Acupuncture -
Michele Van Hal ; Alexander M. Dydyk ; Michael S. Authors Michele Van Hal 1 ; Alexander M. Dydyk 2 ; Michael S. Green 3. Acupuncture is a system of medical treatment and ideology that is based on the principle of applying small needles or pressure to specific points in the body.
The origins of this treatment system are grounded in traditional Chinese medicine TCM , with underlying philosophical principles associated with Confucianism and Taoism. This activity describes the physiology and mode of action underlying acupuncture and highlights the role of interprofessional healthcare providers in educating patients on pain management.
Objectives: Explain how acupunctures works. Describe the techniques involved in performing acupuncture. Identify patient populations that might benefit from acupuncture. Summarize the clinical impact that acupuncture can have and how the interprofessional team can help coordinate care for patients who might benefit from acupuncture.
Access free multiple choice questions on this topic. Acupuncture is a nonpharmacological treatment option for multiple different diseases and symptoms. Although numerous studies have been done regarding the efficacy of acupuncture, there only been a few landmark high-quality randomized controlled trials.
The article mainly focuses on the evidence of these high-quality studies. This in-office procedure has varying degrees of efficacy. Acupuncture treatments include nausea, pain, allergies, hot flashes, breathing difficulty, mood disorders, dyspepsia, and even tobacco use. Acupuncture is mainly safe.
Local side effects can occur, but they typically resolve reasonably quickly after removing the acupuncture needle. Acupuncture is most commonly used in the treatment of chronic, noncancer pain in adults.
Acupuncture is a system of medical treatment and ideology based on the principle of applying small needles or pressure to specific points in the body. Five elements are the foundation of this theory of qi: wood, water, fire, earth, and metal.
A blockage or excess of any disrupts this vital energy. Acupuncture aims to open the blockage or reduce the excess of qi flowing through specific channels in the body, known as meridians.
Under this ideology, health is not simply the absence of disease, but rather the functioning interconnection of wellness. There are no isolated symptoms, but rather each symptom arises in the context of blockage or excess specific to the individual.
Balancing the qi restores the interconnectedness, thus restoring wellness. Although acupuncture originated in TCM, its migration to the West was through other Asian countries, chiefly Korea and Japan. Many consider this a relatively recent movement; however, Osler himself mentioned acupuncture in his writings on medicine in the s.
However, acupuncture was considered for some time as a fringe treatment and not part of legitimate medical care. The efficacy of acupuncture is changing. Up to 1. Acupuncture is seldom used as a sole treatment, however, but rather in conjunction or as an adjunct to traditional medical care.
As more studies are done showing the efficacy of acupuncture to treat various types of pain, insurance companies are beginning to take notice. Acupuncture is now an in-office procedure covered by multiple insurance providers.
Multiple studies have shown the effectiveness in the treatment of back pain, either acute or chronic, knee pain secondary to osteoarthritis, myofascial pain, and headaches [4] [5] [6] [7].
However, it must be noted that there is a significant placebo effect. There is power in belief. Many studies show not only acupuncture leading to superior pain relief for various ailments but also sham acupuncture. However, given the overall positive patient response, limited side effect profile, and little to no cost on the healthcare system, acupuncture is an essential alternative treatment modality [8] [9].
Qi is arranged into meridians or channels that allow the flow of qi. Traditionally and most commonly, needle penetration is the means of opening qi. Manual pressure, electrical stimulation, laser, heat, and even ultrasound have also been utilized.
The application of these modalities is thought to manipulate qi in much the same way that needle penetration would. The primary proponent to whether acupuncture should or should not be recommended is the desired to pursue acupuncture therapy from the patient.
The first rule of medicine is not to harm. Acupuncture or sham acupuncture makes patients feel better. There is a psychological component to therapy. However, like many medications and treatment modalities, their effectiveness can be directly correlated to the physician or healthcare provider endorsing the treatment.
If the provider is seeing a patient with chronic low back pain and is hopeful that acupuncture could help with their pain, the patient is more likely to believe acupuncture will help with her pain. In comparison, if a provider approaches the patient by saying acupuncture does not work, then the patient may not think it works nearly as well.
Given the ideology underlying acupuncture, almost every medical condition has been treated with this modality in the East. Even in western medicine, acupuncture has been attempted and studied in a variety of diseases and disorders, ranging from seasonal allergic rhinitis to fibromyalgia.
Most commonly, acupuncture has been indicated for pain, chronic and acute; and for nausea and vomiting, both postoperative, peripartum, and chemotherapy-induced. There are very few strict contraindications to acupuncture. It has been used even in vulnerable populations, such as in pregnant and pediatric patients.
Nausea and vomiting in both of these populations seem to be more effectively improved by acupuncture than in the general population. In general, acupuncture needles are thinner and thus gentler than conventional hollow bore needles such as intravenous IV catheters, phlebotomy needles, or neuraxial needles.
Anticoagulation is also not a strict contraindication based on this rationale. Most practitioners recommend not undergoing acupuncture if experiencing active infection, especially cutaneous, malignancy, as there might be a threat of the spread of neoplastic cells; and severe neutropenia secondary to the risk of infection.
Otherwise, the judgment of the practitioner is considered paramount. Two specific contraindications deserve special mention: patients with an AICD should avoid any electromagnetic stimulation that might be used as a form of acupuncture.
Also, it is not recommended that patients that suffer or are predisposed to suffer from psychosis or delusions undergo acupuncture as well.
People on warfarin or other anticoagulants, as well as people with a history of bleeding disorders, are not contraindications to acupuncture [13]. Pregnancy is also not a contraindication to acupuncture. In the United States, clinical acupuncturists are credentialed through the American Board of Medical Acupuncture.
The National Certification Commission for Acupuncture and Oriental medicine certifies non-clinical acupuncturists. Both of these endorse the requirement for to hours of training in a 3- to a 4-year program.
Board certification encompasses a final standardized exam and the demonstration of adequate training before certification. Many states allow physicians to practice acupuncture without significant training, and others may require a few hundred hours of additions to training and certification.
Some examples of this could be a natural pathic office. Physical therapy, primary care office, integrative medicine office, and pain clinics. Before beginning acupuncture, patients generally undergo a thorough interview and examination by the practitioner.
The background can include conventional medical history, and physical but might also expand to specific analysis of the tongue and radial pulse. The acupuncturist will identify the specific acupuncture points, of which there are approximately positioned over the 14 meridians.
These points may be associated with particular organs or organ systems, but treatment is not based on an anatomical basis as much as it is a holistic basis. Sterile, stainless steel needles are used and are often single-use.
A plastic guide tube might be necessary for the insertion of very thin or fragile needles. The practitioner will quickly insert the needle at the identified point.
The needle will then remain in position for 10 to 20 minutes. Patients often endorse numbness or mild radiculopathies that may radiate. The needle might be manipulated if the patient does not endorse this characteristic feeling.
Anytime a foreign body is introduced into a patient even on a superficial level, there is no risk of bleeding, local irritation, or infection. Complications of acupuncture were briefly mentioned previously under contraindications; they are the same as with any procedure that involves needles: infection, disease transmission, trauma, nerve injury, and bleeding.
Also, dependent upon where the acupuncture is being performed, there is a risk of pneumothorax and pneumoperitoneum or even organ puncture. Overall, complications from acupuncture are infrequent and are generally associated with less qualified or experienced practitioners.
Acupuncture has gained popularity as an adjunct to conventional allopathic medical treatments and is offered even at prestigious academic medical centers. However, despite numerous studies, the mechanism for how acupuncture might be functional physiologically is yet to be determined.
Hypotheses include that the stimulation influences inflammatory markers induces hormonal changes, or even that the pressure itself manipulates loose connective tissue that causes immunomodulation.
It is theorized that analgesia results as well from the release of natural opioids at both spinal or supraspinal levels. Functional MRI has shown physiologic changes in the central nervous system while undergoing acupuncture.
Complementary and alternative medicine modalities are often not candidates for randomized controlled trials, which are the foundation of evidence-based medical practices in the United States.
Acupuncture is no exception. Another limitation is that acupuncture is an individualized treatment, which makes standardization for a study difficult. Therefore, acupuncturists often do not feel they can adequately treat patients if they are mandated to perform specific points or techniques for the sake of variable control.
Methods vary as well by school and style, which have variability as to the locations themselves, the manipulation manner, length of treatment, and the desired response from the patient. Lastly, the theory of health and disease for this modality is not based on Western traditional medical philosophy, which makes the characterization of disease and treatment itself a limiting factor.
All of these dynamics intertwine to make it difficult to prove or disprove the efficacy of acupuncture according to Western evidence-based medicine standards. It is questionable if acupuncture is clinically superior when compared to sham acupuncture. However, this does not take into the fact both acupuncture and sham are both effective in the reduction of symptoms and improving the function of patients with back pain, headaches, knee pain, and hot flashes.
Both therapies are superior to no treatment at all [18] [19]. Studies have demonstrated that acupuncture treatment improves functional status and reduced low back pain.
Six different randomized control trials focusing on chronic low back pain did show a small benefit to the use of acupuncture in both 1, 3, and 6-month follow-ups [20]. However, sham acupuncture seems to have nearly the same effect and, in some studies, better improvement scores—one creative study utilized toothpicks as sham acupuncture.
Patients were asked to lie prone and then touched with a toothpick in a similar motion as one would for an actual needle. Back dysfunction scores were equally improved as in the acupuncture group.
Of note, both of these groups had better pain improvement scores over conventional treatment. It is the recommendation of the American College of physicians to use and recommend acupuncture as a first-line, nonpharmacological treatment for patients suffering from chronic low back pain [21].
There are limited studies on efficacy in the use of acupuncture for acute back pain. The results may not have clinical significance pain relief compared to statistical significance compared to no treatment or sham [22]. Medically reviewed by Kerry Boyle D.
How does it work? What are the benefits? What to expect How to find an acupuncturist Home alternatives Acupuncture, the practice of treating conditions through triggering certain points on the skin with needles, may help with allergies, migraines, or insomnia.
What is acupuncture? What does acupuncture do? Incorporating acupuncture into real life. How do I find an acupuncturist? Share on Pinterest. How we reviewed this article: Sources. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations.
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Sep 20, Written By Danielle Sinay. Medically Reviewed By Kerry Boyle D. Jul 3, Written By Danielle Sinay. Share this article. Read this next. Acupuncture for Headaches and Migraines. Medically reviewed by Daniel Bubnis, M. Dry Needling vs. Acupuncture: Which Is Right for You? How to Quit Smoking Naturally — from an Eastern Perspective Not everyone wants to use medications or cessation aids to quit smoking.
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Acupuncture Acupuncture a form of traditional Chinese cAupuncture that has been practiced for Acupuncturre. Acupuncture based on the theory Satisfying food cravings Acupuncture, called chi Acupuncture "chee"Acupuncture through and around your body along pathways called meridians. Acupuncturists believe that illness occurs when something blocks or unbalances your chi. Acupuncture is a way to unblock or influence chi and help it flow back into balance. Acupuncture is done by putting very thin needles into your skin at certain points on your body.Video
The Science Behind How Acupuncture Helps Relieve Pain: A Doctor Of Chinese Medicine ExplainsAcupuncture -
Acupuncture has been used to treat a number of mental health conditions, including depression, post-traumatic stress disorder, and anxiety. Acupuncture has been well-studied for treating headache pain, including migraine headaches and tension headaches.
Acupuncture is sometimes used to treat insomnia. There is some evidence that it is effective for this, though it's unclear whether it is acting as a placebo. One review of studies found that acupuncture provided better relief of symptoms after more than three weeks of treatment than pharmacological treatments.
Acupuncture is sometimes used to treat infertility. Much of the research into this use has focused on women undergoing assisted reproductive techniques such as in vitro fertilization.
One review of studies found that combining acupuncture with other fertility treatments might help improve the chances of pregnancy, but the authors also noted that the evidence is not yet robust enough to form a solid conclusion.
Other studies have found no benefit compared to placebo for women undergoing in vitro fertilization. Acupuncture has also been used to treat male infertility. A review of studies, however, noted that most of the scientific evidence to support this use comes from poorly designed studies or studies with a small sample size.
Some studies have also reported that control groups receiving "sham" treatments also experienced a therapeutic benefit. A separate review study also concluded that acupuncture does not seem to help improve sperm quality, though it noted that research has so far been limited and larger studies are needed.
Cosmetic acupuncture , also known as facial acupuncture, is used to improve the appearance of the skin on the head, face, and neck.
This use has not been well studied, but a review of studies found that existing trials were well-designed and showed positive benefits. The authors did note that further research is needed.
Acupuncture is sometimes used as an adjunctive or complementary therapy for people with chronic respiratory conditions. For example, one review of studies found that people with chronic obstructive pulmonary disease COPD experienced significant improvement in symptoms when acupuncture was used as an adjunctive therapy.
People with advanced cancers may also benefit from acupuncture. Another review of studies found that acupuncture could help reduce breathlessness and improve quality of life for people experiencing severe breathlessness as a result of advanced cancers or COPD.
People undergoing treatment for cancer or recovery from surgery often experience nausea and vomiting. Some studies have found that acupuncture can help reduce these symptoms. For example, one review of studies concluded that using acupuncture alongside standard treatments could help control vomiting compared to standard treatments alone.
However, the study authors noted that the quality of the evidence was low, and more studies are needed to confirm the usefulness of acupuncture for treating chemotherapy-associated nausea and vomiting.
A small trial looked at acupuncture as a preventative measure for postoperative nausea and vomiting in children undergoing tonsillectomy. It found that the incidence of nausea and vomiting was reduced significantly when acupuncture was used during early recovery.
Prior to getting acupuncture, your acupuncturist will ask about your health history and may give you a physical examination. During the acupuncture session, thin needles are placed in specific areas to address your concern or condition. The acupuncturist may gently twist the needles for added effect.
The needles are often left in for 15 to 20 minutes, with the total session lasting anywhere from 30 minutes to an hour. Your acupuncturist may use additional techniques during your session including:. After the treatment, some people may feel relaxed, while others may feel energetic. If you experience any unusual symptoms, you should contact your healthcare provider.
You may feel a slight sting, pinch, ache, or some pain as the acupuncture needle is being inserted. Some acupuncturists move the needle after it has been placed in the body, which can cause additional pressure.
Once the needle has been properly placed, you may feel a tingling or heavy feeling, which is referred to as de qi. Let your acupuncturist know if you are uncomfortable or in a lot of pain at any point during the session.
Intense pain may mean the needle has not been inserted or placed correctly. Some people believe that acupuncture helps relieve pain by releasing endorphins, which are pain-relieving chemicals produced by the human body.
This may be why some people report immediate relief of symptoms. This type of pain relief, however, may be short-term. How long acupuncture takes to work also depends on the condition being treated. For some people, it may take a few sessions before considerable improvement is noted.
The effects may persist for some time after treatment ends, but it is unknown how long acupuncture can continue to provide relief after stopping sessions. As with any treatment, acupuncture may cause side effects in some individuals.
Side effects may include:. In order to reduce the risk of side effects, acupuncture should always be done by a licensed and properly trained healthcare provider using clean, disposable needles. Acupuncture is generally considered safe as long as it's done by a licensed professional using clean, sterilized needles.
Still, it's a good idea to speak with your primary care physician before getting acupuncture, as this treatment may not be right for people with certain health conditions. One of the risks of acupuncture is the accidental insertion of a needle into the space between the lungs and the chest wall.
This can lead to pneumothorax or collapsed lung. However, this is uncommon. It is also possible to experience blood vessel and nerve injury , complications from the needle breaking during treatment, organ injuries, as well as brain and spinal cord injuries. While rare, acupuncture complications can lead to death.
Acupuncture is not recommended for people who have a pacemaker. You should not have acupuncture if you are at high risk for infection or you have chronic skin problems.
People with bleeding disorders or who are taking a blood thinning medication should also avoid acupuncture. You should also avoid getting acupuncture in any areas where you have had lymph nodes removed, as acupuncture could increase the risk of infection.
People who are pregnant or who have cosmetic implants such as breast implants should ask a healthcare provider before having acupuncture.
Make sure to tell your healthcare provider about any medications or dietary supplements you're taking. Not every insurance policy covers acupuncture, but some do. It is best to check with your insurance company before setting up an appointment. Be sure to ask your provider whether they accept your insurance.
Researchers aren't exactly sure how acupuncture works, however, theories suggest that it may help release endorphins, as well as influence the autonomic nervous system. Acupuncture may be helpful for a variety of concerns, including some mental health disorders, pain, inflammatory conditions, stress, and skin appearance.
However, keep in mind that acupuncture can lead to mild or serious side effects in some individuals. An acupuncture session can take anywhere from 30 minutes to an hour and usually involves about 20 minutes with the needles in.
Some individuals may feel some pain or pressure while the needles are inserted, while others may feel different sensations while the needles are in. Johns Hopkins Medicine. Hao JJ, Mittelman M.
Acupuncture: past, present, and future. Glob Adv Health Med. Harvard Health Publishing. Relieving pain with acupuncture. Li YW, Li W, Wang ST, et al. The autonomic nervous system: A potential link to the efficacy of acupuncture.
Front Neurosci. Moura CC, Chaves ECL, Cardoso ACLR, Nogueira DA, Azevedo C, Chianca TCM. Auricular acupuncture for chronic back pain in adults: A systematic review and metanalysis.
Rev Esc Enferm USP. Wang H, Yang G, Wang S, Zheng X, Zhang W, Li Y. The most commonly treated acupuncture indications in the United States: A cross-sectional study. Am J Chin Med. Shin BC, Lim KT. Acupuncture for cosmetic use: A systematic review of prospective studies. J Cosmet Med. Lim TK, Ma Y, Berger F, Litscher G.
Acupuncture and neural mechanism in the management of low back pain-An update. Medicines Basel. Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for chronic pain: Update of an individual patient data metaanalysis. J Pain. Lin X, Huang K, Zhu G, Huang Z, Qin A, Fan S.
The effects of acupuncture on chronic knee pain due to osteoarthritis: A meta-analysis. J Bone Joint Surg.
Tedesco D, Gori D, Desai KR, et al. Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
JAMA Surg. Zhu J, Arsovska B, Kozovska K. Acupuncture treatment in osteoarthritis. Int J Recent Sci Res. Smith CA, Armour M, Lee MS, Wang LQ, Hay PJ. Acupuncture for depression. Cochrane Database Syst Rev. Grant S, Colaiaco B, Motala A, et al. Acupuncture for the treatment of adults with posttraumatic stress disorder: A systematic review and meta-analysis.
J Trauma Dissociation. Yang XY, Yang NB, Huang FF, Ren S, Li ZJ. Effectiveness of acupuncture on anxiety disorder: A systematic review and meta-analysis of randomised controlled trials. Ann Gen Psychiatry. Motlagh FE, Ibrahim F, Rashid RA, Seghatoleslam T, Habil H.
Acupuncture therapy for drug addiction. Chin Med. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Acupuncture is often seen as a form of complementary or alternative medicine CAM.
Western medical acupuncture dry needling is the use of acupuncture following a medical diagnosis. It involves stimulating sensory nerves under the skin and in the muscles.
This results in the body producing natural substances, such as pain-relieving endorphins. It's likely that these naturally released substances are responsible for the beneficial effects experienced with acupuncture. A course of acupuncture is usually recommended because it can take a few sessions for you to see improvements.
Traditional acupuncture is based on the belief that an energy, or "life force", flows through the body in channels called meridians. This life force is known as Qi pronounced "chee". Practitioners who use acupuncture in the traditional way believe that when Qi does not flow freely through the body, this can cause illness.
They also believe acupuncture can restore the flow of Qi, and so restore health. Acupuncture practitioners — sometimes called acupuncturists — use acupuncture to treat a wide range of health conditions.
However, the use of acupuncture is not always based on rigorous scientific evidence. The National Institute for Health and Care Excellence NICE provides guidelines for the NHS on the use of treatments and care of patients. Currently, NICE only recommends considering acupuncture as a treatment option for:.
Acupuncture is also often used to treat other conditions and symptoms, including:. However, the evidence on the effectiveness of acupuncture compared with other treatments is unclear. Acupuncture is sometimes available on the NHS, most often from GP surgeries or physiotherapists, although access is limited.
Most acupuncture patients pay for private treatment. The cost of acupuncture varies widely between practitioners. If you're being treated by an acupuncture practitioner for a health condition or are considering having acupuncture, it's advisable to discuss this with your GP.
An initial acupuncture session usually lasts 20 minutes to 1 hour and involves an assessment of your general health, medical history and a physical examination, followed by insertion of the acupuncture needles. Courses of treatment often involve several separate sessions, but this can vary. The needles are inserted into specific places on the body, which practitioners call acupuncture points.
During the session, you'll usually be asked to sit or lie down. You may also be asked to remove some clothes so the practitioner can access certain parts of your body. The needles used are very fine and are usually a few centimetres long.
Ear Acupuncture involves placing acupuncture needles into Post-workout recovery meals for cyclists points Acupuncture Afupuncture Acupuncture. These points Acuppuncture Acupuncture Acupunctture correspond with specific Acupuncture, emotions or sensory Acupuncture. Acupuncture involves the insertion Acupuncturd very Acupuncture needles through Acupuncture skin at strategic points on your body. A key component of traditional Chinese medicine, acupuncture is most commonly used to treat pain. Increasingly, it is being used for overall wellness, including stress management. Traditional Chinese medicine explains acupuncture as a technique for balancing the flow of energy or life force — known as chi or qi chee — believed to flow through pathways meridians in your body. By inserting needles into specific points along these meridians, acupuncture practitioners believe that your energy flow will re-balance.
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