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Acupuncture -ˌpəŋ(k)-chər

By Steven Novella, MD, Assistant Professor of Neurology, Yale University School of Medicine

Acupuncture, a therapy within traditional Chinese medicine, is one of the most widely accepted alternative medicine techniques in the Western world. Licensed practitioners do not necessarily have a medical degree, although some medical doctors, often pain specialists, are trained and licensed to perform acupuncture. Millions of people are treated with acupuncture every day.

Acupuncture involves stimulating specific points on the body, usually by inserting very fine needles into the skin and underlying tissues. Stimulating these specific points is believed to unblock the flow of qi (pronounced chee). Qi is the life force that permeates the body. Traditional Chinese medicine believes that illness results from the improper flow of qi along energy pathways or meridians (there are more than 2,000 of these points along the meridians). Stimulating these points helps restore the balance between yin (dark, feminine, negative forces) and yang (bright, masculine, positive forces).

Sometimes stimulation is increased by twisting or warming the needle.

Acupuncture points may also be stimulated by the following

  • Pressure (called acupressure)

  • Lasers

  • Ultrasound

  • A very low-voltage electrical current (called electroacupuncture) applied to the needle

Acupuncture is not painful but may cause a tingling sensation.

Medicinal claims

Proposed uses include

  • Pain relief after surgical or dental procedures

  • Relief of the nausea and vomiting that commonly occur during pregnancy or after surgery or chemotherapy

  • Treatment of addiction, carpal tunnel syndrome, fibromyalgia, headache, low back pain, osteoarthritis, rheumatoid arthritis, asthma, and dry mouth (in people with advanced cancer)

Acupuncture is ineffective in helping people stop smoking or lose weight.

Research has shown that acupuncture releases various chemical messengers in the brain (neurotransmitters) that serve as natural painkillers, including endorphins. However, placebos and sham acupuncture (insertion of needles at points other those used in acupuncture) can also cause endorphins to be released.

Despite extensive study, there is no conclusive evidence that acupuncture is effective in treating any disorder or symptom. In well-designed studies, true acupuncture was no more effective than a placebo or than sham acupuncture. The placebo for acupuncture involves using opaque sheaths containing a blunt needle or toothpick that is pressed against the skin but is not inserted.

Possible side effects

Side effects of acupuncture are usually mild if the technique is done correctly, but the following should be noted:

  • Temporary worsening of symptoms may occur.

  • Occasionally, needles are mistakenly left in place after acupuncture is completed.

  • Infection is extremely rare because most health care practitioners use disposable needles. Reusable needles must be sterilized correctly.

  • As with any medical treatment involving needles, some people may feel faint and need to lie down.

  • Acupuncture may cause bruising or bleeding in people who have severe bleeding disorders or who take warfarin, an anticoagulant (a drug that makes blood less likely to clot).

  • People who have a pacemaker or an implanted defibrillator should not undergo electroacupuncture.

  • Acupuncture has many proposed uses in pregnancy, such as the control of nausea, the reversal of breech presentation, and regulation of labor. However, because acupuncture may stimulate uterine contractions, it should only be administered by a specially trained practitioner.

  • Rarely, deep needle placement can cause a collapsed lung and internal injury.

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