In.ther.ords,.aham'.r.placebo'.cupuncture.enerally produces the same effects as 'real' acupuncture and, in some cases, does better.” 78 A 2013 meta-analysis found little evidence that the effectiveness of acupuncture on pain Dompared to sham was modified by the location of the needles, the number of needles used, the experience or technique of the practitioner, or by the circumstances of the sessions. 79 The same analysis also suggested that the number of needles and sessions is important, as greater numbers improved the outcomes of acupuncture compared to non-acupuncture controls. 79 There has been little systematic investigation of which components of an acupuncture session may be important for any therapeutic effect, including needle placement and depth, type and intensity of stimulation, and number of needles used. 76 The research seems to suggest that needles do not need to stimulate the traditionally specified acupuncture points or penetrate the skin to attain an anticipated effect e.g. psychosocial factors. 2 A response to “sham” acupuncture in osteoarthritis may be used in the elderly, but placebos have usually been regarded as deception and thus unethical. 80 However, some physicians and ethicists have suggested circumstances for applicable uses for placebos such as it might present a theoretical advantage of an inexpensive treatment without adverse reactions or interactions with drugs or other medications. 80 As the evidence for most types of alternative medicine such as acupuncture is far from strong, the use of alternative medicine in regular healthcare can present an ethical question. 81 Using the principles of evidence-based medicine to research acupuncture is controversial, and has produced different results. 72 Some research suggests acupuncture can alleviate pain but the majority of research suggests that acupuncture's effects are mainly due to placebo. 9 Evidence suggests that any benefits of acupuncture are short-listing. 15 There is insufficient evidence to support use of acupuncture compared to mainstream medical treatments . 82 Acupuncture is not better than mainstream treatment in the long term. 75 Publication bias is cited as a concern in the reviews of randomized controlled trials CRTs of acupuncture. 58 83 84 A 1998 review of studies on acupuncture found that trials originating in China, Japan, Hong Kong, and Taiwan were uniformly favourable to acupuncture, as were ten out of eleven studies conducted in Russia. 85 A 2011 assessment of the quality of CRTs on ACM, including acupuncture, concluded that the methodological quality of most such trials including randomization, experimental control, and blinding was generally poor, particularly for trials published in Chinese journals though the quality of acupuncture trials was better than the trials testing ACM remedies. 86 The study also found that trials published in non-Chinese journals tended to be of higher quality. 86 Chinese authors use more Chinese studies, which have been demonstrated to be uniformly positive. 87 A 2012 review of 88 systematic reviews of acupuncture published in Chinese journals found that less than half of these reviews reported testing for publication bias, and that the majority of these reviews were published in journals with impact factors of zero. 88 The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent with each other. 13 A 2011 overview of high-quality Cochran reviews suggests that acupuncture is effective for certain types of pain. 14 A 2011 systematic review of systematic reviews found that for reducing pain, real acupuncture was no better than sham acupuncture, and concluded that numerous reviews have shown little convincing evidence that acupuncture is an effective treatment for reducing pain. 10 The same review found that neck pain was one of only four types of pain for which a positive effect was suggested, but cautioned that the primary studies used carried a considerable risk of bias. 10 A 2009 overview of Cochran reviews found acupuncture is not effective for a wide range of conditions, and suggested that it may be effective for only chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache. 13 A 2014 systematic review suggests that the nocebo effect of acupuncture is clinically relevant and that the rate of adverse events may be a gauge of the nocebo effect. 89 According to the 2014 Miller's anaesthesia book, “when compared with placebo, acupuncture treatment has proven efficacy for chinese herbal remedies relieving pain”. 45 A 2012 meta-analysis conducted by the Acupuncture Trialists' Collabouration found “relatively modest” efficiency of acupuncture in comparison to sham for the treatment of four different types of chronic pain back and neck pain, knee osteoarthritis, chronic headache, and shoulder pain and on that basis concluded that it “is more than a placebo” and a reasonable referral option. 90 Commenting on this meta-analysis, both Eduard Ernst and David Colquhoun said the results were of negligible clinical significance. 91 92 Eduard Ernst later stated that “I fear that, once we manage to eliminate this bias that operators are not blind … we might find that the effects of acupuncture exclusively are a placebo response.” 93 Andrew Vickers, lead author of the original 2012 paper and chair of the Acupuncture Trialists' Collabouration, rejects that analysis, stating that the differences between acupuncture and sham acupuncture are statistically significant. 93 A 2010 systematic review suggested that acupuncture is more than a placebo for commonly occurring chronic pain conditions, but the authors acknowledged that it is still unknown if the overall benefit is clinically meaningful or cost-effective. 94 A 2010 review found real acupuncture and sham acupuncture produce similar improvements, which can only be accepted as evidence against the efficacy of acupuncture. 95 The same review found limited evidence that real acupuncture and sham acupuncture appear to produce biological differences despite similar effects. 95 A 2009 systematic review and meta-analysis found that acupuncture had a small analgesic effect, which appeared to lack any clinical importance and could not be discerned from bias. 16 The same review found that it remains unclear whether acupuncture reduces pain independent of a psychological impact of the needling ritual. 16 A 2016 Cochran review found moderate quality evidence that real acupuncture was more effective than sham acupuncture or inactive for short-term relief of neck pain measured either upon completion of treatment or at short-term follow-up. 96 A 2013 meta-analysis found that acupuncture was better than no treatment for reducing lower back pain, but not better than sham acupuncture, and concluded that the effect of acupuncture “is likely to be produced by the non-specific effects of manipulation”. 97 A 2013 systematic review found supportive evidence that real acupuncture may be more effective than sham acupuncture with respect to relieving lower back pain, but there were methodological limitations with the studies. 98 A 2013 systematic review found that acupuncture may be effective for non-specific lower back pain, but the authors noted there were limitations in the studies examined, such as heterogeneity in study characteristics and low methodological quality in many studies. 99 A 2012 systematic review found some supporting evidence that acupuncture was more effective than no treatment for chronic non-specific low back pain; the evidence was conflicting comparing the effectiveness over other treatment approaches. 12 A 2011 overview of Cochran reviews found inconclusive evidence regarding acupuncture efficacy in treating low back pain. 14 A 2011 systematic review of systematic reviews found that “for chronic low back pain, individualized acupuncture is not better in reducing symptoms than formula acupuncture or sham acupuncture with a toothpick that does not penetrate the skin.” 10 A 2010 review found that sham acupuncture was as effective as real acupuncture for chronic low back pain. 2 The specific therapeutic effects of acupuncture were small, whereas its clinically relevant benefits were mostly due to contextual and psychosocial circumstances. 2 Brain imaging studies have shown that traditional acupuncture and sham acupuncture differ in their effect on limbic structures, while at the same time showed equivalent analgesic effects. 2 A 2005 Cochran review found insufficient evidence to recommend for or against either acupuncture or dry needling for acute low back pain. 100 The same review found low quality evidence for pain relief and improvement compared to no treatment or sham therapy for chronic low back pain only in the short term immediately after treatment. 100 The same review also found that acupuncture is not more effective than conventional therapy and other alternative medicine treatments. 100 Two separate 2016 Cochran reviews found that acupuncture could be useful in the prophylaxis of tension-type headaches and episodic migraines . 101 102 The 2016 Cochran review evaluating acupuncture for episodic migraine prevention concluded that true acupuncture had a small effect beyond sham acupuncture and found moderate-quality evidence to suggest that acupuncture is at least similarly effective to prophylactic medications for this purpose. 102 A 2012 review found that acupuncture has demonstrated benefit for the treatment of headaches, but that safety needed to be more fully documented in order to make any strong recommendations in support of its use. 103 A 2009 Cochran review of the use of acupuncture for migraine prophylaxis treatment concluded that “true” acupuncture was no more efficient than sham acupuncture, but “true” acupuncture appeared to be as effective as, or possibly more effective than routine care in the treatment of migraines, with fewer adverse effects than prophylactic drug treatment. 104 The same review stated that the specific points chosen to needle may be of limited importance. 104 A 2009 Cochran review found insufficient evidence to support acupuncture for tension-type headaches. 104 The same review found evidence that suggested that acupuncture might be considered a helpful non-pharmacological approach for frequent episodic or chronic tension-type headache. 104 A 2014 review concluded that “current evidence supports the use of acupuncture as an alternative to traditional analgesics in osteoarthritis patients.” 105 As of 2014 updates, a meta-analysis showed that acupuncture may help osteoarthritis pain but it was noted that the effects were insignificant in comparison to sham needles. 106 A 2013 systematic review and network meta-analysis found that the evidence suggests that acupuncture may be considered one of the more effective physical treatments for alleviating pain due to knee osteoarthritis in the short-term compared to other relevant physical treatments, though much of the evidence in the topic is of poor quality and there is uncertainty about the efficacy of many of the treatments. 107 A 2012 review found “the potential beneficial action of acupuncture on osteoarthritis pain does not appear to be clinically relevant.” 75 A 2010 Cochran review found that acupuncture shows statistically significant benefit over sham acupuncture in the treatment of peripheral joint osteoarthritis; however, these benefits were found to be so small that their clinical significance was doubtful, and “probably due at least partially to placebo effects from incomplete blinding”. 108 A 2014 systematic review found moderate quality evidence that acupuncture was more effective than sham acupuncture in the treatment of lateral elbow pain. 109 A 2014 systematic review found that although manual acupuncture was effective at relieving short-term pain when used to treat tennis elbow, its long-term effect in relieving pain was “unremarkable”. 110 A 2007 review found that acupuncture was significantly better than sham acupuncture at treating chronic knee pain; the evidence was not conclusive due to the lack of large, high-quality trials. 111 A 2011 overview of Cochran reviews found inconclusive evidence regarding acupuncture efficacy in treating shoulder pain and lateral elbow pain. 14 Nausea and vomiting and post-operative pain A 2014 overview of systematic reviews found insufficient evidence to suggest that acupuncture is an effective treatment for postoperative nausea and vomiting pond in a clinical setting. 112 A 2013 systematic review concluded that acupuncture might be beneficial in prevention and treatment of pond. 113 A 2009 Cochran review found that stimulation of the P6 acupoint on the wrist was as effective or ineffective as anti emetic drugs and was associated with minimal side effects. 112 114 The same review found “no reliable evidence for differences in risks of postoperative nausea or vomiting after P6 acupoint stimulation compared to anti emetic drugs.” 114 A 2014 overview of systematic reviews found insufficient evidence to suggest that acupuncture is effective for surgical or post-operative pain. 112 For the use of acupuncture for post-operative pain, there was contradictory evidence. 112 A 2014 systematic review found supportive but limited evidence for use of acupuncture for acute post-operative pain after back surgery. 115 A 2014 systematic review found that while the evidence suggested acupuncture could be an effective treatment for postoperative gastroparesis, a firm conclusion could not be reached because the trials examined were of low quality. 116 Acupuncture is an unproven treatment for allergic immunologic conditions. 117 A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis A, 118 and a number of randomized clinical trials CRTs support the use of acupuncture for A and itch . 119 There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis PA, though all the efficacy studies were small and conclusions should be made with caution. 120 There is mixed evidence for the symptomatic treatment or prevention of AR. 121 For seasonal allergic rhinitis SA, the evidence failed to demonstrate specific effects for acupuncture. 121 Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis is not recommended. 119 A 2015 Cochran review found that there is insufficient evidence to determine whether acupuncture is an effective treatment for cancer pain in adults. 122 A 2014 systematic review found that acupuncture may be effective as an adjunctive treatment to palliative care for cancer patients. 123 A 2013 overview of reviews found evidence that acupuncture could be beneficial for people with cancerrelated symptoms, but also identified few rigorous trials and high heterogeneity between trials. 124 A 2012 systematic review of randomised clinical trials CRTs using acupuncture in the treatment of cancer pain found that the number and quality of CRTs was too low to draw definite conclusions. 125 A 2014 systematic review reached inconclusive results with regard to the effectiveness of acupuncture for treating cancer-related fatigue. 126 A 2013 systematic review found that acupuncture is an acceptable adjunctive treatment for chemotherapy-induced nausea and vomiting, but that further research with a low risk of bias is needed. 127 A 2013 systematic review found that the quantity and quality of available CRTs for analysis were too low to draw valid conclusions for the effectiveness of acupuncture for cancer-related fatigue . 128 A 2012 systematic review and meta-analysis found very limited evidence regarding acupuncture compared with conventional intramuscular injections for the treatment of hiccups in cancer patients. 129 The methodological quality and amount of CRTs in the review was low. 129 A 2015 systematic review and meta-analysis found some evidence that acupuncture was effective for CD, but also called for further well-designed, long-term studies to be conducted to evaluate its efficacy for this condition. 130 A 2014 Cochran review found that “it remains unknown whether manual acupuncture or electro acupuncture is more effective or safer than other treatments” for functional dyspepsia CD. 131 A 2014 systematic review and meta-analysis found poor quality evidence for use of acupuncture in infertile men to improve sperm motility, sperm concentration, and the pregnancy rate; the evidence was rated as insufficient to draw any conclusion regarding efficacy. 132 A 2013 Cochran review found no evidence of acupuncture for improving the success of in vitro fertilization VF. 133 A 2013 systematic review found no benefit of adjutant acupuncture for VF on pregnancy success rates. 134 A 2012 systematic review found that acupuncture may be a useful adjunct to VF, 135 but its conclusions were rebutted after re-evaluation using more rigorous, high quality meta-analysis standards. 136 A 2012 systematic review and meta-analysis found that acupuncture did not significantly improve the outcomes of in vitro fertilization. 137 A 2011 overview of systematic reviews found that the evidence that acupuncture was effective was not compelling for most gynecologic conditions. Enjoy our Acupressure Chart. The exceptions to this conclusion included the use of acupuncture during embryo transfer as an adjunct to in vitro fertilization. 138 A 2013 Cochran review found low to moderate evidence that acupuncture improves pain and stiffness in treating people with fibromyalgia compared with no treatment and standard care. 139 A 2012 review found “there is insufficient evidence to recommend acupuncture for the treatment of fibromyalgia.” 75 A 2010 systematic review found a small pain relief effect that was not apparently discernible from bias; acupuncture is not a recommendable treatment for the management of fibromyalgia on the basis of this review. 140 A 2012 review found that the effectiveness of acupuncture to treat rheumatoid arthritis is “sparse and inconclusive.” 75 A 2005 Cochran review concluded that acupuncture use to treat rheumatoid arthritis “has no effect on ear, CPR, pain, patient's global assessment, number of swollen joints, number of tender joints, general health, disease activity and reduction of analgesics.” 141 A 2010 overview of systematic reviews found insufficient evidence to recommend acupuncture in the treatment of most rheumatic conditions, with the exceptions of osteoarthritis, low back pain, and lateral elbow pain. 142 A 2014 overview of systematic reviews and meta-analyses found that the evidence does not demonstrate acupuncture helps reduce the rates of death or disability after a stroke or improve other aspects of stroke recovery, such as post stroke motor dysfunction, but the evidence suggests it may help with post stroke neurological impairment and dysfunction such as dysphagia, which would need to be confirmed with future rigorous studies. 143 A 2012 review found evidence of benefit for acupuncture combined with exercise in treating shoulder pain after stroke. 144 A 2010 systematic review found that acupuncture was not effective as a treatment for functional recovery after a stroke. 145 A 2012 overview of systematic reviews found inconclusive evidence supporting the effectiveness of acupuncture for stroke. 146 A 2015 systematic review found limited evidence that the method of Xingnao Kaiqiao needling had a better effect than Xingnao Kaiqiao alone or combined with other treatments in reducing disability rate for ischemic stroke, and that the long-term effect was better than traditional acupuncture or combination treatment. 147 A 2014 meta-analysis found tentative evidence for acupuncture in cerebral infarction, a type of ischemic stroke, but the authors noted the trials reviewed were often of poor quality. 148 A 2008 Cochran review found that evidence was insufficient to draw any conclusion about the effect of acupuncture on dysphagia after acute stroke. 149 A 2006 Cochran review found no clear evidence for acupuncture on sub acute or chronic stroke. 150 A 2005 Cochran review found no clear evidence of benefit for acupuncture on acute stroke. 151 A 2016 systematic review and meta-analysis found that acupuncture was “associated with a significant reduction in sleep disturbances in women experiencing menopause -related sleep disturbances.” 152 For the following conditions, the Cochran Collaboration or other reviews have concluded there is no strong evidence of benefit: alcohol dependence, 153 angina pectoris, 154 ankle sprain, 155 156 Alzheimer's disease, 157 attention deficit hyperactivity disorder, 158 159 autism, 160 161 asthma, 162 163 bell's palsy, 164 165 traumatic brain injury, 166 carpal tunnel syndrome, 167 chronic obstructive pulmonary disease, 168 cardiac arrhythmias, 169 cerebral haemorrhage, 170 cocaine dependence, 171 constipation, 172 depressions, 173 174 diabetic peripheral neuropathy, 175 drug detoxification, 176 177 dry eye, 178 primary dysmenorrhoea, 179 enuresis, 180 endometriosis, 181 epilepsy, 182 erectile dysfunction, 183 essential hypertension, 184 glaucoma, 185 gynaecological conditions except possibly fertility and nausea/vomiting, 186 hot flashes, 187 188 189 hypoxic ischemic encephalopathy in neonates, 190 insomnia, 191 192 193 inductions of childbirth, 194 irritable bowel syndrome, 195 labor pain, 196 197 lumbar spinal stenos is, 198 major depressive disorders in pregnant women, 199 musculoskeletal disorders of the extremities, 200 myopia, 201 obesity, 202 203 obstetrical conditions, 204 Parkinson's disease, 205 206 poly cystic ovary syndrome, 207 premenstrual syndrome, 208 preoperative anxiety, 209 psychological symptoms associated with opioid addiction, 210 restless legs syndrome, 211 schizophrenia, 212 sensorineural hearing loss, 213 smoking cessation, 214 stress urinary incontinence, 215 acute stroke, 216 stroke rehabilitation, 217 temporomandibular joint dysfunction, 218 219 tennis elbow, 220 labor induction, 221 tinnitus, 222 223 uraemic itching, 224 uterine fibroids, 225 vascular dementia, 226 and whiplash . 227 A 2010 overview of systematic reviews found that moxibustion was effective for several conditions but the primary studies were of poor quality, so there persists ample uncertainty, which limits the conclusiveness of their findings. 228 A 2012 systematic review suggested that cupping therapy seems to be effective for herpes Foster and various other conditions but due to the high risk of publication bias, larger studies are needed to draw definitive conclusions. 229 Acupuncture is generally safe when administered by an experienced, appropriately trained practitioner using clean-needle technique and sterile single-use needles. 17 18 When improperly delivered it can cause adverse effects. 17 Accidents and infections are associated with infractions of sterile technique or neglect on the part of the practitioner. 18 To reduce the risk of serious adverse events after acupuncture, acupuncturists should be trained sufficiently. 10 People with serious spinal disease, such as cancer or infection, are not good candidates for acupuncture. 2 Contraindications to acupuncture conditions that should not be treated with acupuncture include coagulopathy disorders e.g. haemophilia and advanced liver disease, warfarin use, severe psychiatric disorders e.g. psychosis, and skin infections or skin trauma e.g. burns. 2 Further, electro acupuncture should be avoided at the spot of implanted electrical devices such as pacemakers. 2 A 2011 systematic review of systematic reviews internationally and without langumge restrictions found that serious complications following acupuncture continue to be reported. 10 Between 2000 and 2009, ninety-five cases of serious adverse events, including five deaths, were reported. 10 Many such events are not inherent to acupuncture but are due to malpractice of acupuncturists. 10 This might be why such complications have not been reported in surveys of adequately-trained acupuncturists. 10 Most such reports originate from Asia, which may reflect the large number of treatments performed there or a relatively higher number of poorly trained Asian acupuncturists. 10 Many serious adverse events were reported from developed countries. 10 These included Australia, Austria, Canada, Croatia, France, Germany, Ireland, the Netherlands, New Zealand, Spain, Sweden, Switzerland, the UK, and the US. 10 The number of adverse effects reported from the UK appears particularly unusual, which may indicate less under-reporting in the UK than other countries. 10 Reports included 38 cases of infections and 42 cases of organ trauma. 10 The most frequent adverse events included pneumothorax, and bacterial and viral infections . 10 A 2013 review found without restrictions regarding publication date, study type or language 295 cases of infections; mycobacterium was the pathogen in at least 96%. 19 Likely sources of infection include towels, hot packs or boiling tank water, and reusing reprocessed needles. 19 Possible sources of infection include contaminated needles, reusing personal needles, a person's skin containing mycobacterium, and reusing needles at various sites in the same person. 19 Although acupuncture is generally considered a safe procedure, a 2013 review stated that the reports of infection transmission increased significantly in the prior decade, including those of mycobacterium. 19 Although it is recommended that practitioners of acupuncture use disposable needles, the reuse of sterilized needles is still permitted. 19 It is also recommended that thorough control practices for preventing infection be implemented and adapted. 19 The Xingnao Kaiqiao approach appears to be a safe form of treatment. 147 Fainting was the most frequent adverse event. 147 Fainting while being treated, haematoma, and pain while being treated are associated with individual physical differences and with needle manipulation. 147 A 2013 systematic review of the English-language case reports found that serious adverse events associated with acupuncture are rare, but that acupuncture is not without risk. 17 Between 2000 and 2011 the English-language literature from 25 countries and regions reported 294 adverse events. 17 The majority of the reported adverse events were relatively minor, and the incidences were low. 17 For example, a prospective survey of 34,000 acupuncture treatments found no serious adverse events and 43 minor ones, a rate of 1.3 per 1000 interventions. 17 Another survey found there were 7.1% minor adverse events, of which 5 were serious, amid 97,733 acupuncture patients. 17 The most common adverse effect observed was infection e.g. mycobacterium, and the majority of infections were bacterial in nature, caused by skin contact at the needling site. 17 Infection has also resulted from skin contact with unsterilised equipment or with dirty towels in an unhygienic clinical setting. 17 Other adverse complications included five reported cases of spinal cord injuries e.g. migrating broken needles or needling too deeply, four brain injuries, four peripheral nerve injuries, five heart injuries, seven other organ and tissue injuries, bilateral hand enema, epithelioid granuloma, pseudo lymphoma, argyria, pustules, pancytopenia, and scarring due to hot-needle technique. 17 Adverse reactions from acupuncture, which are unusual and uncommon in typical acupuncture practice, included syncope, galactorrhoea, bilateral nystagmus, pyoderma gangrenosum, hepatotoxicity, eruptive lichen planes, and spontaneous needle migration. 17 A 2013 systematic review found 31 cases of vascular injuries caused by acupuncture, three resulting in death. 230 Two died from pericardia tamponade and one was from an aortoduodenal fistula. 230 The same review found vascular injuries were rare, bleeding and pseudo aneurysm were most prevalent. 230 A 2011 systematic review without restriction in time or language, aiming to summarize all reported case of cardiac tamponade after acupuncture, found 26 cases resulting in 14 deaths, with little doubt about causality in most fatal instances. 231 The same review concluded cardiac tamponade was a serious, usually fatal, though theoretically avoidable complication following acupuncture, and urged training to minimize risk. 231 A 2012 review found a number of adverse events were reported after acupuncture in the UK's National Health Service NHS but most 95% were not severe, 43 though miscategorization and under-reporting may alter the total figures. 43 From January 2009 to December 2011, 468 safety incidents were recognized within the NHS organizations. 43 The adverse events recorded included retained needles 31%, dizziness 30%, loss of consciousness/unresponsive 19%, falls 4%, bruising or soreness at needle site 2%, pneumothorax 1% and other adverse side effects 12%. 43 Acupuncture practitioners should know, and be prepared to be responsible for, any substantial harm from treatments. 43 Some acupuncture proponents argue that the long history of acupuncture suggests it is safe. 43 However, there is an increasing literature on adverse events e.g. spinal-cord injury. 43 Acupuncture seems to be safe in people getting anticoagulants, assuming needles are used at the correct location and depth. 232 Studies are required to verify these findings. 232 The evidence suggests that acupuncture might be a safe option for people with allergic rhinitis. 118 Chinese, South Korean, and Japanese-language A 2010 systematic review of the Chinese-language literature found numerous acupuncture-related adverse events, including pneumothorax, fainting, sub arachnoid haemorrhage, and infection as the most frequent, and cardiovascular injuries, sub arachnoid haemorrhage, pneumothorax, and recurrent cerebral haemorrhage as the most serious, most of which were due to improper technique. 233 Between 1980 and 2009, the Chinese-language literature reported 479 adverse events. 233 Prospective surveys show that mild, transient acupuncture-associated adverse events ranged from 6.71% to 15%. 233 In a study with 190,924 patients, the prevalence of serious adverse events was roughly 0.024%. 233 Another study showed a rate of adverse events requiring specific treatment of 2.2%, 4,963 incidences among 229,230 patients. 233 Infections, mainly hepatitis, after acupuncture are reported often in English-language research, though are rarely reported in Chinese-language research, making it plausible that acupuncture-associated infections have been under-reported in China. 233 Infections were mostly caused by poor sterilization of acupuncture needles. 233 Other adverse events included spinal epidural haematoma in the cervical, thoracic and lumbar spine, chylothorax, injuries of abdominal organs and tissues, injuries in the neck region, injuries to the eyes, including orbital haemorrhage, traumatic cataract, injury of the oculomotor nerve and retinal puncture, haemorrhage to the cheeks and the hypo glottis, peripheral motor-nerve injuries and subsequent motor dysfunction, local allergic reactions to metal needles, stroke, and cerebral haemorrhage after acupuncture. 233 A causal link between acupuncture and the adverse events cardiac arrest, pyknolepsy, shock, fever, cough, thirst, aphonic, leg numbness, and sexual dysfunction remains uncertain. 233 The same review concluded that acupuncture can be considered inherently safe when practice by properly trained practitioners, but the review also stated there is a need to find effective strategies to minimize the health risks. 233 Between 1999 and 2010, the Republic of Korean-literature contained reports of 1104 adverse events. 234 Between the 1980s and 2002, the Japanese-language literature contained reports of 150 adverse events. 235 Although acupuncture has been practice for thousands of years in China, its use in paediatrics in the United States did not become common until the early 2000s. Laminated acupuncture charts will create a professional atmosphere in your office - acupressure.com/acupuncture_charts.html . Acupressure meridians are on the acupressure point chart. J alter Complement Meg. 2006 12.5: 489-495. © Copyright 2014 Michael Reed Bach, Ph.D. Students from all over the world utilize acupressure charts by Michael Reed Bach. Learn acupressure using Acupressure Charts. Both practices cultivate healing energy through exercise, diet, and visualizations. Be patient and consistent when practising acupressure on them. The point P6 can be found by turning the arm so that the palm is facing up. From day-to-day pressures to life's most significant trials, emotional stress causes the body to shut down, which keeps negative feelings stuck, resulting in physical ailments and emotional imbalances. The Chinese call healing energy Qi or Chi. You can learn self-care applications and pressure point formulas for specific conditions, such as chronic fatigue, fibromyalgia, chronic muscular pain, mental stress, addiction recovery, learning disorders, trauma, emotional imbalances and more. Some even believe that therapists can transmit the vital energy external qi to another person. All major acupressure points are on the acupressure chart. Back Care Acupressure Therapy is highly effective for relieving muscular tension in all areas of the back. Some other common therapeutic methods used to stimulate acupoints include: deep-tissue massage, laser acupuncture, cupping, gua sha, and more.

It is located just above the wrist. 28 Place your hand so your palm is facing you with your fingers towards the ceiling. Energy Flow Governs Well-Being in people and animals alike. In addition to relieving nausea, there are multiple reports that the stimulation of acupressure points helps reduce stress, improve energy levels, and relieve pain. Lay the first 3 fingers of your opposite hand across your wrist.