Around.his time the surgeon-general of the Dutch East India Company met Japanese and Chinese acupuncture practitioners and later encouraged Europeans to further investigate it. 29 :264-265 He published the first in-depth description of acupuncture for the European audience and created the term “acupuncture” in his 1683 work De acupuncture. acupuncture clinic 269 France was an early adopter among the West due to the influence of Jesuit missionaries, who brought the practiced to French clinics in the 16th century. 27 The French doctor Louis Berlioz the father auscultation and olfaction, inquiring, and palpation. The.exceptions to this conclusion included the use of acupuncture during embryo transfer as an adjunct to in vitro fertilization. 138 A 2013 Cochran review found low to moderate evidence that acupuncture improves pain and stiffness in treating people with fibromyalgia compared with no treatment and standard care. 139 A 2012 review found “there is insufficient evidence to recommend acupuncture for the treatment of fibromyalgia.” 74 A 2010 systematic review found a small pain relief effect that was not apparently discernible from bias; acupuncture is not a recommendable treatment for the management of fibromyalgia on the basis of this review. 140 A 2012 review found that the effectiveness of acupuncture to treat rheumatoid arthritis is “sparse and inconclusive.” 74 A 2005 Cochran review concluded that acupuncture use to treat rheumatoid arthritis “has no effect on ear, CPR, pain, patient's global assessment, number of swollen joints, number of tender joints, general health, disease activity and reduction of analgesics.” 141 A 2010 overview of systematic reviews found insufficient evidence to recommend acupuncture in the treatment of most rheumatic conditions, with the exceptions of osteoarthritis, low back pain, and lateral elbow pain. 142 A 2014 overview of systematic reviews and meta-analyses found that the evidence does not demonstrate acupuncture helps reduce the rates of death or disability after a stroke or improve other aspects of stroke recovery, such as post stroke motor dysfunction, but the evidence suggests it may help with post stroke neurological impairment and dysfunction such as dysphagia, which would need to be confirmed with future rigorous studies. 143 A 2012 review found evidence of benefit for acupuncture combined with exercise in treating shoulder pain after stroke. 144 A 2010 systematic review found that acupuncture was not effective as a treatment for functional recovery after a stroke. 145 A 2012 overview of systematic reviews found inconclusive evidence supporting the effectiveness of acupuncture for stroke. 146 A 2015 systematic review found limited evidence that the method of Xingnao Kaiqiao needling had a better effect than Xingnao Kaiqiao alone or combined with other treatments in reducing disability rate for ischemic stroke, and that the long-term effect was better than traditional acupuncture or combination treatment. 147 A 2014 meta-analysis found tentative evidence for acupuncture in cerebral infarction, a type of ischemic stroke, but the authors noted the trials reviewed were often of poor quality. 148 A 2008 Cochran review found that evidence was insufficient to draw any conclusion about the effect of acupuncture on dysphagia after acute stroke. 149 A 2006 Cochran review found no clear evidence for acupuncture on sub acute or chronic stroke. 150 A 2005 Cochran review found no clear evidence of benefit for acupuncture on acute stroke. 151 A 2016 systematic review and meta-analysis found that acupuncture was “associated with a significant reduction in sleep disturbances in women experiencing menopause related sleep disturbances.” 152 For the following conditions, the Cochran collabouration or other reviews have concluded there is no strong evidence of benefit: alcohol dependence, 153 angina pectoris, 154 ankle sprain, 155 156 Alzheimer's disease, 157 attention deficit hyperactivity disorder, 158 159 autism, 160 161 asthma, 162 163 bell's palsy, 164 165 traumatic brain injury, 166 carpal tunnel syndrome, 167 chronic obstructive pulmonary disease, 168 cardiac arrhythmias, 169 cerebral haemorrhage, 170 cocaine dependence, 171 constipation, 172 depressions, 173 174 diabetic peripheral neuropathy, 175 drug detoxification, 176 177 dry eye, 178 primary dysmenorrhoea, 179 enuresis, 180 endometriosis, 181 epilepsy, 182 erectile dysfunction, 183 essential hypertension, 184 glaucoma, 185 gynaecological conditions except possibly fertility and nausea/vomiting, 186 hot flashes, 187 188 189 190 hypoxic ischemic encephalopathy in neonates, 191 insomnia, 192 193 194 inductions of childbirth, 195 irritable bowel syndrome, 196 labour pain, 197 198 lumbar spinal stenos is, 199 major depressive disorders in pregnant women, 200 musculoskeletal disorders of the extremities, 201 myopia, 202 obesity, 203 204 obstetrical conditions, 205 Parkinson's disease, 206 207 polies cystic ovary syndrome, 208 premenstrual syndrome, 209 preoperative anxiety, 210 opioid addiction, 211 212 restless legs syndrome, 213 schizophrenia, 214 sensorineural hearing loss, 215 smoking cessation, 216 stress urinary incontinence, 217 acute stroke, 218 stroke rehabilitation, 219 temporomandibular joint dysfunction, 220 221 tennis elbow, 222 labor induction, 223 tinnitus, 224 225 uraemic itching, 226 uterine fibroids, 227 vascular dementia, 228 and whiplash . 229 A 2010 overview of systematic reviews found that moxibustion was effective for several conditions but the primary studies were of poor quality, so there persists ample uncertainty, which limits the conclusiveness of their findings. 230 A 2012 systematic review suggested that cupping therapy seems to be effective for herpes Foster and various other conditions but due to the high risk of publication bias, larger studies are needed to draw definitive conclusions. 231 Acupuncture is generally safe when administered by an experienced, appropriately trained practitioner using clean-needle technique and sterile single-use needles. 16 17 When improperly delivered it can cause adverse effects. 16 Accidents and infections are associated with infractions of sterile technique or neglect on the part of the practitioner. 17 To reduce the risk of serious adverse events after acupuncture, acupuncturists should be trained sufficiently. 10 People with serious spinal disease, such as cancer or infection, are not good candidates for acupuncture. 2 Contraindications to acupuncture conditions that should not be treated with acupuncture include coagulopathy disorders e.g. haemophilia and advanced liver disease, warfarin use, severe psychiatric disorders e.g. psychosis, and skin infections or skin trauma e.g. burns. 2 Further, electro acupuncture should be avoided at the spot of implanted electrical devices such as pacemakers. 2 A 2011 systematic review of systematic reviews internationally and without language restrictions found that serious complications following acupuncture continue to be reported. 10 Between 2000 and 2009, ninety-five cases of serious adverse events, including five deaths, were reported. 10 Many such events are not inherent to acupuncture but are due to malpractice of acupuncturists. 10 This might be why such complications have not been reported in surveys of adequately-trained acupuncturists. 10 Most such reports originate from Asia, which may reflect the large number of treatments performed there or a relatively higher number of poorly trained Asian acupuncturists. 10 Many serious adverse events were reported from developed countries. 10 These included Australia, Austria, Canada, Croatia, France, Germany, Ireland, the Netherlands, New Zealand, Spain, Sweden, Switzerland, the UK, and the US. 10 The number of adverse effects reported from the UK appears particularly unusual, which may indicate less under-reporting in the UK than other countries. 10 all the ancient materials that could have been used for acupuncture and which often produce archaeological evidence, such as sharpened bones, bamboo or stones, were also used for other purposes. 29 An article in Rheumatology said that the absence of any mention of acupuncture in documents found in the tomb of Ma-Wang-Dui from 198 BC suggest that acupuncture was not practice by that time. 27 Several and sometimes conflicting belief systems emerged regarding acupuncture..>Acupuncture.Tote..s..orm.f.lternative.edicine 2 in which thin needles are inserted into the body. 3 It is a key component of traditional Chinese medicine ACM. 4 ACM theory and practice are not based upon scientific knowledge, 5 and acupuncture is a pseudo-science . 6 7 There is a diverse range of acupuncture theories based on different philosophies, 8 and techniques vary depending on the country. 9 The method used in ACM is likely the most widespread in the US. 2 It is most often used for pain relief, 10 11 though it is also used for a wide range of other conditions. 4 Acupuncture is generally used only in combination with other forms of treatment. 12 The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent. 10 13 An overview of Cochran reviews found that acupuncture is not effective for a wide range of conditions, and it suggests acupuncture may be effective only for chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache. 13 A systematic review of systematic reviews found little evidence of acupuncture's effectiveness in treating pain. 10 The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits. 14 Some research results suggest acupuncture can alleviate pain, though the majority of research suggests that acupuncture's effects are mainly due to placebo . 9 A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias. 15 Acupuncture is generally safe when done by an appropriately trained practitioner using clean needle technique and single-use needles. 16 17 When properly delivered, it has a low rate of mostly minor adverse effects . 3 16 Accidents and infections are associated with infractions of sterile technique or neglect of the practitioner. 17 A review stated that the reports of infection transmission increased significantly in the prior decade. 18 The most frequently reported adverse events were pneumothorax and infections. 10 Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk. 10 A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care, 19 while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain. 20 Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points, n 1 24 and many modern practitioners no longer support the existence of life force energy qi flowing through meridians, which was a major part of early belief systems. 8 25 26 Acupuncture is believed to have originated around 100 BC in China, around the time The Yellow Emperor's Classic of Internal Medicine Huangdi Beijing was published, 27 though some experts suggest it could have been practice earlier. 9 Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's “rhythm” on the effectiveness of treatment. 28 Acupuncture grew and diminished in popularity Reports included 38 cases of infections and 42 cases of organ trauma. 10 The most frequent adverse events included pneumothorax, and bacterial and viral infections . 10 A 2013 review found without restrictions regarding publication date, study type or language 295 cases of infections; mycobacterium was the pathogen in at least 96%. 18 Likely sources of infection include towels, hot packs or boiling tank water, and reusing reprocessed needles. 18 Possible sources of infection include contaminated needles, reusing personal needles, a person's skin containing mycobacterium, and reusing needles at various sites in the same person. 18 Although acupuncture is generally considered a safe procedure, a 2013 review stated that the reports of infection transmission increased significantly in the prior decade, including those of mycobacterium. 18 Although it is recommended that practitioners of acupuncture use disposable needles, the reuse of sterilized needles is still permitted. 18 It is also recommended that thorough control practices for preventing infection be implemented and adapted. 18 The Xingnao Kaiqiao approach appears to be a safe form of treatment. 147 Fainting was the most frequent adverse event. 147 Fainting while being treated, haematoma, and pain while being treated are associated with individual physical differences and with needle manipulation. 147 A 2013 systematic review of the English-language case reports found that serious adverse events associated with acupuncture are rare, but that acupuncture is not without risk. 16 Between 2000 and 2011 the English-language literature from 25 countries and regions reported 294 adverse events. 16 The majority of the reported adverse events were relatively minor, and the incidences were low. 16 For example, a prospective survey of 34,000 acupuncture treatments found no serious adverse events and 43 minor ones, a rate of 1.3 per 1000 interventions. 16 Another survey found there were 7.1% minor adverse events, of which 5 were serious, amid 97,733 acupuncture patients. 16 The most common adverse effect observed was infection e.g. mycobacterium, and the majority of infections were bacterial in nature, caused by skin contact at the needling site. 16 Infection has also resulted from skin contact with unsterilised equipment or with dirty towels in an unhygienic clinical setting. 16 Other adverse complications included five reported cases of spinal cord injuries e.g. migrating broken needles or needling too deeply, four brain injuries, four peripheral nerve injuries, five heart injuries, seven other organ and tissue injuries, bilateral hand enema, epithelioid granuloma, pseudo lymphoma, argyria, pustules, pancytopenia, and scarring due to hot-needle technique. 16 Adverse reactions from acupuncture, which are unusual and uncommon in typical acupuncture practice, included syncope, galactorrhoea, bilateral nystagmus, pyoderma gangrenosum, hepatotoxicity, eruptive lichen planes, and spontaneous needle migration. 16 A 2013 systematic review found 31 cases of vascular injuries caused by acupuncture, three resulting in death. 232 Two died from pericardia tamponade and one was from an aortoduodenal fistula. 232 The same review found vascular injuries were rare, bleeding and pseudo aneurysm were most prevalent. 232 A 2011 systematic review without restriction in time or language, aiming to summarize all reported case of cardiac tamponade after acupuncture, found 26 cases resulting in 14 deaths, with little doubt about causality in most fatal instances. 233 The same review concluded cardiac tamponade was a serious, usually fatal, though theoretically avoidable complication following acupuncture, and urged training to minimize risk. 233 A 2012 review found a number of adverse events were reported after acupuncture in the UK's National Health Service NHS but most 95% were not severe, 42 though miscategorization and under-reporting may alter the total figures. 42 From January 2009 to December 2011, 468 safety incidents were recognized within the NHS organizations. 42 The adverse events recorded included retained needles 31%, dizziness 30%, loss of consciousness/unresponsive 19%, falls 4%, bruising or soreness at needle site 2%, pneumothorax 1% and other adverse side effects 12%. 42 Acupuncture practitioners should know, and be prepared to be responsible for, any substantial harm from treatments. 42 Some acupuncture proponents argue that the long history of acupuncture suggests it is safe. 42 However, there is an increasing literature on adverse events e.g. spinal-cord injury. 42 Acupuncture seems to be safe in people getting anticoagulants, assuming needles are used at the correct location and depth. 234 Studies are required to verify these findings. 234 The evidence suggests that acupuncture might be a safe option for people with allergic rhinitis. 118 Chinese, South Korean, and Japanese-language A 2010 systematic review of the Chinese-language literature found numerous acupuncture-related adverse events, including pneumothorax, fainting, sub arachnoid haemorrhage, and infection as the most frequent, and cardiovascular injuries, sub arachnoid haemorrhage, pneumothorax, and recurrent cerebral haemorrhage as the most serious, most of which were due to improper technique. 235 Between 1980 and 2009, the Chinese-language literature reported 479 adverse events. 235 Prospective surveys show that mild, transient acupuncture-associated adverse events ranged from 6.71% to 15%. 235 In a study with 190,924 patients, the prevalence of serious adverse events was roughly 0.024%. 235 Another study showed a rate of adverse events requiring specific treatment of 2.2%, 4,963 incidences among 229,230 patients. 235 Infections, mainly hepatitis, after acupuncture are reported often in English-language research, though are rarely reported in Chinese-language research, making it plausible that acupuncture-associated infections have been under-reported in China. 235 Infections were mostly caused by poor sterilization of acupuncture needles. 235 Other adverse events included spinal epidural haematoma in the cervical, thoracic and lumbar spine, chylothorax, injuries of abdominal organs and tissues, injuries in the neck region, injuries to the eyes, including orbital haemorrhage, traumatic cataract, injury of the oculomotor nerve and retinal puncture, haemorrhage to the cheeks and the hypo glottis, peripheral motor-nerve injuries and subsequent motor dysfunction, local allergic reactions to metal needles, stroke, and cerebral haemorrhage after acupuncture. 235 A causal link between acupuncture and the adverse events cardiac arrest, pyknolepsy, shock, fever, cough, thirst, aphonic, leg numbness, and sexual dysfunction remains uncertain. 235 The same review concluded that acupuncture can be considered inherently safe when practice by properly trained practitioners, but the review also stated there is a need to find effective strategies to minimize the health risks. 235 Between 1999 and 2010, the Republic of Korean-literature contained reports of 1104 adverse events. 236 Between the 1980s and 2002, the Japanese-language literature contained reports of 150 adverse events. 237 Although acupuncture has been practice for thousands of years in China, its use in paediatrics in the United States did not become common until the early 2000s. If de-qi can not be generated, then inaccurate location of the acupoint, improper depth of needle insertion, inadequate manual manipulation, 238 Acupuncture can potentially improve a number of common paediatric issues, including gastrointestinal issues, reflux, colic, asthma, allergies, add, and headaches, 239 however, its safety has been debated. The World Health Organization recommends that before being licensed or certified, an acupuncturist receive 200 hours of specialized training if they are a physician and 2,500 hours for non-physicians; Alternative Medicine was created within the NIH.
Around this time the surgeon-general of the Dutch East India Company met Japanese and Chinese acupuncture practitioners and later encouraged Europeans to further investigate it. 29 :264-265 He published the first in-depth description of acupuncture for the European audience and created the term “acupuncture” in his 1683 work De acupuncture. 269 France was an early adopter among the West due to the influence of Jesuit missionaries, who brought the practice to French clinics in the 16th century. 27 The French doctor Louis Berlioz the father of the skin by thin metal needles, which are manipulated manually or the needle may be further stimulated by electrical stimulation electro acupuncture. 2 Acupuncture needles are typically made of stainless steel, making them flexible and preventing them from rusting or breaking. 46 Needles are usually disposed of after each use to prevent contamination. 46 Reusable needles when used should be sterilized between applications. 46 47 Needles vary in length between 13 to 130 millimetres 0.51 to 5.12 in, with shorter needles used near the face and eyes, and longer needles in areas with thicker tissues; needle diameters vary from 0.16 mm 0.006 in to 0.46 mm 0.018 in, 48 with thicker needles used on more robust patients. The US Congress created the Office of Alternative Medicine in 1992 and the National Institutes Minister of Health, Labour and Welfare after passing an examination and graduating from a technical school or university. 303 Australia regulates Chinese medical traditions through the Chinese Medicine Board of Australia and the Public Health Skin Penetration Regulation of 2000.