Acupuncture: Overview and Effectiveness

What Is the History of Acupuncture?

Acupuncture was practiced as a treatment in China as early as 100 BC and resurged in the 1950s and 1960s when China’s communist leader, Mao Zedong, promoted acupuncture as a solution for health care problems.² Traditional Chinese medicine emphasizes mind-body connections and posits that good health is created when a person’s energy flow, also known as qi, is balanced.³ It characterizes illness as the result of imbalanced or disrupted energy. Acupuncture as a practice was developed to release and rebalance the flow of energy in a person’s body.⁴ It was accepted as a practice in the United States when the National Institutes of Health proposed evidence for its efficacy in some conditions.⁵ Research has shown increasing support for the use of acupuncture in treating many conditions outside of just pain management.

Acupuncture has a contested history within Western medicine. Although Western biomedical doctors and scientists consider acupuncture controversial, researchers have investigated acupuncture’s effect on many mental health disorders in pursuit of establishing strong support for its status as a modality of treatment.^6,7

How Does Acupuncture Work?

Licensed acupuncturists administer this treatment in specialized wellness settings such as acupuncture clinics. Acupuncture is considered to be safe for most people; however, acupuncturists recommend against seeking this form of treatment if a person has a bleeding disorder or a pacemaker, uses blood thinners, or is pregnant. It is usual for individuals to receive six to eight treatments, but the number of treatments varies from person to person.⁸

The general procedure for acupuncture involves these steps:

1. An acupuncturist will ask a client to lie down on their back and will then insert between 5 and 20 needles at various depths into the person’s skin. Sterilized, single-use needles are used, and clients may experience some discomfort.
2. An acupuncturist may then manipulate the needles by moving them around, applying heat, or applying electrical pulses. The acupuncturist will ask the client to remain still and to relax.
3. Finally, the acupuncturist will remove the needles after 10 to 20 minutes. Clients should experience little to no discomfort when the needles are removed.

Effectiveness of Acupuncture

Few evidence-based studies strongly support the benefits of acupuncture despite its longevity. However, several limitations to studying this practice result in unreliable literature with inconsistent findings. Some limitations include the fact that acupuncture is an individualized treatment, making it difficult to generalize to others, and the idea that the flow of energy, or qi, is still a theoretical belief that keeps physicians from exploring it. ^9,10,11

Despite the dearth of evidence supporting its efficacy, licensed professionals have been increasingly using acupuncture to alleviate mental struggles. Several studies with small sample sizes show promising results, but researchers need to conduct more research on the practice.

Research has demonstrated the following findings regarding acupuncture’s effectiveness in the treatment of depression, anxiety disorders, and substance use disorders and in decreasing side effects of certain medications:

• Acupuncture was found to be effective in reducing the severity of depressive symptoms.¹²
• Acupuncture was found to be superior to the antidepressant amitriptyline but not other antidepressants.¹⁴
• Auricular acupuncture, stimulation of specific points in the ear, was successful in treating addictions; specifically, it helped facilitate smoking cessation, reduce drug cravings, and decrease emotional distress.¹⁵
• Acupuncture significantly reduced cravings and anxiety levels and was found to be effective for relapse prevention of substance use disorders.¹⁵
• Acupuncture resulted in decreased sexual dysfunction side effects of the class of antidepressant medication called selective serotonin reuptake inhibitors.¹⁶
• Electroacupuncture, a mild electric current transmitted through needles, was as effective as Prozac in reducing symptoms of depression.¹⁷
• Acupuncture improved the course of depression more than a pharmacological-only treatment.¹⁷
• There is strong evidence for acupuncture as a therapy for women with major depressive disorder.¹⁸
• Positive findings have been demonstrated for acupuncture as a treatment for generalized anxiety disorder, but there is a need for a better designed study.¹⁹
• Acupuncture was found to be a promising intervention for patients with chronic anxiety who are resistant to other forms of treatment.²¹
• Side effects of an antipsychotic medication were lower in a group that received both acupuncture and antipsychotic medication.²³

Some of these findings are elaborated on below.

A group of researchers investigated whether acupuncture could be an effective treatment of depression. They analyzed eight randomized controlled trials involving a total of 477 participants with depression who were assessed by either the Hamilton Depression Rating Scale (HAM-D) or the Beck Depression Inventory (BDI). Their results validated acupuncture’s benefits and showed a significant reduction in depression severity. Although the sample sizes in each trial were small, acupuncture showed promising benefits for patients with depression.¹¹

Chang and Sommers conducted a randomized controlled trial with homeless veterans taking part in a substance abuse rehabilitation program. The 67 participants were randomly assigned to an acupuncture group, a relaxation response group, or a control group. The results showed that the acupuncture group had a significant decrease in their degree of craving and their anxiety levels after just one session. The degree of craving continued to drop after each session. This study supports acupuncture as a promising treatment for substance use disorders.¹⁴

Pilkington and colleagues evaluated the efficacy of acupuncture in the treatment of anxiety and anxiety disorders through a systematic literature review of 12 controlled studies. They reported improvements of anxiety symptoms for generalized anxiety disorder, making acupuncture a possible effective treatment of anxiety.¹⁸

Overall, acupuncture has been shown to: ⁴

• improve pain relief;
• improve energy level;
• reduce symptoms of anxiety and depression; and
• improve mood.