Acupuncture is a traditional Chinese medicine technique that involves inserting fine needles at strategic points in the body with the intent of relieving pain. Acupuncture is used in many clinical practices in the Western world as complementary or alternative medicine (CAM) following a medical diagnosis.

How acupuncture works

An initial evaluation by a certified acupuncturist involves trying to understand the origin of the pain, checking the patient’s pulse and features such as the shape and color of the tongue and color of the face.

Traditional Chinese acupuncture is based on the belief that a “life force” called qi (pronounced “chi”) is channeled through the body in pathways called meridians. It is believed that when the flow of qi is interrupted, it may result in illness or pain.

By inserting fine needles at strategic points along the so-called meridians, it is believed that the flow of qi can be corrected and health will be restored. The acupuncturist may move or twirl the needles, or may even apply heat or mild electric impulses to them.

In Western practice, acupuncture is seen as a way to stimulate nerves, muscles, and connective tissue that stimulates the production of the body’s natural painkillers called endorphins.

A long-term acupuncture course often is more beneficial than a single session. Usually, six to eight sessions can be expected, with each session lasting about 20 minutes.

Acupuncture in clinical practice

Although there is some evidence that acupuncture helps relieve pain associated with endometriosis, clinical practice guidelines are still inconsistent. Not many complications have been reported from the use of acupuncture, but there are opinions that the technique does not work, or is just an enhanced placebo.

Acupuncture is often suggested as complementary medicine, but not as a substitute for proper medical care for treating pain.

The U.S. Food and Drug Administration (FDA) regulates the use of acupuncture needles and mandates their use according to certain prescribed standards by licensed practitioners. The FDA’s initial blueprint for pain management recommended physicians familiarize themselves with non-pharmacological therapies such as acupuncture. However, many organizations criticized this as unscientific.

That being said, there are several clinical trials being conducted to determine the effectiveness of acupuncture in relieving the symptoms for conditions such as endometriosis (NCT03125304) and depression (NCT03452384), among others.

The trial for endometriosis is a multicenter, randomized, and controlled study that is recruiting an estimated 106 participants who will be receiving therapy at five different acupoints in the body, namely Sanyinjiao (SP 6), Zhaohai (KI 6), Taichong (LR 3), Qichong (ST 30), and Guanyuan.

Acupuncture will be administered once a day, three times a week, and will commence seven days before the onset of the menstrual cycle. Once the menstrual period starts, the therapy, which lasts for about 30 minutes, will be done every day that the individual complains of pain. This will continue for three menstrual cycles, and then another three cycles for follow-up. Results will be compared with a placebo group that undergoes the same treatment schedule, but receives acupuncture at non-acupoints.

The study is still recruiting participants in China and is expected to be completed in April 2020, with the results expected to be available a month after.

Other information

It is important to approach a registered acupuncturist vetted by professional associations, such as the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), and the British Acupuncture Council (BAcC), to minimize complications as much as possible.

The insertion and removal of acupuncture needles is relatively painless, but patients may experience a mild tingling or a dull, aching sensation, depending on how deep the needle is inserted.

Sterile, disposable, and single-use needles are standard and should be mandatory.

It is recommended to consult the healthcare provider before the session if the patient has a history of bleeding disorders, a pacemaker implant, or is pregnant. Acupuncture is not recommended for infants or those with weakened immune systems.

Some patients might experience “needle shock” — a feeling of chilliness, faintness, and slight nausea — especially if they are nervous about needles or have low blood sugar.

Last updated Aug. 1, 2019.

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