Judith Ritchie slowly eases a fine steel needle into the back of her patient at a point marked out in felt-tip ink. As the needle is gently tapped, Judith explains: 'This point lies over the organ I want to strengthen, her liver. I want to improve the quality of her blood and her yin, which affects the energy balance.'
Acupuncture relies on a different language and different tools from Western medicine, but however strange it seems at first, this patient, Louise Shelver, is a convert. For years she has had debilitating migraines and pre-menstrual tension.
'The doctor told me that I could go on the Pill or have anti-depressants,' said Shelver, from Reading, Berkshire, who is treated fortnightly. 'I didn't want that, so I came here and it has totally altered my life.
'The migraines come maybe every three months now, but they are not so bad and I feel like a different person. My husband has noticed a huge change because I don't get so low. Some days I feel on top of the world.'
Controversy has raged for years over whether acupuncture has only a placebo effect that makes people feel psychologically and physically better but changes nothing physiologically.
However, this weekend a new study reveals for the first time that it provokes a specific response in the brain, shedding light on how it might affect the body's pain pathways. This helps to explain why both patients and health professionals trained in Western medicine are increasingly turning to this ancient form of Chinese healing.
Ritchie is a qualified children's nurse who has spent the last nine months learning this complementary therapy.
'I began to realise acupuncture's use goes far beyond pain relief. In the West you treat a disease. With acupuncture you're treating the whole person - the root of the problems, not just the symptoms.
'I can spend an hour or more with a patient. In the NHS you never get that time. Acupuncture can benefit so many adults and children.'
More than two million treatments will be given this year. Most practitioners work in private clinics, charging around £30 a time.
Increasingly, however, acupuncture is becoming mainstream, and it is being offered in the NHS because of patient demand. The profession is heading towards self-regulation on the recommendation of a House of Lords committee. This will protect patients more by preventing just anyone calling themselves acupuncturists.
The latest study is from researchers at Southampton University and University College London, who devised a clever trial to determine whether acupuncture worked by carrying out brain scans on patients receiving it.
The patients, all with painful osteoarthritis in their thumbs, were divided into three groups. The first group were touched by blunt needles which did not pierce the skin and had no therapeutic value.
The second had 'sham acupuncture' they believed was real. Their scans showed that one area of the brain associated with the production of natural opiates lit up.
In the third group, who received real acupuncture, the scans showed that, as well as the opiate centre, another region of the brain, the ipsilateral insular, was activated. This region appears to be involved in pain modulation.
Dr George Lewith, a research team member from Southampton, said: 'This shows us that real acupuncture produces a demonstrable physiological effect over and above a simple skin prick.
'We still don't fully understand how pain works, but we do know that after patients receive acupuncture there are changes in the way they manage their problems that last for up to two years.'
Acupuncturists believe there are 12 energy pathways in the body, each associated with a different organ, and the treatment re-establishes the energy balance in organs when it goes awry.
To treat an illness, practitioners take a full view of the patient, asking how their body functions, about their character and even their childhood. Treatment is varied accordingly. Fine needles are inserted into different points, either to stimulate or reduce the flow of energy along pathways.
It is said to work for an increasing number of conditions. Its worth for depression, migraines, chronic pain, rheumatism, eczema, multiple sclerosis and high blood pressure has been subjected to clinical studies. Yet a growing number of patients have it simply because they say that acupuncture makes them feel happier and more fulfilled.
The patients' profile is also changing. Gwyneth Paltrow and Cherie Blair are at the celebrity end of the scale, but such patients as retired firefighter John Thurston show how widespread acceptance of the therapy has become.
Thurston, at 79, is one of the oldest patients at the College of Integrated Chinese Medicine in Reading, Berkshire, where he has been treated fortnightly for several months.
A stroke last year left him with difficulty in walking, numbness in one hand and unable to lift one of his arms. 'It has made a remarkable difference,' said a delighted Thurston. 'I can dress myself now, whereas after the stroke I couldn't do a button up. I used to find it hard to lift my left leg up and I'm now walking more or less straight. I have got a lot more movement back.
'When the doctors signed me off at the hospital, they said cheerio and that was it. I did have a a bit of physiotherapy, but it's coming here that has really helped. I wish everyone could have it. It's done me a world of good.'
Pinpoint prowess
Researchers in Sweden have found that acupuncture is effective at relieving pelvic pain, a common complaint during pregnancy. Another clinical trial at Stanford University in the US showed it could help alleviate depression in pregnant women.
A study in the British Medical Journal showed that patients with osteoarthritis in the knee who received acupuncture a well as an anti-inflammatory painkiller suffered less pain and stiffness than those who received the drug plus sham acupuncture, where the needle did not penetrate the skin.
Children with hay fever and nasal allergies had fewer sneezing bouts and congestion after acupuncture compared with a placebo group, in research carried out in Hong Kong.
A study of rats showed that acupuncture lowered their blood pressure by as much as 50 per cent. Researchers in California are trying to establish if the technique will have the same effect on humans.
