How is it promoted for use?

There is evidence that acupuncture eases nausea caused by chemotherapy and surgical anesthesia and relieves pain after dental surgery. It may also assist withdrawal from addiction to drugs and alcohol, and help relieve headaches, menstrual cramps, tennis elbow, low back pain, carpal tunnel syndrome, and asthma.

In China, acupuncture is used as an anesthetic during surgery and is believed to have the power to cure diseases and relieve symptoms of illness. The teachings of traditional Chinese medicine explain that acupoints lie along invisible meridians, which are channels for the flow of vital energy or life force called qi (or chi) that is present in all living things. Meridians also represent an internal system of communication that is said to connect specific organs or networks of organs. There are 12 major meridians in the human body. Illness is claimed to occur when the energy flow along one or more meridians is blocked or out of balance. Some practitioners in the West reject the traditional philosophies of Chinese medicine and claim that acupuncture relieves pain by stimulating the production of natural substances in the body called endorphins that are responsible for relieving pain.

What does it involve?

In traditional acupuncture, needles are inserted at specific locations called acupoints. In order to restore balance and a healthy energy flow to the body, needles are inserted at acupoints just deep enough into the skin to keep them from falling out. They are usually left in place for a few minutes. Skilled acupuncturists cause virtually no pain. The acupuncturist may twirl the needles, or apply heat or a weak electrical current to enhance the effects of the therapy. Acupuncture is sometimes used along with less well-known traditional healing techniques (see Moxibustion and Cupping).

Sonopuncture is similar to acupuncture, but an ultrasound device that transmits sound waves is applied to the body's acupoints. Needles are not used. Sonopuncture is sometimes combined with tuning forks and other vibration devices. Proponents claim this approach is useful to treat many of the same disorders as acupuncture. There is no scientific evidence to support these claims.

Electroacupuncture, considered an enhanced version of traditional acupuncture, involves applying electrical stimulation, with or without needles, to the acupoints that are targeted during traditional acupuncture (see Transcutaneous Electrical Nerve Stimulation). Electroacupuncture devices may be used for diagnosis or testing.

In acupressure, a popular variation of acupuncture, therapists press on acupoints with their fingers instead of using needles. This technique is used by itself or as part of an entire system of manual healing such as in shiatsu (see Acupressure, Shiatsu, and Other Asian Bodywork).

In other variations of acupuncture, heat, friction, suction, magnets, or laser beams are directed to acupoints (see Electromagnetic Therapy, Cold Laser Therapy).

What is the history behind it?

Acupuncture began over 2,000 years ago and is an important part of traditional Chinese medicine. Originally, 365 acupoints were identified, corresponding to the number of days in a year, but gradually, the number of acupoints grew to more than 2,000. Traditional acupuncture needles were made of bone, stone, or metal, including silver and gold. Modern acupuncture needles are made of very thin sterile stainless steel and are disposable. In 1996, the FDA approved the use of acupuncture needles by licensed practitioners. By law, needles must be labeled for one-time use only.

In China, acupuncture is commonly accepted as a treatment for many diseases. Acupuncture has also become quite popular in the United States and Europe, where the technique is mainly used to control pain and relieve symptoms of disease such as nausea caused by chemotherapy drugs but not to cure the disease itself. It is estimated that there are over 10,000 acupuncturists in the United States, and about 35 states have established training standards for licensing the practice of acupuncture. Medicare does not cover acupuncture, but it is covered by some private health insurance plans and HMOs. The American Academy of Medical Acupuncture maintains a current referral list of nearly 2,000 doctors who also practice acupuncture.

What is the evidence?

There is no scientific evidence that acupuncture is effective as a treatment for cancer, but it appears to be useful as a complementary method for relieving some symptoms related to cancer and other conditions. Acupuncture has been the subject of many clinical studies. According to a National Institutes of Health (NIH) expert panel consisting of scientists, researchers, and health care providers, acupuncture is an effective treatment for nausea caused by chemotherapy drugs and surgical anesthesia and the treatment of dental pain following surgery. Acupuncture may also be useful by itself or combined with conventional therapies to treat addiction, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, lower back pain, carpal tunnel syndrome and asthma, and to help in the rehabilitation of stroke patients.

A small clinical trial recently found acupuncture was effective in reducing the number of hot flashes men experienced after prostate cancer hormonal therapy. There is also some evidence that acupuncture may lessen the need for pain medicines. A study of headache sufferers compared acupuncture with standard medical treatment. Those treated with acupuncture used less pain medicines and missed fewer work days. However, some recent studies of acupuncture have had mixed or uncertain results. Part of the problem is that itÂ’s hard to come up with good control procedures (sham acupuncture) for scientific comparisons.

Controlled clinical studies of electroacupuncture have suggested that it may help some people with pain after surgery, nausea related to chemotherapy, and renal colic (pain from kidney stones.) However, it was found ineffective in a recent study that compared it to conventional anesthesia during in vitro fertilization (IVF).

Are there any possible problems or complications?

When done by a trained professional, acupuncture is generally considered safe. The number of complications reported have been relatively few, but there is a risk that a patient may be harmed if the acupuncturist is not well trained. Traditional needle acupuncture can cause dizziness, fainting, local internal bleeding, convulsions, hepatitis B, dermatitis, nerve damage, and increased pain. Punctured lungs have happened rarely but have resulted in a few deaths. Traditional acupuncture also poses risks such as infection from contaminated needles or improper delivery of treatment. People with cardiac pacemakers, infusion pumps, or other electrical devices should avoid electroacupuncture.

Relying on this type of treatment alone, and avoiding conventional medical care, may have serious health consequences.