Acupuncture is a form of alternative medicine in which thin needles are inserted into the body. It is a key component of traditional Chinese medicine (TCM). TCM theory and practice are not based upon scientific knowledge, and acupuncture is a pseudoscience. There are a diverse range of acupuncture theories based on different philosophies, and techniques vary depending on the country. The method used in TCM is likely the most widespread in the US. It is most often used for pain relief, though it is also used for a wide range of other conditions. Acupuncture is generally used only in combination with other forms of treatment.

The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent. An overview of Cochrane reviews found that acupuncture is not effective for a wide range of conditions. A systematic review of systematic reviews found little evidence of acupuncture’s effectiveness in treating pain. The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits. Some research results suggest acupuncture can alleviate pain, though the majority of research suggests that acupuncture’s effects are mainly due to the placebo effect. A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias. A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care, while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain.

Acupuncture is generally safe when done by an appropriately trained practitioner using clean needle technique and single-use needles. When properly delivered, it has a low rate of mostly minor adverse effects. Accidents and infections are associated with infractions of sterile technique or neglect of the practitioner. A review stated that the reports of infection transmission increased significantly in the prior decade. The most frequently reported adverse events were pneumothorax and infections. Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk.

Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points, and many modern practitioners no longer support the existence of life force energy (qi) flowing through meridians, which was a major part of early belief systems. Acupuncture is believed to have originated around 100 BC in China, around the time The Yellow Emperor’s Classic of Internal Medicine (Huangdi Neijing) was published, though some experts suggest it could have been practiced earlier. Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body’s “rhythm” on the effectiveness of treatment  Acupuncture grew and diminished in popularity in China repeatedly, depending on the country’s political leadership and the favor of rationalism or Western medicine. Acupuncture spread first to Korea in the 6th century AD, then to Japan through medical missionaries, and then to Europe, starting with France. In the 20th century, as it spread to the United States and Western countries, the spiritual elements of acupuncture that conflict with Western beliefs were abandoned in favor of tapping needles into nerves.

Clinical practice

One type of acupuncture needle
Acupuncture is a form of alternative medicine. It is commonly used for pain relief, though it is also used to treat a wide range of conditions. The majority of people who seek out acupuncture do so for musculoskeletal problems, including low back pain, shoulder stiffness, and knee pain. Acupuncture is generally only used in combination with other forms of treatment. For example, American Society of Anesthesiologists states it may be considered in the treatment for nonspecific, noninflammatory low back pain only in conjunction with conventional therapy.

Acupuncture is the insertion of thin needles into the skin. According to the Mayo Foundation for Medical Education and Research (Mayo Clinic), a typical session entails lying still while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes. It can be associated with the application of heat, pressure, or laser light. Classically, acupuncture is individualized and based on philosophy and intuition, and not on scientific research. There is also a non-invasive therapy developed in early 20th century Japan using an elaborate set of “needles” for the treatment of children.

Clinical practice varies depending on the country. A comparison of the average number of patients treated per hour found significant differences between China  and the United States  Chinese herbs are often used.[ There is a diverse range of acupuncture approaches, involving different philosophies. Although various different techniques of acupuncture practice have emerged, the method used in traditional Chinese medicine (TCM) seems to be the most widely adopted in the US. Traditional acupuncture involves needle insertion, moxibustion, and cupping therapy, and may be accompanied by other procedures such as feeling the pulse and other parts of the body and examining the tongue. Traditional acupuncture involves the belief that a “life force” (qi) circulates within the body in lines called meridians. The main methods practiced in the UK are TCM and Western medical acupuncture. The term Western medical acupuncture is used to indicate an adaptation of TCM-based acupuncture which focuses less on TCM. The Western medical acupuncture approach involves using acupuncture after a medical diagnosis. Limited research has compared the contrasting acupuncture systems used in various countries for determining different acupuncture points and thus there is no defined standard for acupuncture points.

In traditional acupuncture, the acupuncturist decides which points to treat by observing and questioning the patient to make a diagnosis according to the tradition used. In TCM, the four diagnostic methods are: inspection, auscultation and olfaction, inquiring, and palpation. Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge. Auscultation and olfaction involves listening for particular sounds such as wheezing, and observing body odor. Inquiring involves focusing on the “seven inquiries”: chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea. Palpation is focusing on feeling the body for tender “A-shi” points and feeling the pulse