NIH panel offers limited acupuncture endorsement
The jury is still out on many forms of alternative therapy, but there is growing evidence that acupuncture offers real benefits to some patients. In perhaps the most thorough analysis of the treatment method to date, a consensus panel convened by the National Institutes of Health (NIH) concluded that "there is clear evidence that needle acupuncture treatment is effective for postoperative and chemotherapy nausea and vomiting, nausea of pregnancy, and postoperative dental pain."
The 12-member panel also concluded in its consensus statement that there are a number of other pain-related conditions for which acupuncture "may be effective as an adjunct therapy, an acceptable alternative, or as part of a comprehensive treatment program, but for which there is less convincing scientific data. These conditions include, but are not limited to, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia (general muscle pain), low back pain, carpal tunnel syndrome, and asthma."
More research needed
"We need more high quality research to validate what appears to be useful for the millions of Americans that have used acupuncture in this country. The challenge in studying acu puncture is to integrate the theory of Chinese medicine into the conventional Western biomedical research model and into the conventional health care arena," said panel chairman David J. Ramsay, MD, president of the University of Maryland in Baltimore, when the panel’s conclusions were released in November 1997.
Acupuncture is a family of procedures, the most well known of which involves penetration of specific anatomic locations on the skin, called acupuncture points, by thin, solid, usually metallic needles. Acupuncture is one of the oldest and most commonly used forms of traditional medicine in the world, dating back at least 2,500 years, according to the NIH panel. The general theory of acupuncture is based on the premise that there are patterns of energy flow called Qi (pronounced "chee") throughout the body that are essential for optimal health.
Public awareness and use of acupuncture increased in the United States after President Nixon’s visit to China in 1972 and New York Times reporter James Reston’s account of how physicians in Beijing eased his post-surgery abdominal pain with needles. According to the World Health Organization, there are approximately 10,000 acupuncture specialists in the United States, and an estimated 3,000 practicing acupuncturists are physicians. In 1993 the Food and Drug Administration reported that Americans were spending $500 million per year and making approximately 9 million to 12 million patient visits for acupuncture treatments.
Noting that it can be difficult to introduce any new treatment, especially when that treatment is unfamiliar to Western medicine, the NIH panel called for more uniform licensing, certification, and accreditation of acupuncturists among states, which it says will help the public identify qualified acupuncture practitioners and to have more assurance in quality of service.
Thirty-four states license or otherwise regulate the practice of acupuncture by nonphysicians, and have established training standards for certification to practice acupuncture.
Adverse side effects of acupuncture are extremely low and often lower than conventional treatments, the NIH panel concluded. However, the panel noted that adverse side effects have occurred on rare occasions. It recommended that patients be fully informed of their treatment options, expected prognosis, relative risk, and safety practices to minimize the risks prior to undergoing acupuncture treatment.
Because many individuals seek health care treatment from both acupuncturists and physicians, the consensus panel advocated a strengthening of communications between these health care provider groups to maximize the possibility that important medical problems are not overlooked.
The full NIH Consensus Statement on Acupuncture is available by calling (888) NIH-CONSENSUS [(888) 644-2667] or by visiting the NIH Consensus Development Program Web site at http://consensus.nih.gov.
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