Acupuncture: ancient tradition meets modern science

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Acupuncture is among the oldest healing practices in the world. It has been practiced in China and other Asian countries for thousands of years. According to the philosophy of traditional acupuncture, energy circulates in ’meridians’ located throughout the body. When something occurs to cause this meridian energy circulation to be blocked, pain or ill health will result. The way to restore energy circulation, health, and balance, is to stimulate the appropriate combination of the estimated 400 traditional meridian acupuncture points in the body, generally by using fine stainless steel needles. In some cases a small electrical impulse is added to the needles.

Research suggests that acupuncture may work by stimulating the nervous system to release neurotransmitters involved in pain-suppressing mechanisms or by suppressing the nervous system pathways involved in the sensory and affective components of pain.

Given that it is a relatively safe treatment, the question of whether or not acupuncture is an effective healthcare treatment therefore is highly relevant. Cochrane Review Groups have been preparing Cochrane Reviews that assess the efficacy of acupuncture for different health questions. The Cochrane Complementary Medicine (CAM) Field supports and promotes the production of Cochrane Reviews of acupuncture, and has helped prepare this Special Collection. There are over 25 published Cochrane Reviews, as shown below, and over 30 reviews in development.

Asthma

Acupuncture for chronic asthma

Asthma is a major health problem and causes significant mortality. Although the symptoms can be controlled by drug treatment in most patients, effective low-risk, non-drug strategies could constitute a significant advance in asthma management. Acupuncture has traditionally been used to treat asthma in China and is used increasingly for this purpose in other countries. This review assesses the effects of acupuncture for the treatment of asthma or asthma-like symptoms.

Eyes & vision

Acupuncture for glaucoma

Glaucoma is a multifactorial optic neuropathy in which there is an acquired loss of retinal ganglion cells at levels beyond normal age-related loss and corresponding atrophy of the optic nerve. Although there are many existing treatments, glaucoma is a chronic condition. Some patients may seek complementary or alternative medicine such as acupuncture to supplement their regular treatment. This review assesses the effectiveness and safety of acupuncture in people with glaucoma.

Gastrointestinal disorders

Acupuncture for treatment of irritable bowel syndrome

Irritable bowel syndrome is a disorder of altered bowel habits associated with abdominal pain or discomfort. Symptoms caused by irritable bowel syndrome often lead to healthcare medical consultation, workplace absenteeism, and associated economic costs. This review evaluates whether acupuncture is more effective than no treatment, 'sham' (placebo) acupuncture, and other interventions used to treat irritable bowel syndrome.

Headache

Acupuncture for tension-type headache

Acupuncture is often used for tension-type headache prophylaxis, but its effectiveness is still uncertain. This review compares the effects of acupuncture against no prophylactic treatment/routine care only, 'sham' (placebo) acupuncture, and other interventions, in reducing headache frequency in patients with episodic or chronic tension-type headache. [Download PDF]

Acupuncture for migraine prophylaxis

Acupuncture is often used for migraine prophylaxis, but its effectiveness is still uncertain. This review investigates whether acupuncture is more effective than no prophylactic treatment/routine care only, 'sham' (placebo) acupuncture, and other interventions in reducing headache frequency in patients with migraine. [Download PDF]

Mental Health

Acupuncture for schizophrenia

Antipsychotic drugs have been the mainstay of treatment for schizophrenia since the early 1950s. While effective for some people with the illness, these treatments still leave many with disabling adverse effects. Acupuncture may be more socially acceptable, tolerable, and inexpensive than the more conventional drugs, but evidence is needed to inform clinicians and people with schizophrenia of the effects of acupuncture. This review evaluates the effects of acupuncture for people with schizophrenia and related psychoses, and evaluates acupuncture alone and in combination regimens compared with antipsychotics alone.

Acupuncture for depression

There is interest from the community in the use of self help and complementary therapies for depression. This review examines the effectiveness and adverse effects of acupuncture in the treatment for depression, when compared with sham acupuncture, no treatment and standard treatment (defined as medication or psychological intervention). [Download PDF]

Musculoskeletal disorders (including arthritis)

Acupuncture for shoulder pain

There are many commonly employed forms of treatment for shoulder disorders. This review of acupuncture is one in a series of reviews of different interventions for shoulder disorders including adhesive capsulitis (frozen shoulder), rotator cuff disease, and osteoarthritis. Acupuncture to treat musculoskeletal pain is being used increasingly to confer an analgesic effect, and this review aims to determine the efficacy and safety of acupuncture in the treatment of adults with shoulder pain. [Download PDF]

Acupuncture for lateral elbow pain

Lateral elbow pain, or tennis elbow, is a common condition causing pain in the elbow and forearm, and lack of strength and function of the elbow and wrist. Acupuncture has long been used to treat lateral elbow pain in China. In Western countries, practitioners and consumers are increasingly exploring acupuncture as a first-line treatment for musculoskeletal disorders. This review assesses the effectiveness of acupuncture in the treatment of adults with lateral elbow pain with respect to pain reduction, improvement in function, grip strength, and adverse effects.

Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis

Acupuncture has been used by rehabilitation specialists as an adjunct therapy for the symptomatic treatment of rheumatoid arthritis. This review evaluates the effects of acupuncture or electroacupuncture on the objective and subjective measures of disease activity in patients with rheumatoid arthritis. [Download PDF]

Acupuncture for peripheral joint osteoarthritis

Peripheral joint osteoarthritis is a major cause of pain and functional limitation. Few treatments are safe and effective, and many patients seek out complementary and alternative medicine therapies, including acupuncture. This review compares the effects of traditional needle acupuncture with a sham, another active treatment, or with a waiting list control, for people with osteoarthritis of the knee, hip, or hand. [Download PDF]

Acupuncture and dry-needling for low back pain

Although low-back pain is usually a self-limiting and benign disease that tends to improve spontaneously over time, a large variety of therapeutic interventions are available for its treatment. This review assesses the effects of acupuncture for the treatment of non-specific low-back pain and dry-needling for myofascial pain syndrome in the low-back region.

Acupuncture for neck disorders

Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are the perceptions of benefits. Acupuncture has been used as an alternative to more traditional treatments for musculoskeletal pain. This review evaluates the effects of acupuncture for individuals with acute, subacute, or chronic neck pain.

Nausea and vomiting

Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting

There have been recent advances in chemotherapy-induced nausea and vomiting treatment using 5-HT3 inhibitors and dexamethasone. However, many people still experience these symptoms, and this has led to interest in additional methods to reduce these symptoms. This review assesses the effectiveness of acupuncture-point stimulation (manual acupuncture, electroacupuncture, non-invasive electrostimulation, and acupressure) on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients.

Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting

Postoperative nausea and vomiting are common complications following surgery and anaesthesia. Drugs to prevent postoperative nausea and vomiting are only partially effective. An alternative approach is to stimulate the P6 acupoint on the wrist. This review aims to determine the efficacy and safety of P6 acupoint stimulation in preventing postoperative nausea and vomiting.

Neurological disorders (including stroke)

Acupuncture for Bell's palsy

Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. It is the most common disorder affecting the facial nerves and results in weakness or paralysis on one side of the face. The paralysis causes distortion of facial features and interferes with normal functions, such as closing the eye and eating. Acupuncture has been used in the treatment of Bell’s palsy. This review examines the efficacy of acupuncture in hastening recovery and reducing long-term morbidity from Bell's palsy.

Acupuncture for restless legs syndrome

Restless legs syndrome is a common movement disorder for which patients may seek treatment with acupuncture. This review evaluates the efficacy and safety of acupuncture therapy in patients with restless legs syndrome.

Acupuncture for epilepsy

Seizures are poorly controlled in many people with epilepsy despite current antiepileptic treatments. There is increasing interest in alternative therapies such as acupuncture; however, it remains unclear whether the existing evidence is rigorous enough to support the use of acupuncture. This review aims to determine the effectiveness and safety of acupuncture in people with epilepsy.

Acupuncture for vascular dementia

Dementia is a widespread condition characterized by acquired global impairment of intellect, memory, and personality, but with no impairment of consciousness. There is no definitive medical or surgical treatment for vascular dementia. Acupuncture, most commonly body acupuncture and electroacupuncture, has been used for treating vascular dementia. This review assesses the efficacy and possible adverse effects of acupuncture therapy for treating vascular dementia.

Acupuncture for stroke rehabilitation

Stroke is the third leading cause of death in Western society; in China it is the second most common cause of death in cities and the third in rural areas. It is also a main cause of adult disability and dependency. Acupuncture for stroke has been used in China for hundreds of years and is increasingly practiced in some Western countries. This review assesses the efficacy and safety of acupuncture for patients with stroke in the subacute or chronic stage. [Download PDF]

Acupuncture for acute stroke

Acupuncture has been used in China to improve motor, speech, and other function after stroke. This review assesses the effectiveness and safety of acupuncture in patients with acute stroke. [Download PDF]

Acupuncture for dysphagia in acute stroke

Dysphagia after acute stroke is associated with poor prognosis, particularly if prolonged. Acupuncture has been widely used for this complication in China. This review aims to determine the therapeutic effect of acupuncture for dysphagia after acute stroke compared with placebo, sham, or no acupuncture intervention. [Download PDF]

Sleep disorders

Acupuncture for insomnia

Although conventional non-pharmacological and pharmacological treatments for insomnia are effective in many people, they may be associated with important adverse effects. Alternative therapies such as acupuncture are also widely practiced. This review assesses the efficacy and safety of acupuncture in people with insomnia.

Tobacco & drug dependence

Auricular acupuncture for cocaine dependence

Auricular acupuncture (insertion of acupuncture into a number, usually five, of specific points in the ear) is a widely-used treatment for cocaine dependence. This review evaluates whether auricular acupuncture is effective compared with sham or no treatment for the reduction of cocaine use in cocaine-dependent individuals; and whether variations in treatment, such as modification of the (American) National Acupuncture Detoxification Association (NADA) protocol or additional treatments used along with acupuncture, influence its effectiveness.

Acupuncture and related interventions for smoking cessation

Acupuncture and related techniques are promoted as a treatment for smoking cessation in the belief that they may reduce nicotine withdrawal symptoms. This review aims to determine the effectiveness of acupuncture and the related interventions of acupressure, laser therapy, and electrostimulation, in smoking cessation in comparison with no intervention, sham treatment, or other interventions.

Women's health

Acupuncture and assisted conception

Acupuncture has recently been studied in assisted reproductive treatment although its role in reproductive medicine is still debated. This review aims to determine the effectiveness of acupuncture in the outcomes of assisted reproductive treatment. [Download PDF]

Acupuncture for induction of labour

The use of complementary therapies is increasing, and some women look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. This review aims to determine the effects of acupuncture for third trimester cervical ripening or induction of labour.

Acupuncture for uterine fibroids

Uterine fibroids (UFs) are benign growths within the uterine muscle and are present in 30% of women during their reproductive years. With the exception of hysterectomy, there are no effective medical and surgical treatments for women with uterine fibroids. There are many types of acupuncture used to manage uterine fibroids, with body acupuncture being the most commonly used. This review assesses the benefits and harms of acupuncture in women with uterine fibroids.

Image credit: TEK Image/Science Photo Library, M746/043

Date published: 10 May 2010

Contact: Cochrane Editorial Unit (editorial-unit@cochrane.org)

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