Acupuncture: An Overview of Scientific Evidence
BY MEL HOPPER KOPPELMAN, DAC, MSC, MSC
Research into acupuncture as a medical treatment has grown exponentially in the past 20 years, increasing at twice the rate of research into conventional biomedicine. Over this period, there have been over 13,000 studies conducted in 60 countries, including hundreds of meta-analyses summarizing the results of thousands of human and animal studies.1 A wide-variety of clinical areas have been studied, including pain, cancer, pregnancy, stroke, mood disorders, sleep disorders and inflammation, to name a few.
A recent review examined clinical guideline recommendations from around the world made by a variety of groups including government health institutions, national guidelines, and medical specialty groups.
These official recommendations indicate that acupuncture’s evidence is now acknowledged by medical experts and that acupuncture is no longer ‘alternative.’ Indeed, this new data illustrates that acupuncture is one of the most widely recommended treatments in modern medicine.
Looking at the evidence for currently recommended biomedical treatments, a recent review published in the proceedings of the Mayo Clinic in 2013 found that studies that examined the evidence for the standard of care (i.e. what doctors usually prescribe) recommended against current practice 46% of the time.
Another recent review also found that only about half of standard treatments were evidence-based.
In short, nearly half of all medical practices do not have positive evidence for their use and are not considered to fall into the category of ‘evidence based medicine.’
Below are a few examples of how acupuncture compares to other treatments.
A 2013 network meta-analysis comparing physical treatments for osteoarthritis of the knee found that, when looking at high quality studies, acupuncture had the largest effect compared to usual care out of the conditions evaluated, out-performing exercise, sham acupuncture, and weight-loss.9
A 2015 network meta-analysis comparing treatments in addition to exercise for shoulder impingement syndrome found that acupuncture was the most effective adjunctive treatment out of 17 interventions, outperforming all other adjuncts such as steroid injection, NSAIDs, and ultrasound therapy.10
A 2016 comparison of 20 treatments for sciatica ranked acupuncture as 2nd most effective after the use of biological agents, outperforming manipulation, epidurals, disc surgery, opioids, exercise, and an invasive procedure called radio-frequency denervation, which came in last11
In 2018, a network-meta-analysis found that acupuncture was more effective than drugs for treating chronic constipation and with the fewest side-effects.12
In addition to biochemical actions, studies also demonstrate direct effects of acupuncture on the central nervous system. These include spinal reflex effects, where acupuncture stimulates muscle relaxation and changes in visceral organs. In the brain, acupuncture has been shown to change functional connectivity, decreasing activity in limbic structures associated with stress and illness while improving the regulation of the hypothalamus, pituitary, adrenal axis, the primary system that the body uses for regulating hormones and the physiological stress response.31 Additionally, acupuncture modulates parasympathetic activity, the branch of the nervous system associated with rest, relaxation, digestion and tissue healing.32
Acupuncture is considered safe in the hands of a well-trained practitioner and has been found to be cost-effective for some conditions. Patients, medical professionals, and healthcare administrators can be confident that the recommendation of acupuncture for many patients is a safe, cost-effective, and evidence-based recommendation.