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If you’re needle-phobic, the thought of getting acupuncture—where thin needles are inserted into the skin—may seem unnerving. But, the traditional Chinese medicine practice has been around for centuries, and now it’s often used along with western medicine to treat a variety of conditions.

Plenty of celebrities have even shared their love for acupuncture. Meghan Markle and Ashley Graham used acupuncture during their pregnancies to keep their bodies healthy. And, Gwyneth Paltrow posted a video of her own acupuncture session on her Goop YouTube channel.

Even though acupuncture has become mainstream, and research backs its benefits, there are still a few misconceptions about the treatment, says George Stretch, interim assistant dean of acupuncture and oriental medicine at National University of Health Sciences.

“How can a needle being inserted help me? How can that be medicine?” he says he’s often asked. “The answer is, this is very intricate. It’s a very long history, and the studies are out there now.”

What is acupuncture?

Acupuncture involves inserting thin-gauge needles through the skin at specific points on the body to control pain or other symptoms.

“When you look at the acupuncture practice, three things are most important: needling, specific points and stimulation,” explains Jinhua Xie, an acupuncturist and professor of oriental medicine at Midwest College of Oriental Medicine.

Inserting needles at specific acupuncture points, not random locations, stimulates the body, regulating its physiological activities and helping it deal with symptoms of a health issue, he says.

In traditional Chinese medicine, acupuncture focuses on the “meridian system,” an invisible energy channel in the body. The purpose is to regulate and balance the body’s energy by focusing on yin and yang, qi and blood, cold and hot, and excess and deficiency. Xie says needle insertion and the stimulation it creates is essential for good therapeutic effect.

Over the past few decades, researchers have been working to understand how acupuncture works from a biomedical standpoint, Xie says.

“The local effect of acupuncture stimulation may produce an effect of improved blood circulation and anti-inflammatory effect, which may improve arthritis and muscle pain,” he says. “And, acupuncture stimulation may improve the neurotransmitter balance in our brain which may be related to the effect of acupuncture on pain and mood disorders.  However, there is so much we do not know.”

Is acupuncture painful?

Even though the procedure involves needles inserted into your skin, acupuncture is essentially painless.

“This is the most common misunderstanding about acupuncture,” Xie says.

He tells patients to think of a 10-point scale. If the pain linked to having blood drawn is a 10, acupuncture needling is 0.5 to 1.

Where are needles placed in acupuncture?

“Acupuncture is an energetic medicine,” Stretch says. “We move energy, and we treat different types of disorders and pathology through acupuncture and in using the body’s own innate way of healing itself with it.”

The placement of needles is based on the conditions in the body being treated. In traditional Chinese medicine, the tongue and pulse are used to determine which organs of the body are involved, he says.

“There are meridians throughout the body that are lined up with those organs, and we make a determination as far as what points we’re going to needle in and what kind of protocol we’re going to use in regards to that,” he explains. “So, if I want an effect, I’m going to hit this point, and I know exactly what that point’s going to do.”

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What conditions can acupuncture treat?

“Acupuncture treatment can help maintain health, improve the symptoms of health problems, promote recovery from a disease, and reduce the side effects of some conventional medical treatments,” Xie says.

Pain is the most common reason people seek acupuncture. Research published in the Journal of Pain found that acupuncture is an effective treatment for chronic pain, including musculoskeletal pain, headaches and osteoarthritis pain, and the treatment effects last over time.

Acupuncture treatment may also activate certain regions of the brain and control certain neurotransmitters, and could help with nerve-related disorders, like cardiovascular diseases, epilepsy, anxiety, circadian rhythm disorders, polycystic ovary syndrome and others.

Mood disorders, gastrointestinal conditions, women’s health, fertility and post-traumatic stress disorder can also be treated with acupuncture. It can also help you quit smoking and sleep better.

Does insurance cover acupuncture?

Acupuncture is also often used as a complement to prescription medication and other medical treatments and in integrative and functional medicine, Stretch says. Many insurance companies, and even Medicare, cover acupuncture treatment.

How often do you need acupuncture?

How acupuncture treatments you need and often you seek treatment depends on your condition. For most conditions, Xie recommends trying three to six treatments.

Sometimes, you can stop treatment once symptoms are gone, but for chronic conditions, he suggests maintaining treatment about once a month for several years.

Acupuncture vs. dry needling

Dry needling is becoming more popular with athletes to aid in performance and recovery. But, it isn’t necessarily the same as acupuncture.

Xie considers dry needling a “newer style” of acupuncture since it uses needles and stimulates points on the body, but not in the traditional Chinese medicine sense.

Dry needling doesn’t follow the 14-meridian system when determining where to place the needles. Instead, he says needles may be placed in a more localized spot on the body, such as where the injury or pain is occurring.

Are there any risks or side effects with acupuncture?

The needles used in acupuncture are sterile and single-use, and licensed acupuncturists are also certified in Clean Needle Technique, so there’s no risk of cross-contamination, Stretch says.

There are few side effects with acupuncture, Xie says. Some patients could see some bruising or bleeding, but instances are rare.

Patients are evaluated on a case-by-case basis before undergoing acupuncture. People with bleeding disorders, surgical conditions and malignant tumors, or who take blood-thinning medication, generally shouldn’t try acupuncture. But, Xie says acupuncture could be used for cancer patients to complement other treatments, to relive pain or side effects of chemotherapy.