Summary
Acupuncture is a system of treatment which involves the insertion of thin, solid needles into specific areas of the body known as acupuncture points, or acupoints, with the intention of positively affecting a patient’s clinical condition or health status. In recent decades, the integration of the Western scientific model has provided novel means of furthering our understanding of acupuncture and its effects. Of all the complementary and alternative therapies, acupuncture is one of the best researched. Since the National Institute of Health Consensus Statement on Acupuncture, published in 1997, there has been a flood of high-quality randomized controlled clinical trials as well as a much broader investigation into the basic mechanisms of acupuncture. This chapter will define the various mechanisms by which acupuncture is believed to operate, both from traditional naturalistic and modern scientific contexts. A brief historical narrative will bridge the two approaches as they have flourished over different periods of time. An evidence-based review of the potential uses of acupuncture for various pain conditions will follow, along with discussions regarding acupuncture safety and its incorporation into a integrative pain management practice.
Key Words
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Kaptchuk TJ. Acupuncture: theory, efficacy, and practice. Ann Intern Med. Mar 5 2002;136(5):5374–383.
Ramey DW. Inaccurate acupuncture history. Rheumatology (Oxford). Dec 2004;43(12):121593; author reply 1593–1594.
White A, Ernst E. A brief history of acupuncture. Rheumatology (Oxford). May 2004;43(5):5662–663.
Andrews BJ. History of Pain: Acupuncture and the Reinvention of Chinese Medicine. APS Bulletin. May/June 1999;9(3).
Bonica JJ. Anesthesiology in the People’s Republic of China. Anesthesiology. Feb 1974;40(2):2175–186.
Bonica JJ. Therapeutic acupuncture in the People’s Republic of China implications for American medicine. Jama. Jun 17 1974;228(12):121544–1551.
Han JS. Acupuncture and endorphins. Neurosci Lett. May 6 2004;361(1–3):258–261.
Ma SX. Neurobiology of Acupuncture: Toward CAM. Evid Based Complement Alternat Med. Jun 1 2004;1(1):141–47.
Chen S, Ma SX. Nitric oxide in the gracile nucleus mediates depressor response to acupuncture (ST36). J Neurophysiol. Aug 2003;90(2):2780–785.
Lewith GT, White PJ, Pariente J. Investigating acupuncture using brain imaging techniques: The current state of play. Evidence-Based Complementary and Alternative Medicine. 2005;2(3):3315–319.
Yoo SS, Teh EK, Blinder RA, Jolesz FA. Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study. Neuroimage. Jun 2004;22(2):2932–940.
Yan B, Li K, Xu JY, et al. Acupoint-specific fMRI patterns in human brain. Neuroscience Letters. Aug 2005;383(3):3236–240.
Wu MT, Hsieh JC, Xiong J, et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain–preliminary experience. Radiology. Jul 1999;212(1):1133–141.
Wager TD, Dagfinn MB, Casey KL. Placebo effects in laser-evoked pain potentials. Brain Behavior and Immunity. May 2006;20(3):3219–230.
Audette JF, Wang F, Smith H. Bilateral activation of motor unit potentials with unilateral needle stimulation of active myofascial trigger points. American Journal of Physical Medicine & Rehabilitation. May 2004;83(5):5368–374.
Audette JF, Blinder RA. Acupuncture in the management of myofascial pain and headache. Curr Pain Headache Rep. Oct 2003;7(5):5395–401.
Shah JP, Phillips TM, Danoff JV, Gerber LH. An in-vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol Nov 2005;99(5):51977–1984.
Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for pain: correlations and implications. Pain. Feb 1977;3(1):13–23.
Kao MJ, Hsieh YL, Kuo FJ, Hong CZ. Electrophysiological assessment of acupuncture points. Am J Phys Med Rehabil. May 2006;85(5):5443–448.
Grigg P, Schaible HG, Schmidt RF. Mechanical Sensitivity of Group-Iii and Group-Iv Afferents from Posterior Articular Nerve in Normal and Inflamed Cat Knee. Journal of Neurophysiology. Apr 1986;55(4):4635–643.
Wesselmann U, Lai J. Mechanisms of referred visceral pain: uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain. Dec 1997;73(3):3309–317.
Langevin HM, Churchill DL, Wu J, et al. Evidence of connective tissue involvement in acupuncture. Faseb J. Jun 2002;16(8):8872–874.
Sierpina VS, Frenkel MA. Acupuncture: a clinical review. South Med J. Mar 2005;98(3):3330–337.
Park J, White A, Stevinson C, Ernst E, James M. Validating a new non-penetrating sham acupuncture device: two randomized controlled trials. Acupunct Med. Dec 2002;20(4):4168–174.
Kleinhenz J, Streitberger K, Windeler J, Gussbacher A, Mavridis G, Martin E. Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis. Pain. Nov 1999;83(2):2235–241.
Streitberger K, Friedrich-Rust M, Bardenheuer H, et al. Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized controlled single-blind trial. Clin Cancer Res. Jul 2003;9(7):72538–2544.
Streitberger K, Kleinhenz J. Introducing a placebo needle into acupuncture research. Lancet. Aug 1 1998;352(9125):9125364–365.
Acupuncture. NIH Consens Statement. Nov 3–5 1997;15(5):51–34.
Berman BM, Ezzo J, Hadhazy V, Swyers JP. Is acupuncture effective in the treatment of fibromyalgia? J Fam Pract. Mar 1999;48(3):3213–218.
Deluze C, Bosia L, Zirbs A, Chantraine A, Vischer TL. Electroacupuncture in fibromyalgia: results of a controlled trial. Bmj. Nov 21 1992;305(6864):68641249–1252.
Assefi NP, Sherman KJ, Jacobsen C, Goldberg J, Smith WR, Buchwald D. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern Med. Jul 5 2005;143(1):110–19.
Harris RE, Tian X, Williams DA, et al. Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency. J Altern Complement Med. Aug 2005;11(4):4663–671.
Irnich D, Behrens N, Gleditsch JM, et al. Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, double-blind, sham-controlled crossover trial. Pain. Sep 2002;99(1–2):83–89.
Itoh K, Katsumi Y, Kitakoji H. Trigger point acupuncture treatment of chronic low back pain in elderly patients–a blinded RCT. Acupunct Med. Dec 2004;22(4):4170–177.
Ceccherelli F, Rigoni MT, Gagliardi G, Ruzzante L. Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study. Clin J Pain. May-Jun 2002;18(3):3149–153.
Ceccheerelli F, Bordin M, Gagliardi G, Caravello M. Comparison between superficial and deep acupuncture in the treatment of the shoulder’s myofascial pain: a randomized and controlled study. Acupunct Electrother Res. 2001;26(4):4229–238.
Casimiro L, Barnsley L, Brosseau L, et al. Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005(4):CD003788.
Man SC, Baragar FD. Preliminary clinical study of acupuncture in rheumatoid arthritis. J Rheumatol. Mar 1974;1(1):1126–129.
David J, Townsend S, Sathanathan R, Kriss S, Dore CJ. The effect of acupuncture on patients with rheumatoid arthritis: a randomized, placebo-controlled cross-over study. Rheumatology (Oxford). Sep 1999;38(9):9864–869.
Linde K, Jonas WB, Melchart D, Willich S. The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture. Int J Epidemiol. Jun 2001;30(3):3526–531.
Hesse J, Mogelvang B, Simonsen H. Acupuncture versus metoprolol in migraine prophylaxis: a randomized trial of trigger point inactivation. J Intern Med. May 1994;235(5):5451–456.
Melchart D, Streng A, Hoppe A, et al. The acupuncture randomised trial (ART) for tension-type headache–details of the treatment. Acupunct Med. Dec 2005;23(4):4157–165.
Melchart D, Linde K, Streng A, et al. Acupuncture Randomized Trials (ART) in patients with migraine or tension-type headache–design and protocols. Forsch Komplementarmed Klass Naturheilkd. Aug 2003;10(4):4179–184.
White AR, Ernst E. A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology (Oxford). Feb 1999;38(2):2143–147.
White P, Lewith G, Prescott P, Conway J. Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial. Ann Intern Med. Dec 21 2004;141(12):12911–919.
Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN. Acupuncture for patients with chronic neck pain. Pain. Nov 2006;125(1–2):98–106.
Goolkasian P, Wheeler AH, Gretz SS. The Neck Pain and Disability Scale: Test-retest reliability and construct validity. Clinical Journal of Pain. Jul-Aug 2002;18(4):4245–250.
Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-analysis: acupuncture for low back pain. Ann Intern Med. Apr 19 2005;142(8):8651–663.
Green S, Buchbinder R, Hetrick S. Acupuncture for shoulder pain. Cochrane Database Syst Rev. Apr 18 2005;2:CD005319.
Guerra de Hoyos JA, Andres Martin Mdel C, Bassas y Baena de Leon E, et al. Randomised trial of long term effect of acupuncture for shoulder pain. Pain. Dec 2004;112(3):3289–298.
Trinh KV, Phillips SD, Ho E, Damsma K. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology (Oxford). Sep 2004;43(9):91085–1090.
Fink M, Wolkenstein E, Karst M, Gehrke A. Acupuncture in chronic epicondylitis: a randomized controlled trial. Rheumatology. Feb 2002;41(2):2205–209.
Ezzo J, Hadhazy V, Birch S, et al. Acupuncture for osteoarthritis of the knee: a systematic review. Arthritis Rheum. Apr 2001;44(4):4819–825.
Berman BM, Lao LX, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee - A randomized, controlled trial. Annals of Internal Medicine. Dec 2004;141(12):12901–910.
Witt C, Brinkhaus B, Jena S, et al. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet. Jul 2005;366(9480):9480136–143.
Melchart D, Weidenhammer W, Streng A, et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Archives of Internal Medicine. Jan 2004;164(1):1104–105.
Umlauf R. Completion of Research into the Feasibility and Implementation of Acupuncture for Trauma Care and Medical First-Aid. American Journal of Acupuncture. 1991;19(2):2192–192.
Ernst E, White AR. Prospective studies of the safety of acupuncture: a systematic review. Am J Med. Apr 15 2001;110(6):6481–485.
Birch S, Jamison RN. Controlled trial of Japanese acupuncture for chronic myofascial neck pain: assessment of specific and nonspecific effects of treatment. Clin J Pain. Sep 1998;14(3):3248–255.
Lao LX, Hamilton GR, Fu JP, Berman BM. Is acupuncture safe? A systematic review of case reports. Alternative Therapies in Health and Medicine. Jan-Feb 2003;9(1):172–83.
Rampes H, James R. Complications of acupuncture. Acup Med. May 1995;13(1):126–33.
Lee TL. Acupuncture and chronic pain management. Ann Acad Med Singapore. Jan 2000;29(1):17–21.
Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies Trends Neurosci. January 2003;26(1):117–22.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Humana Press
About this chapter
Cite this chapter
Wang, D., Audette, J.F. (2008). Acupuncture in Pain Management. In: Audette, J.F., Bailey, A. (eds) Integrative Pain Medicine. Contemporary Pain Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-344-8_18
Download citation
DOI: https://doi.org/10.1007/978-1-59745-344-8_18
Publisher Name: Humana Press
Print ISBN: 978-1-58829-786-0
Online ISBN: 978-1-59745-344-8
eBook Packages: MedicineMedicine (R0)