Acupuncture: Does it work and for what?
Acupuncture therapy has been a well-known part of Traditional Chinese Medicine (TCM) since ancient times dating back at least 3000 yrs. However, for anyone new to the realm of holistic medicine, this practice can seem quite the mystery. How can inserting needles into the skin possibly make a person feel better and where's the proof?
In short, acupuncture is a safe, minimally invasive technique that stimulates nerve-rich areas of the skin surface in order to influence organs, tissues, glands and various functions of the body. In a world where people are searching in earnest for safe alternatives to prescription drugs, acupuncture, well-known for its minimal side-effects, is a very compelling therapy to consider...and the evidence that it actually works is piling up.
Over the past 20 years, there have been over 13,000 studies conducted across the globe in 60 countries, including hundreds of meta-analyses summarizing the results of thousands of human and animal studies.1 The clinical areas that have been studied include pain, cancer, pregnancy, stroke, mood disorders, sleep disorders and inflammation, among many others. In 2014 the entire literature base was summarized by the Australian Department of Veteran Affairs).2 This was followed by a landmark review in 2017 called The Acupuncture Evidence Project which determined that acupuncture demonstrates moderate to strong evidence of effectiveness in the treatment of 46 conditions and is considered safe in the hands of properly trained practitioners. 3 In this review the strongest evidence was shown for migraine prophylaxis, headache, chronic low back pain, allergic rhinitis, knee osteoarthritis, chemotherapy-induced nausea and vomiting, post-operative nausea and vomiting and post-operative pain.A research studies of how acupuncture compares to other treatments in head to head analysis include :
- 2013 meta-analysis comparing treatments for osteoarthritis of the knee found that acupuncture out-performed exercise, sham acupuncture, and weight-loss. 4
- 2015 meta-analysis comparing treatments for shoulder impingement syndrome (all along with exercise) found that acupuncture outperformed 17 interventions such as steroid injection, NSAIDs, and ultrasound therapy. 5
- 2016 comparison of 20 treatments for sciatica concluded that acupuncture was 2nd most effective after the use of biological agents, outperforming epidurals, disc surgery, manipulation, opioids, exercise, and a procedure called radio-frequency denervation. 6
- 2018 meta-analysis concluded that acupuncture was more effective than drugs for treatment of chronic constipation, with fewer side-effects. 7
Concerning acupuncture for chronic pain, the Archives of Internal Medicine published a meta-analysis which reviewed 4 chronic pain conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain, and concluded that "acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option". 8 Additionally, a review published in Current Opinion in Anaesthesiology summarized acupuncture as being "effective, safe, and cost-effective for treating several chronic pain conditions when performed by well-trained healthcare professionals. 9
Many of my clients ask what acupuncture is good for, and the list is long! Naturally the first thing that comes to mind is pain, but there is so much more...
The NCCIH (National Center for Complementary and Integrative Health) 10, notes that acupuncture has been proven to help in cases of:
- low back pain
- neck pain
- knee pain
- headache and migraine
In 2003, the World Health Organization (WHO) listed a number of conditions in which they say acupuncture has been proven effective. 11 These include:
- high and low blood pressure
- chemotherapy-induced nausea and vomiting
- some gastric conditions, including peptic ulcer
- painful periods
- allergic rhinitis
- facial pain
- morning sickness
- rheumatoid arthritis
- tennis elbow
- dental pain
- reducing the risk of stroke
- inducing labor
Other conditions for which the WHO say that acupuncture may help but more evidence is needed include:
- post-operative convalescence
- substance, tobacco and alcohol dependence
- spine pain
- stiff neck
- vascular dementia
- whooping cough, or pertussis
- Tourette's syndrome
- may help treat a number of infections, including some urinary tract infections and epidemic hemorrhagic fever.
(For a more extensive list of the WHO recommendations pls refer to : 12 )
It is important to note, however, that the WHO points out that “only national health authorities can determine the diseases, symptoms, and conditions for which acupuncture treatment can be recommended.” Equally important is that the NCCIH advise people not to use acupuncture instead of seeing a conventional health care provider, and this is sage advice all around that I always encourage in my practice.
All together, this strong scientific support and global endorsement is impressive and helpful for patients in the context of a healthcare system where many treatments lack evidence for their use. Acupuncture is also considered cost-effective for a number of conditions where evidence is available and carries minimal side-effects. Patients and medical professionals alike can be confident that the recommendation of acupuncture for many patients is a safe, cost-effective, and evidence-based recommendation.
- Ma Y, Dong M, Zhou K, et al. Publication Trends in Acupuncture Research: A 20-Year Bibliometric Analysis Based on PubMed. PLoS ONE 2016;11
- Hempel S, Taylor SL, Solloway MR, et al. Evidence Map of Acupuncture. Washington (DC): : Department of Veterans Affairs 2014
- The Acupuncture Evidence Project – A Comparative Literature Review 2017 – Acupuncture.org.au. 2017;1–81.
- Corbett MS, Rice SJC, Madurasinghe V, et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis and Cartilage 2013;21:1290–8.
- Dong W, Goost H, Lin X-B, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore) 2015;94
- Lewis R, FLCOM NHWPF, PhD AJS, et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. The Spine Journal 2015;15:1461–77.
- Zhu L, Ma Y, Deng X. Comparison of acupuncture and other drugs for chronic constipation: A network meta-analysis. PLoS ONE 2018;13
- Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., et al. (2012). Acupuncture for Chronic Pain. Archives of Internal Medicine, 172(19), 1444.
- Yin, C., Buchheit, T. E., & Park, J. J. (2017). Acupuncture for chronic pain: an update and critical overview. Current Opinion in Anaesthesiology
- Acupuncture: In depth. (2017, February 21)
- Chmielnicki, B. (2003). Evidence-based acupuncture WHO official position