The modalities of acupuncture and chiropractic are highly compatible.
Bringing them together can offer tremendous advantages to practitioners, but the recipe needs to be just right.
Some licensed acupuncturists (LAcs) and DCs are highly philosophical. Others are more practical, preferring evidence and research to direct their approach to treatment. And, of course, there are people who take positions all along the spectrum.
Forming a successful relationship between acupuncture and chiropractic takes thought and planning. Some DCs may choose to pursue their own LAc degree, while others prefer to partner with a LAc to share the workload. Together, the two disciplines have the potential to increase the tools a DC has available and gives patients more options to find the best treatment for their individual needs.
Complementary modalities
In some practices, acupuncture and chiropractic techniques are already going hand in hand to improve patient outcomes. “When a patient comes in and they’re in pain, we as chiropractors can address the function and structure to help them feel better, through increased range of motion or an adjustment and improved nutrition,” says Andria Marie D’Amato, DC. She adds, however, that some chiropractic patients may not achieve immediate or long-lasting effects without additional visits.
“When I incorporate acupuncture as well in the treatment for that acute condition, their outcomes improve in a shorter period of time,” D’Amato says. The most obvious measure also improves when acupuncture is added to the treatment plan: Patients feel better in less time. The two fields complement each so that patients feel better and get back to their normal routine sooner.
With many years of work as both a chiropractor and an acupuncturist under his belt, Ivo F. Waerlop, DC, says the two disciplines have great synergy. “Both are working on the nervous system,” he explains. That common area of focus can often act as a multiplying force when it comes to patient outcomes, and Waerlop says of the modalities that “the effects of one sometimes outlast the effects of the other.”
The combination of chiropractic and acupuncture also offers DCs a way to expand their scope of care and broaden their patient demographic. “You can treat mechanical issues and also treat a wider variety of systems throughout the body,” Waerlop says
Haley Honeysett, AP, Dipl Ac, finds that combining the disciplines of chiropractic care and acupuncture provides many patients with significantly better pain management. “It helps to relieve pain more quickly using both modalities,” she explains. “It helps with inflammation, reducing pain, and relaxing the muscles.” That pain management benefit comes whether patients are experiencing discomfort as a result of an injury or some other condition.
“For patients who are pregnant, acupuncture and chiropractic methods together can help with any pain they’re experiencing now, plus they can also ease their labor and delivery,” Honeysett says. From sinus pain to injuries, she sees acupuncture and chiropractic treatments working together to produce results sooner than if only one modality were used alone.
Benefits to the DC
Most DCs are practically oriented, and they look to get a patient into and out of the office as efficiently as possible, obtaining the optimal response in the least amount of time, says John A. Amaro, DC, LAc, Dipl Ac. Chiropractors who seek to pursue an LAc degree of their own and incorporate acupuncture into their treatments will likely tailor their approach in accord with the type of acupuncture they’ve been taught. “The Japanese approach to acupuncture uses a whole different way of inserting the needle and doing any type of application,” Amaro explains. Those whose experience leans toward the methods favored in northern China, by contrast, will use a different insertion style and, Amaro says, “It just depends on which you prefer to use and where your indoctrination came from.”
Chiropractors who opt to partner with an acupuncturist, rather than gaining an LAc themselves, will likely discover a variety of benefits from the relationship. Kristine Tohtz, DC, LAc, is president of the ACA’s Council of Chiropractic Acupuncture, and she says someone with experience in acupuncture can bring a broader scope of the discipline’s skills to the practice, filling in the gaps where a DC isn’t as comfortable or able to undertake a treatment or procedure alone. “For example, if the primary focus of the practice leans more toward musculoskeletal concerns, they could treat digestive issues and other things in conjunction with nutrition and acupuncture,” she says.
Partnering with an acupuncturist may be more expedient, but Tohtz suggests DCs may want to “take some classes and see if it’s something they want to pursue.” Whether they gain direct acupuncture expertise or not, she believes that bridging the two worlds results in improved patient care and the ability to broaden the range of available treatments.
An expanded treatment portfolio spawns a number of additional benefits. A practice that offers chiropractic along with acupuncture draws a larger number of patients. “You attract more patients to the office and you get a reputation for treating lots of things,” Waerlop says. That bi-modality patient base represents an additional revenue stream. “Many insurance companies are starting to cover acupuncture, but even if not, it’s a source of revenue for the practice,” Waerlop says. The partnering providers can also collaborate on cases, bringing a wider knowledge base to bear when a patient’s concerns fall outside the routine.
Greater than the sum of the parts
Waerlop works with medical professionals to help treat patients undergoing pre-and post-surgical rehabilitation.
He says it’s a good example of the power chiropractic care and acupuncture can have when used together: “We’ll see a patient with a post-surgical knee, hip, or ankle, and they’ll go back through for their recheck at two and four weeks, and the doctor can’t believe how little swelling they have and how much function they have.”
Acupuncture’s ability to diminish joint swelling enhances the effects of chiropractic treatments, helping patients see faster healing times. That translates to decreased downtime and less lost time from work.
Not only do patients feel better faster when they receive chiropractic and acupuncture care in combination, D’Amato says, but they also become champions of the modalities once they see the effects for themselves. “They share their excitement and enthusiasm with their primary care physicians and other practitioners,” she says. “They’re now our best advocates for an alter- native approach to low-back pain or neck pain, for example.”
Because patients are quick to spread the word about how acupuncture and chiropractic helped them, D’Amato says her practice is getting referrals from specialists and family physicians who may not even fully understand what a DC does. “The doctors say, ‘It’s working for this patient, the evidence is here in my office,’” she explains.
Patients want to feel better and they want their activities to improve. When that happens, they’re eager to tell others about it.
Musculoskeletal pain is perhaps the most common reason patients use acupuncture and chiropractic care in tandem. “From a structural standpoint, chiropractic can help to put them back in alignment,” Honeysett says. “Then you can follow up with acupuncture, which can control inflammation.” Together, the muscles around the spine stay relaxed, giving a better net effect than chiropractic treatment alone.
Some patients may even see better results from acupuncture than they would with a traditional medication. “Acupuncture releases endorphins, which are natural painkilling hormones,” Honeysett says.
The sweet spots
There are some areas where acupuncture has shown particular prowess.
Women’s health issues are an example. “I see a lot of different ailments, such as people with irregular menstruation or a lot of related pain and cramping,” Honeysett says. Fertility patients are often good candidates for acupuncture treatment. Those who have had a tough time conceiving often turn to drug therapies to increase their chances.
“For people put on different medications to stimulate their ovaries, acupuncture can help balance out the side effects of those medications,” Honeysett explains. Acupuncture is also sometimes used to complement other fertility methods, such as artificial insemination.
Acupuncture and chiropractic are neck and neck for musculoskeletal conditions, but patients experiencing problems in other body systems may find increased relief with acupuncture. “Sometimes we steer people into the pathway we think is potentially a better option for them, such as with internal medicine issues like irritable bowel syndrome,” Tohtz says. “Unless you have a hardcore nutrition practice, I think acupuncture does a better, more expedient job for those patients than solely straight chiropractic.” Insomnia is another example often cited as a strong indicator for acupuncture.
Organic issues also lend themselves to acupuncture treatment along with a number of other conditions. Waerlop says that men experiencing impotence may benefit from the use of acupuncture. It can also be used for a variety of other conditions he says. “We see people with sinusitis or a cold and we use acupuncture and herbs along with adjusting.” Not only does acupuncture often provide fast relief for patients in these cases, but Waerlop says that together you can get better results than manipulation alone.
Benefits for the LAc
Just as acupuncture can add to the chiropractic practice, the LAc who chooses to partner with a DC will find similar advantages. Honeysett says it’s helpful to offer her patients access to a lot of different methods. “Sometimes the chiropractor has had patients who, two years later, start coming into my office for acupuncture.”
Other people may also hear good things about acupuncture from other patients and decide to try it for themselves. “I think it’s nice to have one-stop shopping for people and have different things to offer patients,” Honeysett says.
For acupuncturists interested in expanding their own scope of knowledge, a relationship with a DC may be just the ticket. Tohtz has an acupuncturist in her office and when her own schedule is full, those patients who are good candidates for acupuncture treatment may still be able to be seen. It’s good for patients and is also a great opportunity for the acupuncturist.
“One reason she wanted to work with us is because she wanted to focus on musculoskeletal issues,” Tohtz says of the partnering acupuncturist. There are few better places to get exposure to these types of patient cases than a DC’s practice. It also gives the LAc the kind of experience that directly benefits the chiropractic side of the house. Patient numbers and revenue both increase because patients are drawn to integrative clinics that can deliver real results.
Making the relationship work
Forming a successful partnership calls for the DC and LAc to have a synergistic perspective. Simple logistics offer a good place to begin: “When you are blending a healing professional and multiple specialists in one space, you need to make sure everyone is compatible with their work schedule,” D’Amato explains. And that doesn’t mean just opening and closing hours. “It’s about the energy they bring into the space and that patients feel they’re in a healthy environment and not walking into chaos.”
Even the amount of time each provider spends with a patient needs to be considered, as short appointments for one type of treatment may need to be balanced against longer visits for others.
Today’s DCs are trained in a much different way than LAcs are, putting the disciplines far enough apart that a partnership may be difficult to sustain without a concentrated effort. “The two very seldom appreciate what the other one does,” Amaro says of DCs and LAcs.
Coming together under the umbrella of one practice needs to be carefully viewed as a business decision. Even if the LAc has a big practice, only a handful of patients may be seen due to the time required for each visit. “In a chiropractic practice, a DC can see more patients with high effectiveness,” Amaro says. He adds that coming together successfully requires an astute business sense.
Getting your office ready
A traditional chiropractic practice doesn’t need to invest in much special- ized equipment if a DC wants to add acupuncture services. Looking beyond training expenditures, a table more suited to acupuncture than a standard chiropractic table will likely be the largest expense. “Our tables aren’t meant for 15 or 30 minutes of lying down,” Tohtz says. Patients will be far more comfortable on a massage or physical therapy table instead. That’s especially true if the DC wants to do acupunc- ture with the patient prone. “Ensure it has a face cradle,” Tohtz adds.
Though the cost outlay for the necessary needles and trays will be low, related items must also be considered before acupuncture services can be added. “As chiropractors, we wouldn’t think of the need for a sharps container or a quiet room for relaxation,” D’Amato says. “The DC will need an environment in their office space that can support that.”
In addition to provisions for disposal, storage for the required supplies is also typically minimal, but it’s some- thing you’ll need to plan for if you want to expand your practice in this direction.
Julie Knudson is a freelance business writer with a background in the life sciences industry. She specializes in healthcare and technology, with a focus on where those disciplines intersect. Her work has also appeared in various commercial publications, and she develops thought-leadership content for businesses in those same industries. She can be contacted through julieknudson.com.
