Acupuncture

Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. Its proponents variously claim that it relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes.[1] Acupuncture typically incorporates traditional Chinese medicine (TCM) as an integral part of its practice and theory. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points.[2][3] Acupuncture dates back to prehistoric times, with written records from the second century BCE.[4] Different variations of acupuncture are practiced and taught throughout the world.[5]

Ideas of what constitutes health and healing sometimes differ from concepts used in scientific, evidence based medicine. Traditional acupuncture was developed prior to the understanding of human anatomy and cell theory upon which modern biology is based. According to acupuncture, disease is believed to be produced by an imbalance of yin and yang caused by a "blockage" or "stagnation" of metaphysical energy known as qi, whereas in science based medicine disease is attributed to physical causes, for example bacteria, viruses, or genetic conditions. Qi is believed to flow in and around the body in channels called meridians. Heart-qi is believed to be a force that causes the blood to circulate through the body, whereas in science based medicine the blood is propelled by the heart pumping it, and it is not propelled by a metaphysical force. Traditional Chinese Medicine (TCM) is based in part on Daoism, with a belief that all parts of the universe are interconnected.[6] The location of meridians are based on the number of rivers flowing through the ancient Chinese empire, and acupuncture points were originally derived from Chinese astrological calculations.[7][8][9] and do not correspond to any anatomical structure. No force corresponding to qi (or yin and yang) has been found in the sciences of physics or human physiology.[8][10][11][12][13]

The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established.[14][15][16] Systematic reviews have concluded that acupuncture is no more effective than nonpenetrating stimulation of one point to reduce some types of nausea.[17] Evidence for the treatment of other conditions is equivocal.[18] Although evidence exists for a very small and short-lived effect on some types of pain, several review articles discussing the effectiveness of acupuncture have concluded it is possible to explain as a placebo effect.[14][19][20] Publication bias is a significant concern when evaluating the literature. Reports from the US National Center for Complementary and Alternative Medicine In America (NCCAM), the American Medical Association (AMA) and various US government reports have studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles.