March 21, 2014

Acupuncture: Bottom-line Monograph

Assessing the research on this popular treatment
The practice of acupuncture originated in China 5,000 years ago. Today it is widely used throughout the world and is one of the main pillars of Chinese medicine. There are many different varieties of the practice of acupuncture, both in the Orient and in the West. Traditional Chinese medicine (TCM) usually combines acupuncture with Chinese herbs. Classical acupuncture (also known as five element acupuncture) uses a different needling technique and relies on acupuncture independent of the use of herbs. Japanese acupuncture uses smaller needles than the other varieties. Medical acupuncture refers to acupuncture practiced by a conventional medical doctor. Auricular acupuncture treats the entire body through acupuncture points in the ears only. Electroacupuncture uses electrical currents attached to acupuncture needles.

Related Terms

  • Abdominal cluster needling, acupoint, acupressure, acupuncture point stimulation, acustimulation, auricular acupuncture, auriculotherapy, back shu-points, Baihui, Bingfeng, BL58, BL67, body-acupuncture, brain-resuscitation acupuncture, centro-square needling, chi, chronopuncture, Chung Chi, Ciliao, classical balance method, computer-controlled electroacupuncture, conscious restoring resuscitation method, cranial needling, CV3, CV4, De Qi, Dicang, Diji, ear acupuncture, electro-acupuncture-anesthesia-device (EAAD), electroacupuncture, electroacupuncture according to Voll (EAV), energy medicine, ethnic traditional Chinese medicine, eye acupuncture, eye needling, filiform needle acupuncture, French acupuncture, French energetic acupuncture, Ganshu, GB8, GB14, GB44, Guanyuan, GV20, GV21, H9, Han's acupoint nerve stimulator (HANS), hand acupuncture, Hegu, hot red needle therapy, HT7, intradermal acupuncture, Japanese acupuncture, Japanese meridian, Jiache, Jiafeng, Jingmen, K1, K7, Kaiyin point No. 1, Korean acupuncture, Korean hand acupuncture, Kuan Yuan, laser acupuncture, laser acupuncture therapy, LI1, LI4, LI11,LI20, long needle retention, low level laser acupuncture, LU9, LU11, manual acupuncture, manual stimulation of needles, Matsumoto, medical acupuncture, meridian, motor therapy, moxibustion, myofascial acupuncture, nei-quan, Neiguan, neural therapy, otopuncture, P6 point, P9, PC6, Pishu, point injection, Qi, Qimen, reflexotherapy, Ren17, Ryodoraku, Sanyinjiao, scalp acupuncture, seed, sham acupuncture, sham laser acupuncture, Shaoze, shen-men, Shenshu, shonishin, Shu-Mu points, SI1, SI4, SJ5, somatic acupuncture, SP1, SP6, sphenopalatine ganglion, ST2, ST36, ST40, ST45, superficial dry needling, Taiyang, TB1, tendon muscle picking, thunder fire miraculous needling, 'ti qi tiao xue, fu ben pei, yuan' acupuncture, Tongnao Huoluo acupuncture (TNHLA), tongue acupuncture, traditional Chinese acupuncture (TCA), traditional Chinese medicine (TCM), transcutaneous electrical nerve stimulation (TENS), transcutaneous nerve stimulation, trigger point acupuncture, triple needling, Tzu Liao, UB2, UB32, verum acupuncture, Vietnamese acupuncture, warm reinforcing needling, Weiwanxiashu of Gliguidon, Weizhong, Western acupuncture, wrist-ankle acupuncture, Xiajuxu, Yangbai, Yanglingquan, Xinshu, Zhangmen, Zhongji, Zhuya Tongfu (ZYTF), Zusanli points.
  • Not included in this review: Acupressure, acustimulation, percutaneous electrical nerve stimulation, transcutaneous electrical nerve stimulation (TENS), shiatsu.

Background

  • The practice of acupuncture originated in China 5,000 years ago. Today it is widely used throughout the world and is one of the main pillars of Chinese medicine.
  • There are many different varieties of the practice of acupuncture, both in the Orient and in the West. Traditional Chinese medicine (TCM) usually combines acupuncture with Chinese herbs. Classical acupuncture (also known as five element acupuncture) uses a different needling technique and relies on acupuncture independent of the use of herbs. Japanese acupuncture uses smaller needles than the other varieties. Medical acupuncture refers to acupuncture practiced by a conventional medical doctor. Auricular acupuncture treats the entire body through acupuncture points in the ears only. Electroacupuncture uses electrical currents attached to acupuncture needles.
  • Aside from needles, other methods of stimulation are also considered forms of "acupuncture." These include the use of heat from the burning of herbs placed on specific points ("moxibustion") and the placement of herbal pastes on specific points.
  • Research on the effectiveness of acupuncture has special challenges. These include the diversity of approaches, the practice of individualizing treatment for each patient, differing skill levels between practitioners, and difficulty separating out the effects of acupuncture from placebo effects (i.e., how the patient's beliefs and expectations affect his/her perception of symptoms).
  • Based on acupuncture's long history of use as well as the limited research available, both the World Health Organization and the National Institutes of Health have identified many conditions for which it may be recommended. However, many common uses do not yet have formal scientific evidence to support them.

Theory

  • Chinese medicine theory holds that the human body contains a network of energy pathways through which vital energy, called "chi" (also spelled "qi"), circulates. These pathways are called "meridians."
  • The meridians contain specific "points" that function somewhat like gates or way stations through which chi flows as it circulates through the body. Acupuncture needles are inserted into these points to regulate the flow of chi through the meridians.
  • Illness and symptoms are believed to be caused by problems in the circulation of chi through the meridians (e.g., blockage or impairment of proper flow). Good health is considered an indication of the proper circulation of chi - a state of "balance" or "harmony."
  • Chi is believed to have subtle qualities (sometimes referred to as "elements"), which can be in balance or out of balance, causing symptoms.
  • Western science has determined that the meridians and points identified in Chinese medicine coincide with anatomical features that can be observed with scientific instruments. For example, electrically-charged particles called "ions" have been found to flow through "ionic streambeds" that correspond with the meridians just beneath the surface of the skin. Acupuncture points have been found to emit light, which can be detected with sensitive laboratory equipment.
  • The chi proposed by Chinese medicine theory is not electricity and is not directly detectable with scientific instruments. Western science has studied electrical phenomena (ions, electrons, electrical energy) that occur with acupuncture. These phenomena are detectable and appear to accompany the circulation of chi through the body.
  • Acupuncture has been shown to effectively treat some health conditions, including pain. However, the mechanism of action remains unclear. Endogenous opioid-mediated mechanisms of electroacupuncture as used in China only appear to explain how acupuncture works in part. Acupuncture is purported to also affect the brain's reward systems as well as blood flow in the skin, muscles, and nerves. Research has also shown regional effects on neurotransmitter expression.
  • One of the challenges in reviewing acupuncture and other complementary practices is the lack of placebo or sham-groups in most clinical trials. Some experts argue that blinding and placebo controls are not necessary, since when they are used, they are often not true shams. Recent study investigated a sham retractable type acupuncture needle and found that the applicability of "placebo" needling may be influenced by inter-tester variability, as well as the patient's knowledge and experience of acupuncture, acupuncture point selection, the visual impact of needling, and so on.

Scientific Evidence


UsesaGradeb
Osteoarthritis
There has been substantial research on the efficacy of acupuncture in the treatment of osteoarthritis. Most studies focus on knee, cervical, and hip osteoarthritis symptoms. In recent years, the evidence has improved and is now considered strong for the use of acupuncture in osteoarthritis of the knee.
A
Pain (chronic)
Strong evidence supports the use of acupuncture in long-lasting back pain and neck pain.
A
Post-operative pain
Several studies have tested the effects of acupuncture on pain after surgery. A clear majority of these studies have reported beneficial effects.
A
Dental procedures
Results of acupuncture in postoperative dental pain have been promising and supported by numerous studies.
B
Fibromyalgia
There is evidence from several studies suggesting that acupuncture may help with pain relief in fibromyalgia. Some research suggests it may also improve symptoms of fatigue and anxiety.
B
Nausea and vomiting (chemotherapy-induced)
Evidence from several small studies supports the use of acupuncture at a specific point on the wrist (P6) to help chemotherapy patients reduce nausea and vomiting. Electroacupuncture has also been used in combination with anti-nausea medications.
B
Post-operative nausea / vomiting (adults)
Evidence supports the use of acupuncture at the wrist P6 point for the relief of post-operative nausea and vomiting in adults. Some research has shown that acupuncture is equally as effective as anti-nausea drugs.
B
Acute cerebral infarction
Acupuncture may regulate metabolic disorders of lipids and improve main clinical symptoms in patients with cerebral infarction and hyperlipidemia. Better-designed trials are needed to confirm these results.
C
Anesthesia
Based on the possible pain-relieving effects of electroacupuncture, this therapy has been suggested as a possible form of anesthesia. Limited research has tested its anesthestic effects in patients undergoing heart surgery. More research is needed to determine if this is a safe and effective treatment.
C
Angina pectoris (chest pain)
Some research has suggested that acupuncture might help reduce distress and symptoms of angina, but this has not been consistently shown in other studies.
C
Ankylosing spondylitis
Based on limited research, acupuncture combined with motor therapy may help treat ankylosing spondylitis, an inflammatory disease of the spine and nearby joints.
C
Annexitis
There is not enough evidence to recommend for or against the use of acupuncture in patients with annexitis (inflammation of the uterus).
C
Anxiety
Several studies suggest that acupuncture may help improve symptoms of anxiety, especially before surgical or diagnostic procedures. However, the sum of the evidence is conflicting.
C
Asthma
Some research suggests that acupuncture may help prevent exercise-induced asthma. It may also reduce the perceived level of breathlessness associated with asthma or emphysema and allow patients to take lower doses of asthma medications. However, the available studies are insufficient for making strong recommendations.
C
Autism
Early research suggests that a combination of electroacupuncture and behavioral or educational therapy may help improve symptoms of autism. However, acupuncture did not improve intelligence. More research is needed to confirm these early findings.
C
Bladder disorders
Acupuncture plus Methycobal® has been studied as a possible treatment for diabetic neurogenic bladder. This condition occurs when a problem with the nervous system prevents people from properly controlling their bladders. More research is needed to determine if acupuncture is effective for this disorder.
C
Blood circulation (following hysterectomy)
Hand acupuncture has been compared to moxibustion in relieving pain in women who have undergone hysterectomies; however, it is impossible to reach a firm conclusion at this time.
C
Blood vessel disorders (aortitis)
Researchers have tested the effects of acupuncture-moxibustion on multiple aortitis, a condition that causes the main blood vessel (called the aorta) to swell. Although acupuncture-moxibustion was shown to be more effective than standard medications, more research with acupuncture alone is needed before a firm conclusion can be made.
C
Breast cancer (vasomotor symptoms)
Early research suggests that acupuncture or electroacupuncture may help treat vasomotor symptoms, such as hot flashes, in breast cancer patients. More study is needed before a strong recommendation can be made.
C
Breast milk stimulant
Early research suggests that acupuncture may improve breast milk flow in women who do not produce enough milk after delivery. More research is needed in this area.
C
Burn pain
There is insufficient evidence to recommend for or against the use of acupuncture in pain associated with burns.
C
Cancer pain
There has been limited research on acupuncture for cancer pain, and the research that was done was shown to have mixed results. More studies are needed to determine potential benefits.
C
Cardiovascular conditions
Acupuncture has been found to be superior to medication (shenmai injection) for low pulse pressure syndrome. More studies are needed before a firm conclusion can be drawn.
C
Carpal tunnel syndrome
Currently, there is insufficient evidence available to recommend for or against the use of acupuncture in carpal tunnel syndrome.
C
Cerebral palsy
There is not enough evidence available from well-designed studies to recommend either for or against the use of acupuncture in cerebral palsy. Many studies combined acupuncture with rehabilitation therapies, such as motor therapy.
C
Cervical spondylosis
Both needle-knife therapy and acupuncture have been used to treat cervical spondylosis, with one study showing needle knife therapy as a superior treatment. However, higher-quality studies are needed before strong recommendations can be made.
C
Chemotherapy-induced leukopenia
It is unclear if acupuncture can help increase white blood cells (called leukocytes) in cancer patients who are receiving chemotherapy. Well-designed research is needed in this area.
C
Cognitive disorders
There is not enough available evidence to recommend either for or against the use of acupuncture in nervous system disorders that affect brain functioning or communication.
C
Colitis
Early study has used acupuncture for acute and chronic colitis. More study is needed before a strong recommendation can be made.
C
Communication disorder
The combination of acupuncture and Schuell's stimulation and psychological care may be effective in treating aphasia due to cerebrovascular disorders. Additional study is needed in this area.
C
COPD (chronic obstructive pulmonary disease)
Overall there is insufficient evidence on which to base strong recommendations for acupuncture to treat breathlessness in patients with COPD.
C
Dementia
There is not enough evidence to recommend the use of acupuncture in the treatment of vascular dementia.
C
Depression
There is some evidence to suggest that acupuncture may help treat symptoms of depression, especially in menopausal or stroke patients. Study results are mixed. More studies are needed before a strong recommendation can be made.
C
Diabetes
There is a lack of well-designed studies to determine the effect of acupuncture in this condition.
C
Diabetic retinopathy
There is promising research that acupuncture may be an effective therapy for diabetic retinopathy, an eye disease that may lead to vision loss. However, additional studies are needed before a recommendation can be made.
C
Diagnostic procedure (pneumoencephalography side effects)
Acupuncture therapy has been suggested as a possible treatment for the side effects associated with various diagnostic procedures. More research is needed in this area.
C
Dry mouth (xerostomia)
There is some limited evidence suggesting that acupuncture may stimulate salivary flow in some patients with dry mouth (xerostomia). More studies of better design are needed to evaluate this use.
C
Dysmenorrhea (painful menstruation)
It is unclear if acupuncture can improve symptoms of painful menstruation. Study results are mixed. Additional research is needed before a conclusion can be made.
C
Dyspepsia (functional)
Currently, there is not enough data to recommend for or against the use of acupuncture in functional dyspepsia.C
C
Enuresis (bedwetting)
The available studies do not offer enough evidence to make a strong recommendation.
C
Epilepsy
The use of acupuncture as a treatment for epilepsy has aroused researcher interest because many patients have difficulty controlling their seizures despite antiepileptic treatments. Limited evidence does not support acupuncture as a treatment for epilepsy, but more studies are needed in this area.
C
Erectile dysfunction
There is insufficient available evidence to recommend for or against acupuncture in the treatment of erectile dysfunction.
C
Exercise performance
It is unclear if acupuncture can improve muscular performance, muscle strength, or heart rate recovery after exercise. Additional research is needed to determine if acupuncture is an effective therapy for exercise performance.
C
Eye disorders (ophthalmoplegia)
Early evidence has shown that eye-needling combined with medication may be more effective than medication alone in the treatment of ophthalmoplegia, a condition that causes paralysis of the motor nerves of the eye.
C
Facial paralysis
Acupuncture has been studied as a possible therapy for facial paralysis. Additional studies are needed before recommendations can be made.
C
Fasciitis (back muscles)
Fasciitis is inflammation of the layer of connective tissue that covers, separates, and supports muscles. Acupuncture has been studied in fasciitis of back muscles. More studies are needed to make any firm conclusions.
C
Fever
Early research suggests that acupuncture may help reduce a high fever associated with the common cold. More research is needed to confirm these early findings.
C
Gastric disorders (gastroparesis)
Early evidence suggests that acupuncture may help treat gastroparesis, which refers to nerve or muscle damage in the stomach that causes slow digestion and emptying, vomiting, nausea, and bloating. More research is needed in this area.
C
Headache (migraine, myogenic, tension, unspecified)
Acupuncture may offer promise for various types of headaches, but higher quality studies are needed before recommendations can be made.
C
Heart attack treatment/prevention/rehabilitation
Few studies have tested the use of specific therapies, separate from herbal or oral supplements, in rehabilitation of the heart. It remains unclear if acupuncture is an effective treatment.
C
Hemiplegia
Hemiplegia is a condition of full or partial paralysis of one side of the body due to disease, trauma, or stroke. Various types of acupuncture, such as scalp acupuncture and traditional acupuncture, have been used to treat hemiplegia. Although early research is promising, more studies are needed before a recommendation can be made.
C
Hemorrhage (cerebral, vocal cords)
Limited evidence indicates that acupuncture may benefit patients with cerebral hemorrhage or submucosal hemorrhage of the vocal cords. Study of acupuncture's effects alone vs. in combination with other therapies may help make a firm conclusion.
C
Herpes zoster
Based on early research, acupuncture therapy may help treat herpes zoster and improve symptoms of pain. However, more high-quality studies are needed before a conclusion can be made.
C
High blood pressure
There is insufficient evidence available on which to base any recommendation for or against the use of acupuncture in high blood pressure.
C
Hormone regulation
It is unclear if acupuncture has beneficial effects on hormone levels in patients with Sjogren's syndrome or partial androgen deficiency of aging (PADAM). More research is needed in this area.
C
Infertility
More studies are needed to determine the benefits of acupuncture on infertility.
C
Insomnia
Traditional Chinese medicine commonly uses acupuncture to treat insomnia. A review of the available studies found reports of benefit, but major weaknesses in the design of the research makes the evidence insufficient to recommend for or against acupuncture for insomnia.
C
Irritable bowel syndrome (IBS)
Although limited evidence suggests benefit may be possible, more studies are needed in order to make recommendations for or against acupuncture in IBS.
C
Keratoconjunctivitis sicca (dry eyes)
There is not enough evidence on which to base recommendations for keratoconjunctivitis sicca at this time.
C
Kidney disorders
There has been limited research on acupuncture for kidney disorders, such as gouty renal damage or kidney hypertension of long-lasting (chronic) kidney disease. There is currently not enough available evidence to recommend for or against the use of acupuncture in these conditions.
C
Mastitis (breast pain and inflammation)
Acupuncture has been studied as a treatment for mastitis in breastfeeding women. Researchers have found that acupuncture may have beneficial effects when combined with standard treatment. More research is needed in this area.
C
Menopausal symptoms
There has been limited research on acupuncture for menopausal symptoms, such as hot flashes and menopause-related high blood pressure. However, because results are mixed, more studies are needed before a conclusion can be made.
C
Muscle strength
A limited amount of research suggests that acupuncture may increase leg strength. Additional studies are needed.
C
Myofascial pain
Early research suggests that acupuncture may help reduce myofascial pain. However, additional studies are needed to confirm these findings.
C
Nausea
Acupuncture may be effective in reducing the occurrence of nonspecific nausea. Additional studies are needed before a strong recommendation can be made.
C
Nausea and vomiting (postoperative in children)
Several attempts have been made to document the benefits of stimulation of the P6 wrist point to reduce post-operative nausea and vomiting. Both acupuncture and acupressure wristbands have been tried. Study results are mixed. More trials are needed to make any firm conclusion regarding the use of acupuncture in adults and children.
C
Nausea and vomiting of pregnancy (hyperemesis gravidarum)
It is unclear if acupuncture can help treat nausea and vomiting of pregnancy. Additional studies are needed in this area.
C
Nerve damage
It is unclear if acupuncture can help treat nerve damage. More research is needed in this area.
C
Pain (craniofacial)
There is insufficient evidence available on which to base recommendations for or against acupuncture in craniofacial pain.
C
Parkinson's disease
There is not sufficient evidence available on which to base recommendations for or against acupuncture in Parkinson's disease.
C
Peptic ulcers
Based on early study results, acupuncture may have a beneficial effect on peptic ulcers. However, a conclusion cannot be made until more studies are performed.
C
Polycystic ovary syndrome
Acupuncture and electroacupuncture may help prevent and reduce symptoms in patients with polycystic ovary syndrome. However, further research is needed before a firm recommendation can be made.
C
Post-traumatic stress disorder (PTSD)
It is unclear if acupuncture is beneficial for patients with post-traumatic stress disorder (PTSD). Early study results are promising, but larger studies are needed in this area.
C
Pregnancy (reducing back strain)
Early evidence suggests that acupuncture may substantially reduce low back pain in pregnancy. More studies are needed to confirm these results.
C
Pregnancy and labor
Acupuncture has been reported to encourage uterine contractions during labor and to reduce the pain of labor. However, results of formal studies are mixed, and the research designs have been weak. More studies are needed to clarify the potential of acupuncture in labor.
C
Pregnancy support
Moxibustion has been used historically in acupuncture to correct cephalic version (breech presentation) by turning the fetus' head in utero. Further studies are needed to determine its role in the correction of breech presentation.
C
Prostatitis (prostate inflammation)
While limited evidence suggests benefit may be possible, there is insufficient available evidence to recommend either for or against acupuncture in prostatitis.
C
Pruritus (itchy skin)
While limited evidence suggests benefit may be possible, there is insufficient available evidence to recommend either for or against acupuncture in uremic cutaneous pruritus.
C
Raynaud's disease
There is insufficient evidence on which to base recommendations for the use of acupuncture in Raynaud's syndrome at this time.
C
Rectal prolapse
While limited evidence suggests benefit may be possible, there is insufficient available evidence to recommend either for or against acupuncture in prolapsed rectums.
C
Rheumatoid arthritis
Some studies of weak design have reported that acupuncture may relieve pain associated with rheumatoid arthritis. However, a well-designed trial was unable to confirm this. More evidence is needed to clarify if or when acupuncture is beneficial in rheumatoid arthritis.
C
Rhinitis
There is not enough available evidence on which to base recommendations for acupuncture in patients with rhinitis.
C
Shoulder pain
The available research on acupuncture for shoulder pain of varying causes shows mixed results.
C
Sinusitis (chronic)
More studies are needed of stronger design to determine whether or not acupuncture offers benefit in sinusitis.
C
Skin disorders
There is evidence from several studies suggesting that laser acupuncture therapy may be beneficial for skin conditions. However, due to weaknesses in study methods, as well as the wide variety of conditions (such as psoriasis) in this category, it is difficult to make specific recommendations.
C
Sleep apnea
Some evidence suggests that acupuncture may help improve breathing in patients with moderate obstructive sleep apnea. Additional studies are needed to confirm these early findings.
C
Speech disorders (aphasia)
Scalp acupuncture combined with rehabilitation training may help improve symptoms of aphasia, a condition that occurs when a person has difficulty understanding and/or producing spoken and written language. More research is needed in this area.
C
Stroke recovery
Several studies have been conducted in stroke rehabilitation. More studies are needed to determine what can be expected in the use of acupuncture with regard to this application.
C
Substance abuse
The evidence on acupuncture in treating substance abuse is mixed. More studies are needed to evaluate the use of acupuncture in this application.
C
Temporomandibular joint (TMJ) disorders
The available evidence suggests acupuncture may be comparable to other forms of conservative treatments. However, the studies that have been performed have major weaknesses that call into question the meaning of the findings. More studies of better design are needed for definitive recommendations.
C
Tennis elbow
Evidence suggests that there is a reduction of pain and an improvement of function in the afflicted elbow.
C
Tourette's syndrome
Based on early evidence, acupuncture may be an effective therapy for Tourette's syndrome. Further research is needed to confirm these results.
C
Trigeminal neuralgia (primary)
Currently, there is insufficient available evidence to recommend either for or against acupuncture in primary trigeminal neuralgia.
C
Trigeminal neuralgia (primary)
Currently, there is insufficient available evidence to recommend either for or against acupuncture in primary trigeminal neuralgia.
C
Urinary tract infection
Early study in women suggests a reduced recurrence over six months and reduced residual urine (urine retained in the bladder after voiding). Better-designed studies are needed to determine recommendations for this use.
C
Vertigo (cervical)
Both ginger moxibustion and acupuncture have been studied for cervical vertigo, although few conclusions can be drawn at this time.
C
Vision problems
Acupuncture has been combined with other therapies, such as massage, manual therapy, and Chinese medicine, to treat vision problems, including nearsightedness, optic atrophy, and visual recovery. Additional studies with acupuncture alone are needed before any conclusions can be made.
C
Vulvodynia
Subjective observations in one small study suggest a possible role of acupuncture in the treatment of vulvodynia symptoms (chronic burning or stinging sensation of the vulva in the vagina). However, there is currently not enough evidence on which to base recommendations.
C
Weight loss
Evidence is inconsistent on whether acupuncture might contribute to weight loss. Some studies show modest benefit but others show none. Currently, there is not enough available evidence to recommend either for or against acupuncture in weight loss.
C
Hearing loss
Early evidence suggests that acupuncture is not effective in treating hearing loss in adults or children.
D
Smoking cessation
Numerous studies of acupuncture for smoking cessation have been conducted, and the quality of studies has varied widely. Results have been inconsistent. Several critical reviews of the research have concluded that the evidence does not support acupuncture as a reliable or effective method for smoking cessation. There may, however, be some benefit in reducing side effects of withdrawal such as irritation, cigarette craving, and headache.
D
Tinnitus
Small trials have been conducted and found no benefits over placebo for the treatment of chronic unilateral or bilateral tinnitus. However, non-controlled case series have found possible benefit. Larger studies are needed before a strong recommendation can be made.
D
Whiplash (adjunct)
Early study does not show that laser acupuncture is any more effective than sham laser acupuncture when used in combination with drugs and other mobilization therapies. More study is needed in this area.
D

aThese uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
bFor an explanation of Natural Standard's grading system, click here.

Tradition/Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Abnormal menstruation, abscesses, acute bacterial dysentery, allergies, Alzheimer's disease, anorexia, arm pain, attention deficit hyperactivity disorder, autonomic activity, balance disorder, bronchitis (acute), bruises, cancer, cardiac X syndrome, cataract, cervicobrachial syndrome, chemical sensitivities (environmental sensitivities), chronic cough, chronic fatigue syndrome, collagen-vascular disease, colorectal cancer, cervical vertebropathy, congestive heart failure, conjunctivitis, constipation, degenerative disk disease, diarrhea, digestive disorders, dyslexia, ear infection, energy enhancement, facial tics, fatigue (chemotherapy-related), flu, hot flashes (in men), frequent urination, gag reflex abnormalities, gastritis (acute and chronic), gastroesophageal reflux, gingivitis, glaucoma, gynecological disorders, hiccup, high cholesterol, HIV-related chronic diarrhea, immune system enhancement, incontinence, , intestinal occlusion, jet lag, joint disorders (facet syndrome), learning disorder, lung disease, memory improvement, Meniere's disease, mental illness, metabolic abnormalities (Dercum's disease), mood swings, multiple sclerosis, muscle cramps, muscle soreness (delayed onset), muscle spasm (of the esophagus, cardia, colon), overall wellbeing, overuse syndromes, pancreatic cancer, pancreatitis, paralysis (paralysis secondary to poliomyelitis), paralytic ileus, phantom limb pain, pharyngitis, placental detachment, plantar fasciitis, premenstrual syndrome (PMS), psychological stress, psychosis, reflex sympathetic dystrophy, respiratory-tract illness, retinitis, schizoaffective disorder, sciatica, scleroderma, sensory disturbances, soft-tissue contusions, sore throat, spinal stenosis, sports injuries, sprains and strains, stress-related conditions, stutter, tardive dyskinesia, tension, tonsillitis, toothache, travel sickness, trauma (pain), uterine fibroids, wound healing.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

  • Acupuncture does not usually cause serious side effects. There have been reports of dizziness and rapid, involuntary eye movements after acupuncture. Needles must be sterile in order to avoid disease transmission or infections (most practitioners now use disposable needles). Acupuncture should only be performed by qualified healthcare professionals. A woman who tried to perform acupuncture on herself experienced a spinal cord injury after inserting a sewing needle into her spinal cord.
  • Rare side effects include collapsed lung (called pneumothorox), blood clots (which may block blood vessels), ruptured artery (called a pseudoaneurysm), bleeding, abscesses, cerebrospinal fluid fistula, and diabetic ketoacidosis. A case of Bell's palsy has occurred after acupuncture. Symptoms went away two weeks after therapy was stopped, but it is unclear if acupuncture caused the condition.
  • Acupuncture should be avoided in the following conditions: valvular heart disease, known bleeding disorders, use of anticoagulants (blood thinners), pregnancy (may induce unwanted labor and possible miscarriage), systemic or local infection, pain of unknown medical origin, medical condition of unknown origin such as dermatologic lesions, and neurologic disorders (e.g., severe polyneuropathy or paraplegia, or following certain forms of neurosurgery) as well as on areas that have received radiation therapy.
  • Caution is advised in patients with pulmonary disease, elderly or medically compromised patients, diabetics (due to poor circulation), and in patients with a history of seizures. Wrist-ankle acupuncture may improve metabolism of blood sugar and blood-lipids, and a healthcare provider should monitor these levels in diabetic patients as medication adjustments may be necessary.
  • Electroacupuncture should be avoided in people with arrhythmia or pacemakers.

Author Information

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Categorized Under

References

1. Allen JJ, Schnyer RN, Chambers AS, et al. Acupuncture for depression: a randomized controlled trial. J Clin Psychiatry. 2006 Nov;67(11):1665-73.

2. Bjordal JM, Johnson MI, Lopes-Martins RA, et al. Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomized placebo-controlled trials. BMC Musculoskelet Disord 2007 Jun 22;8:51.

3. Bolton CM, Myles PS, Nolan T, et al. Prophylaxis of postoperative vomiting in children undergoing tonsillectomy: a systematic review and meta-analysis. Br J Anaesth 2006 Nov;97(5):593-604.

4. Brinkhaus B, Witt CM, Jena S, et al. Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med 2006 Feb 27;166(4):450-7.

5. Ceccherelli F, Tortora P, Nassimbeni C, et al. The therapeutic efficacy of somatic acupuncture is not increased by auriculotherapy: a randomised, blind control study in cervical myofascial pain. Complement Ther Med 2006 Mar;14(1):47-52.

6. Cheuk DK, Yeung WF, Chung KF, et al. Acupuncture for insomnia. Cochrane Database Syst Rev 2007 Jul 18;(3):CD005472.

7. Diener HC, Kronfeld K, Boewing G, et al. Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial. Lancet Neurol 2006 Apr;5(4):310-6.

8. Dune LS, Shiao SY. Meta-analysis of acustimulation effects on postoperative nausea and vomiting in children. Explore (NY) 2006 Jul-Aug;2(4):314-20.

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