Energy medicine intends to manipulate subtle energy fields (also called biofields) thought to exist in and around the body. All energy therapies are based on the belief that a universal life force or subtle energy resides in and around the body. Qi gong, which is used in traditional Chinese medicine, is an energy therapy.
Acupuncture, a therapy within traditional Chinese medicine, is one of the most widely accepted alternative therapies in the western world. Specific points on the body are stimulated, usually by inserting thin needles into the skin and underlying tissues. Stimulating these specific points is believed to unblock the flow of qi along energy pathways (meridians) and thus restore balance; > 350 defined points are located along the meridians. The procedure is generally not painful but may cause a tingling sensation. Sometimes stimulation is increased by twisting or warming the needle. Acupuncture points may also be stimulated by pressure (called acupressure), lasers, ultrasound, or a very low voltage electrical current (called electroacupuncture) applied to the needle.
Evidence and uses:
Research has shown that acupuncture releases various neurotransmitters (eg, endorphins) that act as natural painkillers. Reasonable evidence supports the efficacy of acupuncture as a pain reliever, an antinauseant, and an antiemetic. However, in many studies, results of sham acupuncture are comparable to those of actual acupuncture; the relative efficacy of sham and actual acupuncture is still not clear.
Acupuncture relieves nausea and vomiting related to surgery and chemotherapy. When used with antiemetic drugs, acupuncture has an additive effect. Acupuncture also helps relieve nausea and vomiting during pregnancy. Acupuncture has been used to relieve pain after surgical or dental procedures. As part of a comprehensive treatment plan (sometimes as adjunctive treatment), acupuncture may be useful in treating addiction, carpal tunnel syndrome, fibromyalgia, headache, low back pain, osteoarthritis, and xerostomia (in patients with advanced cancer) and in stroke rehabilitation.
Preliminary evidence suggests that acupuncture may relieve vasomotor symptoms in men taking gonadotropin analogs for prostate cancer. The evidence for relieving symptoms and improving pulmonary function in patients with asthma and for relieving pain or improving function in patients with RA is mixed. Acupuncture is ineffective for smoking cessation and weight loss.
Possible adverse effects and contraindications:
Adverse effects are rare if the procedure is done correctly. Worsening of symptoms (usually temporary) and vasovagal symptoms are the most common. Because acupuncture can cause fainting and drowsiness (although rarely), patients should be supine at least for their first treatment and should not drive or do any tasks that require alertness after treatment until they know how it affects them. Infection is extremely rare; most practitioners use disposable needles.
Acupuncture is contraindicated in patients with severe bleeding disorders. Electroacupuncture is contraindicated in patients with a pacemaker or an implanted defibrillator. Acupuncture at certain points may stimulate uterine contractions, and in traditional Chinese medicine, it is used to modulate labor. Only specially trained practitioners should use acupuncture in pregnant women.
Energy therapy may rely on magnetic (alternating- or direct-current) fields.
Evidence and uses:
Magnets, in particular, are a popular treatment for various musculoskeletal disorders, although multiple studies have shown no effectiveness, especially for pain relief, one of their most common applications.
Preliminary evidence suggests that static (permanent) magnets may help relieve pain in patients with osteoarthritis. However, the evidence that electromagnets may reduce pain and improve physical function is more consistent than that for static magnets. Using pulsating electromagnetic fields to speed healing of nonunion fractures is well-established.
Possible contraindications for magnets include pregnancy (effects on the fetus are unknown) and use of implanted cardiac devices, an insulin pump, or a drug given by patch.
Therapeutic touch, sometimes referred to as laying on of hands, uses the therapist's healing energy to identify and repair imbalances in a patient's biofield. Usually, practitioners do not touch the patient; instead, they move their hands back and forth over the patient. Therapeutic touch has been used to lessen anxiety and improve the sense of well-being in patients with cancer, but these effects have not been rigorously studied. In the US, nurses have introduced therapeutic touch into ICUs and other hospital settings.
Reiki, which originated in Japan, is a similar technique; in Reiki, practitioners channel energy through their hands and transfer it into the patient's body to promote healing. Practitioners are thought to have special healing powers, which are required for these treatments.
Last full review/revision February 2010 by Steven Rosenzweig, MD
Content last modified February 2012