The concept of turning a human into a pincushion makes some people squeamish, but the practice clearly appeals to many—after all, acupuncture has been around for more than 3,000 years and is currently practiced almost everywhere in the world. Rooted in key principles of traditional Chinese medicine, acupuncture is based on the idea of creating and sustaining balance within the body.

are yin, which is nourishing, receptive, and protective, and yang, which is hard, dominant, and energetic. The circulation between these forces is the qi. Traditionally, an acupuncturist inserts fine needles into acupoints to affect the qi and find balance.

A Growing Interest

The practice’s prevalence in the West has been on the rise in recent years: Between 2000 and 2012, the number of people receiving acupuncture in the U.S. increased by 50 percent, and the number of licensed acupuncturists doubled. Cui J, Wang S, Ren J. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 2017, Jan.;35(3):1759-9873. Despite this steady climb in popularity, the science behind acupuncture still isn’t well understood by the nonmedical public.

While the points touched by an acupuncturist might seem random to most of us, acupoints are packed full of neurovascular structures, which means that inserting a small sterile needle into a specific point in your leg actually can trigger a reaction in your eye.

A Difference in Perspectives

Because of its far-reaching impact and medical applications, the practice of acupuncture in the U.S. is tightly controlled. Licensed acupuncturists go through years of education and often pair their studies with other forms of traditional medicine and therapy.

Chris Chen, a licensed acupuncturist, has spent a total of 10 years studying acupuncture, qigong, and pulse diagnosis, and has logged 25 years of intensive yoga practice, all with world-renowned experts and practitioners. According to Chen, the difference between Western medicine and traditional medicines like acupuncture is that Western medicine is about treating a specific issue, whereas traditional medicine is "more like tuning an engine."

The practitioner observes a patient’s breath, posture, and how they interact with their environment in order to come up with a plan for helping the body run more efficiently. He says the process is similar to "the way that a naturalist learns to see the tree in relation to the surrounding forest."

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The language acupuncturists and traditional medical practitioners use to describe their work often follows this model of tying into greater forces and systems, but the actual mechanisms of the practice of acupuncture are pretty concrete.

For a long time, acupuncture was the weird thing mainstream medicine gave the side-eye, but deep study of why it works and where it works best has formed a link between the traditional and the contemporary.

Acupuncture and Infertility

In vitro fertilization is often the best choice for people who are struggling with infertility but want to carry a child. However, IVF is also very expensive, and each cycle comes with an average success rate that starts around 40 percent for patients under 35, then plummets steeply as the age of the patient climbs. . Fertility and sterility, 2014, May.;101(3):1556-5653. IVF patients can go through multiple cycles, costing thousands of dollars each, and still not carry a child to term. So it should come as no surprise there is ample curiosity about traditional and alternative medical practices that may increase the likelihood of IVF being successful.

In a review of randomized controlled trials published by Fertility and Sterility in 2012, researchers found that acupuncture at key points in the IVF process and live birth rates. Chen describes the process in less clinical terms, returning to a nature analogy: "Even if acupuncture cannot be used to plant the seeds," by which he means implanting fertilized eggs, "it can be used to create strong soil" by increasing blood flow and improving digestion, which increases the likelihood of a healthy pregnancy.

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Acupuncture and Pain Relief

Acupuncture has been proven to help in other areas, as well, such as by and potentially strengthening the immune system in patients suffering from chronic illness. In cases where significant medical intervention is the only way forward, acupuncture can help relieve some of the side effects. A 1997 National Institutes of Health panel found evidence of acupuncture working effectively to . "While the acupuncture is not being used to treat the cancer, it is being used to treat the side effects," Chen says, which keeps patients more comfortable and can reduce their need for pain medications.

, only 55.3 percent of NIH survey respondents using acupuncture reported they were addressing a specific health issue, compared with 84.7 percent in 2002. This suggests it's being integrated more into personal care regimes, something that could reduce the need for more serious intervention in the future. For those using acupuncture to help with conception, to manage pain, or even , its ability to enhance conventional medicine can make a huge difference in a patient’s well-being.

Risk and Reward

Acupuncture does come with —a foreign object is being inserted into the human body, after all. Poorly executed acupuncture can have severe consequences, including organ puncture, infection, and hematomas. However, cases of serious injury are extraordinarily rare.

Rather than focusing on very unlikely side effects, Chen warns people to be careful about blindly buying into what can sometimes amount to unrealistic hype. "It’s very easy," he says, "for acupuncturists and other healers to overstep their boundaries and scope of practice when they make claims about their treatment being more effective than another type of treatment." He recommends doing your research when finding a practitioner and going in with realistic expectations.

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Of course, some question whether acupuncture is a scientifically sound practice at all. Whether it works to reduce nausea, to give one example, isn’t really up for debate, as studies show patients report a reduction in pain. But what is up for debate is .

Does acupuncture work, , or does a belief in acupuncture work? In the end, it’s hard to prove whether acupuncture outcomes are a result of the needles or a result of faith in the power of the needles. Some say patients who choose to take part in acupuncture studies are a self-selecting crowd who are more likely to believe in its benefits. Meaning reductions in pain, inflammation, and stress could be a result of this faith rather than actual function. After all, how many people would opt for needles instead of a pill if they didn’t truly think it had the possibility of working?

However, the success of acupuncture in treating does advance the idea that, unless belief in acupuncture is genetic (and let’s be real—it isn’t) or passed along while it utero (similarly absurd), acupuncture isn’t just a placebo.

The shift in the way we perceive acupuncture in the Western world—from a strange curiosity to a leading therapy—is a testament to its efficacy when used appropriately. It’s amazing, Chen says, how in "placing a bunch of sterile stainless steel pins on your body, the way you feel can change. When your feelings change, your fundamental sense of who you are can also change." While his language might appeal to the hippie crowd more than the medical establishment, the point holds: There’s evidence acupuncture can work.

is a writer interested in culture, complex systems, and making sense of the world. Her work has been published by Wired, BBC Travel, and more. Follow her on Twitter .

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