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Info


A. Introduction

  1. Mechanism is largely unexplained [1]
    1. May lead to stimulation of small diameter nerves
    2. These nerves send messages to and activate the spinal cord
    3. Changes in cerebrospinal fluid composition have been documented
    4. Some of the effects of acupuncture are reversed with naloxone
  2. Efficacy in specific areas now fully validated with randomized, controlled trials
  3. Given low rates of side effects, acupuncture should be considered in any of above areas
  4. Feelings of relaxation following acupuncture reported in >80% of patients
  5. Acupuncturists are now licensed and available for therapy

B. Good Evidence of Efficacy [3]

  1. Postoperative nausea and vomiting in adults (not effective in children)
  2. Chemotherapy-related nausea and vomiting
  3. Pregnancy-related nausea and vomiting
  4. Postoperative dental pain
  5. Chronic low back pain (inconclusive for acute low back pain) [4]
  6. Acupuncture alone has not been shown to benefit any medical condition in randomized, blinded, duplicated studies [3]

C. Utility of Acupuncture

  1. Reasonable Evidence for Efficacy [3]
    1. Chronic low back pain
    2. Headache
    3. Chemotherapy induced nausea and vomiting
  2. Some Evidence for Efficacy
    1. Knee osteoarthritis (conflicting results) [7,9]
    2. Menstrual Cramps
    3. Headache (including migraine)
    4. Myofascial Pain
    5. Fibromyalgia
    6. Postoperative Pain
    7. Temporomandibular Joint (TMJ) Disorder
    8. Addiction
    9. Carpal Tunnel Syndrome
    10. Epicondylitis
    11. Osteoarthritis of the knee
    12. Chronic obstructive pulmonary disease
  3. Osteoarthritis of the Knee [7]
    1. 26 weeks superior to 8 weeks [5]
    2. 8 weeks superior to placebo or sham acupuncture [6]
  4. Conflicting Results
    1. Chronic pain
    2. Osteoarthritis (other than knee)
    3. Alcoholism
    4. Asthma
    5. Weight reduction
    6. Stroke Rehabilitation

D. Ineffective

  1. Pain due to HIV peripheral neuropathy
  2. Smoking cessation
  3. Tinnitus
  4. Neck Pain [8]

E. Acupuncture Side Effects [3]

  1. Majority are mild and associated with needles
  2. Needle pain
  3. Fatigue
  4. Bleeding (minor)

References

  1. Kaptchuk TJ. 2002. Ann Intern Med. 136(5):374 abstract
  2. NIH Consensus Statement on Acupuncture. 1998. JAMA. 280(17):1518 abstract
  3. Acupuncture. 2006. Med Let. 48(1234):38 abstract
  4. Manheimer E, White A, Berman B, et al. 2005. Ann Intern Med. 142(8):651 abstract
  5. Berman BM, Lao L, Langenberg P, et al. 2004. Ann Intern Med. 141(12):90
  6. Witt C, Brinkhaus B, Jena S, et al. 2005. Lancet. 366(9480):136 abstract
  7. Berman B. 2007. JAMA. 297(15):1697 abstract
  8. White P, Lewith G, Prescott P, Conway J. 2004. Ann Intern Med. 141(12):911 abstract
  9. Manheimer E, Linde K, Lao L, et al. 2007. Ann Intern Med. 146(12):868 abstract