Eight-year-old Beatrice Roussell is no fan of needles, but she didn't flinch as Dr. Mark McDonald inserted thin ones in her left ankle during a recent acupuncture treatment.
?At first, I was sort of scared. ? I felt like they'd be stinging. But it just felt like a very small pinch,? the Louisville third-grader said, recalling her first experience with the ancient Asian practice to treat her elbow pain. ?I still shake a little when I do it, but you don't feel it much at all.?
A growing number of American children are getting acupuncture, which is increasingly offered by doctors as a sideline to their traditional practices, surveys and studies say.
The National Health Interview Survey, which in 2007 asked about acupuncture use, reported that about 150,000 children had received the treatment in the previous year for conditions such as pain, nausea, migraine and anxiety.
Experts estimate that about a third of pediatric pain-management services affiliated with major universities offer it ? part of a larger trend of providing ?alternative? or ?complementary? medicine alongside traditional services.
McDonald, who spends most of his time as a pediatric critical-care physician for the University of Louisville, is one of at least two area doctors who offer acupuncture to young patients. Another is Dr. Edin Jusufbegovic, who is part of an anesthesiology group that works with Kosair Children's Hospital.
McDonald, who began offering acupuncture in September, had eight patient visits the first two months, 40 the second two months, and now sees nine patients during the one day a week he offers acupuncture.
?I'm as ?Western medicine' as someone can be. ? But I can break away from that and realize there are some things you can't treat with Western medicine,? said McDonald, who administers Japanese acupuncture treatments in his Eastern Louisville office. ?There's a place for acupuncture. I certainly don't think it replaces antibiotics, but it's helpful for some conditions in children.?
Dr. Mary Fallat, Kosair's chief of surgery, agrees.
?The ability to offer alternative therapies is a very useful way to help patients who don't respond to narcotics or the usual pain remedies,? she said.
But critics say the science isn't there to support it.
?Why are you using an unproven method on children?? asked Dr. Robert Baratz of Massachusetts. ?Why are you torturing children with needles when most of them are needle-phobic??
McDonald acknowledged that acupuncture hasn't been studied as widely in the United States as Western therapies, but he said ?there's literature out there ? that shows good results.?
He said he became interested in the practice after it helped his daughter with persistent and abdominal migraines ?? which cause pain, nausea and vomiting ? when traditional medical treatments did not.
?I don't know how to argue with something that's been around 3,000 years,? he said. ?I think (criticizing it as unproven) is sort of a short-sighted view of the world.?
Acupuncture, a family of techniques in traditional Chinese medicine, aims to restore and maintain health by stimulating specific points on the body.
The most well-known type involves penetrating the skin with needles and manipulating them by hand or with electric stimulation. One visit may provide relief, doctors said, but sometimes it takes more than five.
Experts say consumers should look for trained professionals.
In addition to their medical training, McDonald and Jusufbegovic received training in acupuncture ? McDonald through an eight-month Harvard University program and Jusufbegovic through the Academy of Pain Research at the University of California-Irvine. The Kentucky Board of Medical Licensure and the American Board of Medical Acupuncture offer certifications, but medical doctors in Kentucky can practice without them.
Non-physician practitioners often have more training in acupuncture; those who become a ?Diplomate of Acupuncture,? for example, complete three to four academic years at the master's degree level in an accredited program.
Dr. Stacey Roussell, Beatrice's mother and a pediatrician, said acupuncture helped her daughter when traditional medicine did not.
Beatrice, a gymnast, started complaining about her right elbow last spring. She had all sorts of traditional care: X-rays, an MRI, orthopedic visits, a visit to an arm and hand specialist, a cast for three weeks and physical therapy for six. But it continued to hurt, and no one knew why.
Roussell went to a non-physician acupuncturist, but Beatrice wouldn't let her insert the needles. She didn't let McDonald either during her first visit in December, but eventually relented after her mother said she should try what the doctor suggested. Roussell's insurance covers the treatment ?? although many plans don't. McDonald charges $75 for the first visit and $50 for subsequent visits.
Beatrice barely notices the needles now. During a recent treatment, she played an iPhone game as she lay with needles in her body, and later said she felt only a slight tickle when McDonald ran a low-level electrical current through the needles.
Her 11-year-old brother, Benjamin, was being treated in a nearby room for anxiety he's felt since his parents' recent divorce.
?I think it's fun,? he said, adding that he feels very relaxed after treatments.
As for Beatrice, she says her elbow feels much better. She's even started gymnastics again after a 3?-month hiatus.
?So far,? Roussell said, ?this has been the best treatment.?
Relatively few acupuncture-related complications have been reported to the U.S. Food and Drug Administration ?generally infections or organ punctures that are the result of inadequately sterilized needles or improper treatment delivery.
A 2008 review of studies published in the Journal of Pediatric Hematology/Oncology ?found evidence of some efficacy and low risk associated with acupuncture in pediatrics,? and it highlighted one study saying children getting acupuncture face the same low risk of a serious problem as those taking penicillin.
But the review also said the use of needles can be questionable in some cases, such as on infants when the soft spot on the skull isn't yet closed.
The American Academy of Pediatrics acknowledges more families are using acupuncture and other alternative therapies, and an article in its journal, Pediatrics, points to studies suggesting potential benefits. But the organization also urges doctors to seek information on such practices when families express interest, evaluate them on their scientific merits and pass the information along to parents.
Other research focuses on needle fears.
A 2003 study in the journal Medical Acupuncture, for example, showed that fear eases over time, with the majority of children studied reporting they were no longer afraid after six treatments.
Jusufbegovic, who offers acupuncture to inpatients and outpatients for post-operative nausea and vomiting, as well as for general pain, said it's not an exact science. But when traditional methods fail and patients are receptive, he offers acupuncture. And for those patients, he said, ?it worked.?
Sharing that view is Maura Fitzgerald, a clinical nurse specialist at Children's Hospitals and Clinics of Minnesota, which has one of the nation's oldest and largest integrative medicine clinics.
?Particularly for pain management, most patients will report some relief,? she said.
Roussell said she's recently referred a couple of her pain patients to McDonald for acupuncture.
?I'm certainly for medication if it's gonna help. But I'd really like to find a way to treat (pain) without medication if possible,? she said. ?I think Americans in general say are too often saying ?Give me a pill. I want a quick fix.' ?
Reporter Laura Ungar can be reached at (502) 582-7190
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