Acupuncture Safe and Effective

(HealthScout) -- If you wonder whether acupuncture is safe, you can relax, according to a review of medical literature from around the world.

Only nine studies have been published since 1956 detailing adverse reactions or problems with acupuncture, the ancient Asian needle therapy used to treat everything from dull pain to arthritis.

To determine how many acupuncture-related problems have been reported in the last half century, Dr. Edzard Ernst, a professor of complementary medicine at England's University of Exeter, and a colleague examined all available medical literature on the subject -- nine surveys in 10 articles, including five from Europe and four from the Far East.

"We analyzed these nine surveys and found there were relatively few adverse effects reported among one-quarter of a million subjects reviewed in those studies," Ernst says.

Anywhere from 1 percent to 45 percent of patients reported needle pain and 2 percent to 41 percent reported a little bleeding, Ernst says. While a few patients reported feeling faint, 86 percent said they had a deep sense of relaxation after treatment. Forty-one percent reported feeling tired after treatment. No study mentioned infection or transmission of disease.

Only two studies noted serious problems: two cases of lung collapse and two cases of a needle breaking, requiring surgical removal, Ernst says. And one patient suffered a burn after moxibustion, a heat application treatment done at needle insertion points.

Ernst says he was surprised to find only nine studies on the subject. "One would have thought that a treatment that started before the invention of science would have received a lot more attention," he says.

His findings were published in the April 15 issue of The American Journal of Medicine.

The reports of side effects show that acupuncture works, says Dr. Marc Micozzi, editor of the textbook Fundamentals of Complementary Alternative Medicine and executive director of the College of Physicians of Philadelphia. He says, "People need to understand that part of taking alternative medicine seriously is to take a look at and understand the side effects."

The fact that acupuncture causes tiredness or relaxation is particularly interesting, Micozzi says. "It shows that the treatment is working in those areas. Curiously, a lot of patients occasionally report agitation, though Ernst's study did not show examples of that."

Acupuncture was first mentioned in a Chinese medical test written in the 2nd century B.C. It cited the use of long, thin needles to pierce the skin to create a "harmonious balance" within the body.

Today, proponents say acupuncture produces a range of benefits, from easing pain to curing a variety of gastrointestinal or metabolic disorders.

In North America, Ernst says acupuncture mainly is used to relieve pain, and the treatment can be effective.

"There are two hypotheses: one that acupuncture stimulates endorphins in the brain, which are natural painkillers. The other is related to pain and its communication mechanisms in the nervous system. Acupuncture may stimulate nerve fibers, causing them to fire, thus blocking transmission of the pain impulse in the spinal cord," Ernst says.

Ernst says more research is needed. "While acupuncture is safe when compared to other treatments, that doesn't mean you can assume anything. We need more studies or observations on a constant basis."

For example, he cites anecdotal reports of punctures of the kidney, bladder and spinal medulla, although not many. None of those reports turned up in his review of the medical literature, he says.

In addition, he says he's heard reports of dirty needles causing skin rashes, irritations or infections. And outbreaks of hepatitis B documented in Europe and the United States have been traced to single practitioners reusing unsterilized needles, Ernst says.

One potential pitfall for acupuncture is missing an important diagnosis of disease by skipping a visit to your doctor, says Bruce Dubin, dean of Ohio University's College of Osteopathic Medicine.

"The reports I have heard are about someone who would seek a complementary alternative practitioner and forgo a standard practitioner who practices western medicine," says Dubin. Delayed diagnosis could be a problem, he says.

"In the hands of a trained professional, acupuncture is very safe and effective. Like everything else, acupuncture is not effective for everything. Certainly, it has demonstrated itself as effective for pain that does not respond well to even high doses of medication or chronic pain," "Dubin says.

For more information on acupuncture, see Acupuncture.com or the American Academy of Medical Acupuncture.

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