Acupuncture Education

Reviews with consistent statistically significant positive effects and where authors have recommended the intervention

• Allergic rhinitis (perennial & seasonal)
• Chemotherapy-induced nausea and vomiting (cinv) (with anti-emetics)
• Chornic low back pain
• Headache (tension-type and chronic)
• Knee osteoarthritis
• Migraine prophylaxis
• Postoperative nausea & vomiting
• Postoperative pain

Individual patient data meta-analysis of 17,922 patients treated with acupuncture for chronic pain found:

• Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo

A review of 6,376 patients with chronic pain found that:

• 90% of the pain-relieving benefits of acupuncture persisted 12 months after treatment

MacPherson H, Vertosick EA, Foster NE, Lewith G, Linde K, Sherman KJ, et al. The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain. Pain. 2016

Individual patient data meta-analysis of 17,922 patients treated with acupuncture for chronic pain found:

• Acupuncture is effective for chronic pain

US VA Evidence Map of Acupuncture (2014) found:

Acupuncture demonstrates “Evidence of positive effects” for chronic pain

Hempel S. Taylor SL, Solloway MR, Miake-Lye IM, Beroes JM, Shanman R, et al. VA. Evidence-based Synthesis Program Reports. Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs : 2014

Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, et al.

Acupuncture for chronic pain: individual patient data meta-analysis.  Archives of internal medicine. 2012;172(19):1444-53.

Acute Pain Management: Scientific Evidence (Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine) found NHMRC Level I evidence for acupuncture for:

• Labour pain
• Ocyte retrieval pain
• Primary dysmenorrhoea
• Tension-type headaches
• Migraine
• Postoperative pain
• Back pain
• Acute burns pain

Schug SA, Palmer GM, Scott DA, Halliwell R, Trinca J. Acute pain management: scientific evidence, fourth edition, 2015. The Medical Journal of Australia. 2016;204(8):315-7.

• Higher success rate than morphine (92% vs 78%)
• Shorter resolution time (16+8 minutes vs 28+14 minutes)
• Fewer minor adverse events (4 vs 85)

Grissa MH, Baccouche H, Boubaker H, Beltaief K, Bzeouich N, Fredj N, et al. Acupuncture vs intravenous morphine in the management of acute pain in the ED. The American journal of emergency medicine. 2016;34(11):2112-6.

Multicentre randomised trial in four Melbourne hospitals (acupuncture vs pharmacotherapy vs acupuncture plus pharmacotherapy) for lower back pain, ankle sprain and migraine found:

• Acupuncture was found to be a safe and acceptable treatment and comparable (equivalent and non-inferior) to pharmacotherapy in analgesia

Cohen MM, Smit, De Villiers, Adrianopoulos, Nick, Ben-Meir, Taylor, David McD, Parker, SHefton, J, Xue, Charlie C, Cameron, Peter A. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Medical Journal of Australia. 2017;206(11):494-9

A review by the UK National Institute for Health Research (NIHR) in 2017 concluded that:

• Acupuncture is more effective than both usual care and sham acupuncture for chronic pain based on the most robust evidence from high-quality trials of acupuncture for chronic pain.

MacPherson H, Vickers A, Bland M, Torgerson D, Corbett M, Spackman E, et al. Programme Grants for Applied Research. Acupuncture for chronic pain and depression in primary care: a programme of research. Southhamptom (UK): NIHR Journals Library

• Acupuncture has an anti-histamine action
  Antihistamines (Zyrtec, Claratyne, Telfast)

• Acupuncture has also been found to suppress the expression of cyclooxygenase 1 & 2 (COX-1 & COX-2) and inducible nitric oxide synthase (iNOS)
  COX-2 inhibitors (Mobic, Viox, Celebrex)

• Acupuncture down-regulates pro-inflammatory neuropeptides:
  • Substance P (SP) (allergic rhinitis, allergic asthma, irritable bowel syndrome)
  • Calcitonin Gene-related Peptide (CGRP) (menopausal hot flushes, migraine)
  • Vasoactive Intestinal Peptide (VIP) (allergic rhinitis, irritable bowel syndrome)

• Acupuncture’s effects on inflammatory oedema are mediated via the HPA (hypothalamic-pituitary-adrenal) axis and appear to use different pathways to those for acupuncture analgesic effects
  Prednisone

• EA stimulation of vagus nerve and sciatic nerve activates Dopamine receptor D1, exerting powerful anti-inflammatory effects (Torres-Rosas et al, 2014)