Acupuncture
is among the oldest healing practices in the world. As
part of traditional Chinese medicineA whole medical
system that originated in China. It is based on the concept
that disease results from disruption in the flow of qi
and imbalance in the forces of yin and yang. Practices
such as herbs, meditation, massage, and acupuncture seek
to aid healing by restoring the yin-yang balance and the
flow of qi (TCM), acupunctureA family of
procedures that originated in traditional Chinese medicine.
Acupuncture is the stimulation of specific points on the
body by a variety of techniques, including the insertion
of thin metal needles though the skin. It is intended
to remove blockages in the flow of qi and restore and
maintain health. aims to restore and maintain health
through the stimulation of specific points on the body.
In the United States, where practitioners incorporate
healing traditions from China, Japan, Korea, and other
countries, acupuncture is considered part of complementary
and alternative medicineA group of diverse medical
and health care systems, practices, and products that
are not presently considered to be part of conventional
medicine. Complementary medicine is used together with
conventional medicine, and alternative medicine is used
in place of conventional medicine. (CAM).
Key
Points
Acupuncture
has been practiced in China and other Asian countries
for thousands of years.
Scientists
are studying the efficacy of acupuncture for a wide
range of conditions.
Relatively
few complications have been reported from the use of
acupuncture. However, acupuncture can cause potentially
serious side effects if not delivered properly by a
qualified practitioner.
Tell
your health care providers about any complementary and
alternative practices you use. Give them a full picture
of what you do to manage your health. This will help
ensure coordinated and safe care.
About
Acupuncture
The
term "acupuncture" describes a family of procedures involving
the stimulation of anatomical points on the body using
a variety of techniques. The acupuncture technique that
has been most often studied scientifically involves penetrating
the skin with thin, solid, metallic needles that are manipulated
by the hands or by electrical stimulation.
Practiced
in China and other Asian countries for thousands of years,
acupuncture is one of the key components of traditional
Chinese medicine. In TCM, the body is seen as a delicate
balance of two opposing and inseparable forces: yin and
yangThe concept of two opposing yet complementary
forces described in traditional Chinese medicine. Yin
represents cold, slow, or passive aspects of the person,
while yang represents hot, excited, or active aspects.
A major theory is that health is achieved through balancing
yin and yang and disease is caused by an imbalance leading
to a blockage in the flow of qi.. Yin represents
the cold, slow, or passive principle, while yang represents
the hot, excited, or active principle. According to TCM,
health is achieved by maintaining the body in a "balanced
state"; disease is due to an internal imbalance of yin
and yang. This imbalance leads to blockage in the flow
of qiIn traditional Chinese medicine, the vital
energy or life force proposed to regulate a person's spiritual,
emotional, mental, and physical health and to be influenced
by the opposing forces of yin and yang. (vital
energy) along pathways known as meridians. Qi can be unblocked,
according to TCM, by using acupuncture at certain points
on the body that connect with these meridians. Sources
vary on the number of meridians, with numbers ranging
from 14 to 20. One commonly cited source describes meridians
as 14 main channels "connecting the body in a weblike
interconnecting matrix" of at least 2,000 acupuncture
points.
Acupuncture
became better known in the United States in 1971, when
New York Times reporter James Reston wrote about how doctors
in China used needles to ease his pain after surgery.
American practices of acupuncture incorporate medical
traditions from China, Japan, Korea, and other countries.
Acupuncture
Use in the United States
The
report from a Consensus Development Conference on Acupuncture
held at the National Institutes of Health (NIH) in 1997
stated that acupuncture is being "widely" practiced—by
thousands of physicians, dentists, acupuncturists, and
other practitioners-for relief or prevention of pain and
for various other health conditions. According to the
2002 National Health Interview Survey—the largest and
most comprehensive survey of CAMA group of diverse
medical and health care systems, practices, and products
that are not presently considered to be part of conventional
medicine. Complementary medicine is used together with
conventional medicine, and alternative medicine is used
in place of conventional medicine. use by American
adults to date—an estimated 8.2 million U.S. adults had
ever used acupuncture, and an estimated 2.1 million U.S.
adults had used acupuncture in the previous year.
Acupuncture
Side Effects and Risks
The
U.S. Food and Drug Administration (FDA) regulates acupuncture
needles for use by licensed practitioners, requiring that
needles be manufactured and labeled according to certain
standards. For example, the FDA requires that needles
be sterile, nontoxic, and labeled for single use by qualified
practitioners only.
Relatively
few complications from the use of acupuncture have been
reported to the FDA, in light of the millions of people
treated each year and the number of acupuncture needles
used. Still, complications have resulted from inadequate
sterilization of needles and from improper delivery of
treatments. Practitioners should use a new set of disposable
needles taken from a sealed package for each patient and
should swab treatment sites with alcohol or another disinfectant
before inserting needles. When not delivered properly,
acupuncture can cause serious adverse effects, including
infections and punctured organs.
Status
of Acupuncture Research
There
have been many studies on acupuncture's potential health
benefits for a wide range of conditions. Summarizing earlier
research, the 1997 NIH Consensus Statement on Acupuncture
found that, overall, results were hard to interpret because
of problems with the size and design of the studies.
In
the years since the Consensus Statement was issued, the
National Center for Complementary and Alternative Medicine
(NCCAM) has funded extensive research to advance scientific
understanding of acupuncture. Some recent NCCAM-supported
studies have looked at:
Whether
acupuncture works for specific health conditions such
as chronic low-back pain, headache, and osteoarthritis
of the knee
How
acupuncture might work, such as what happens in the
brain during acupuncture treatment
Ways
to better identify and understand the potential neurological
properties of meridians and acupuncture points
Methods
and instruments for improving the quality of acupuncture
research
Finding
a Qualified Practitioner
Health
care providers can be a resource for referral to acupuncturists,
and some conventional medical practitioners—including
physicians and dentists—practice acupuncture. In addition,
national acupuncture organizations (which can be found
through libraries or Web search engines) may provide referrals
to acupuncturists.
Check
a practitioner's credentials. Most states require
a license to practice acupuncture; however, education
and training standards and requirements for obtaining
a license to practice vary from state to state. Although
a license does not ensure quality of care, it does indicate
that the practitioner meets certain standards regarding
the knowledge and use of acupuncture.
Do
not rely on a diagnosis of disease by an acupuncture
practitioner who does not have substantial conventional
medical training. If you have received a diagnosis
from a doctor, you may wish to ask your doctor whether
acupuncture might help.
What
To Expect from Acupuncture Visits
During
your first office visit, the practitioner may ask you
at length about your health condition, lifestyle, and
behavior. The practitioner will want to obtain a complete
picture of your treatment needs and behaviors that may
contribute to your condition. Inform the acupuncturist
about all treatments or medications you are taking and
all medical conditions you have.
Acupuncture
needles are metallic, solid, and hair-thin. People experience
acupuncture differently, but most feel no or minimal pain
as the needles are inserted. Some people feel energized
by treatment, while others feel relaxed. Improper needle
placement, movement of the patient, or a defect in the
needle can cause soreness and pain during treatment. This
is why it is important to seek treatment from a qualified
acupuncture practitioner.
Treatment
may take place over a period of several weeks or more.
Treatment
Costs
Ask
the practitioner about the estimated number of treatments
needed and how much each treatment will cost. Some insurance
companies may cover the costs of acupuncture, while others
may not. It is important to check with your insurer before
you start treatment to see whether acupuncture is covered
for your condition and, if so, to what extent. (For more
information, see NCCAM's fact sheet Paying
for CAM Treatment.)
Barnes
PM, Powell-Griner E, McFann K, Nahin RL. Complementary
and alternative medicine use among adults: United States,
2002. CDC Advance Data Report #343. 2004.
Berman
BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture
as adjunctive therapy in osteoarthritis of the knee:
a randomized, controlled trial. Annals of Internal
Medicine. 2004;141(12):901–910.
Eisenberg
DM, Cohen MH, Hrbek A, et al. Credentialing complementary
and alternative medical providers. Annals of Internal
Medicine. 2002;137(12):965–973.
Ernst
E. Acupuncture—a critical analysis. Journal of
Internal Medicine. 2006;259(2):125–137.
Kaptchuk,
TJ. Acupuncture: theory, efficacy, and practice. Annals
of Internal Medicine. 2002;136(5):374–383.
Lao
L. Safety issues in acupuncture. Journal of Alternative
and Complementary Medicine. 1996;2(1):27–31.
MacPherson
H, Thomas K. Short-term reactions to acupuncture—a cross-sectional
survey of patient reports. Acupuncture in Medicine.
2005;23(3):112–120.
National
Institutes of Health Consensus Panel. Acupuncture:
National Institutes of Health Consensus Development
Conference Statement. National Institutes of
Health Web site. Accessed at http://consensus.nih.gov/1997/1997acupuncture107html.htm
on June 22, 2007.
Reston
J. Now, about my operation in Peking; Now, let me tell
you about my appendectomy in Peking…. New York
Times. July 26, 1971:1.
The
NCCAM Clearinghouse provides information on CAM and NCCAM,
including publications and searches of Federal databases
of scientific and medical literature. The Clearinghouse
does not provide medical advice, treatment recommendations,
or referrals to practitioners.
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A
service of the National Library of Medicine (NLM), PubMed
contains publication information and (in most cases) brief
summaries of articles from scientific and medical journals.
CAM on PubMed, developed jointly by NCCAM and NLM, is
a subset of the PubMed system and focuses on the topic
of CAM.
ClinicalTrials.gov
is a database of information on federally and privately
supported clinical trials (research studies in people)
for a wide range of diseases and conditions. It is sponsored
by the National Institutes of Health and the U.S. Food
and Drug Administration.
This
publication is not copyrighted and is in the public domain.
Duplication is encouraged.
NCCAM has provided this material for
your information. It is not intended to substitute
for the medical expertise and advice of your primary
health care provider. We encourage you to discuss
any decisions about treatment or care with your
health care provider. The mention of any product,
service, or therapy is not an endorsement by NCCAM.
