One of the most beautiful and most frustrating things about the natural medicine world is that no two practitioners are alike. It’s wonderful to find a practitioner with whom you develop a deep bond; in fact, it’s essential to the healing process. They understand you as an individual and tailor their care to meet your needs. Likewise, you are drawn to their unique practice style and appreciate the particular modalities they use. It can be devastating if that practitioner decides to move or retire, and it can be frustrating to find another whose style is similar.

In order to find someone with a comparable style, it’s important to know a few specifics about the types of treatment you received. In this post, I’ll cover a the differences in the most common types of acupuncture practiced in the United States.

That’s right, not all acupuncture is alike. There are many cultures (China, Japan, Korea, Thailand, India, etc.) with healing traditions that include needling certain points on the body. The most common form of acupuncture taught in the United States is a version of Chinese acupuncture called Traditional Chinese Medicine, or TCM. Contrary to its name, it is not the most traditional form of Chinese medicine, but it is the most well known. When you visit an acupuncturist in the United States, they have most likely been trained in TCM.

The spleen meridian in Chinese medicine.

The spleen meridian in Chinese medicine.

I received training in TCM and Five Element acupuncture, which is another part of the Chinese acupuncture system, so I’ll mainly discuss the differences between these two systems. I have a very surface-level understanding of Japanese and Korean acupuncture, so I won’t be going into as much detail with these medicines. From what I’ve learned and experienced of Japanese acupuncture, it involves a very light needling style and is perhaps the gentlest of the systems that I’ve mentioned. Practitioners believe that the point needs only a little stimulation for the body to respond (the same can usually be said for Five Element acupuncture). Korean acupuncture is unique in that all of the points are located only on the hand, rather than spanning across the entire body. You can read more about Japanese acupuncture and Korean acupuncture here and here.

I mentioned earlier that Traditional Chinese Medicine is the most taught form of acupuncture in the states, but it is not, in fact, traditional. Five Element acupuncture, in its current form, is not traditional either. True traditional Chinese medicine existed before Mao Zedong’s cultural revolution that took place in the 1970s. Mao effectively split Chinese medicine into two systems during this time.

Pre-1970s Chinese medicine (the stuff that had been around for thousands of years) is a beautifully intertwined, deep, and complex healing system. It addressed physical, mental, emotional, and spiritual issues, and many acupuncture points have these layers purposes. There were two types of diagnoses given: constitutional and acute/chronic conditions. Constitutional diagnosis and treatment addresses who you are at a core level and is often more mentally/emotionally/spiritually focused. Acute or chronic diagnoses specify which organs or meridians are out of balance in terms of an illness, like a cold or back pain. These diagnoses are most often representative of the physical plane.

All ailments have physical, mental, emotional, and spiritual components. Take something like back pain, for instance. It seems to be a mainly physical complaint, but at the very least the pain causes stress, and stress is emotional. Without addressing the emotional aspect of illness (as well as mental and spiritual), acute back pain can become a chronic problem that never heals or continues to recur. Fibromyalgia, a condition in which there is widespread pain throughout the body, typically comes on after a major emotionally traumatic event. If emotions are not processed properly, they stay in the body and manifest on a physical level. Those who developed Chinese medicine thousands of years ago understood these profound connections and developed a system that addressed all levels of health. The levels are interconnected and related; we cannot parse them out to address only the physical or only the emotional. Unfortunately, Traditional Chinese Medicine attempts just that.

TCM is a physically based system. It’s very useful for those acute and chronic conditions that don’t have much to do with who you are a person. TCM is effectively a symptomatic treatment. Back pain? Great! Menstrual cramps? Great! TCM will oftentimes abate or resolve these symptoms. However, if there is a constitutional imbalance, which there almost always is, TCM will not address it. Symptoms will resolve for a bit, then return if constitution is not treated.

Five Elements of Chinese Medicine. All elements are connected and interrelated.

Five Elements of Chinese Medicine. All elements are connected and interrelated.

Five element acupuncture treats people on a constitutional level. By addressing the root, the whole being can begin to heal itself. After treatment you feel more like yourself, you are throw off less by the stresses of life, and illness comes and goes more easily. Being balanced on a constitutional level decreases your likelihood of developing acute or chronically recurring conditions, and it can also resolve them for a longer duration. Five element acupuncture is a more subtle and deeper medicine than TCM, as it is a mentally/emotionally/spiritually based medicine. It’s downfall is in treating the physical conditions that pop up. If you are acutely ill or in pain, a constitutional treatment can help, but it sure would be nice to add in some points or treatment protocols that address the physical level as well.

  • Sidenote: TCM has a wide range of needling techniques, and is generally the most aggressive. Because it is a physically based system, practitioners typically want you to feel the point. It can be a more intense and painful treatment style, depending on your practitioner. Five element acupuncture, on the other hand, is usually quite gentle.


In graduate school, I learned about these two systems of acupuncture separately and I found myself asking why they weren’t integrated. Later, I discovered that until about 40 years ago, they were one complete system of medicine. I attended a TCM based school, but met a few practitioners who used both systems concurrently. I saw markedly better and lasting results in their patients and I added Five Element training to my schooling. I use a combination of TCM and Five Element techniques in my practice because it just makes sense to me. My goal is to address illness on all levels and create lasting health for my patients.

As you can see, knowing the type of acupuncture you receive is important. Unfortunately, there is a significant rift between TCM and Five Element acupuncturists, each dead set that their system is the best. There are a few of us who integrate techniques, but not many. I sincerely hope more acupuncturists embrace both systems, as together they form true Chinese medicine and provide the best care for patients.

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