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Acupuncture

Other common name(s): acupuncture therapy, Zhenjiu, electroacupuncture, sonopuncture

Scientific/medical name(s): none

Description

Acupuncture is a technique in which very thin needles of varying lengths are inserted through the skin to treat a variety of conditions. There are a number of different acupuncture techniques, including some that use sound waves, tiny electrical charges, and some that may or not use actual needles.

Overview

Although available evidence does not suggest acupuncture is effective as a treatment for cancer, clinical studies have found it may help treat nausea caused by chemotherapy and surgical anesthesia (the drugs used to make you sleep and not feel pain during surgery). It may also help relieve pain after dental surgery. The technique has been tested on people who are trying to stop addictive behaviors, such as smoking or alcoholism, but reports are mixed. It may be useful for treating headaches, helping in rehabilitation from strokes, and treating a number of musculoskeletal conditions.

How is it promoted for use?

In China, acupuncture is used as an anesthetic during surgery and is believed to have the power to cure diseases and relieve symptoms of illness. The theories and teachings of traditional Chinese medicine explain that acupoints lie along invisible meridians. There are said to be 12 major meridians in the human body. These are thought to be channels for the flow of vital energy or life force called qi (also spelled ch'i or ki, and pronounced "chee" or "kee") that is present in all living things. Meridians also represent an internal system of communication between specific organs or networks of organs. According to traditional Chinese medicine theory, illness may occur when the energy flow along one or more meridians is blocked or out of balance. The goal of acupuncture is to restore health and balance to the energy flow. Supporters claim that acupuncture can be used to treat physical illness, addiction, and mental illness.

Some practitioners in the West reject the traditional philosophies of Chinese medicine, believing that any relief given by acupuncture or acupressure is caused by other factors, such as the stimulation of endorphin production in the body. (Endorphins are natural substances made by the body which help relieve pain.)

What does it involve?

In traditional acupuncture (sometimes called acupuncture therapy), needles are inserted at specific locations called acupoints in order to restore balance and healthy energy flow to the body. Needles are put just deep enough into the skin to keep them from falling out and are usually left in place for a few minutes. Skilled acupuncturists cause virtually no pain. The acupuncturist may twirl the needles or apply heat or a weak electrical current to enhance the effects of the therapy (see Moxibustion and Cupping).

Sonopuncture is similar to acupuncture, but needles are not used. Instead, an ultrasound device that transmits sound waves is applied to the body's acupoints. Sonopuncture is sometimes combined with tuning forks and other vibration devices. Proponents claim this approach is useful to treat many of the same disorders as acupuncture.

Electroacupuncture is considered an enhanced version of traditional acupuncture. It uses tiny electrical charges, with or without needles, to stimulate the same acupoints that are used in traditional acupuncture (see Transcutaneous Electrical Nerve Stimulation). Electroacupuncture devices are sometimes promoted for diagnosis or testing.

In acupressure, a popular variation of acupuncture, therapists press on acupoints with their fingers instead of using needles. This technique is used by itself or as part of an entire system of manual healing, such as in shiatsu.

In other variations of acupuncture, heat, friction, suction, magnets, or laser beams are directed to acupoints (see Electromagnetic Therapy and Cold Laser Therapy). Acupuncture is sometimes used along with less well-known traditional healing techniques, such as moxibustion (see Moxibustion) and cupping (see Cupping). Acupuncture may sometimes be referred to as Zhenjiu, which is the standard Mandarin word for needle.

What is the history behind it?

Acupuncture began more than 2,000 years ago and is an important part of traditional Chinese medicine (also called Oriental Medicine). Originally, 365 acupoints were identified, corresponding to the number of days in a year. Over time, the number of acupoints grew to more than 2,000. Traditional acupuncture needles were made of bone, stone, or metal, including silver and gold. Modern acupuncture needles are made of very thin sterile stainless steel and are disposable. In 1996, the US Food and Drug Administration (FDA) approved the use of acupuncture needles by licensed practitioners. By law, needles must be labeled for one-time use only to prevent infection and the transmission of germs.

In China, acupuncture is commonly accepted as a treatment for many diseases. Acupuncture has also become quite popular in the United States and Europe, where the technique is mainly used to control pain and relieve symptoms of disease, such as nausea caused by chemotherapy, but not to cure the disease itself.

In 2010, there are an estimated 18,000 licensed acupuncturists in the United States. More than 40 states have set up training standards for licensing or certification to practice acupuncture. There are also about 8,000 medical doctors in the United States who have been trained to practice acupuncture. Medicare does not cover acupuncture, but it is covered by some private health insurance plans and HMOs.

What is the evidence?

Available scientific evidence does not support claims that acupuncture is an effective treatment for cancer. Still, it appears it may be useful as a complementary method for relieving some symptoms related to cancer and other conditions.

Acupuncture has been the subject of many clinical studies and has been tested as treatment for a wide range of conditions. At this time, there is sound scientific support for acupuncture for 2 conditions: nausea/vomiting and headaches.

A 2006 analysis of 11 studies looked at the effect of acupuncture in reducing nausea and vomiting related to chemotherapy. The report suggested that acupuncture may reduce the vomiting that occurs shortly after chemotherapy is given, even though it had little effect on nausea. It also did not seem to help with delayed vomiting. There is also some evidence that acupuncture may lessen the need for pain medicine. A study of headache sufferers compared acupuncture with standard medical treatment. Those treated with acupuncture used less pain medicines and missed fewer work days.

Some studies suggest that acupuncture may help relieve mouth dryness (xerostomia) in patients whose salivary glands were damaged as a side effect of radiation therapy. It has also been used to relieve hot flashes, but most studies found that acupuncture using traditional acupuncture points is no more effective than sham (placebo) acupuncture. Still, some practitioners feel that it is worth trying when men or women getting hormone therapy for prostate or breast cancer have severe hot flashes that persist after trying other treatments.

Acupuncture remains a subject of research interest. But some recent studies of acupuncture have had mixed or uncertain results. Part of the problem is that it can be difficult to come up with good control procedures—one that convincingly mimics acupuncture—for scientific comparisons.

A number of studies have looked at the effectiveness of acupuncture in helping smokers quit. Experts reviewed studies in which acupuncture was used to help reduce withdrawal symptoms from quitting smoking. When the studies were analyzed as a group, the evidence suggested that sham acupuncture (placebo) worked as well as real acupuncture for smoking cessation. Similar results were found when studies of acupuncture for cocaine withdrawal were analyzed.

Although the scientific evidence is not strong, acupuncture may prove to be useful by itself or when combined with mainstream therapies to treat headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, lower back pain, carpal tunnel syndrome and asthma, and to help in the rehabilitation of stroke patients. Further research is needed in these areas.

Controlled clinical studies of electroacupuncture have suggested that it may help some people with pain after surgery, some of the nausea related to chemotherapy, and pain from kidney stones. However, it was found ineffective in a study that compared it to conventional anesthesia during in vitro fertilization.

Are there any possible problems or complications?

When done by a trained professional, acupuncture is generally considered safe. Relatively few complications have been reported, but there is a risk that a patient may be harmed if the acupuncturist is not well trained.

Traditional needle acupuncture can cause dizziness, fainting, local bleeding or bruising, internal bleeding, convulsions, dermatitis, nerve damage, and increased pain. Rarely, punctured lungs have happened, resulting in a few deaths. Traditional acupuncture also poses risks such as infection from contaminated needles or improper delivery of treatment. In the United States, sterile, single-use needles are required by law. This minimizes the risk of infection from diseases like hepatitis B or C, as well as the risk of local infection where the needle was put into the skin.

People who are taking anticoagulants (blood thinners) may have bleeding problems with traditional needle acupuncture. People with cardiac pacemakers, infusion pumps, or other electrical devices should avoid electroacupuncture.

Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer, may have serious health consequences.

Additional resources

More information from your American Cancer Society

The following information on complementary and alternative therapies may also be helpful to you. These materials may be found on our Web site (www.cancer.org) or ordered from our toll-free number: 1-800-227-2345.

Complementary and Alternative Methods and Cancer

Placebo Effect

Learning About New Ways to Treat Cancer

Learning About New Ways to Prevent Cancer

Moxibustion

Cupping

Transcutaneous Electrical Nerve Stimulation

Electromagnetic Therapy

Cold Laser Therapy

Dietary Supplements: What Is Safe?

American Cancer Society Operational Statement on Complementary and Alternative Methods of Cancer Management

References

Anonymous. United States Acupuncture Laws by State. Accessed at: www.acupuncture.com/statelaws/statelaw.htm on March 9, 2010.

American Academy of Medical Acupuncture. Personal correspondence with C. James Dowden March 9, 2010

American Academy of Medical Acupuncture. Accessed at www.medicalacupuncture.org/aama_marf/aama_membership.html on June March 9, 2010.

Barrett S. Acupuncture, qigong, and "chinese medicine." Accessed at www.quackwatch.org/01QuackeryRelatedTopics/acu.html on March 16, 2010.

Deng GE, Frenkel M, Cohen L, et al. Society for Integrative Oncology. Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals. J Soc Integr Oncol. 2009;7(3):85-120.

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Ernst E. Acupuncture: what does the most reliable evidence tell us? J Pain Symptom Manage. 2009;37(4):109-714.

Ernst E (ed). The Desktop Guide to Complementary and Alternative Medicine. New York, NY: Mosby 2001.

Ernst G, Strzyz H, Hagmeister H. Incidence of adverse effects during acupuncture therapy-a multicentre survey. Complement Ther Med. 2003;11:93-97.

Ezzo JM, Richardson MA, Vickers A., et al. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev. 2006;(2).

Gates S, Smithe LA, Foxcroft DR. Auricular acupuncture for cocaine dependence. Cochrane Database Syst Rev. 2006;(1):CD005192.

Gejervall AL, Stener-Victorin E, Moller A, et al. Electro-acupuncture versus conventional analgesia: a comparison of pain levels during oocyte aspiration and patients' experiences of well-being after surgery. Hum Reprod. 2005;20:728-735.

Hammar M, Frisk J, Grimas O, et al. Acupuncture treatment of vasomotor symptoms in men with prostatic carcinoma: a pilot study. J Urol. 1999;161:853-856.

He JP, Friedrich M, Ertan AK, Muller K, Schmidt W. Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer. Clin Exp Obstet Gynecol. 1999;26:81-84.

Kemper KJ, Sarah R, Silver-Highfield E, et al. On Pins and Needles? Pediatric Pain Patients' Experience With Acupuncture. Pediatrics. 2000;105;941-947.

National Institutes of Health National Center for Complementary and Alternative Medicine. Acupuncture: An Introduction. Accessed at http://nccam.nih.gov/health/acupuncture/introduction.htm on March 9, 2010.

Sherman KJ, Cherkin DC, Eisenberg DM, et al. The Practice of Acupuncture: Who Are

the Providers and What Do They Do? Ann of Fam Med. 2005;3:151-158.

Vickers AJ, Rees RW, Zollman CE, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ. 2004;328:744.

White AR, Rampes H, Campbell JL. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2006; (1): CD000009.

Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.

Last Medical Review: 05/11/2010
Last Revised: 05/11/2010