Acupuncture

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Acupuncture

THC Editorial Team January 28, 2021
Image of person conducting acupuncture
Photo by Katherine Hanlon on Unsplash

Contents

What Is Acupuncture?

Acupuncture is a form of complementary and alternative medicine (CAM) based on traditional Chinese medicine. In this practice, thin needles are inserted throughout a person’s body at specific points to stimulate nerves, muscles, and connective tissues. Acupuncture is most commonly used to relieve pain or discomfort associated with medical issues such as blood pressure problems, morning sickness, rheumatoid arthritis, Tourette’s syndrome, chronic headaches, and pulled muscles.1 However, some practitioners have recently moved toward using acupuncture to treat mental health issues.

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.

References

  1. Brazier, Y. (n.d.). Acupuncture: How it works, uses, benefits, and risks.
    https://www.medicalnewstoday.com/articles/156488
  2. Hao, J. J., & Mittelman, M. (2014). Acupuncture: Past, present, and future. Global Advances in Health and Medicine, 3(4), 6–8.
    https://doi.org/10.7453/gahmj.2014.042
  3. Omura, Y. (2003). Acupuncture medicine: Its historical and clinical background. Dover Publications.
  4. Johns Hopkins Medicine. (n.d.).Acupuncture.Retrieved January25, 2021, from
    https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture
  5. Mandal, D. (2019, June 19). Acupuncture history. Retrieved January 17, 2021, from
    https://www.news-medical.net/health/Acupuncture-History.aspx
  6. Interlandi, J. (2016, August 1). Research casts doubt on the value of acupuncture. Retrieved January 17, 2021, from
    https://www.scientificamerican.com/article/research-casts-doubt-on-the-value-of-acupuncture/
  7. Lu, D. P., & Lu, G. P. (2013). An historical review and perspective on the impact of acupuncture on U.S. medicine and society. Medical Acupuncture, 25(5), 311–316.
    https://doi.org/10.1089/acu.2012.0921
  8. Mayo Clinic. (2020, March 3). Acupuncture. Retrieved December 28, 2020, from
    https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763
  9. Hal, M. V., Dydyk, A. M., & Green, M. S. (2020). Acupuncture. StatPearls.
    https://www.ncbi.nlm.nih.gov/books/NBK532287/
  10. Rubin, P. (n.d.). Acupuncture studies: Where do we go from here? Subtle Energies & Energy Medicine, 18, 41–53.
  11. Alternative Institute of Alternative Medicine. (n.d.). What is qi stagnation? Retrieved August 24, 2020, from
    https://www.aiam.edu/acupuncture/qi-stagnation/
  12. Wang, H., Qi, H., Wang, B., Cui, Y., Zhu, L., Rong, Z., & Chen, H. (2008). Is acupuncture beneficial in depression: A meta-analysis of 8 randomized controlled trials? Journal of Affective Disorders, 111(2–3), 125–134.
    https://doi.org/10.1016/j.jad.2008.04.020
  13. Horowitz, S. (2009). Acupuncture for treating mental health disorders. Alternative and Complementary Therapies, 15(3), 135–141.
    https://doi.org/10.1089/act.2009.15310
  14. Röschke, J., Wolf, C., Müller, M., Wagner, P., Mann, K., Grözinger, M., & Bech, S. (2000). The benefit from whole body acupuncture in major depression. Journal of Affective Disorders, 57(1–3), 73¬–81.
    https://doi.org/10.1016/s0165-0327(99)00061-0
  15. Chang, B., Sommers, E., & Herz, L. (2010). Acupuncture and relaxation response for substance use disorder recovery. Journal of Substance Use, 15(6), 390–401.
    https://doi.org/10.3109/14659890903580466
  16. Khamba, B., Aucoin, M., Lytle, M., Vermani, M., Maldonado, A., Iorio, C., Cameron, C., Tsirgielis, D., D’Ambrosio, C., Anand, L., & Katzman, M. A. (2013). Efficacy of acupuncture treatment of sexual dysfunction secondary to antidepressants. Journal of Alternative and Complementary Medicine, 19(11), 862–869.
    https://doi.org/10.1089/acm.2012.0751
  17. Sun, H., Zhao, H., Ma, C., Bao, F., Zhang, J., Wang, D. H., Zhang, Y. X., & He, W. (2013). Effects of electroacupuncture on depression and the production of glial cell line-derived neurotrophic factor compared with fluoxetine: A randomized controlled pilot study. Journal of Alternative and Complementary Medicine, 19(9), 733–739.
    https://doi.org/10.1089/acm.2011.0637
  18. Allen, J. J., Schnyer, R. N., & Hitt, S. K. (1998). The efficacy of acupuncture in the treatment of major depression in women. Psychological Science, 9(5), 397–401.
    https://doi.org/10.1111/1467-9280.00074
  19. Pilkington, K., Kirkwood, G., Rampes, H., Cummings, M., & Richardson, J. (2007). Acupuncture for anxiety and anxiety disorders—a systematic literature review. Acupuncture in Medicine, 25(1–2), 1–10.
    https://doi.org/10.1136/aim.25.1-2.1
  20. Horowitz, S. (2009). Acupuncture for treating mental health disorders. Alternative and Complementary Therapies, 15(3), 135–141.
    https://doi.org/10.1089/act.2009.15310
  21. Amorim, D., Amado, J., Brito, I., Fiuza, S. M., Amorim, N., Costeira, C., & Machado, J. (2018). Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complementary Therapies in Clinical Practice, 31, 31–37.
    https://doi.org/10.1016/j.ctcp.2018.01.008
  22. Errington-Evans, N. (2015). Randomised controlled trial on the use of acupuncture in adults with chronic, non-responding anxiety symptoms. Acupuncture in Medicine, 33(2), 98–102.
    https://doi.org/10.1136/acupmed-2014-010524
  23. Bosch, P., van den Noort, M., Yeo, S., Lim, S., Coenen, A., & van Luijtelaar, G. (2015). The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. Journal of Integrative Medicine, 13(6), 380–390.
    https://doi.org/10.1016/S2095-4964(15)60204-7

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