MEDICAL ACUPUNCTURE

Volume 35, Number 6, 2023

EDITORIAL
# Mary Ann Liebert, Inc.
DOI: 10.1089/acu.2023.29242.editorial

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Electroacupuncture:
Negative-Charged Subatomic Particles Pushing
the Qi Through the Meridians
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Richard C. Niemtzow, MD, PhD, MPH

f you understand that I = E/R when I = current, E = voltage and R = resistance, you are on your way to
I understanding that electroacupuncture (EA) is a force multiplier in an acupuncture practice. In 2007,
I interviewed William Craig, MD, the inventor of the Craig–PENS technique, which was published in
Medical Acupuncture. At the time, I was a struggling physician–medical acupuncturist just trying to make
things work—if I needled the correct points and the patient got better that was a great day for me. I was
fascinated by the ‘‘Craig—PENS’’ technique and Bill’s videos. This was a no-nonsense approach to pain
relief, substance ‘‘P,’’ and frequency-dependent ‘‘neuro transmitters’’ stimulated by an electrostimulator,
with electrical leads clipping acupuncture needles ‘‘positive to negative.’’ I could relate to this sort of thing
better than the invisible Qi. I attended almost every course that Bill taught from the mid-90s to the start of
the new millennium. Perhaps the best part was learning from Bill. Unfortunately, Bill passed away many
years ago.1
Our current special issue dealing with EA features our guest editors: Richard Hobbs, MD, and Gerhard
Litscher, MSc, PhD, MDsc. There is a lot to learn. You will be captivated by the Electroacupuncture
Roundtable (pp. 281–289) and enlightened about advancements in the field and the theoretical evolution
that is occurring. EA remains a stalwart for eliminating acute and chronic pain. To focus on the latest
attributes of this fast-evolving field, the members of the roundtable were challenged to address questions
about 4 topics:
1. What is really happening when you make acupuncture points or channels a part of an electrical
circuit?
2. What kinds of electrical stimulation do existing devices provide?
3. Why choose EA over manual stimulation?
4. What parameters should be reported in EA research and why?
This fresh roundtable is indispensable to our dynamic understanding how EA is an attribute in your
clinical practice. Leveraging this knowledge may offer you proactive clinical tactics to help remediate the
challenges of everyday pain.
What do you do if you wish to start using EA in your clinic setting and have no idea where to start?
Voltage, current, resistance, impedance, and frequency seem complicated, and the placement of needles
and cable connections can be somewhat overwhelming. As you read the contents of this special issue, you
may even feel the trepidation of learning not only the theory, but the many EA techniques; it can be
voluminous. Where should you start? Perhaps you have a colleague and friend who will offer to be your
mentor. I glanced on the internet and found EA courses and books geared to clinical practice. If you are

The opinions and assertions contained herein are the private views of the author and are not to be construed as
official or as reflecting the views of the United States Air Force Medical Corps, the Air Force at large, or the
Department of Defense. The author indicates that he does not have any conflicts of interest.

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like me, you learn better with hands-on and prefer a course rather than turning pages in a book. Once you
overcome the inertia of starting, you will be fascinated with the results. Quickly, you will feel very
competent to exercise your EA skills. Medical Acupuncture will help you gain forward momentum, and
the various articles will add to your knowledge rapidly.
Finally, here are the key points that I have learned by practicing EA over many years. I never turn up
the current to make the patient’s muscles twitch. I like to avoid the buildup of lactic acid. My favorite
frequencies are between 5 and 12 Hz to stimulate long-acting neurotransmitters. If a 30-minute treatment
is not sufficient, I will try 45 minutes to 1 hour. If the pain area is located near a bony structure, my
montage will include putting the needle as close to the periosteum as possible. This appears to ‘‘amplify’’
the effect of the EA to reduce the pain. Most purchases of an electrostimulator must include a ‘‘sweep’’
function and my lowest frequency will be 5 Hz and my highest frequency will be 20 Hz. The best duration
of the sweep is 45 minutes. I do not necessarily have to be on an acupuncture point to make the montage
successful for reducing pain. If I have a patient with stubborn spinal-cord pain, I angle the needles on one
side of the spine pointing toward the lateral processes and place the connections in a ‘‘daisy chain’’
fashion at 5 Hz and the opposite side of the spinal cord at 12 Hz. Finally, I keep in mind the blunt words
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that Bill Craig would interrupt me with whenever I asked a question regarding ‘‘How to treat.?’’
He would jump in and say: ‘‘Of course, you can!’’

REFERENCE

1. Niemtzow RC. Interview with William Craig, inventor of Craig–PENS. Med Acupunct 2007;19(4):165–168; doi:
10.1089/acu.2007.0562

—Richard C. Niemtzow, MD, PhD, MPH

Editor-in-Chief