On this page
Any decision you make about your health care is important--including
deciding whether to use acupuncture. The National Center for
Complementary and Alternative Medicine (NCCAM) has developed this fact
sheet to provide you with information on acupuncture. It includes
frequently asked questions, issues to consider, and a list of sources
for further information. Terms that are underlined are defined at the
end of this fact sheet.
Key Points
- Acupuncture originated in China more than 2,000 years ago, making
it one of the oldest and most commonly used medical procedures in the
world.
- It is important to inform all of your health care providers about
any treatment that you are using or considering, including acupuncture.
Ask about the treatment procedures that will be used and their
likelihood of success for your condition or disease.
- Be an informed consumer and find out what scientific studies have
been done on the effectiveness of acupuncture for your health condition.
- If you decide to use acupuncture, choose the practitioner with
care. Also check with your insurer to see if the services will be
covered.
Top
What is acupuncture?
Acupuncture is one of the oldest, most commonly used medical
procedures in the world. Originating in China more than 2,000 years
ago, acupuncture began to become 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.
The term acupuncture describes a family of procedures involving
stimulation of anatomical points on the body by a variety of
techniques. American practices of acupuncture incorporate medical
traditions from China, Japan, Korea, and other countries. The
acupuncture technique that has been most studied scientifically
involves penetrating the skin with thin, solid, metallic needles that
are manipulated by the hands or by electrical stimulation.
Top
How widely is acupuncture used in the United States
In the past two decades, acupuncture has grown in popularity 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.1 According to the 2002 National Health Interview Survey--the largest and most comprehensive survey of complementary and alternative medicine (CAM)
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.2
Top
What does acupuncture feel like?
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 are energized by treatment, while
others feel relaxed.3 Improper needle placement, movement of the patient, or a defect in the needle can cause soreness and pain during treatment.4 This is why it is important to seek treatment from a qualified acupuncture practitioner.
Top
Is acupuncture safe?
The U.S. Food and Drug Administration (FDA) approved acupuncture
needles for use by licensed practitioners in 1996. The FDA requires
that sterile, nontoxic needles be used and that they be labeled for
single use by qualified practitioners only.5
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.6
Top
Does acupuncture work?
According to the NIH Consensus Statement on Acupuncture, there have
been many studies on acupuncture's potential usefulness, but results
have been mixed because of complexities with study design and size, as
well as difficulties with choosing and using placebos
or sham acupuncture. However, promising results have emerged, showing
efficacy of acupuncture, for example, in adult postoperative and
chemotherapy nausea and vomiting and in postoperative dental pain.
There are other situations--such as addiction, stroke rehabilitation,
headache, menstrual cramps, tennis elbow, fibromyalgia,
myofascial pain, osteoarthritis, low-back pain, carpal tunnel syndrome,
and asthma--in which acupuncture may be useful as an adjunct treatment
or an acceptable alternative or be included in a comprehensive
management program. An NCCAM-funded study recently showed that
acupuncture provides pain relief, improves function for people with
osteoarthritis of the knee, and serves as an effective complement to
standard care.7 Further research is likely to uncover additional areas where acupuncture interventions will be useful.8
NIH has funded a variety of research projects on acupuncture. These
grants have been funded by NCCAM, its predecessor the Office of
Alternative Medicine, and other NIH institutes and centers.
Top
How might acupuncture work?
Acupuncture is one of the key components of the system of traditional Chinese medicine (TCM).
In the TCM system of medicine, the body is seen as a delicate balance
of two opposing and inseparable forces: yin and yang. Yin represents
the cold, slow, or passive principle, while yang represents the hot,
excited, or active principle. Among the major assumptions in TCM are
that health is achieved by maintaining the body in a "balanced state"
and that disease is due to an internal imbalance of yin and yang. This
imbalance leads to blockage in the flow of qi (vital energy) along pathways known as meridians.
It is believed that there are 12 main meridians and 8 secondary
meridians and that there are more than 2,000 acupuncture points on the
human body that connect with them.
Preclinical studies have documented
acupuncture's effects, but they have not been able to fully explain how
acupuncture works within the framework of the Western system of
medicine that is commonly practiced in the United States.9-14
It is proposed that acupuncture produces its effects through regulating
the nervous system, thus aiding the activity of pain-killing
biochemicals such as endorphins and immune system cells at specific
sites in the body. In addition, studies have shown that acupuncture may
alter brain chemistry by changing the release of neurotransmitters and
neurohormones and, thus, affecting the parts of the central nervous
system related to sensation and involuntary body functions, such as
immune reactions and processes that regulate a person's blood pressure,
blood flow, and body temperature.15,16
Top
How do I find a licensed acupuncture practitioner?
Health care practitioners can be a resource for referral to
acupuncturists. More medical doctors, including neurologists,
anesthesiologists, and specialists in physical medicine, are becoming
trained in acupuncture, TCM, and other CAM therapies. 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.
An acupuncture practitioner who is licensed and credentialed may
provide better care than one who is not. About 40 states have
established training standards for acupuncture certification, but
states have varied requirements for obtaining a license to practice
acupuncture.17
Although proper credentials do not ensure competency, they do indicate
that the practitioner has met certain standards to treat patients
through the 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.
Top
How much will acupuncture cost?
A practitioner should inform you about the estimated number of
treatments needed and how much each will cost. If this information is
not provided, ask for it. Treatment may take place over a few days or
for several weeks or more. Physician acupuncturists may charge more
than nonphysician practitioners.
Top
Will it be covered by my insurance?
Acupuncture is one of the CAM therapies that are more commonly
covered by insurance. However, you should check with your insurer
before you start treatment to see whether acupuncture will be covered
for your condition and, if so, to what extent. Some insurance plans
require preauthorization for acupuncture. (For more information, see
NCCAM's fact sheet "Consumer Financial Issues in Complementary and Alternative Medicine")
Top
What should I expect during my first visit?
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.
Top
Definitions
Complementary and alternative medicine (CAM):
A group of diverse medical and health care systems, practices, and
products that are not presently considered an integral part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. Some health care providers practice both CAM and conventional medicine.
Conventional medicine: A whole medical
system practiced by holders of M.D. (medical doctor) or D.O. (doctor of
osteopathy) degrees and by their allied health professionals, such as
physical therapists, psychologists, and registered nurses. Other terms
for conventional medicine include allopathy; Western, mainstream, and
orthodox medicine; and biomedicine.
Fibromyalgia: A complex chronic condition
having multiple symptoms, including muscle pain, fatigue, and
tenderness in precise, localized areas, particularly in the neck,
spine, shoulders, and hips. People with this syndrome may also
experience sleep disturbances, morning stiffness, irritable bowel
syndrome, anxiety, and other symptoms.
Meridian: A traditional Chinese
medicine term for each of the 20 pathways throughout the body for the
flow of qi, or vital energy, accessed through acupuncture points.
Placebo: An inactive pill or sham
procedure given to a participant in a research study as part of a test
of the effects of another substance or treatment. Scientists use
placebos to get a true picture of how the substance or treatment under
investigation affects participants. In recent years, the definition of
placebo has been expanded to include such things as aspects of
interactions between patients and their health care providers that may
affect their expectations and the study's outcomes.
Preclinical study: A study done to
obtain information about a treatment's safety and side effects when
given at different doses to animals or to cells grown in the laboratory.
Qi: A Chinese term for vital energy or life
force. In traditional Chinese medicine, qi (pronounced "chee") is
believed to regulate a person's spiritual, emotional, mental, and
physical balance, and to be influenced by the opposing forces of yin
and yang.
Traditional Chinese medicine (TCM): A whole
medical system that was documented in China by the 3rd century B.C. TCM
is based on a concept of vital energy, or qi, that is believed to flow
throughout the body. It is proposed to regulate a person's spiritual,
emotional, mental, and physical balance and to be influenced by the
opposing forces of yin (negative energy) and yang (positive energy).
Disease is proposed to result from the flow of qi being disrupted and
yin and yang becoming unbalanced. Among the components of TCM are
herbal and nutritional therapy, restorative physical exercises,
meditation, acupuncture, and remedial massage.
Top
References
- Culliton PD. Current utilization of acupuncture by
United States patients. Abstract presented at: National Institutes of
Health Consensus Development Conference on Acupuncture; 1997.
- 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.
- American Academy of Medical Acupuncture. Doctor, What's This Acupuncture All About? A Brief Explanation. American Academy of Medical Acupuncture Web site. Accessed at www.medicalacupuncture.org/acu_info/articles/aboutacupuncture.html on December 14, 2004.
- Lao L. Safety issues in acupuncture. Journal of Alternative and Complementary Medicine. 1996;2(1):27-31.
- U.S. Food and Drug Administration. Acupuncture needles no longer investigational. FDA Consumer. 1996;30(5). Also available at: www.fda.gov/fdac/departs/596_upd.html.
- Lytle CD. An Overview of Acupuncture. Rockville, MD: U.S. Food and Drug Administration, Center for Devices and Radiological Health; 1993.
- 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.
- National Institutes of Health Consensus Panel. Acupuncture: National Institutes of Health Consensus Development Statement. National Institutes of Health Web site. Accessed at odp.od.nih.gov/consensus/cons/107/107_statement.htm on December 14, 2004.
- Eskinazi DP. NIH Technology Assessment Workshop on
Alternative Medicine: Acupuncture. Gaithersburg, Maryland, USA, April
21-22, 1994. Journal of Alternative and Complementary Medicine. 1996;2(1):1-256.
- Tang NM, Dong HW, Wang XM, et al. Cholecystokinin
antisense RNA increases the analgesic effect induced by
electroacupuncture or low dose morphine: conversion of low responder
rats into high responders. Pain. 1997;71(1):71-80.
- Cheng XD, Wu GC, He QZ, et al. Effect of
electroacupuncture on the activities of tyrosine protein kinase in
subcellular fractions of activated T lymphocytes from the traumatized
rats. Acupuncture and Electro-Therapeutics Research. 1998;23(3-4):161-170.
- Chen LB, Li SX. The effects of electrical
acupuncture of Neiguan on the PO2 of the border zone between ischemic
and non-ischemic myocardium in dogs. Journal of Traditional Chinese Medicine. 1983;3(2):83-88.
- Lee HS, Kim JY. Effects of acupuncture on blood
pressure and plasma renin activity in two-kidney one clip Goldblatt
hypertensive rats. American Journal of Chinese Medicine. 1994;22(3-4):215-219.
- Okada K, Oshima M, Kawakita K. Examination of the
afferent fiber responsible for the suppression of jaw-opening reflex in
heat, cold, and manual acupuncture stimulation in rats. Brain Research. 1996;740(1-2):201-207.
- Takeshige C. Mechanism of acupuncture analgesia based on animal experiments. In: Pomerantz B, Stux G, eds. Scientific Bases of Acupuncture. Berlin, Germany: Springer-Verlag; 1989.
- Lee BY, LaRiccia PJ, Newberg AB. Acupuncture in theory and practice. Hospital Physician. 2004;40:11-18.
- White House Commission on Complementary and Alternative Medicine Policy: Final Report. March 2002. White House Commission on Complementary and Alternative Medicine Policy Web site. Accessed at www.whccamp.hhs.gov/finalreport.html on December 14, 2004.
Top
For More Information
NCCAM Clearinghouse
The NCCAM Clearinghouse provides information on CAM and on 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.
Toll-free in the U.S.: 1-888-644-6226
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
Web site: nccam.nih.gov
E-mail: info@nccam.nih.gov
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 in this information is not an
endorsement by NCCAM.
|
NCCAM, National Institutes of Health
9000 Rockville Pike
Bethesda, Maryland 20892 USA
