The word “acupuncture” is derived from the Latin words “acus” (needle) and “punctura” (penetration). Acupuncture originated in China approximately 2000 years ago and is one of the oldest medical procedures in the world.
Over its long history and dissemination, acupuncture has diversified and encompasses a large array of styles and techniques. Common styles include Traditional Chinese, Japanese, Korean, Vietnamese, and French acupuncture, as well as specialized forms such as hand, auricular, and scalp acupuncture.
Acupuncture also refers to a family of procedures used to stimulate anatomic points. Aside from needles, acupuncturists can incorporate manual pressure, electrical stimulation, magnets, low-power lasers, heat, and ultrasound.
Three important concepts in acupuncture are qi, yin/yang, and Five Elements.
●Qi (pronounced “chee”) is frequently translated as “vital energy.” It is felt to permeate all things, may assume different forms, and travels through meridians located on the body. It can be described as stagnant, depleted, collapsed, or rebellious. Whether qi is a quantitative force or a metaphor for the way people experience and depict connections and interconnections is not clear. It likely provides a rationale for explaining change and linking phenomena.
●Yin and yang are felt to be complementary opposites and are used to describe all things in nature. Yin is used to represent more material, dense states of matter, while yang represents more immaterial, rarefied states of matter. The interplay between the two opposites is dynamic and cyclical. To the acupuncturist, health is a constant state of dynamic balance, and one must employ a series of qualitative assessments to establish a patient’s present disposition. The evaluation is more complex than merely designating a patient as “more yin” or “more yang.” An intricate set of qualitative measures, examination tools, and symptom evaluations are used.
●Five Elements, along with yin/yang theory, form the basis of Chinese medical theory. The Five Elements are wood, water, fire, earth, and metal. These elements are not basic constituents of nature but represent different basic processes, qualities, or phases of a cycle. Each element can generate or counteract another element. Most vital organs, acupuncture meridians, emotions, and other health-related variable are assigned an element, thus providing a global description of the balancing dynamics seen in each person.
The Eastern medical practitioner relies on these principles for diagnosis and treatment selection. Once the nature of imbalance is determined, the practitioner aims to shift the constitution toward balance with the use of various interventions. Acupuncture is one important option.
CLINICAL CONSIDERATIONS
Clinical applications — There have been thousands of controlled trials of acupuncture for various conditions. Examples of some of the best-studied conditions are provided below.
Some conditions for which acupuncture has been studied and appears to have possible efficacy include:
●Pain conditions – Chronic pain, headache, neck pain, low back pain, knee osteoarthritis, fibromyalgia, postoperative pain, cancer-related pain, acute pain including dental pain.
●Women’s health – Menopausal hot flashes, dysmenorrhea, premenstrual syndrome, pain control after cesarean delivery.
●Gastrointestinal disorders – Functional constipation, irritable bowel syndrome, postoperative nausea and vomiting, chemotherapy-induced nausea.
●Mental health and sleep disorders – Anxiety, depression, insomnia.
●Other – Chronic obstructive pulmonary disease, seasonal allergic rhinitis, chronic prostatitis.
●Prevention – Migraine prevention is discussed elsewhere.
Adverse events — Acupuncture is generally safe but can lead to the complications seen with any type of needle use. These include transmission of infectious diseases, retained needle fragments, nerve damage, and, very rarely, pneumothorax, pneumoperitoneum, organ puncture, cardiac tamponade, and osteomyelitis. Local complications may include bleeding, contact dermatitis, infection, pain, and paresthesia. Practitioners should use sterile needles to prevent transmission of disease. In the United States, acupuncture practitioners are required to use disposable sterile needles.
Despite the variety of listed complications and the occasional case reports in major journals, major adverse events are exceedingly rare and are usually associated with poorly trained, unlicensed acupuncturists.
From “UpToDate 2024” February 18, 2024