Is acupuncture effective from the point of view of evidence-based medicine, what consequences can the incorrect procedure lead to, and where is it better to undergo it if you are determined to “pierce”? told about this and not only neurologist Anastasia Borodina.
Acupuncture (acupuncture or acupuncture) is a type of alternative medicine based on the introduction of sterile disposable needles into special acupuncture points. According to the theory, such points form meridians through which vital energy circulates, and the introduction of needles leads to “stimulation of recovery processes” in the body. Often this method is combined with other interventions, such as passing a small electric current through needles (electroacupuncture) or low-power lasers or ultrasound.
In traditional Chinese medicine, acupuncture treats almost all diseases. In our country, acupuncture is usually recommended for diseases of the musculoskeletal system, dysfunctions of the nervous system, cardiovascular diseases and diseases of the gastrointestinal tract.
To evaluate the effectiveness of this method in terms of evidence-based medicine, it is necessary to conduct large randomized double-blind studies (when neither the doctor nor the patient knows which drug or manipulation they are using). For this, real treatment is usually carried out for one group of patients, and sham treatment for another group. It is difficult to conduct such studies for acupuncture.
Based on hundreds of controlled studies and reviews, patients’ overall well-being scores improved equally in the acupuncture groups with “real” needles and sham acupuncture (eg, toothpicks).
Also, there was no significant difference between the introduction of needles into special acupuncture points and meridians or into fictitious points. At the same time, in patients with chronic pain, acupuncture and acupuncture imitation were more effective than no treatment.
Although the study of acupuncture has its own challenges, randomized trials show that acupuncture and its imitation may be equally effective.
This means that most or all of the effect of acupuncture may be due to the placebo effect. Improvement in well-being occurs only due to the fact that a person believes in the effectiveness of the method.
How safe are needles?
Acupuncture is generally safe, but can lead to complications that occur with any type of needle. This is a risk of infection, damage to nerves and blood vessels, very rarely – pneumothorax (accumulation of air or gases in the pleural cavity, which leads to impaired lung function and gas exchange during breathing), pneumoperitoneum (presence of air in the abdominal cavity), puncture (puncture of organs), tamponade heart (presence of fluid between the sheets of the pericardium, due to which compression of the cavities of the heart occurs, this makes normal heart contractions impossible), osteomyelitis (inflammation of the bone marrow).
Local complications include bleeding, burns during electroacupuncture, contact dermatitis, shooting pain and paresthesia (burning, tingling, goosebumps, etc.).
However, serious adverse events with acupuncture are extremely rare and are usually associated with treatment by unlicensed acupuncturists.
Absolute contraindications to the procedure are:
- foci of active infection or malignant neoplasms. If a needle gets into them, there is a risk of metastasis of tumor cells;
- having an automated implantable cardioverter defibrillator (ICD) or pacemaker due to the risk of electrical interference in the device;
- infectious diseases (hepatitis, HIV, etc.);
- severe neutropenia after myelosuppressive chemotherapy;
- diseases of the blood and skin.
Pregnancy is not an absolute contraindication. However, needles hitting some points can cause childbirth, so the acupuncturist must be informed of the pregnancy. Also, the doctor should be aware of bleeding disorders or taking anticoagulants, which increase the risk of bleeding. Acupuncture is not recommended for people over 70 and children under one year old.
When choosing a specialist, it is important to pay attention to the specialization of the doctor. Neurologists often take refresher courses in acupuncture. Their medical experience can help decide whether acupuncture is needed or if there is another effective method of treatment.
It is not safe to undergo this procedure with specialists without a higher medical education, or in non-medical clinics. Be sure to check the licenses and certificates of the clinic, which are usually listed on the clinic’s website, as well as reviews of the clinic and doctors on independent sites.