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Acupuncture

Acupuncture (from Lat. acus, 'a needle', and pungere, 'to prick') is the
practice of inserting very thin needles in particular points on the body to
improve health and well-being, and is one component of traditional Oriental
medicine. It has long been used by the Chinese for a wide variety of health
complaints, and is practised throughout Asia. The practice of acupuncture is
at least 2000 years old. Forms of acupuncture are also described in the
literature of the traditional medicine of India.

In China, acupuncture is known as zhen1 jiu3 (??). Zhen means needle, jiu
means to cauterize by burning a herb called moxa. Historically, it was
generally understood that to cauterize an acupuncture point was a stronger
treatment than to needle the point. In modern times, the cauterization of
acupoints (known as "moxibustion") has been largely supplanted by methods of
indirect heating. Needling of points is performed with fine-gauge sterile
disposable stainless steel needles.

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 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"} and 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". Research into the phenomena of "deqi" has
mostly been conducted in China and Japan.

Treatment of acupoints may be performed locally at the site of a particular
problem, or at locations elsewhere on the body that are considered to be
helpful based on either theoretical or empirical considerations.

Although accepted as a medical treatment in Asia for centuries,
acupuncture's arrival in the United States has sparked controversy at times.
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. As
an 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 medications (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."

NCAHF Position Paper on Acupuncture

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.

     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.

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