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acupuncture

The piercing of specific body sites with needles to produce pain relief. Indications: - may be of benefit in treatment of chronic pain (see notes) - chronic nonspecific musculoskeletal pain - osteoarthritis (may be placebo effect, see notes) - may be of benefit for aromatase inhibitor-related arthralgias [27] - chronic headache - may be of benefit in prevention of migraine [23] - may provide long-term relief from chronic tension type headache [26] - shoulder pain - may be of benefit in non-specific low back pain [4] - benefit for chronic sciatica from herniated disk [34] - effective for chronic musculoskeletal, headache, & osteoarthritis pain [33] - cancer pain [22]; pain relief in cancer survivors* - may improve dyspnea on exertion in patients with COPD [8] - may be of benefit in patients with depression [11] - may be of benefit for postprandial dyspepsia [24] - questionable benefit for irritable bowel syndrome [13] - electroacupuncture may improve symptoms of chronic constipation [15] - infant colic ? [16] - may be of benefit for women with stress urinary incontinence [17] - adjunctive therapy for chronic stable angina [21] - combat-related post-traumatic stress disorder in veterans [29] - acupuncture may reduce methadone maintence of abstinence dose & decrease opioid craving [30] * electroacupuncture & auricular acupuncture beneficial for pain relief in cancer survivors [25] - auricular acupuncture did not demonstrate noninferiority to electroacupuncture, & patients receiving it had more adverse events [25] * moderate or high-certainty evidence that acupuncture is superior to other active therapies is rare [28] Contraindications: (non indications) - of no benefit for migraine headache [3] - of no benefit for knee osteoarthritis [6] - statistically significant benefits are small & do not meet thresholds for clinical relevance [14] - benefit for chronic neck pain not clinically meaningful [32] - of little or no benefit for allergic rhinitis [10] - no benefit for infertility associated with polycystic ovary syndrome [18] - no benefit of acupuncture during in vitro fertilization [20] - lumbar spinal stenosis [31] Complications: (low risk, incidence 14 in 10,000) 1) needle loss 2) fainting 3) worsening of symptoms (3%) 4) infections, including a) Staphylococcus b) atypical Mycobacteria [7] Notes: - much of the benefit of acupuncture in treating chronic pain can be explained by a placebo effect [9] - benefits of acupuncture not much better than sham procedure for treatmemt of chronic pain [12]

Related

acupressure

General

clinical procedure alternative medicine (complementary medicine)

References

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  2. Journal Watch 21(20):165, 2001 White A et al Adverse events following acupuncture: prospective survey of 32,000 consultations with doctors and physiotherapists. BMJ 323:485, 2001 PMID: 11532840 - MacPherson H et al The York acupuncture safety study: prospective survey of 34,000 treatments by traditional acupuncturists. BMJ 323:486, 2001 PMID: 11532841
  3. Journal Watch 25(11):91, 2005 Linde K, Streng A, Jurgens S, Hoppe A, Brinkhaus B, Witt C, Wagenpfeil S, Pfaffenrath V, Hammes MG, Weidenhammer W, Willich SN, Melchart D. Acupuncture for patients with migraine: a randomized controlled trial. JAMA. 2005 May 4;293(17):2118-25. PMID: 15870415
  4. Thomas KJ et al, Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non- specific low back pain. BMJ 2006, 333:623 PMID: 16980316 - Ratcliffe J et al, A randomised controlled trial of acupuncture care for persistent low back pain: Cost effectiveness analysis BMJ 2006, 333:626 PMID: 16980315 - Wonderling D. Acupuncture in mainstream of health care. BMJ 2006, 333:611 PMID: 16990295
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  21. Zhao L, Li D, Zheng H et al. Acupuncture as adjunctive therapy for chronic stable angina: A randomized clinical trial. JAMA Intern Med 2019 Jul 29; PMID: 31355870 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2739058
  22. He Y, Guo X, May BH et al Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer PainA Systematic Review and Meta-Analysis. JAMA Oncol. Published online December 19, 2019. PMID: 31855257 https://jamanetwork.com/journals/jamaoncology/fullarticle/2757396 - He Y, May BH, Zhang AL et al Acupuncture for cancer pain: protocol for a pilot pragmatic randomised controlled trial. BMJ Open. 2019 Jul 9;9(7):e025564. PMID: 31289059 Free PMC Article
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  25. Mao JJ, Liou KT, Baser RE et al Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial. JAMA Oncol. 2021 May 1;7(5):720-727 PMID: 33734288
  26. Whitlock Burton K Acupuncture Deep Needling Technique Points to Greater Tension Headache Relief. Medscape. June 22, 2022 https://www.medscape.com/viewarticle/976051 - Zheng H, Gao T, Zheng QH Acupuncture for Patients With Chronic Tension-Type Headache: A Randomized Controlled Trial. Neurology, 2022. June 22 PMID: 35732505 https://n.neurology.org/content/early/2022/06/22/WNL.0000000000200670
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