acupuncture
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Introduction
The piercing of specific body sites with needles to produce pain relief.
Indications
- may be of benefit in treatment of chronic pain (see notes)
- acupuncture associated with pain reduction & improved fatigue, insomnia, & quality of life in patients with cancer pain[35]
- cancer pain[22]; pain relief in cancer survivors*
- chronic nonspecific musculoskeletal pain
- osteoarthritis (may be placebo effect, see notes)
- may be of benefit for aromatase inhibitor-related arthralgias[27]
- chronic headache
- may be of benefit in prevention of migraine[23]
- may provide long-term relief from chronic tension type headache[26]
- shoulder pain
- may be of benefit in non-specific low back pain[4]
- benefit for chronic sciatica from herniated disk[34]
- effective for chronic musculoskeletal, headache, & osteoarthritis pain[33]
- may improve dyspnea on exertion in patients with COPD[8]
- may be of benefit in patients with depression[11]
- may be of benefit for postprandial dyspepsia[24]
- questionable benefit for irritable bowel syndrome[13]
- electroacupuncture may improve symptoms of chronic constipation[15]
- infant colic ?[16]
- may be of benefit for women with stress urinary incontinence[17]
- adjunctive therapy for chronic stable angina[21]
- combat-related post-traumatic stress disorder in veterans[29]
- acupuncture may reduce methadone maintenance of abstinence dose & decrease opioid craving[30]
* electroacupuncture & auricular acupuncture beneficial for pain relief in cancer survivors[25]
- auricular acupuncture did not demonstrate noninferiority to electroacupuncture, & patients receiving it had more adverse events[25]
* moderate or high-certainty evidence that acupuncture is superior to other active therapies is rare[28]
Contraindications
(non indications)
- of no benefit for migraine headache[3]
- of no benefit for knee osteoarthritis[6]
- statistically significant benefits are small & do not meet thresholds for clinical relevance[14]
- benefit for chronic neck pain not clinically meaningful[32]
- of little or no benefit for allergic rhinitis[10]
- no benefit for infertility associated with polycystic ovary syndrome[18]
- no benefit of acupuncture during in vitro fertilization[20]
- lumbar spinal stenosis[31]
Complications
(low risk, incidence 14 in 10,000)
- needle loss
- fainting
- worsening of symptoms (3%)
- infections, including
- Staphylococcus
- atypical Mycobacteria[7]
Notes
- much of the benefit of acupuncture in treating chronic pain can be explained by a placebo effect[9]
- benefits of acupuncture not much better than sham procedure for treatmemt of chronic pain[12]
More general terms
Additional terms
References
- ↑ Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999.
- ↑ Journal Watch 21(20):165, 2001 White A et al Adverse events following acupuncture: prospective survey of 32,000 consultations with doctors and physiotherapists. BMJ 323:485, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11532840
MacPherson H et al The York acupuncture safety study: prospective survey of 34,000 treatments by traditional acupuncturists. BMJ 323:486, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11532841 - ↑ 3.0 3.1 Journal Watch 25(11):91, 2005 Linde K, Streng A, Jurgens S, Hoppe A, Brinkhaus B, Witt C, Wagenpfeil S, Pfaffenrath V, Hammes MG, Weidenhammer W, Willich SN, Melchart D. Acupuncture for patients with migraine: a randomized controlled trial. JAMA. 2005 May 4;293(17):2118-25. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15870415
- ↑ 4.0 4.1 Thomas KJ et al, Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non- specific low back pain. BMJ 2006, 333:623 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16980316
Ratcliffe J et al, A randomised controlled trial of acupuncture care for persistent low back pain: Cost effectiveness analysis BMJ 2006, 333:626 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16980315
Wonderling D. Acupuncture in mainstream of health care. BMJ 2006, 333:611 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16990295 - ↑ Cherkin DC et al, A review of the evidence for the effectiveness, safety and cost of acupuncture, massage therapy, and spinal manipulation for back pain, Ann Intern Med 2003, 138:898 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12779300
Manheimer E et al, Meta-Analysis: Acupuncture for low back pain Ann Intern Med 2003, 142:651 PMID: https://www.ncbi.nlm.nih.gov/pubmed/15838072 - ↑ 6.0 6.1 Foster NE et al, Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: Randomised controlled trial. BMJ 2007, 355:436 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17699546
- ↑ 7.0 7.1 Woo PCY et al. Acupuncture transmitted infections. BMJ 2010 Mar 18; 340:c1268. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20299695 <Internet> http://dx.doi.org/10.1136/bmj.c1268
- ↑ 8.0 8.1 Suzuki M et al. A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): The COPD-Acupuncture Trial (CAT). Arch Intern Med 2012 May 14 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22905352
- ↑ 9.0 9.1 Vickers AJ et al. Acupuncture for chronic pain: Individual patient data meta-analysis. Arch Intern Med 2012 Oct 22; 172:1444. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22965186 PMCID: PMC3658605 Free PMC article <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1357513
Avins AL. Needling the status quo. Arch Intern Med 2012 Oct 22; 172:1454. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22965282 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1357516 - ↑ 10.0 10.1 Brinkhaus B et al. Acupuncture in patients with seasonal allergic rhinitis: A randomized trial. Ann Intern Med 2013 Feb 19; 158:225 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23420231
- ↑ 11.0 11.1 MacPherson H et al. Acupuncture and counselling for depression in primary care: A randomised controlled trial. PLoS Med 2013 Sep 24; 10:e1001518 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24086114 <Internet> http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001518
- ↑ 12.0 12.1 Vickers AJ and Linde K. Acupuncture for chronic pain. JAMA 2014 Mar 5; 311:955 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24595780
- ↑ 13.0 13.1 Manheimer E, Cheng K, Wieland LS et al Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2012 May 16;5:CD005111. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22592702
- ↑ 14.0 14.1 Manheimer E, Cheng K, Linde K et al Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001977 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20091527
- ↑ 15.0 15.1 Liu Z, Yan S, Wu J et al Acupuncture for Chronic Severe Functional Constipation: A Randomized, Controlled Trial. Ann Intern Med. Published online 13 September 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27618593 <Internet> http://annals.org/article.aspx?articleid=2552074
- ↑ 16.0 16.1 Landgren K, Hallstrom I. Effect of minimal acupuncture for infantile colic: a multicentre, three-armed, single-blind, randomised controlled trial (ACU-COL). Acupunct Med. Jan 16, 2017 http://aim.bmj.com/content/early/2017/01/03/acupmed-2016-011208
- ↑ 17.0 17.1 Liu Z, Liu Y, Xu H et al Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary IncontinenceA Randomized Clinical Trial. JAMA. 2017;317(24):2493-2501 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28655016 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2633916
- ↑ 18.0 18.1 Wu XK, Stener-Victorin E, Kuang HY et al Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary SyndromeA Randomized Clinical Trial. JAMA. 2017;317(24):2502-2514 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28655015 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2633915
- ↑ Briggs JP, Shurtleff D Acupuncture and the Complex Connections Between the Mind and the Body. JAMA. 2017;317(24):2489-2490 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28654992 <Internet> http://jamanetwork.com/journals/jama/fullarticle/2633891
- ↑ 20.0 20.1 Smith CA, de Lacey S, Chapman M et al Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization. A Randomized Clinical Trial. JAMA. 2018;319(19):1990-1998. May 15, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29800212 https://jamanetwork.com/journals/jama/article-abstract/2681194
- ↑ 21.0 21.1 Zhao L, Li D, Zheng H et al. Acupuncture as adjunctive therapy for chronic stable angina: A randomized clinical trial. JAMA Intern Med 2019 Jul 29; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31355870 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2739058
- ↑ 22.0 22.1 He Y, Guo X, May BH et al Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer PainA Systematic Review and Meta-Analysis. JAMA Oncol. Published online December 19, 2019. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31855257 https://jamanetwork.com/journals/jamaoncology/fullarticle/2757396
He Y, May BH, Zhang AL et al Acupuncture for cancer pain: protocol for a pilot pragmatic randomised controlled trial. BMJ Open. 2019 Jul 9;9(7):e025564. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31289059 Free PMC Article - ↑ 23.0 23.1 Xu S, Yu L, Luo X Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial BMJ 2020;368:m697 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32213509 https://www.bmj.com/content/368/bmj.m697
Angus-Leppan H Manual acupuncture for migraine BMJ 2020;368:m1096 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32213481 https://www.bmj.com/content/368/bmj.m1096 - ↑ 24.0 24.1 Yang JW, Wang LQ, Zou X et al. Effect of acupuncture for postprandial distress syndrome: A randomized clinical trial. Ann Intern Med 2020 May 12; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32422066 https://www.acpjournals.org/doi/10.7326/M19-2880
- ↑ 25.0 25.1 25.2 Mao JJ, Liou KT, Baser RE et al Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial. JAMA Oncol. 2021 May 1;7(5):720-727 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33734288
- ↑ 26.0 26.1 Whitlock Burton K Acupuncture Deep Needling Technique Points to Greater Tension Headache Relief. Medscape. June 22, 2022 https://www.medscape.com/viewarticle/976051
Zheng H, Gao T, Zheng QH Acupuncture for Patients With Chronic Tension-Type Headache: A Randomized Controlled Trial. Neurology, 2022. June 22 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35732505 https://n.neurology.org/content/early/2022/06/22/WNL.0000000000200670 - ↑ 27.0 27.1 Hershman DL, Unger JM, Greenlee H et al Comparison of Acupuncture vs Sham Acupuncture or Waiting List Control in the Treatment of Aromatase Inhibitor-Related Joint Pain. A Randomized Clinical Trial. JAMA Netw Open. 2022;5(11):e2241720 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798317
- ↑ 28.0 28.1 Allen J, Mak SS, Begashaw M et al Use of Acupuncture for Adult Health Conditions, 2013 to 2021. A Systematic Review. JAMA Netw Open. 2022;5(11):e2243665. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36416820 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798899
- ↑ 29.0 29.1 Hollifield M, Hsiao AF, Smith T et al Acupuncture for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2024 Feb 21:e235651. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38381417 PMCID: PMC10882512 Free PMC article. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2814938
- ↑ 30.0 30.1 Lu L, Chen C, Chen Y et al Effect of Acupuncture for Methadone Reduction: A Randomized Clinical Trial Ann Intern Med. 2024 Jul 9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38976882 https://www.acpjournals.org/doi/10.7326/M23-2721
- ↑ 31.0 31.1 Zhu L, Sun Y, Kang J Effect of Acupuncture on Neurogenic Claudication Among Patients With Degenerative Lumbar Spinal Stenosis : A Randomized Clinical Trial. Ann Intern Med. 2024 Jul 2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38950397 https://www.acpjournals.org/doi/10.7326/M23-2749
- ↑ 32.0 32.1 Zhao L, Sun M, Yn Z et al Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain: A Randomized Controlled Trial. Ann Intern Med. 2024 Sep 3 PMID: https://www.ncbi.nlm.nih.gov/pubmed/39222507 https://www.acpjournals.org/doi/10.7326/M23-2425
- ↑ 33.0 33.1 Vickers AJ, Vertosick EA, Lewith G et al. Acupuncture Trialists' Collaboration. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018 May;19(5):455-474. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29198932 PMCID: PMC5927830 Free PMC article. Review.
- ↑ 34.0 34.1 Gever J Acupuncture for Sciatica: Will This Trial Finally Silence the Skeptics? Findings from new study raise the bar MedPage Today October 14, 2024 https://www.medpagetoday.com/rheumatology/backpain/112381
Tu JF, Shi GX, Yan SY et al Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial. JAMA Intern Med. 2024 Oct 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39401008
Kneifati-Hayek JZ, Katz MH. Moving the Needle on Acupuncture Trials. JAMA Intern Med. 2024 Oct 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39401014 - ↑ 35.0 35.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ Acupuncture: Medline Plus http://www.nlm.nih.gov/medlineplus/acupuncture.html