knew there had to be something to it," says Terry Arnold, M.D., assistant professor in SIU's Department of Family Practice. A physician for more than 25 years, Dr. Arnold has had an interest in acupuncture for many years. In 1999, he undertook professional training in medical acupuncture and has incorporated the therapy into his family practice in at the SIU Family Practice Center in Quincy, Illinois.

"Acupuncture often will provide relief without the side effects of pharmaceutical therapies," says Dr. Arnold. Acupuncture bases its approach on maintaining harmony of the body's life forces. It is used to treat more than 200 different diseases and conditions, including stroke, heart attack, asthma, infertility, addiction withdrawl and chronic fatigue.

"Acupuncture's purpose is to restore the body to its normal status," says Dr. Arnold, who uses it strictly as an adjunctive therapy for patients with chronic pain problems, such as back pain, carpal tunnel or fibromyalgia. He administers acupuncture once or twice a week, using it as a "last resort" if a patient is not responding to traditional therapies. Research has shown that medical acupuncture - acupuncture administered by a physician - is most beneficial when used in correlation with modern medicine.

While some acupuncturists may extol the spiritual experience of acupuncture, Dr. Arnold prefers the objective, scientific perspective of a physician. "Medical acupuncture is a very well-disciplined approach with extremely rigid parameters of treatment. Acupuncture is an art, but it has scientific data to support it."

Before treating with acupuncture, Dr. Arnold educates patients about it and gives them a thorough physical exam to assess their likelihood of positive response to the procedure. Then, he designs an acupuncture plan for patients based on their medical history and symptoms. Some acupuncturists, he explains, design plans based on a patient's personality and preferences for things like weather, flavors and colors. Others examine the tongue as a kind of road map for internal organs.

The typical therapy involves 10-30 thin, sterile, stainless steel acupuncture needles of varying lengths that are inserted into specific acupuncture points on the body, just millimeters beneath the skin.

According to acupuncture practitioners, the body contains more than 400 acupuncture points found in small depressions in the skin called "gates" where the body's energy channels, or meridians, come closest to the surface. Individual parts of the body such as the hand or the ear contain additional sets of hundreds of points. Acupuncture "opens the gates" of the body to mobilize and balance energies by stimulating circulation of the body's animating forces and releasing one of the body's natural hormones, endorphins, to restore and regulate organ function.

The needles are left in place for 30-45 minutes, with the practitioner manually manipulating them to direct the body's energy and - in Dr. Arnold's use - affect the perception of pain.

"In an acute injury, such as a muscle sprain, there is too much energy, and that is causing inflammation," says Dr. Arnold, who cools the needles with alcohol to draw out the excess energy. Chronic pain signals a lack of energy, so needles are warmed with heat lamps or electricity to provide more energy.

A typical session takes quite a bit of time: 60-90 minutes. To relax the patient, Dr. Arnold darkens the room and plays traditional Chinese music for sleeping. Because the needles barely poke the surface of the skin, the procedure is not painful, nor are there any side effects when the procedure is administered properly. Patients find it a relaxing experience, sometimes even drifting off to sleep.

"Acupuncture is a controlling measure, not a cure," says Dr. Arnold, who recommends a minimum of three to four treatments to see any significant reduction in pain. He explains the cumulative effect. "With each subsequent treatment, the effects become longer lasting to the point that ideally a patient could go several weeks or months between treatments." If patients fail to experience significant relief, Dr. Arnold is not shy about suggesting they abandon the procedure, as did the 70-year-old physician with back pain. "But he was very open to the procedure and he was glad he tried it," says Dr. Arnold.

Along with standard acupuncture, Dr. Arnold sometimes connects the needles to an electrical device to send a painless electrical pulse to the targeted areas. Cupping is another acupuncture procedure he uses to augment patient response. In this procedure, Chinese fire cups of different sizes are warmed and placed on the skin to increase the blood flow.

"This is not a mental or spiritual response," he stresses. "There is no question that there is a physical component to acupuncture involving the body's release of endorphins."

Though acupuncture has been used by the Chinese continuously for two millennia, the western world has opened up to it as a legitimate medical practice only over the past two decades. In 1994, the FDA upgraded the "experimental" status of acupuncture needles, approving them for medical use. The Illinois Acupuncture Practice Act (1997) requires practicing acupuncturists to obtain physician referrals. In 1999, the World Heath Organization published guidelines for basic training and safety in acupuncture, considering acupuncture an appropriate tool to treat bodily infections, musculoskeletal pain, internal and neurological diseases, reproductive problems and mental disorders, among others.

Dr. Arnold definitely sees a future for medical acupuncture. As an associate program director of the SIU Quincy Family Practice Residency Program, he has created opportunities for students and residents to observe the procedure. "It's very worthwhile for physicians to know a little bit about this process and realize that it is a tool they can use - maybe not in their own offices - but they can refer patients to a resource in their community."

As this centuries-old practice continues to grow in popularity, time will tell how much medicine can fit on the tip of a needle.