- Acupuncture: Why Does It Work?
- What does acupuncture feel ?
- How does acupuncture affect the body?
- What conditions may benefit from acupuncture?
- Considerations when choosing acupuncture
- Acupuncture: How it works, uses, benefits, and risks
- How do I find an acupuncturist?
- You Asked: Does Acupuncture Work?
- How Does Acupuncture Work? Points, Benefits & Needles
- Relieving pain with acupuncture
- What Is Acupuncture? What Are the Benefits?
Acupuncture: Why Does It Work?
From the WebMD Archives
For millions of people who live with pain, acupuncture is no longer an exotic curiosity. It's now widely accepted among the medical community. And it's pretty popular with patients as well. A recent survey found almost 3.5 million Americans said they'd had acupuncture in the previous year.
“In our clinic, we have been in existence for 22 years,” says Ka-Kit Hui, MD, founder and director of the UCLA Center for East-West Medicine. “We have a 4- or 5-month wait for new patients.
Acupuncture — in which needles, heat, pressure, and other treatments are applied to certain places on the skin — has come a long way since 1971. That's when the 2,000-year-old Chinese healing art first caught on in the United States, thanks to a story in The New York Times.
The piece was written by a reporter who had visited China and wrote about how doctors healed his pain from back surgery using needles.
In 1996, the FDA gave acupuncture its first U.S. seal of approval, when it classified acupuncture needles as medical devices. In the 20 years since, study after study indicates that, yes, acupuncture can work.
“There's nothing magical about acupuncture,” Hui says. “Many of these [alternative] techniques, including acupuncture, they all work by activating the body's own self-healing [mechanism].”
And that's the main goal of acupuncture: self-healing.
“Our bodies can do it,” says Paul Magarelli, MD, a clinical professor at California's Yo San University. “We are not animals who are dependent on drugs.” If you're deciding if acupuncture is right for you, it's best to be open to its benefits and skeptical of claims it's a magical cure-all.
“It should be part of a comprehensive approach to solve problems,” Hui says.
Acupuncture has long been recognized as an effective treatment for chronic pain. In 2012, a study found acupuncture was better than no acupuncture or simulated acupuncture for the treatment of four chronic pain conditions:
The National Institutes of Health calls the study “the most rigorous evidence to date that acupuncture may be helpful for chronic pain.”
Now, doctors are eager to find a drug-free approach to pain treatment in light of the dangers of opioids — the class of powerful pain medications that includes codeine, morphine, OxyContin, Percocet, and Vicodin. In March, the CDC called deaths from opioid overdoses “an epidemic.”
Now, the CDC says doctors should turn to other treatments for chronic pain in cases that don't involve active cancer, palliative care, and end-of-life care.
“Now, you're , 'OK, well, if we're not using opioids, what should we use?'” says Houman Danesh, MD, director of integrative pain management at New York's Mount Sinai Hospital. That dilemma has many people giving acupuncture a second look when it comes to treating pain.
“If a lot of people recognize the value of acupuncture,” Hui says, “it will be one of the components of addressing the prescription drug epidemic that we're talking about in our country right now.”
Many who get treatment for cancer get acupuncture in addition to standard cancer treatments chemotherapy, radiation, or surgery. Acupuncture can help people who have nausea and vomiting during treatment.
“We have many patients come through with cancer,” Hui says. He adds his department treats people in all phases of cancer treatment: from those who are newly diagnosed, to those dealing with the discomfort of cancer treatment, to those in the later stages.
Keep in mind, chemo and radiation weaken the body's immune system. So it's important for your acupuncturist to follow strict clean-needle procedures.
Some women who have extremely painful periods, a condition known as dysmenorrhea, try acupuncture. The science looks promising. Some research suggests acupuncture may help with pain from menstrual cramps. So far, though, that research is limited.
For women trying to get pregnant with expensive and time-consuming fertility treatments, acupuncture can make a big difference. It can improve the success rates of treatments such as in vitro fertilization. One study suggests acupuncture can help some women get pregnant by:
- Alleviating anxiety and stress felt by those having fertility treatment
- Promoting blood flow to the uterus
“Logic tells me more blood flow, more access to eggs,” says Magarelli, who founded Reproductive Medicine & Fertility Centers in Colorado and New Mexico. “More eggs, more embryos, more choice, better chance for a baby.”
Acupuncture is safe if done correctly. If you're thinking about getting it, remember these tips:
Acupuncture can be dangerous if you take certain medications, have a pacemaker, are at risk of infection, have chronic skin problems, or are pregnant. Talk to your doctor before you jump in.
Check your acupuncturist's credentials. Most states require a license to practice it. You can get a referral from your doctor.
Don't rely on a disease diagnosis you may get from an acupuncture practitioner unless they're also a licensed medical doctor. The American Academy of Medical Acupuncture can provide a referral list of doctors who practice it.
If you get a diagnosis from a doctor, ask him if acupuncture might help.
Check your insurance. Some plans cover it. Some don't.
Doctors learn more about acupuncture each year. But still, no one fully understands how acupuncture works. Does it boost your body's painkilling ability? Does it affect your blood flow? Can it help your body manage depression to promote further healing? Scientists continue to study — and debate — the issues.
But those who practice acupuncture say that's no reason to stop doing it. Danesh suggests we remember how aspirin became accepted as more than an over-the-counter painkiller.
“It took years and years for us to figure out the exact molecular mechanisms, but we were [still] giving aspirin,” Danesh says. 'You have a headache? Take aspirin.' 'You have back pain? Take aspirin.' You have heart problems? …' We accepted that aspirin was used.
“Acupuncture has good evidence [supporting it]. Just because we can't necessarily explain it down to the molecular level doesn't mean we need to abandon it.”
CDC: “Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002-2012.”
National Institutes of Health: “Backgrounder: Acupuncture.”
National Cancer Institute: “Acupuncture-Patient Version.”
Vickers, A. Journal of the American Medical Association, Oct. 22, 2012.
The Arthritis Foundation: “Osteoarthritis.”
National Center for Complementary and Integrative Health: “Acupuncture May Be Helpful for Chronic Pain: A Meta-Analysis.”
National Institute on Drug Abuse: “Prescription Drug Abuse.”
CDC: “Guideline for Prescribing Opioids for Chronic Pain – United States, 2016.”
National Center for Complementary and Integrative Health. “Cancer: In Depth.”
American College of Obstetricians and Gynecologists: “Dysmenorrhea: Painful Periods.”
National Center for Complementary and Integrative Health. “Acupuncture for Pain.”
Zhang, Y. Evidence-Based Complementary and Alternative Medicine, 2014.
Johns Hopkins Medicine: “Acupuncture.”
Medline Plus: “Acupuncture.”
© 2016 WebMD, LLC. All rights reserved.
Acupuncture is the practice of penetrating the skin with thin, solid, metallic needles which are then activated through gentle and specific movements of the practitioner's hands or with electrical stimulation.
Acupuncture is part of the ancient practice of Traditional Chinese medicine. Traditional Chinese medicine practitioners believe the human body has more than 2,000 acupuncture points connected by pathways or meridians.
These pathways create an energy flow (Qi, pronounced “chee”) through the body that is responsible for overall health. Disruption of the energy flow can cause disease.
By applying acupuncture to certain points, it is thought to improve the flow of Qi, thereby improving health.
Studies have shown that acupuncture is effective for a variety of conditions.
Acupuncture is not for everyone. If you choose to see an acupuncturist, discuss it with your doctor first and find a practitioner who is licensed as having proper training and credentials.
What does acupuncture feel ?
Acupuncture is done using hair-thin needles. Most people report feeling minimal pain as the needle is inserted. The needle is inserted to a point that produces a sensation of pressure or ache. Needles may be heated during the treatment or mild electric current may be applied to them. Some people report acupuncture makes them feel energized. Others say they feel relaxed.
Improper placement of the needle can cause pain during treatment. Needles must be sterilized to prevent infection. That is why it is important to seek treatment from a qualified acupuncture practitioner. The FDA regulates acupuncture needles just as it does other medical devices under good manufacturing practices and single-use standards of sterility.
Instead of needles, other forms of stimulation are sometimes used over the acupuncture points, including:
- Heat (moxibustion)
- Pressure (acupressure)
- Suction (cupping)
- Impulses of electromagnetic energy
How does acupuncture affect the body?
Acupuncture points are believed to stimulate the central nervous system. This, in turn, releases chemicals into the muscles, spinal cord, and brain. These biochemical changes may stimulate the body's natural healing abilities and promote physical and emotional well-being.
National Institutes of Health (NIH) studies have shown that acupuncture is an effective treatment alone or in combination with conventional therapies to treat the following:
- Nausea caused by surgical anesthesia and cancer chemotherapy
- Dental pain after surgery
- Menstrual cramps
- Tennis elbow
- Myofascial pain
- Low back pain
- Carpal tunnel syndrome
It may also help with stroke rehabilitation.
What conditions may benefit from acupuncture?
Many Americans seek acupuncture treatment for relief of chronic pain, such as arthritis or low back pain. Acupuncture, however, has expanded uses in other parts of the world. Before considering acupuncture, talk to your doctor. Conditions that may benefit from acupuncture include the following:
|Gastritis Irritable bowel syndrome HepatitisHemorrhoids||Anxiety Depression Insomnia NervousnessNeurosis|
|Rhinitis SinusitisSore throat||Menstrual pain Infertility|
|Arthritis Back pain Muscle cramping Muscle pain and weakness Neck painSciatica||Headaches Migraines Neurogenic bladder dysfunction Parkinson's disease Postoperative painStroke|
|Allergic rhinitis SinusitisBronchitis||Irritable bladder Prostatitis Male infertility Some forms of impotenceAddiction|
Considerations when choosing acupuncture
Because scientific studies have not fully explained how acupuncture works within the framework of Western medicine, acupuncture remains a source of controversy. It is important to take precautions when deciding about acupuncture.
- Discuss acupuncture with your doctor first. Acupuncture is not for everyone. Discuss all the treatments and medicines (dietary supplements, prescription and over-the-counter) you are taking. If you have a pacemaker, are at risk for infection, have chronic skin problems, are pregnant, or have breast or other implants, be sure to tell your doctor. Acupuncture may be risky to your health if you fail to mention these matters.
- Do not rely on a diagnosis of disease by an acupuncture practitioner. If you have received a diagnosis from a doctor, you may wish to ask him or her whether acupuncture might help.
- Choose a licensed acupuncture practitioner. Your own doctor may be a good resource for referrals to a licensed or certified practitioner. Friends and family members may also be good sources of referrals. You do not have to be a doctor to practice acupuncture or to become a certified acupuncturist. About 30 states have established training standards for certification in acupuncture, although not all states require acupuncturists to get a license to practice. Although not all certified acupuncturists are doctors, the American Academy of Medical Acupuncture can provide a referral list of doctors who practice acupuncture.
- Consider costs and insurance coverage. Before starting treatment, ask the acupuncturist about the number of treatments needed and how much the treatments will cost. Some insurers cover the cost of acupuncture while others do not. It is important to know before you start treatment whether acupuncture is covered by your insurance.
Acupuncture: How it works, uses, benefits, and risks
Acupuncture is a form of treatment that involves inserting very thin needles through a person’s skin at specific points on the body, to various depths.
Research suggests that it can help relieve pain, and it is used for a wide range of other complaints.
However, according to the National Center for Complementary and Integrative Health (NCCIH), there is limited evidence for its effectiveness in areas other than pain.
How acupuncture works scientifically remains unclear. Some people claim it works by balancing vital energy, while others believe it has a neurological effect.
Acupuncture remains controversial among Western medical doctors and scientists.
An acupuncurist will insert needles into a person’s body with the aim of balancing their energy.
This, it is claimed, can help boost wellbeing and may cure some illnesses.
Conditions it is used for include different kinds of pain, such as headaches, blood pressure problems, and whooping cough, among others.
Traditional Chinese medicine explains that health is the result of a harmonious balance of the complementary extremes of “yin” and “yang” of the life force known as “qi,” pronounced “chi.” Illness is said to be the consequence of an imbalance of the forces.
Qi is said to flow through meridians, or pathways, in the human body. These meridiens and energy flows are accessible through 350 acupuncture points in the body.
Inserting needles into these points with appropriate combinations is said to bring the energy flow back into proper balance.
There is no scientific proof that the meridians or acupuncture points exist, and it is hard to prove that they either do or do not, but numerous studies suggest that acupuncture works for some conditions.
Some experts have used neuroscience to explain acupuncture. Acupuncture points are seen as places where nerves, muscles, and connective tissue can be stimulated. The stimulation increases blood flow, while at the same time triggering the activity of the body’s natural painkillers.
It is difficult to set up investigations using proper scientific controls, because of the invasive nature of acupuncture. In a clinical study, a control group would have to undergo sham treatment, or a placebo, for results to be compared with those of genuine acupuncture.
Some studies have concluded that acupuncture offers similar benefits to a patient as a placebo, but others have indicated that there are some real benefits.
Research carried out in Germany has shown that acupuncture may help relieve tension headaches and migraines.
The NCCIH note that it has been proven to help in cases of:
- low back pain
- neck pain
- knee pain
- headache and migraine
They list additional disorders that may benefit from acupuncture, but which require further scientific confirmation.
In 2003, the World Health Organization (WHO) listed a number of conditions in which they say acupuncture has been proven effective.
Other conditions for which the WHO say that acupuncture may help but more evidence is needed include:
- post-operative convalescence
- substance, tobaccor and alcohol dependence
- spine pain
- stiff neck
- vascular dementia
- whooping cough, or pertussis
- Tourette syndrome
The WHO also suggest that it may help treat a number of infections, including some urinary tract infections and epidemic hemorrhagic fever.
They point out, however, that “only national health authorities can determine the diseases, symptoms, and conditions for which acupuncture treatment can be recommended.”
Acupuncture can be beneficial in that:
- Performed correctly, it is safe.
- There are very few side effects.
- It can be effectively combined with other treatments.
- It can control some types of pain.
- It may help patients for whom pain medications are not suitable.
The NCCIH advise people not to use acupuncture instead of seeing a conventional health care provider.
According to traditional Chinese medical theory, acupuncture points are located on meridians, through which vital energy runs. This energy is known as “qi” or “chi.”
An acupuncturist will examine the patient and assess their condition, insert one or more thin, sterile needles, and offer advice on self-care or other complementary therapies, such as Chinese herbs.
The patient will be asked to lie down on their back, front, or one side, depending on where the needles are to be inserted. The acupuncturist should use single-use, disposable, sterile needles. As each needle is inserted, the patient may feel a very brief stinging or tingling sensation.
After the needle is inserted, there is occasionally a dull ache at the base of the needle that then subsides. Acupuncture is usually relatively painless.
Sometimes the needles are heated or stimulated with electricity after insertion.
The needles will stay in place for between 5 and 30 minutes.
The number of treatments needed depend on the individual. A person with a chronic condition may need one to two treatments a week over several months. An acute problem normally improves after 8 to 12 sessions.
All therapies have risks as well as benefits.
The possible risks of acupuncture are:
- It is dangerous if a patient has a bleeding disorder or takes blood thinners.
- Bleeding, bruising, and soreness may occur at the insertion sites.
- Unsterilized needles may infect the patient.
- In rare cases, a needle may break and damage an internal organ.
- When inserted deeply into the chest or upper back, there is a risk of collapsed lung, but this is very rare.
The United States (U.S.) Food and Drug Administration (FDA) regulate acupuncture needles as medical devices. Their manufacture and labelling needs to meet certain standards. The needles must be sterile, nontoxic, and labelled for one use only, by a licensed practitioner.
As with any complementary therapy, it is advisable to use it alongside conventional treatments in cases of chronic or severe illness.
How do I find an acupuncturist?
To find a licensed practitioner, visit the website for the National Certification Commission in Acupuncture and Oriental Medicine (NCCAOM). Most states require practitioners to be licensed by this board. People are advised to ask practitioners about their experience and training.
The NCCIH point out that some insurance policies now cover acupuncture, but it is important to check first whether the cost will be covered.
According to Costhelper Health, an acupuncture session and medical consultation will cost from $75 to $95, and a routine visit will cost between $50 and $70.
You Asked: Does Acupuncture Work?
You hear the term “acupuncture,” and visions of needles may dance in your head. But the 3 million Americans (and counting) who have tried it know there’s a lot more to the treatment than pokes and pricks.
A typical visit to an acupuncturist might begin with an examination of your tongue, the taking of your pulse at several points on each wrist and a probing of your abdomen. “They didn’t have MRIs or X-rays 2,500 years ago, so they had to use other means to assess what’s going on with you internally,” says Stephanie Tyiska, a Philadelphia-based acupuncture practitioner and instructor.
These diagnostic procedures inform the placement of the needles, Tyiska says.
But a visit to an acupuncturist could also include a thoughtful discussion of your diet and personal habits, recommendations to avoid certain foods or to take herbal supplements and an array of additional in-office treatments— skin brushing or a kind of skin suctioning known as “cupping”—that together fall under the wide umbrella of traditional Chinese medicine.
But does it work? Figuring out whether each one of these practices may be therapeutically viable is a challenge, and determining how all of them may work in concert is pretty much impossible. Combine them with acupuncturists’ frequent references to “qi,” or energy flow, and it’s easy for a lot of people to dismiss the practice as bunk.
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Not so fast, though. A recent meta-analysis, which examines existing research on a topic, compared acupuncture treatment to standard medical treatment (the kind involving a doctor’s exam and drugs) for musculoskeletal pain, chronic headaches, and osteoarthritis.
It also compared real acupuncture to “sham” acupuncture, a procedure where needles are inserted at random to make patients believe they were receiving acupuncture when they were not.
“There are many poorly designed acupuncture studies out there, so we tried to include only the best trials,” says Andrew Vickers, a biostatistician at Memorial Sloan Kettering Cancer Center who coauthored the meta-analysis.
When comparing legit acupuncture to standard care, there was a statistically significant benefit to acupuncture, Vickers says. “We saw a measurable effect there,” he explains. “If acupuncture were a drug, we’d say the drug works.”
When Vickers and his team compared legitimate acupuncture to sham acupuncture, that benefit persisted, but shrank. There are a lot of ways to interpret this, Vickers says. “It could be acupuncture has a large placebo effect, or it could be that pressure points”—the precise locations at which needles are inserted—“are less important than acupuncturists claim,” he explains.
Many people equate placebo effects with scams. “The term placebo has always had this very negative connotation,” says Vitaly Napadow, director of the Center for Integrative Pain Neuroimaging at Harvard Medical School.
But Napadow says our poor opinion of placebo needs revising. The human body has built-in systems for stoking or calming pain and other subjective sensations.
“If a placebo can target and modulate these endogenous systems, that’s a good and a real thing,” he says.
But acupuncture may have effects even more profound than placebo.
Napadow has conducted dozens of brain imaging studies on acupuncture in an effort to determine just how the treatment may or may not calm pain or related conditions headache or arthritis.
He says there are lots of ways acupuncture might work, and the specific mechanism may depend on the type of condition you’re trying to treat.
One possibility is that being jabbed with a needle induces a tiny injury, causing your immune system to respond by sending inflammatory proteins and other infection-fighting, would-healing chemicals to the source of that injury. “There’s the idea that by inducing many of these very small injuries, you’re ramping up the immune system so that it can deal with bigger problems,” Napadow says.
It’s also possible that the increased flow of blood and immune system chemicals to the poke site could help clear away accumulated cellular byproducts that may trigger or worsen a condition plantar fasciitis or tendonitis, he says.
“Or the needles might activate nerve receptors in the skin, which then pass info up into your spinal cord and brain,” he says.
“That information might trigger a change in brain physiology, the release of endorphins or those sorts of neurotransmitters that could lessen the sensation of pain associated with something fibromyalgia.”
His research has borne out some of these potential mechanisms. One of his studies showed that after traditional acupuncture, opioid receptors were more available, or receptive, to the body’s natural pain-quelling chemicals. There was no such change after sham acupuncture.
It basically means opioid receptors were more available or receptive to the types of body hormones and chemicals that help quell pain.
Napadow says that more research has looked into the effect of expectancy on acupuncture outcomes—or whether people who believe the treatment will work experience more benefit than those who don’t. The evidence suggests that expectancy doesn’t improve acupuncture’s effectiveness. “Often it’s the guy who says his wife made him try it who has the greatest benefit,” he says.
Couple these promising findings with the fact that acupuncture is a low-cost treatment option with very few side effects, and Napadow says it makes sense to consider it a helpful partner to Western medicine—especially when it comes to chronic pain-related ailments for which Western medicine often relies on painkillers. “It won’t cure cancer,” he says. “But it could be effective for managing side effects of radiation or chemotherapy—things pain or neuropathy or nausea.”
Tyiska, the Philadelphia-based acupuncturist, makes a similar argument. “I don’t tell people to stop seeing their doctors,” she says. “But if you’re being prescribed opioids, or you’re considering surgery, you lose very little by trying acupuncture first.”
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How Does Acupuncture Work? Points, Benefits & Needles
Here are current thoughts from the National Institutes of Health on the manner by which acupuncture might produce beneficial health results.
Many studies in animals and humans have demonstrated that acupuncture can cause multiple biological responses. These responses can occur locally, i.e., at or close to the site of application, or at a distance, mediated mainly by sensory neurons to many structures within the central nervous system.
This can lead to activation of pathways affecting various physiological systems in the brain as well as in the periphery. A focus of attention has been the role of endogenous opioids in acupuncture analgesia.
Considerable evidence supports the claim that opioid peptides are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by their actions. That opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis.
Stimulation by acupuncture may also activate the hypothalamus and the pituitary gland, resulting in a broad spectrum of systemic effects. Alteration in the secretion of neurotransmitters and neurohormones and changes in the regulation of blood flow, both centrally and peripherally, have been documented.
There is also evidence that there are alterations in immune functions produced by acupuncture. Which of these and other physiological changes mediate clinical effects is at present unclear.
Despite considerable efforts to understand the anatomy and physiology of the “acupuncture points,” the definition and characterization of these points remains controversial.
Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.
Some of the biological effects of acupuncture have also been observed when “sham” acupuncture points are stimulated, highlighting the importance of defining appropriate control groups in assessing biological changes purported to be due to acupuncture.
Such findings raise questions regarding the specificity of these biological changes.
In addition, similar biological alterations including the release of endogenous opioids and changes in blood pressure have been observed after painful stimuli, vigorous exercise, and/or relaxation training; it is at present unclear to what extent acupuncture shares similar biological mechanisms.
It should be noted also that for any therapeutic intervention, including acupuncture, the so-called “non-specific” effects account for a substantial proportion of its effectiveness, and thus should not be casually discounted.
Many factors may profoundly determine therapeutic outcome including the quality of the relationship between the clinician and the patient, the degree of trust, the expectations of the patient, the compatibility of the backgrounds and belief systems of the clinician and the patient, as well as a myriad of factors that together define the therapeutic milieu.
Although much remains unknown regarding the mechanism(s) that might mediate the therapeutic effect of acupuncture, it is encouraging that a number of significant acupuncture-related biological changes can be identified and carefully delineated.
Further research in this direction not only is important for elucidating the phenomena associated with acupuncture, but also has the potential for exploring new pathways in human physiology not previously examined in a systematic manner.
Relieving pain with acupuncture
The ancient art of acupuncture has been used in Asia for centuries to treat many conditions and relieve pain. It's now being used in the United States and other Western countries to ease everything from low back pain, to nerve pain (such as painful shingles rashes), to headaches, fibromyalgia, and menstrual cramps — and more.
Traditional Chinese acupuncture involves the insertion of extremely fine needles into the skin at specific “acupoints.” This may relieve pain by releasing endorphins, the body's natural pain-killing chemicals, and by affecting the part of the brain that governs serotonin, a brain chemical involved with mood.
In Chinese acupuncture, the acupuncturist may turn or twirl the needles slightly or apply heat or electrical stimulation to enhance the effects. He or she may also burn a therapeutic herb near the skin; this is called moxibustion.
A Japanese form of acupuncture involves more shallow needle insertion than in Chinese acupuncture, and the needles aren't usually manipulated. Korean acupuncture focuses on applying needles to points in just the hands and feet.
The acupuncturist typically inserts four to 10 needles and leaves them in place for 10 to 30 minutes while you rest. A usual course of treatment includes six to 12 sessions over a three-month period.
(Acupressure, a similar technique to acupuncture, does not use needles. Instead, the practitioner uses his or her hands to apply deep pressure at acupressure points.)
Acupuncture is generally quite safe, and the complication rate appears to be quite low.
A review of acupuncture-related complications reported in medical journals found that the most serious problem was accidental insertion of a needle into the pleural space between the lungs and the chest wall (but this is rare).
The advent of single-use, sealed needle packages has all but eliminated the risks of blood-borne infections such as hepatitis B or HIV.
Does acupuncture really work to quell pain? The evidence is mixed, with some studies showing that acupuncture relieves pain and others showing that it works no better than “sham” acupuncture (procedures designed to mimic acupuncture but to have no real effect, much a placebo, or “sugar pill,” used in medication studies). One of the problems with deciphering these results is that most acupuncture studies have been small. The design of “sham” acupuncture techniques has also varied widely, which complicates any comparison. It's also possible that acupuncture works for some people and not others.
If you decide to try acupuncture, seek out an experienced acupuncturist. Licensing requirements vary from state to state. In states with no licensing requirements, your best bet is to find an acupuncturist with certification from the National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org).
For more on treating common pain conditions and learning about other mind-body solutions to relieve pain, buy Pain Relief, a Special Health Report from Harvard Medical School.
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What Is Acupuncture? What Are the Benefits?
Acupuncture is a traditional Chinese medicine (TCM) practice that originated thousands of years ago.
It is the premise that a blockage or disturbance in the flow of the body's life energy, or “qi,” can cause health issues.
Acupuncturists insert hair-thin needles to specific acupuncture points throughout the body to restore the flow of qi, balance the body’s energy, stimulate healing, and promote relaxation.
According to TCM theory, there are over 1000 acupuncture points on the body, each lying on an invisible energy channel, or “meridian.” Each meridian is associated with a different organ system.
Researchers don't fully understand how acupuncture might work, but there are numerous theories. One theory is that acupuncture works by stimulating the release of endorphins, the body's natural pain-relieving chemicals.
Acupuncture is also said to influence the autonomic nervous system (which controls bodily functions) and the release of chemicals that regulate blood flow and pressure, reduce inflammation, and calm the brain.
Acupuncture is said to be useful in addressing a variety of health conditions, including:
- Chronic pain (such as headaches, back pain, neck pain)
- Sinus congestion
- Stress and anxiety
- Weight loss
Some people use acupuncture to promote fertility. It is also used to quit smoking and as a component of the treatment for other addictions.
Here's a look at some findings from the available research on the benefits of acupuncture:
For a report published in the Annals of Internal Medicine in 2017, researchers analyzed previously published trials on the use of non-pharmacologic therapies (including acupuncture) for low back pain.
The report's authors found that acupuncture was associated with decreased pain intensity and better function immediately after an acupuncture treatment, compared with no acupuncture.
In the long-term, however, the differences were small or were not clear.
Noting that the strength of the evidence was low, the authors found “limited evidence” that acupuncture is “modestly effective for acute low back pain.”
In a 2016 review published in the Cochrane Database of Systematic Reviews, scientists reviewed 22 previously published trials (involving 4985 participants). In their conclusion, they found that adding acupuncture to the treatment of migraine symptoms may reduce the frequency of episodes, however, the size of the effect is small when compared to a sham acupuncture treatment.
A 2016 review (involving 12 trials and 2349 participants) suggests that acupuncture involving at least six sessions may help people with frequent tension headaches.
In two studies, acupuncture added to usual care or treatment at the headache onset only (usually with pain medication) resulted in decreased headache frequency compared to those given usual care only.
The researchers note that the specific points used during treatment may play a less important role than previously thought and that much of the benefit may be due to needling effects.
An analysis of previously published studies found that acupuncture improved physical function in the short and long term in people with chronic knee pain due to osteoarthritis, but it appeared to provide only short-term (up to 13 weeks) relief of pain.
Another review, published in JAMA Surgery, analyzed previous studies on non-pharmacological interventions for pain management after total knee arthroplasty and found evidence that acupuncture delayed the use of patient-controlled use of opioid medication to relieve pain.
Before the initial appointment, you will be asked to complete health history. The acupuncturist begins the visit by asking you about your health concerns, diet, sleep, stress level, and other lifestyle habits. You may be asked about your emotions, appetite, food s and diss, and response to changes in temperature and seasons.
During your visit, the acupuncturist will examine your appearance carefully, noting your complexion, voice, and tongue color and coating. He or she will take your pulse at three points on each wrist, noting the strength, quality, and rhythm. In Chinese medicine, the tongue and pulses are considered to reflect the health of your organ systems and meridians.
Typically, acupuncture will use six to 15 tiny needles per treatment (the number of needles doesn't indicate the intensity of the treatment). The needles are often left in for 10 to 20 minutes. The acupuncturist may twist the needles for added effect.
Your acupuncturist may use additional techniques during your session including:
- Moxibustion: Also known as “moxa,” moxibustion involves the use of heated sticks (made from dried herbs) held near the acupuncture needles to warm and stimulate the acupuncture points.
- Cupping: Glass cups are applied to the skin so that there is a suction effect. In TCM theory, cupping is used to relieve the stagnation of qi and blood.
- Herbs: Chinese herbs may be given in the form of teas, pills, and capsules.
- Electroacupuncture: An electrical device is connected to two to four acupuncture needles, providing a weak electrical current that stimulates the acupuncture needles during the treatment.
- Laser Acupuncture: Said to stimulate acupuncture points without the use of needles.
Ear acupuncture, also known as auricular acupuncture, is sometimes used during the treatment for weight loss, smoking cessation, addictions, and anxiety.
Although the length of the acupuncture session can vary from a few minutes to over an hour, the typical treatment length is 20 to 30 minutes. The initial visit may take up to 60 minutes.
After the treatment, some people feel relaxed (or even sleepy), while others feel energetic. If you experience any unusual symptoms, you should consult your doctor.
You may feel a slight sting, pinch, ache, or some pain as the acupuncture needle is being inserted.
Some acupuncturists manipulate the acupuncture needle after it has been placed in the body, by twirling or rotating the needle, moving it up and down, or using a machine with a small electric pulse or current.
Some acupuncturists consider the resulting tingling, numbness, heavy sensation, or ache (known as “de qi”) desirable in achieving the therapeutic effect.
If you experience pain, numbness, or discomfort during the treatment, you should notify your acupuncturist immediately.
As with any treatment, acupuncture does pose some risks, the most common being pain and bleeding from the insertion of acupuncture needles. Other adverse effects can include skin rashes, allergic reactions, bruising, pain, bleeding, nausea, dizziness, fainting, or infections.
In order to reduce the risk of serious adverse effects, acupuncture should always be administered by a licensed and properly trained practitioner using sterile, disposable needles.
According to a report published in Scientific Reports, acupuncture can cause serious adverse effects, such as infections, nerve and blood vessel injury, complications from needle breakage or remnant needle pieces, punctured organs, central nervous system or spinal cord injury, hemorrhage, and other organ and tissue injuries resulting in death. Punctured pleural membranes around the lungs can lead to collapsed lungs. People with a rare, anatomical variation known as sternal foramen (a hole in the breastbone) are at risk of lung or heart (pericardium) puncture.
There have been some reports of needles being left in after the treatment. A report published in the Bulletin of the World Health Organization summarized the acupuncture-related adverse effects in Chinese language studies.
Acupuncture may not be right for people with certain health conditions. The risk of bleeding or bruising increases if you have a bleeding disorder or are taking blood thinners, such as warfarin (Coumadin).
Acupuncture shouldn't be used in place of standard care. Avoiding or delaying standard care may have serious consequences.
If you are having difficulty managing pain or other health issues with conventional methods, acupuncture may be worth a try. Just be sure to check with your doctor first to discuss whether it's appropriate for you.