Acupuncture - What, When, Where And How.

Acupuncture literally means to puncture with a needle. Yet, the use of needles is frequently in combination with moxibustion (the burning over the skin of selected herbs) and may also involve the application of other kinds of stimulation to selected points. In this article acupuncture is used in its broad sense to include traditional body needling, moxibustion, electric acupuncture, photo-acupuncture, microsystem acupuncture such as auricular and facial acupuncture, and application of pressure at selected sites.

Acupuncture originally started in China many centuries ago and later spread to Japan, the Korean peninsula and elsewhere in Asia. Acupuncture is widely used in health care systems in the countries of this part of the world. It is officially accknowledged by governments and well perceived by the general population. Although it was introduced to Europe as early as the seventeenth century, scepticism about its effectiveness continues to exist in regions where Western medicine is the foundation of health delivery system, especially in places where acupuncture has not yet been extensively practised. People question whether acupuncture works merely through the placebo effect. There is as a result a need for scientific research that evaluate the usefulness of acupuncture.

A lot of controlled clinical trials have been conducted to examine the effectiveness of acupuncture. A number of these studies have offered irrefutable scientific evidence that acupuncture is more successful than placebo treatments in certain conditions. For example, the proportion of chronic pain relieved by acupuncture is generally in the range of 55-85%, which compares favourably with that of morphine and far outweighs the placebo effect 30-35%. Furthermore, the mechanisms of acupuncture analgesia have been evaluated widely since the late 1970s, revealing the role of neural factors.

The practicability of acupuncture is also an important element to consider. The advantages of acupuncture inlude that it is convenient and has few contraindications. Although the success rate of acupuncture therapy in managing kidney stones, for instance, is established by comparative studies with other therapies, it is by no means as high as that of surgical intervention. On the other hand, acupuncture treatment of kidney stones is still worth mentioning because of its simplicity, making it more acceptable to patients. There are also instances when acupuncture is not as practicable as regular treatment. For example, the usefulness of acupuncture therapy of acute bacillary dysentery has been known to be comparable with that of furazolidone, but oral administration of furazolidone or other antidysenteric drugs comes more handy.

The conditions of the health delivery service in a given area should also be considered when examining acupuncture practice. In developing countries, where medical personnel are still lacking, the need for acupuncture can be considerable; appropriate use of acupuncture practice could benefit many patients. On the other hand, in developed countries, where the health delivery system is well established, with sophisticated technology and adequate personnel, acupuncture might be considered to be of great value in only a limited number of conditions. It could still serve as a valuable alternative therapy for many diseases or conditions. It is also valuable in situations when the patient is frightened of the potential risks of conventional treatments. As a matter of fact, in certain developed countries, the diseases for which patients seek help from acupuncture practitioners tend to be beyond the scope of orthodox medicine.