Acupuncture: Is it safe?
The most common problems with acupuncture, such as failure to remove the needles, were caused by carelessness on the part of the therapist, according to a large-scale study.
By John Russo/Vicus.com
|VICUS.COM (19 July 2000) — Accurate diagnosis is the key to successful therapy. But once a condition is diagnosed, selection of treatment (conventional medicine or complementary) is based on a thoughtful balance between the benefits versus the risks of each intervention.There are more than two dozen conditions in which the application of acupuncture is likely to have a positive effect. The next logical question is: “Is it safe?”
Once a condition is diagnosed, selection of treatment (conventional medicine or complementary) is based on a thoughtful balance between the benefits versus the risks of each intervention.
There are more than two dozen conditions in which the application of acupuncture is likely to have a positive effect. The next logical question is: “Is it safe?”
What are the risks of acupuncture?
In the hands of an expert, acupuncture has minimal risks for the patient. The results of a six-year survey of adverse events associated with acupuncture and moxibustion at a national clinic in Japan, published in 1999, are listed in the table. During this time, 84 therapists (13 preceptors and 71 interns) at the Tsukuba College of Technology Clinic in Japan were required to report all relevant adverse events during acupuncture treatment.
Adverse events were rare. The most common problems with acupuncture, such as failure to remove the needles, were caused by carelessness on the part of the therapist.
Admittedly, the impressive record of acupuncture’s safety when practiced at an academic institution in Asia may not be representative of what can be expected from a local practitioner in Ames, Iowa or Sorrento, Italy. A more broadly based review of the medical literature suggests that side effects due to acupuncture are still uncommon events. However, poor technique and negligence can place patients at risk of side effects that they had not counted on when they agreed to treatment.
A review of adverse effects of acupuncture as recorded in the MedLine database over 14 years (1981 to 1994) revealed 193 patients with adverse effects. Pneumothorax (lung collapse due to lung or chest penetration) was the most common mechanical organ injury, while hepatitis (liver inflammation, usually due to infection) was the most-mentioned infection. Acupuncture treatment was also reported to be responsible in the death of three patients.
More recently, researchers from the University of Exeter’s Department of Complementary Medicine (U.K.) reported two cases of hepatitis B infection and one case of a lodged broken needle as a result of acupuncture.
Putting it into perspective
Everyone has heard of the surgeon who amputated the wrong limb, or the patient who died because they were given the wrong medicine. Events such as these have been labeled as medical errors, and they are a real but mostly preventable problem. (According to a November 1999 Institute of Medicine report, the cost of errors in the United States totals as much as $29 billion in lost income, disability and health care costs.)
We even unnecessarily expose ourselves to injury when we use power tools or drive a car after taking sedating antihistamines to treat allergy symptoms. So, while it is important to recognize the risks of therapy, any treatment must be viewed from the perspective of its potential benefits and it should be used in a way that minimizes the risk of side effects.
We know that in the hands of experts, acupuncture does not expose patients to unreasonable risk, and may provide analgesia that complements other forms of therapy. The first step in making it safe for you is to find an experienced expert acupuncturist. Many organizations can help you find an expert.
There are more than 10,000 acupuncturists in the United States, and many states require them to be licensed. The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) has certified about 9,000 practitioners who have met national standards. In addition, the American Academy of Medical Acupuncture has a membership of about 1,400 medical doctors and doctors of osteopathy who have completed 220 hours of training in acupuncture.
One more recommendation: At the end of the acupuncture treatment, before you get dressed, make sure all the needles have been removed.
Table 1. Adverse events reported by 84 therapists following 65,482 acupuncture treatments in Japan
John Russo is senior vice president of medical communications at Vicus.com. He is a pharmacist and medical writer with more than 20 years of experience in medical education.
Hidden risks in alternative therapies. Daily Mail (London), December 21, 1998.
Institute of Medicine. To Err is Human: Building a Safer Health System. November 1999.
Norheim AJ. Adverse effects of acupuncture: a study of the literature for the years 1981-1994. J Altern Complement Med 1999; 2(2):291-7.
Yamashita H, Tsukayama H, Tanno Y, Nishijo K. Adverse events in acupuncture and moxibustion treatment: A six-year survey at a national clinic in Japan. J Altern Complement Med 1999; 5(3):229-36.