For Medical Professionals
A Partner in Your Patient’s Care
Ethereal Flow offers medication-informed, outcomes-tracked acupuncture for patients with chronic pain. Many of the patients I see have already been through what conventional care reasonably offers and are still living with pain. Acupuncture is not a replacement for what you do. It is a next step for patients whose progress has plateaued, with measured results you can follow.
Laura Clark, PharmD, L.Ac., Dipl.OM
Licensed Pharmacist (Colorado and Florida) | Colorado Licensed Acupuncturist ACU.0002363 | NCBAHM Diplomate of Oriental Medicine #154385
Why Refer Here
Herb-drug interaction screening
We review each patient’s medications, supplements, and herbs at intake and before any herbal formula is started or refilled. If we see a possible interaction, we’ll reach out to you. Medication decisions always stay with you.
Progress you can see
We track progress at the first visit and every 6 visits with the same measures you use: a numeric pain rating, range of motion, and validated functional tools such as the Oswestry Disability Index, Neck Disability Index, QuickDASH, and LEFS. Progress reports are available whenever you’d like one.
Screening for red flags
We screen every patient for red flag symptoms at each visit. If something needs your attention, we’ll send your patient back to you right away, or to emergency care when needed.
A strong safety record
In a study of 229,230 patients, the most common side effect was minor bleeding or bruising at a needle site (6.1%). Serious complications were very rare: two pneumothoraces in the entire study [1]. We use only sterile, single-use needles.
What the Evidence Supports
Every statement below is tied to a clinical guideline, systematic review, or published trial. References are listed at the bottom of this page.
Chronic Low Back Pain
The American College of Physicians recommends acupuncture as a first-line nonpharmacologic option for acute, subacute, and chronic low back pain (strong recommendation; low-quality evidence) [9]. The VA/DoD guideline found it effective for chronic low back pain, with pain relief lasting up to a year [10].
In the German GERAC trial of 1,162 patients, 47.6% responded to acupuncture at 6 months, compared with 27.4% receiving guideline-based conventional care. Sham acupuncture also outperformed conventional care (44.2%) [11].
A meta-analysis of 20,827 patients found acupuncture more effective than both sham and no acupuncture for back and neck pain, with most of the benefit still present at one year [3].
Neck Pain
A Cochrane review found moderate-quality evidence that acupuncture relieves chronic neck pain better than sham acupuncture at the end of treatment and in the short term [13].
In the ATLAS trial, 517 patients with chronic neck pain added up to 12 acupuncture sessions to their usual care. At 12 months, their pain and disability had fallen 32% from baseline, a significant improvement over usual care alone [19].
The CDC’s 2022 opioid guideline lists acupuncture among nonopioid options for low back and neck pain [4], and neck pain was included in the 20,827-patient meta-analysis described above [3].
Headache and Migraine
A Cochrane review of 22 trials (4,985 people) found that adding acupuncture to usual care halved migraine frequency in 41% of patients, compared with 17% on usual care alone. Compared with sham, the benefit was smaller (50% versus 41% responders) and still present at 6 months. In trials comparing acupuncture with preventive medications, results were similar, and acupuncture patients reported fewer side effects [14].
A second Cochrane review found acupuncture effective for frequent episodic or chronic tension-type headache [15].
Diabetic Peripheral Neuropathy
A 2023 systematic review of 25 randomized trials (1,561 patients) found that adding acupuncture to conventional treatment lowered pain scores by an average of 1.62 points compared with conventional treatment alone. The authors rated the certainty of the evidence as low, because most trials were small and not double-blinded [17]. A 2021 review of 10 clinical trials found that all reported symptom relief, with no serious side effects [18].
Acupuncture is offered alongside your patient’s current neuropathy and diabetes care, never in place of it, and any herbal formula is screened against the full medication list.
Also Supported by Guidelines and Reviews
Knee, hip, and hand osteoarthritis [2]
Shoulder pain [3]
Fibromyalgia [4]
Aromatase inhibitor joint pain and other cancer-related pain [5]
Allergic rhinitis [6]
The Science Behind Acupuncture
In PET imaging of patients with fibromyalgia, real acupuncture increased mu-opioid receptor binding in pain-processing brain regions, and greater increases tracked with greater pain relief. Sham acupuncture did not produce this effect [7]. In animal studies, electroacupuncture activated the vagal-adrenal axis, an anti-inflammatory pathway [8].
What We Track and What We Watch For
Low back: numeric pain rating, Oswestry Disability Index, and lumbar range of motion.
Neck: numeric pain rating, Neck Disability Index, and cervical range of motion.
Headache: numeric pain rating and HIT-6.
Neuropathy: numeric pain rating and sleep quality.
All are measured at the first visit and every 6 visits.
We screen for spinal red flags using an international framework [12] and for secondary headache warning signs using the SNNOOP10 list [16].
Any concern is referred back to you right away, or to emergency care when needed.
Referring Is Simple
Download the referral form.
Fax the completed form to (719) 888-1744.
We contact your patient within 1 business day and share the care plan with you.
Questions? Call (719) 748-7406 or email laura@etherealflowacupuncture.com
Patients can also book directly at etherealflow.janeapp.com.
Self-pay patients receive a superbill to submit to their insurance.
Please do not send patient information by email. Fax referrals and records to (719) 888-1744.
References
[1] Witt CM, et al. Safety of acupuncture: results of a prospective observational study with 229,230 patients. Forsch Komplementmed. 2009;16(2):91-97.
[2] Kolasinski SL, et al. 2019 ACR/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72(2):220-233.
[3] Vickers AJ, et al. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018;19(5):455-474.
[4] Dowell D, et al. CDC clinical practice guideline for prescribing opioids for pain, United States, 2022. MMWR Recomm Rep. 2022;71(3):1-95.
[5] Mao JJ, et al. Integrative medicine for pain management in oncology: Society for Integrative Oncology-ASCO guideline. J Clin Oncol. 2022;40(34):3998-4024.
[6] Seidman MD, et al. Clinical practice guideline: allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152(1 Suppl):S1-S43.
[7] Harris RE, et al. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage. 2009;47(3):1077-1085.
[8] Liu S, et al. A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis. Nature. 2021;598(7882):641-645.
[9] Qaseem A, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
[10] Buelt A, McCall S, Coster J. Management of low back pain: guidelines from the VA/DoD. Am Fam Physician. 2023;107(4):435-437.
[11] Haake M, et al. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007;167(17):1892-1898.
[12] Finucane LM, et al. International framework for red flags for potential serious spinal pathologies. J Orthop Sports Phys Ther. 2020;50(7):350-372.
[13] Trinh K, et al. Acupuncture for neck disorders. Cochrane Database Syst Rev. 2016;(5):CD004870.
[14] Linde K, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;(6):CD001218.
[15] Linde K, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;(4):CD007587.
[16] Do TP, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology. 2019;92(3):134-144.
[17] Zhou L, et al. Acupuncture for painful diabetic peripheral neuropathy: a systematic review and meta-analysis. Front Neurol. 2023;14:1281485.
[18] Cho E, Kim W. Effect of acupuncture on diabetic neuropathy: a narrative review. Int J Mol Sci. 2021;22(16):8575.
[19] MacPherson H, et al. Alexander Technique lessons or acupuncture sessions for persons with chronic neck pain (ATLAS): a randomized trial. Ann Intern Med. 2015;163:653-662.