Distribution of licensed acupuncturists and educational institutions in the United States at the start of 2023,during the late stage of the COVID-19 pandemic

This study was conducted to identify the number and density of active licensed acupuncturists(LAcs),as well as the number of accredited schools in acupuncture and Oriental medicine(AOM),as of January 1,2023,in the United States(U.S.).The number of active LAcs as of January 1,2023 was 34,524,potentially33,364 after removing license duplication in multiple states,among which the largest three states were California(with 7317 LAcs[21.19%of the total]),New York(5024[14.55%])and Florida(2644[7.66%]).The total number of LAcs decreased by 8.87%from 2018,and fell short of our projected number of LAcs in 2023 by 9037,or 20.75%.The overall LAc density in the U.S.Dmeasured as the number of LAcs per 100,000 populationDwas 10.36,less than in 2018.There were 56 active,accredited AOM schools which offered a total of 147 programs(121 at the level necessary for licensing[entry-level],12 for an advanced practicing degree[advanced-level],and 14 for certifications).Broken down further,offerings included 50 master's degrees in acupuncture,40 master's degrees in Oriental medicine,31 entry-level doctorate degrees(10 in acupuncture and 21 in acupuncture plus Chinese herbal medicine),and 12advanced-level doctorate degrees in AOM.The certification programs included one in East-Asian Medical Bodywork and 13 in CHM.Among these schools in 2023,institutions in the West and East Coast states comprised 67.86%(decreased from 77.42%in 2018)of the national total.California,Florida and Illinois represented 39.29%.There were 48 jurisdictions with acupuncture practice laws in place.The data suggests that the acupuncture profession in the U.S.has been significantly impacted during the coronavirus disease 2019 pandemic.

Evidence and Expert Opinions:Drying Needling versus Acupuncture(Ⅰ)--The American Alliance for Professional Acupuncture Safety(AAPAS)White Paper 2016

In the last twenty years, in the United States and other Western countries, dry needling （DN） became a hot and debatable topic, not only in academic but also in legal fields. This White Paper is to provide the authoritative information of DN versus acupuncture to academic scholars, healthcare professional administrators, lawmakers, and the general public through providing the authoritative evidence and experts＇ opinions regarding critical issues of DN versus acupuncture, and then reach consensus. DN is the use of dry needles alone, either solid filiform acupuncture needles or hollow-core hypodermic needles, to insert into the body for the treatment of muscle pain and related myofascial pain syndrome. DN is sometimes also known as intramuscular stimulation, trigger points （TrP） acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. InWestern countries, DN is a form of simplified acupuncture using biomedical language in treating myofascial pain, a contemporary development of a portion of Ashi point acupuncture from Chinese acupuncture. It seeks to redefine acupuncture by reframing its theoretical principles in a Western manner. DN-like needling with filiform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and with hypodermic needles has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since late of 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has a broader scope of indications, not limited to treating the myofascial pain.

Evidence and Expert Opinions:Drying Needling versus Acupuncture(Ⅱ)--The American Alliance for Professional Acupuncture Safety(AAPAS)White Paper 2016

In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding（1） acupuncture as dry needling and（2） acupuncture points as trigger points（dry needling points）. Dry needling simply using English biomedical terms（especially using ＂fascia＂ hypothesis） in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain（dry needling promoters redefined it as ＂myofascial pain＂）. Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy（a surgical procedure） instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture＇s local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients＇ safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.

Evidence and Expert Opinions：Dry Needling versus Acupuncture(Ⅲ)--The American Alliance for Professional Acupuncture Safety(AAPAS) White Paper 2016

Summary of Dry Needling Issues Academic Perspective In regards to terminology,dry needling（DN） is a synonym to acupuncture,just a different English translation from the original Chinese term ＂针刺＂（Zhen Ci）.In China,

Distribution of licensed acupuncturists and educational institutions in the United States in early 2015

In recent decades, acupuncture has been used more widely and extensively in the United States （U.S.）. However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists, This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data, Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U,S, was 34,481. Of this, more than 50% were licensed in three states alone： California （32.39%）, New York （11,89%） and Florida （7.06%）. The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 （n = 27,965） and 2004 （n = 22,671）, respectively; increasing about 1,266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern （9.72%）, northern （8.33%）, and the middle/central states （1.39%）. Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S,

Acupuncture price in forty-one metropolitan regions in the United States: An out-of-pocket cost analysis based on Ok Copay.com

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States(U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, Ok Copay.com. We examined descriptive statistics(range, median and 20% intervals) for the cost of acupuncture "first-time visits"and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15–400;the highest median was $150 in Charleston, South Carolina,while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were:Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits,the cost range was $15–300;the highest median was $108 in Charleston, South Carolina, and the lowest$40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.

Effectiveness of two different acupuncture strategies in patients with vulvodynia Study protocol for a pilot pragmatic controlled trial

Background： Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evalu- ate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with inter- course. The study also examines how long the effect of acupuncture lasts in women with vulvodynia. Methods/design： The study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups la and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group （Group 2）. Patients in Group la will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group lb will receive acupuncture focused on traditional （distal） meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tender- ness and trigger points （Ashi points） are also recorded. All measurements will be recorded at baseline （before the treatment）, at the end of each week during treatment and at the end of the 6weeks. Follow-up will be done 6 weeks following the last treatment. Discussion： Results of this trial will provide preliminary data on whether acupuncture provides better outcomes than nonacupuncture treatments, i.e., standard care, and whether acupuncture focused on the points in pudendal nerve distribution, near the pain area, has better results than traditional acupunc- ture focused on distal meridian points for vulvodynia.