How does acupuncture work?
By Christian Nordqvist
Reviewed by Yamini Ranchod, PhD, MS
Acupuncture is a form of treatment that involves inserting very thin needles through a person's skin at specific points on the body, to various depths.
Research suggests that it can help relieve pain, and it is used for a wide range of other complaints.
However, according to the National Center for Complementary and Integrative Health (NCCIH), there is limited evidence for its effectiveness in areas other than pain.
How acupuncture works scientifically remains unclear. Some people claim it works by balancing vital energy, while others believe it has a neurological effect.
Acupuncture remains controversial among Western medical doctors and scientists.
What is acupuncture?
Acupuncture involves inserting needles at certain points of the body.
An acupuncurist will insert needles into a person's body with the aim of balancing their energy.
This, it is claimed, can help boost wellbeing and may cure some illnesses.
Conditions it is used for include different kinds of pain, such as headaches, blood pressureproblems, and whooping cough, among others.
How does it work?
Traditional Chinese medicine explains that health is the result of a harmonious balance of the complementary extremes of "yin" and "yang" of the life force known as "qi," pronounced "chi." Illness is said to be the consequence of an imbalance of the forces.
Qi is said to flow through meridians, or pathways, in the human body. These meridiens and energy flows are accessible through 350 acupuncture points in the body.
Inserting needles into these points with appropriate combinations is said to bring the energy flow back into proper balance.
There is no scientific proof that the meridians or acupuncture points exist, and it is hard to prove that they either do or do not, but numerous studies suggest that acupuncture works for some conditions.
Some experts have used neuroscience to explain acupuncture. Acupuncture points are seen as places where nerves, muscles, and connective tissue can be stimulated. The stimulation increases blood flow, while at the same time triggering the activity of the body's natural painkillers.
It is difficult to set up investigations using proper scientific controls, because of the invasive nature of acupuncture. In a clinical study, a control group would have to undergo sham treatment, or a placebo, for results to be compared with those of genuine acupuncture.
Some studies have concluded that acupuncture offers similar benefits to a patient as a placebo, but others have indicated that there are some real benefits.
Research carried out in Germany has shown that acupuncture may help relieve tension headaches and migraines.
The NCCIH note that it has been proven to help in cases of:
low back pain
headache and migraine
They list additional disorders that may benefit from acupuncture, but which require further scientific confirmation.
In 2003, the World Health Organization (WHO) listed a number of conditions in which they say acupuncture has been proven effective.
high and low blood pressure
chemotherapy-induced nausea and vomiting
some gastric conditions, including peptic ulcer
reducing the risk of stroke
Other conditions for which the WHO say that acupuncture may help but more evidence is needed include:
substance, tobaccor and alcohol dependence
whooping cough, or pertussis
The WHO also suggest that it may help treat a number of infections, including some urinary tract infections and epidemic hemorrhagic fever.
They point out, however, that "only national health authorities can determine the diseases, symptoms, and conditions for which acupuncture treatment can be recommended."
Acupuncture can be beneficial in that:
Performed correctly, it is safe.
There are very few side effects.
It can be effectively combined with other treatments.
It can control some types of pain.
It may help patients for whom pain medications are not suitable.
The NCCIH advise people not to use acupuncture instead of seeing a conventional health care provider.
What to expect
According to traditional Chinese medical theory, acupuncture points are located on meridians, through which vital energy runs. This energy is known as "qi" or "chi."
An acupuncturist will examine the patient and assess their condition, insert one or more thin, sterile needles, and offer advice on self-care or other complementary therapies, such as Chinese herbs.
The patient will be asked to lie down on their back, front, or one side, depending on where the needles are to be inserted. The acupuncturist should use single-use, disposable, sterile needles. As each needle is inserted, the patient may feel a very brief stinging or tingling sensation.
After the needle is inserted, there is occasionally a dull ache at the base of the needle that then subsides. Acupuncture is usually relatively painless.
Sometimes the needles are heated or stimulated with electricity after insertion.
The needles will stay in place for between 5 and 30 minutes.
The number of treatments needed depend on the individual. A person with a chronic condition may need one to two treatments a week over several months. An acute problem normally improves after 8 to 12 sessions.
All therapies have risks as well as benefits.
The possible risks of acupuncture are:
It is dangerous if a patient has a bleeding disorder or takes blood thinners.
Bleeding, bruising, and soreness may occur at the insertion sites.
Unsterilized needles may infect the patient.
In rare cases, a needle may break and damage an internal organ.
When inserted deeply into the chest or upper back, there is a risk of collapsed lung, but this is very rare.
The United States (U.S.) Food and Drug Administration (FDA) regulate acupuncture needles as medical devices. Their manufacture and labelling needs to meet certain standards. The needles must be sterile, nontoxic, and labelled for one use only, by a licensed practitioner.
As with any complementary therapy, it is advisable to use it alongside conventional treatments in cases of chronic or severe illness.