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Acupuncture

Acupuncture has long been used by the Chinese for a wide variety of health complaints. This practice eventually spread throughout Asia and eventually the world. The Chinese practice of acupuncture is at least 2,000 years old, with physical evidence having been found dating to the Han dynasty. Forms of acupuncture are also described in the literature of the traditional medicine of India. Possibly the earliest evidence for the practice of puncturing specific points for health purposes has been found in Europe, of all places. Ötzi the Iceman, a 5,000 year old mummy found preserved in an Alpine glacier, has tattoos on points which correspond to points that a modern acupuncturist or tui na (Chinese acupressure) specialist would use to treat symptoms of diseases that Ötzi seems to have suffered from, including digestive parasites and degenerative bone disease. One theory being that Ötzi's points were routinely "needled" using thorns from various plants, the vegetable residue left in the insertion sites eventually building up to produce tattoos. More recently in the West acupuncture is usually considered a form of complementary and alternative medicine.

In China, acupuncture is known as zhēn jǐu (針灸). Zhen means needle, jiu means moxibustion. Historically, it was generally understood that to warm an acupuncture point (moxibustion) was a stronger treatment than to needle the point. Moxibustion is still used today in varying degres by different schools of TCM thought. Nowadays, acupuncture needling of points is performed with a very fine gauge of disposable stainless steel needles which are sterilized with ethylene oxide or by autoclave.

Table of contents

1 Medical theory 2 Potential benefits 3 Potential risks 4 Skeptical point of view 5 Evidence of Effectiveness 6 See also 7 External links 8 Bibliography

Medical theory

Traditional Chinese medical theory holds that acupuncture works by redirecting qi "vital energy" in the body. Pain or illnesses are treated by attempting to remedy local or systemic accumulations or deficiencies of qi. Pain is considered to indicate blockage or stagnation of the flow of qi, and an axiom of the medical literature of acupuncture is "no pain, no blockage; no blockage, no pain."

While it is claimed by some that there is no physical evidence for the existence of qi or for its claimed effects, and that acupuncture is therefore a pseudoscience, many patients experience the sensations of stimulus known in Chinese as "deqi" ("obtaining the qi") This was historically considered to be evidence of effective treatment. Often deqi takes the form of a propagation of sensation along the trajectory of the so-called acupuncture "channels" or meridians. Research into the phenomena of "deqi" has mostly been conducted in China and Japan.

Treatment of acupoints may be performed along the 14 main or 8 extra meridians located throughout the body. 10 of the main meridians are named after organs of the body (Heart, Liver etc.) two after so called body functions(Heart Protector or Pericardium, San Jiao) with two central meridians situated at the front and back of the body.

The acupuncturist will decide which points to treat by thoroughly questioning the patient, and utilizing the diagnostic skills of traditional Chinese medicine, such as observation of the left and right radial pulse.

There are various schools of Acupuncture thought. Some examples being the TCM Style, Zang Fu theory, Five Element Acupuncture, Japanese Meridian Therapy and medical acupuncture.

Potential benefits

Although accepted as a medical treatment in Asia for millenia, acupuncture's arrival in the West has sparked some controversy. Acupuncture has eluded scientific explanation to some degree. However, in 1997, the NIH issued a consensus statement on acupuncture that concluded that "there is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value."

The NIH statement noted that "the data in support of acupuncture are as strong as those for many accepted Western medical therapies," and added that "the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. For example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow... are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medicationss (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments. The evidence supporting these therapies is no better than that for acupuncture."

The NIH consensus statement noted that "there is clear evidence that needle acupuncture is efficacious for adult postoperative and chemotherapy nausea and vomiting and probably for the nausea of pregnancy... There is reasonable evidence of efficacy for postoperative dental pain... reasonable studies (although sometimes only single studies) showing relief of pain with acupuncture on diverse pain conditions such as menstrual cramps, tennis elbow, and fibromyalgia..." However, "acupuncture does not demonstrate efficacy for cessation of smoking and may not be efficacious for some other conditions."

Potential risks

Skeptical point of view

In 1990 The National Council Against Health Fraud issued the NCAHF Position Paper on Acupuncture. This report states that:

Richardson and Vincent analyzed 28 studies of effect of acupuncture on pain, all published between 1973 and 1986 in English language peer-reviewed journals. Fifteen showed no difference in effectiveness between acupuncture and control groups. Thirteen showed some effectiveness for acupuncture over control groups, but not all controls were the same. (Some were compared to sham acupuncture, some to medical therapy, etc.) Overall, the differences were small.

The NCAHF Task Force on Acupuncture evaluated the above studies, as well as more recent ones, and found that reported benefits varied inversely with quality of the experimental design. The greater the benefit claimed, the worse the experimental design. Most studies that showed positive effects used too few subjects to be statistically significant. The best designed experiments - those with the highest number of controls on variables - found no difference between acupuncture and control groups. In 1989, three Dutch epidemiologists reported similar conclusions about 91 separate clinical trials of acupuncture for various disorders. They also found that the stricter the controls, the smaller the difference between acupuncture and control groups. They also found that of the 46 official Chinese medical journals, none had published anything regarding acupuncture in the last 25 years. They also found that acupuncture was not used in any of the major Chinese hospitals. If acupuncture was used in a medical setting, it was in rural areas. The authors cited a lack of availability of modern medication as a cause of this.

Acupuncture is being used in drug and alcohol rehabilitation programs. Because there are serious flaws in the way studies on rehabilitation have been performed, the results cannot be considered valid. A successful medical procedure should be consistently effective in a large majority of trials, and be repeatable in the hands of most therapists. Acupuncture does not satisfy these basic criteria.

Evidence of Effectiveness

• NCCAM research summaries on acupuncture

See: http://nccam.nih.gov/health/acupuncture/

See also

• Acupressure
• Qi
• Qigong
• Taoism
• Alchemy
• Chin na
• Chinese martial arts
• (scroll down)

• A Very Informative Site about Acupuncture
• Search for "acupuncture" on PubMed - US National Library of Medicine search engine with thousands of scientific articles on acupuncture
• NIH 1997 Consensus Statement on Acupuncture
• Five Element Acupuncture Information Site A site devoted to the 5 Element Style of Acupuncture
• Acupuncture, The Facts. - An article.
• How acupuncture works explained
• Open Directory: Acupuncture and Chinese Medicine. - A collection of links, mostly to pro-acupuncture sites.
• Acumedico forum, articles and discussion - An Israeli acupuncture site.