Acupuncture - Common, minor adverse events

Common, minor adverse events

A survey by Ernst et al. of over 400 patients receiving over 3500 acupuncture treatments found that the most common adverse effects from acupuncture were:[11]

• Minor bleeding after removal of the needles, seen in roughly 3% of patients. (Holding a cotton ball for about one minute over the site of puncture is usually sufficient to stop the bleeding.)
• Hematoma, seen in about 2% of patients, which manifests as bruises. These usually go away after a few days.
• Dizziness, seen in about 1% of patients. Some patients have a conscious or unconscious fear of needles which can produce dizziness and other symptoms of anxiety. Patients are usually treated lying down in order to reduce likelihood of fainting.

The survey concluded: "Acupuncture has adverse effects, like any therapeutic approach. If it is used according to established safety rules and carefully at appropriate anatomic regions,  it is a safe treatment method."

Exploring Potential Risks

While acupuncture is generally regarded as a safe and effective therapy, it's crucial to be aware of potential risks associated with needle insertion. Some of these risks include:

• Nerve injuries, which may result from accidental puncturing of nerves during the procedure.
• Brain damage or stroke, which is a rare possibility with very deep needling, particularly at the base of the skull.
• Pneumothorax, a condition that can occur when needles penetrate deeply into the lung area.
• Kidney damage, particularly when needling in the lower back region.
• Haemopericardium, or the puncture of the protective membrane surrounding the heart. This may happen when needling over a sternal foramen, which is a hole in the breastbone resulting from a congenital defect.
• Risk of pregnancy termination, associated with specific acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin.
• It's essential to note that the chances of these risks are very small, and they can be further minimized through the proper training of acupuncturists. Graduates of medical schools and accredited acupuncture institutions, particularly in the United States, undergo comprehensive instruction in proper techniques to prevent such occurrences. (Reference: Cheng, 1987)

Learn More About Acupuncture Safety

Exploring Evidence-Based Medicine

Modern healthcare acknowledges the significance of an evidence-based medicine (EBM) framework for evaluating health outcomes. Within this framework, systematic reviews with rigorous protocols play a pivotal role. Esteemed organizations like the Cochrane Collaboration and Bandolier are known for publishing such comprehensive reviews. In practice, EBM revolves around the concept of integrating individual clinical expertise with the best available external evidence, allowing doctors to consider research beyond the confines of its "top-tier" criteria.

The journey to establish the evidence base for acupuncture was encapsulated in a review conducted by researcher Edzard Ernst and colleagues in 2007. They compared systematic reviews conducted with similar methodologies in 2000 and 2005:

The effectiveness of acupuncture continues to be a topic of debate. The results from these reviews indicate that the evidence base has expanded for 13 out of the 26 conditions examined in this comparative analysis. For 7 of these indications, the evidence has become more positive, favoring the use of acupuncture, while for 6, it has shifted in the opposite direction. It is clear that research into acupuncture is an ongoing and evolving field. The emerging clinical evidence suggests that acupuncture is effective for some conditions but may not be universally applicable.

Regarding low back pain, a Cochrane review from 2005 stated:

This systematic review encompassed 35 randomized controlled trials, involving 2861 patients. The review concluded that there was insufficient evidence to make specific recommendations about the use of acupuncture or dry needling for acute low back pain. However, for chronic low back pain, the results indicated that acupuncture provided better pain relief compared to no treatment or sham treatment in short-term assessments. Furthermore, acupuncture was shown to be more effective in improving function compared to no treatment in the short term. When compared to other conventional and alternative treatments, acupuncture didn't demonstrate superior effectiveness. Nevertheless, when used in conjunction with other conventional therapies, it was found to provide better pain relief and improved function, although the effects were generally modest. Dry needling was also identified as a potentially valuable addition to other therapies for chronic low back pain.

In 2008, a study suggested that combining acupuncture with conventional infertility treatments, such as IVF, significantly improved the success rates of these medical interventions.

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