NIH Office of Alternative Medicine
The 12-member panel also concluded in their consensus statement that there are a number of other pain-related conditions for which acupuncture may be effective as an adjunct therapy, an acceptable alternative, or as part of a comprehensive treatment program. but for which there is less convincing scientific data. These conditions include but are not limited to addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia (general muscle pain), low back pain, carpal tunnel syndrome, and asthma.
"We need more high quality research to validate what appears to be useful for the millions of Americans that have used acupuncture in this country. The challenge in studying acupuncture is to integrate the theory of Chinese medicine into the conventional Western biomedical research model and into the conventional health care arena," said panel chairman David J. Ramsay, D.M., D. Phil., president of the University of Maryland, Baltimore.
Acupuncture is a family of procedures, the most well known of which involves penetration of specific anatomic locations on the skin, called acupuncture points, by thin, solid, generally metallic needles.
Acupuncture is one of the oldest and most commonly used forms of traditional medicine in the world--dating back for at least 2,500 years. The general theory of acupuncture is based on the premise that there are patterns of energy flow called Qi (pronounced "chee") throughout the body that are essential for optimal health.
Public awareness and use of acupuncture increased in the United States following President Nixon's visit to China in 1972 and New York Times reporter James Reston's account of how physicians in Beijing eased his post-surgery abdominal pain with needles. According to the World Health Organization, there are approximately 10,000 acupuncture specialists in the U.S., and an estimated 3,000 practicing acupuncturists are physicians. In 1993 the Food and Drug Administration reported that Americans were spending $500 million per year and making approximately 9 to 12 million patient visits for acupuncture treatments.
The introduction and acceptance of any new treatment can be a difficult process. When that new treatment is based on theories unfamiliar to Western medicine, the difficulties are accentuated. To enhance the acceptance of acupuncture in the U.S., the panel emphasized the need for improved understanding of perspectives between acupuncture practitioners and today's conventional health care community. The panel commended the ongoing increase in improved training and called for more uniform licensing, certification, and accreditation of acupuncturists among States, which will help the public identify qualified acupuncture practitioners and to have more assurance in quality of service. Thirty-four states license or otherwise regulate the practice of acupuncture by nonphysicians, and have established training standards for certification to practice acupuncture.
Adverse side effects of acupuncture are extremely low and often lower than conventional treatments. However, the panel noted that adverse side effects have occurred on rare occasions. They recommended that patients be fully informed of their treatment options, expected prognosis, relative risk, and safety practices to minimize the risks prior to undergoing acupuncture treatment. Because many individuals seek health care treatment from both acupuncturists and physicians, the consensus panel advocated a strengthening of communications between these health care provider groups to maximize the possibility that important medical problems are not overlooked. The panel additionally encouraged broader public access to acupuncture treatment by urging insurance companies, Federal and state health insurance programs including Medicare and Medicaid, and other third party payers to expand their coverage to include appropriate acupuncture treatments. Doing so, the panel stated, would help remove the financial barriers to access to these services.
Finally, the panel identified important areas for future acupuncture research. In particular, the panel emphasized the importance of evaluating acupuncture for the treatment of specific conditions using study designs that can withstand rigorous scientific scrutiny. "The acceptance of acupuncture as a reliable therapeutic choice in Western medicine will depend on such rigorous studies," said Dr. Ramsay.
The panel issued their consensus statement following an extensive review of the existing medical literature and a series of presentations by acupuncture research experts at a 3-day NIH Consensus Development Conference on Acupuncture. The full NIH Consensus Statement on Acupuncture is available by calling 1-888-NIH-CONSENSUS (1-888-644-2667) or by visiting the NIH Consensus Development Program Web site at http://consensus.nih.gov.
The National Institutes of Health Consensus Development Program was established in 1977 and is the premier health technology assessment and transfer program in American medicine. Under this program, the Office of Medical Applications of Research at NIH organizes major conferences that produce consensus statements and technology assessment statements on controversial issues in medicine important to health care providers, patients, and the general public.
This conference was sponsored by the NIH Office of Medical Applications of Research and the NIH Office of Alternative Medicine. The conference was cosponsored by the National Cancer Institute, the National Heart, Lung, and Blood Institute, the National Institute of Allergy and Infectious Diseases, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute of Dental Research, the National Institute on Drug Abuse, and the NIH Office of Research on Women's Health.
NOTE TO RADIO EDITORS: An audio report of the conference results are available November 5-14, 1997 from the NIH Radio News Service by calling 1-800-MED-DIAL (1-800-633-3425) or by visiting http://www.radiospace.com/nihhome.htm on the Web.