Acupuncture is a medical alternative for of treatment widely practiced in the U.S. Although there have been many studies of its potential usefulness, many of these studies provide ambiguous results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups.
However, promising results have emerged showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program.
Acupuncture is an important part of the health care system of China; it can be traced back for at least 2500 years. The general theory of acupuncture is based on the premise that there are patterns of energy flow (Qi) through the body that are essential for health.
Disruptions of this flow are believed to be responsible for disease. Acupuncture may correct imbalances of flow at identifiable points close to the skin. The practice of acupuncture to treat medical conditions in American medicine was rare until 1972, when President Nixon visited China.
Since that time, there has been an explosion of interest in the United States and Europe in the application of the technique of acupuncture to Western medicine.
This discipline describes a family of procedures involving stimulation of anatomical locations on the skin by a variety of techniques. There are a variety of approaches to diagnosis and treatment in American acupuncture that incorporates medical traditions from China, Japan, Korea, and other countries.
The most studied mechanism of stimulation of acupuncture points employs penetration of the skin by thin, solid, metallic needles, which are manipulated manually or by electrical stimulation.
Stimulation of these areas by moxibustion, pressure, heat, and lasers is used in acupuncture practice, but because of the absence of studies, these techniques are more difficult to evaluate.
By Annie M. Williams, MD
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