For Reina Akl, spring isn't chirping birds and fragrant blossoms; it's a sign that congestion and constant sneezing are on the horizon - the result of seasonal allergies.
For relief, she has someone poke her with needles.
Ms. Akl has turned to acupuncture and says it works as well as drugs to control her allergies, with none of the pesky side effects such as dry mouth and drowsiness.
"Without medication I couldn't function," the Montreal occupational therapist says. "Before, it was either the allergies or the side effects. But I don't need to take medication any more."
An estimated 20 per cent of Canadians suffer from seasonal allergies, the body's overreaction to airborne particles such as pollen. The season can last from mid-April to the first freeze in the fall, depending on which allergens the body is sensitive to.
Acupuncturist Neemez Kassam of the Canadian College of Naturopathic Medicine in Toronto has noticed an increase in allergy patients and thinks people are fed up with drugs' side effects.
"It's very effective and is substantial compared to what they were getting before," he says, comparing acupuncture with medication. "It builds up over time."
The acupuncture approach is two-pronged; the first focus is on relieving acute symptoms such as congestion and sneezing, then it works to build up long-term defences to allergens such as pollen.
"What we look for are the symptoms to decrease in severity, intensity and frequency so you can tolerate them better, and then we start to look at the root," Mr. Kassam explained.
Ms. Akl receives preventative treatments that begin in June, prior to traditional hay fever season. She has been getting this seasonal therapy for the past four years and says her symptoms have gradually diminished with each passing year.
The medical establishment generally accepts acupuncture, according to Paul Lépine of Quebec City, a general practitioner trained in homeopathy, because it is regulated, and scientific studies have indicated that it relieves nausea and pain.
But when it comes to allergies, acupuncture doesn't top Dr. Lépine's list of recommendations. "It's not the first thing we suggest because there needs to be more research. But the evidence is positive," he says, adding that "it's safe and probably effective."
The results of a 2007 study published in The Medical Journal of Australia compared placebos with acupuncture treatments, and concluded that allergy symptoms decreased with acupuncture.
According to practitioners of acupuncture, the hair-thin needles stimulate specific points along meridians or energy pathways in order to encourage the balance of bodily qi or energy, the believed source of good health in Chinese medicine.
Linda Rapson, president of the Ontario Society of Physicians for Complementary Medicine, said conventional medicine treats an allergy's symptoms, while traditional Chinese medicine deals with the root of the problem by correcting the body's energy imbalances.
When monthly allergy shots lost their potency for Cindy Perth of suburban Montreal, she decided to top them off with acupuncture and says it worked immediately.
"When she pokes me with the needles, it opens my airways, it's easier to breathe."
At first, relief from congestion and sneezing was temporary, but the cumulative effect of two years of acupuncture, plus her regular allergy shots, now allows Ms. Perth to enjoy the warm weather.
People who have complete success - the total elimination of any allergic reaction - are not the vast majority, Mr. Kassam said. He estimates that people experience a 50- to 60-per-cent reduction in symptoms and notes that acupuncture has fewer side effects than over-the-counter antihistamines.
Minor adverse effects can include mild bruising and a temporary tingling or numbing sensation, Mr. Kassam said, but any serious consequences are the result of improperly administering treatment. He suggests patients check their practitioner's credentials.
British Columbia, Alberta and Quebec have professional colleges to consult and they set requirements, guidelines and procedures for practitioners. Ontario is in the process of creating a similar institution, so contacting the training institution directly is recommended.