The Puget Sound Consumers’ Checkbook undercover shoppers called a sample of area acupuncturists for their fees for private treatment of arthritic knee pain and were quoted prices ranging from $35 to $275 for an initial private session.

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Consumer’s Checkbook

Back pain. Headaches. Allergies. Arthritis. Anxiety. Morning sickness. Acupuncture practitioners claim their centuries-old approach can successfully treat dozens of medical problems — with few side effects or risk of complications.

Many health-care providers see acupuncture as a possible tool to battle the U.S. opioid epidemic, which largely was brought about by legal prescriptions of painkillers. Recently, the American College of Physicians released a recommendation to use acupuncture as one of the first treatments for low back pain, and The Joint Commission’s “Pain Management Standards” now includes acupuncture as a non-pharmacological strategy for managing pain.

Western medicine proposes several theories on how acupuncture works. One premise: It releases the body’s own painkillers, or endorphins. This theory is supported by research that indicates needle insertion prompts the flow of adenosine, a chemical that reduces inflammation. Another hypothesis, the Gate Control Theory of Pain, argues that the body shuts down pain receptors in response to acupuncture’s needling.

Although there’s much evidence that acupuncture often alleviates pain and successfully treats a range of symptoms and diseases, there’s no clear answer as to whether acupuncture is a microneedle magic bullet. Clinical studies aimed at measuring its effectiveness are limited. Many skeptics argue that any benefits of getting stuck probably derive from a placebo effect.

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That’s because it’s difficult to test the efficacy of acupuncture. In double-blind studies, the gold standard for testing effectiveness of drugs or treatments, neither participants nor experimenters know which group is getting which treatment. Typically, one group receives the conventional drug or treatment while another group receives a placebo. The problem is, there are no good placebo substitutes for acupuncture — even when testers use sham needles, patients typically know they aren’t really being poked.

So maybe acupuncture’s usually positive results are from a placebo effect. Or maybe all those needles somehow stimulate the body to heal itself or suppress pain. Or maybe getting yourself stuck works due to an as-yet-discovered process. If you’re the patient, since it works and, when properly performed, involves very few risks and virtually no negative side effects, maybe you shouldn’t overthink it.

It’s clear that patients who try acupuncture love it. A recent study by American Specialty Health Inc. (ASH) surveyed 89,000 patients who received treatment for chronic pain. It found a vast majority (87 percent) of patients rated their acupuncturists favorably (9 or 10 on a 0-to-10 scale), somewhat more favorably than patients rated conventional health-care providers (76 to 80 percent). Nearly all (99 percent) of the surveyed acupuncture patients rated their providers good or excellent, and almost none reported minor or serious adverse effects.

If you’re looking for an acupuncturist, talk with your friends and physician for recommendations. The nonprofit Puget Sound Consumers’ Checkbook and Checkbook.org regularly surveys its members and Consumer Reports’ subscribers on their experiences with health-care providers, including acupuncturists. For the next month, Checkbook is offering free access to its ratings of acupuncturists to Seattle Times readers via this link: checkbook.org/SeattleTimes/Acupuncture

If the acupuncturist is a physician, look for certification by the American Board of Medical Acupuncture (ABMA) (dabma.org), which means he or she is a medical-school graduate, completed at least 300 hours of acupuncture education in an ABMA-approved education program, passed an exam, and completed at least two years of medical-acupuncture clinical experience with a case history of not less than 500 medical-acupuncture treatments. Alternatively, consider a physician who is a member of the American Academy of Medical Acupuncture (medicalacupuncture.org), which means he or she completed at least 220 hours of formal acupuncture training (there’s no exam).

If the acupuncturist is not a physician, check for certification by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) (nccaom.org), which means he or she earned a three-year master’s degree or a combination of an apprenticeship with at least two academic years of formal education. The apprenticeship route requires at least 500 treatments within the past five years or 5,000 for a career. There’s also an exam. NCCAOM-certified acupuncturists can add “Dipl. Ac.” after their names.

Although some competent acupuncturists don’t bother seeking certification, there are plenty of certified ones, so take advantage of this quality check.

As there are many qualified acupuncturists, and since other consumers tend to be especially satisfied with them, pay attention to prices. Checkbook’s undercover shoppers called a sample of area acupuncturists for their fees for private treatment of arthritic knee pain and were quoted prices ranging from $35 to $275 for an initial private session. There was a lot of variation in how long the acupuncturists said this initial visit would last, though most estimated between 45 minutes and 90 minutes.

We also asked about prices for community acupuncture, which is a growing trend. (Acupuncturists treat multiple patients in the same room.) Prices quoted to our undercover shoppers for community acupuncture were far lower than those for private sessions, ranging from $15 to $55 per session.