Acupuncture

Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body.^[3] Acupuncture is a pseudoscience;^[4][5] the theories and practices of TCM are not based on scientific knowledge,^[6] and it has been characterized as quackery.^[c]

There is a range of acupuncture technological variants that originated in different philosophies,^[7] and techniques vary depending on the country in which it is performed. However, it can be divided into two main foundational philosophical applications and approaches; the first being the modern standardized form called eight principles TCM and the second being an older system that is based on the ancient Daoist wuxing, better known as the five elements or phases in the West.^[8][9][10] Acupuncture is most often used to attempt pain relief,^[11][12] though acupuncturists say that it can also be used for a wide range of other conditions. Acupuncture is typically used in combination with other forms of treatment.^[13]

The global acupuncture market was worth US$24.55 billion in 2017. The market was led by Europe with a 32.7% share, followed by Asia-Pacific with a 29.4% share and the Americas with a 25.3% share. It was estimated in 2021 that the industry would reach a market size of US$55 billion by 2023.^[14]

The conclusions of trials and systematic reviews of acupuncture generally provide no good evidence of benefits, which suggests that it is not an effective method of healthcare.^[15][16] Acupuncture is generally safe when done by appropriately trained practitioners using clean needle techniques and single-use needles.^[17][18] When properly delivered, it has a low rate of mostly minor adverse effects.^[3][17] When accidents and infections do occur, they are associated with neglect on the part of the practitioner, particularly in the application of sterile techniques.^[11][18] A review conducted in 2013 stated that reports of infection transmission increased significantly in the preceding decade.^[19] The most frequently reported adverse events were pneumothorax and infections.^[11] Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk.^[11]

Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points,^[d][23] and many modern practitioners no longer support the existence of qi or meridians, which was a major part of early belief systems.^[7][24][25] Acupuncture is believed to have originated around 100 BC in China, around the time The Inner Classic of Huang Di (Huangdi Neijing) was published,^[26] though some experts suggest it could have been practiced earlier.^[8]

Clinical practice

Acupuncture is a form of alternative medicine.^[2] It is used most commonly for pain relief,^[11][12] though it is also used to treat a wide range of conditions. Acupuncture is generally only used in combination with other forms of treatment.^[13] For example, the American Society of Anesthesiologists states it may be considered in the treatment of nonspecific, noninflammatory low back pain only in conjunction with conventional therapy.^[31]

Acupuncture is the insertion of thin needles into the skin.^[3] 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.^[32] It can be associated with the application of heat, pressure, or laser light.^[3] Classically, acupuncture is individualized and based on philosophy and intuition, and not on scientific research.^[33]

Clinical practice varies depending on the country.^[8][36] A comparison of the average number of patients treated per hour found significant differences between China (10) and the United States (1.2).^[37] Chinese herbs are often used.^[38] There is a diverse range of acupuncture approaches, involving different philosophies.^[7]

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