TYLER, Texas — Roberta Land, 80, lay on her back in a mostly white room of a small clinic in an office complex. She was still as Randy Zhang, a licensed acupuncturist, retrieved plastic encased needles from a metal case then swabbed her legs and feet with an alcohol pad.

With muted sounds of Chinese music in the background, the two exchanged friendly banter as he gently tapped the tiny needles against her legs and feet, targeting acupuncture points one at a time. According to traditional Chinese medicine, there are about 360 acupuncture points on the meridians in the body.

Meridians are channels associated with organs and systems in the body.

Mrs. Land barely notices the long, thin needles entering her skin and there is no pain, she said. Zhang precisely rotated some of the needles which measures about .20 mm in diameter by 30 mm long.

He then pulled out a small square electric machine with wires attached. He placed the wires to the tops of the needles, giving surges of electricity through Mrs. Land's legs and feet, which visibly pulsated. Her visit lasts at least 30 minutes.

Mrs. Land has been having problems with her feet since a series of surgeries left her with nerve damage. She has used acupuncture for two months to get relief from the pain which is sometimes accompanied by a sense of swelling and imbalance.

"The acupuncture has been helping that," she said. "I feel like anything you do naturally is better than taking medication and they have side effects anyway."

The majority of Zhang's patients seek relief from lower back pain and migraine headaches.

"Research is finding that endorphins are the natural pain killer in the body," he said. "Acupuncture encourages the release of endorphins."

Central to acupuncture and traditional Chinese medicine is the yin-yang theory — the concept of two opposing, yet complementary, forces that shape the world and life.

Placing the fine needles in acupuncture points stimulates the body's energy, or the qi, (pronounced "chi"), creating a balance in the body. The Chinese believe qi circulates in the body through meridians and that health is an ongoing process to maintain balance in the circulation of qi.

Acupuncture is gaining popularity in the west as patients, doctors and hospitals look for ways to integrate different types of treatments, although, there are very few people in East Texas who practice it.

Dr. Pieter De Wet, of Quantum Healing Institute, believes he may be the only medical doctor to utilize it. Chiropractors are among those who receive additional training to practice acupuncture.

Referred by her chiropractor, Mrs. Land started going twice a week, but dropped to once a week since Medicare does not pay for the $60 visit.

"I don't think it's too expensive for what it does for me," she said.

Mrs. Land first heard about the benefits of acupuncture from her mother, who tried the service in the 1970s and from her husband, who used it to cope with pain following a car accident. Finding some pain relief is important to her as she likes to country dance about two nights a week.

"I don't let it keep me at home," she said. "As I live this long, I'm taking care of my body."

Acupuncture is a practice dating back more than 3,000 years and is a small part of traditional Chinese medicine, which also includes the use of herbal remedies, massage, mind-body therapy and dietary therapy.

It has spread through the rest of the world but the western world did not catch on until around the 1970s. Today, American health insurance policies are beginning to pay for the service and researchers have studied the ancient modality.

"More people know about it. More people accept it," Zhang said.

It takes years of training for a practitioner, since he or she has to be precise in pointing out the correct locations of acupuncture points and how to stimulate them.

Zhang studied for five years at the Nanjing University of Chinese Medicine in China, followed by a two-year internship. Like medical doctors, he is licensed through the Texas State Board of Medical Examiners.

He's practiced acupuncture for more than 25 years, offering the service to help patients with pain management, stress, anxiety, panic attacks, among other illnesses. His main practice is in Longview, but also twice a week maintains his father's Tyler office — who retired two years ago after 50 years as an acupuncturist.

Mixing conventional western medicine with alternative remedies, or integrative medicine, is becoming popular, as some patients look for more natural ways to treat illnesses.

De Wet said it's especially important to some who are concerned about side effects of certain drugs, such as the pain reliever acetaminophen. He noted that certain drugs can be hard on the kidneys and liver.

"There's just a general trend toward using alternative medicine as more and more people get frustrated with chronic illness," he said. "Drugs don't treat the cause. They treat symptoms."

De Wet, who practices acupuncture, believes it is becoming more accepted as a form of pain management and treatment for chronic illness by the conventional medical community in the U.S. He said it is especially popular on the east and west coasts.

"There's a lot of research being done at UT Southwestern Medical School and other universities showing very strong evidence of its efficacy," he said.

Studies by the National Institutes of Health's National Center for Complementary and Alternative Medicine cite several reports that show acupuncture is promising in treating chronic pain. Studies also note that the effects of acupuncture may peak long after active stimulation ends.

For people like Mrs. Land, the proof is in the end result of a positive experience.

"I feel better when I leave than when I came in," she said.

Information from: Tyler Morning Telegraph, http://www.tylerpaper.com