Acupuncture may have originated in ancient China, but these days it has been recommended for everything from smoking cessation to weight loss. But is it truly effective? The research on the affects of acupuncture is decidedly mixed and requires careful examination.
Acupuncture started over 5,000 years ago and is based on 12 energy lines (meridians) that circulate qi (energy) through the body. Each of the 12 meridians is associated with a different system or organ in the body. When one of these systems is out of balance, it can cause illness. Acupuncturists insert hair-thin needles into specific points along the affected meridian to correct the imbalance. There are at least 1,000 acupuncture points on the body.
In 1996, the U.S. Food and Drug Administration reclassified acupuncture needles from “experimental” to “medical device” and endorsed their use to treat such things as tennis elbow, pain after surgery, and carpal tunnel syndrome. Many people in the U.S. utilize acupuncture to address pain or change behavior. Over $500 million is spent annually on acupuncture treatments, and many insurance plans now cover this popular alternative treatment.
There are different theories on how acupuncture works. Some point to stimulation of neurotransmitters, while others believe that acupuncture changes the electrical currents in the body or stimulates better circulation.
Regardless of how it functions, acupuncture has been used to treat many different ailments, including the following:
But does acupuncture actually work?
Researchers at Rutgers Biomedical and Health Sciences studied the effects of electroacupuncture on inflammation, specifically inflammation that causes death after sepsis. When patients are admitted to the hospital for surgery, there is a risk of sepsis. Doctors found that in fatal cases of sepsis, the cause of death was actually inflammation that developed after the septic infection.
Electroacupuncture passes a weak electrical current between two acupuncture needles. Luis Ulloa, the immunologist at Rutgers New Jersey Medical School who led the study, noted that the electrical current amplified the effect of needle placement. He wanted to see if electro acupuncture could reduce inflammation and injury to organs in mice with sepsis. Ulloa and his team predicted that the electroacupuncture would stimulate the production of anti-inflammatory molecules called cytokines, which it did. Of the study mice, half who received the treatment survived at least a week. The survival rate for those who did not receive the treatment was zero.
The study, which has been published by the journal Nature Medicine, holds promise for electroacupuncture as a treatment for inflammation.
“On the one hand, this research shows physical evidence of acupuncture’s value beyond any that has been demonstrated before. These results show potential benefits not just for sepsis, but treating other inflammatory diseases such as rheumatoid arthritis, osteoarthritis and Crohn’s disease.”
On the other hand, Ulloa found that when the mice’s adrenal glands were removed, the treatment didn’t work but could instead be mimicked using a drug called fenoldopam. This drug reduced sepsis by 40% without acupuncture. These two treatments require further research to determine if they are effective in humans, but they seem at the outset to be promising.
Not so promising is new research studying the affects of acupuncture on knee pain in adults over 50. The study out of the University of Melbourne included 282 patients who were randomly assigned one of three types of treatment: traditional acupuncture, non-invasive laser acupuncture, and sham laser acupuncture (an inactive laser was used). Treatments were administered over a period of 12 weeks.
Study lead Professor Kim Bennell from the Centre for Health, Exercise and Sports Medicine (CHESM) found no real difference in pain reduction among the three treatments at either 12 weeks or one year. Professor Bennell notes:
“Both needle and laser acupuncture resulted in modest improvements in pain compared with the control group who had no treatment at 12 weeks. However, these results were not maintained at one year.”
These results directly contradict earlier analyses of patient data from 29 separate trials administered in a similar fashion. In a 2012 examination of data from randomized controlled trials (RCTs) with a total of 17,922 patients from the United States, UK, Germany, Spain, and Sweden, Andrew J. Vickers, D.Phil., of Memorial Sloan-Kettering Cancer Center, New York, and colleagues attempted to determine if acupuncture was better than either no acupuncture or sham acupuncture in reducing some types of pain.
“We found acupuncture to be superior to both no-acupuncture control and sham acupuncture for the treatment of chronic pain,” the authors comment. “Although the data indicate that acupuncture is more than a placebo, the differences between true and sham acupuncture are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to therapeutic effects.”
If, as the authors suggest, the key to effective acupuncture treatment is receiving effective acupuncture treatment, how should you find a qualified acupuncturist? The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) has a web page that outlines each state’s requirements for licensing and indicates whether or not the practitioner is certified by the NCCAOM. Their requirements for certification are rigorous and require Board Examinations. This is the best starting point for your search. You can also check with your insurance provider to see if they have acupuncturists in their network of doctors. This means that those acupuncturists have also been screened and had their credentials evaluated.
Debate continues on the efficacy of acupuncture, but tell us: have you ever tried it, and did it work for you?
Image by Lars Plougmann via Flickr