Do you suffer from frequent headaches? Have you stopped playing tennis because it hurts your elbow?

Do you suffer from frequent headaches? Have you stopped playing tennis because it hurts your elbow?

For all of his professional life, Gerald Senogles of Medford Acupuncture Clinic has known that acupuncture can relieve these and other types of pain. For the longest time, however, very few people could afford his services. Reminiscing after three decades in practice, Senogles recalls that for years his patients were almost always retired people.

"They had a lot of pain and some money," he explains.

Once insurance companies started covering acupuncture treatments, his clientele became more diverse. He now treats patients of all ages and from every walk of life.

And not just for pain. People come to him seeking relief for allergies and asthma, diarrhea and constipation, insomnia and anxiety. The National Institutes of Health and the World Health Organization agree that acupuncture has been proven safe and effective in treating a long list of conditions.

Practiced in China for at least 2,500 years, acupuncture is a technique of inserting and manipulating fine needles into specific points on the body along which chi, a kind of vital energy, is said to flow. According to acupuncture theory, illness and pain are caused by an imbalance in the flow of chi along these energy meridians. Acupuncturists are trained to decrease, increase or redirect the body's energy flow, thus helping a patient achieve wellness.

"Because acupuncture makes the human body work better, it can help relieve just about anything," claims Senogles, whose views are not unanimously shared by members of the medical establishment. In fact, after all these years, Senogles is still waiting for a first: a doctor to refer a patient to him.

"It doesn't happen," he states flatly. The only way that mainstream medical practitioners "refer" patients to him, he says, is by not being able to help.

"Almost all of my patients have been failed on by one to five doctors," he estimates.

Meet a few other Rogue Valley acupuncturists, who have set up practice since Senogles began his career. Each stakes out his or her position in the marketplace differently, and their reflections upon their place in the medical community vary, as well.

Brian Rosenthal of Rose Acupuncture can see Providence Medical Center in Medford as he looks out his window. Although he does get some referrals from doctors, he doesn't regard himself as part of that scene across the street.

"If I were part of the medical establishment, my office would be attached to the hospital or to a satellite clinic," he remarks. "There are no jobs for acupuncturists. We all have to be businesspeople."

Rosenthal, the businessman, treats up to six patients at a time in his group-treatment room, applying the needles — a slight pinch is all that most people feel — to one patient and then moving to the next. For acupuncture to be effective, the needles — 10 to 20 for most conditions — must stay in place for about 30 minutes. After Rosenthal has started on a few patients, it's usually time to go back and take the needles out of the first person.

Rosenthal's starting price for a treatment is $25.

He insists that his group approach is not the same as an assembly-line approach. Two or more people in the group might be complaining of a headache, but "one headache could be in the back of the head, the other behind the eye," he points out. These are two different situations, requiring that the needles be applied in different places on the body.

It's not only the symptoms that dictate the course of action, but the makeup of the patient, as well, says Shandor Weiss, of Arura Clinic in Ashland. To get the best results for some people, this practitioner is even ready to use acupuncture without needles.

"First, let's get a technicality out of the way," he says. "There is no such thing as acupuncture without needles. Needles are necessary for the 'puncture.' In Oregon, practitioners who are licensed acupuncturists can do needle-less procedures on acupuncture points and call it 'acupuncture without needles.' "

Weiss says that if a person is more "physical," needles are suitable. A sensitive or "energetic" person, on the other hand, usually responds better to needle-less techniques, he says.

Of course, this approach also is good for people who don't like needles.

The bottom line, says Weiss, is that acupuncture is a way to change the flow of chi in a person. "This can be done with needles or without needles, using light, the mind, pressure, sound and other techniques," he says.

Weiss, who also is a naturopathic physician, says she rarely gets referrals from her counterparts in the mainstream medical industry.

"The medical establishment is like a ladder," he proposes. "M.D.s are at the top. Patients go in a flow up the ladder and are rarely sent down by those above."

Jennifer Fletcher's experience is quite different. She says she gets referrals from doctors all the time.

"One neurologist, in particular, and often other doctors, as well," she says, adding that she feels so accepted by the medical establishment that she even wonders whether the name of her practice, Alternative Healing Arts, was appropriate anymore. (She decided that the name still fits because she cannot prescribe medicine.)

Fletcher combines acupuncture with chiropractic when a situation calls for a two-pronged approach. For example: A guy falls off his motorcycle, throwing his ribs out of whack. The ribs are pinching his lungs, causing respiratory problems. He'll need Fletcher the chiropractor to address the structural problem and Fletcher the acupuncturist to bring his stressed lungs back into balance.

In social situations, this Ashland practitioner sometimes has trouble defining herself.

"I usually say I'm a chiropractor, but I'm not sure why. Maybe because it's more familiar.

"Structural alignments are an easy thing for people to grasp," she says. "Acupuncture is more mysterious. It can be hard for someone to grasp that a point on your arm is for your large intestine."

Fletcher's seeming acceptance by the medical mainstream may hint at where acupuncture, as a whole, is headed. However, Weiss' experience of being both an insider and an outsider seems more representative of the profession right now.

"I do consider myself part of the medical establishment," he says. "I refer to M.D.s when appropriate and, as both an acupuncturist and naturopathic doctor, I often work with M.D.s as part of a patient's team of providers. However, many of my patients see me after they have exhausted all possibilities within the medical establishment.

"Alternative medicine is supported by the people," Weiss says. "It is grass roots. That's the whole point of having alternatives. There are many ways to practice medicine and to heal, and no one profession has a monopoly on healing."