Acupuncture

Acupuncture practised today is based upon one of the most ancient systems – Traditional Chinese Medicine (TCM); it involves inserting fine needles into specific points of the body to realign the flow of energy (chi). There are two types of acupuncture in New Zealand; Western medical acupuncture and traditional Chinese acupuncture. Traditional Chinese acupuncture is not regulated, and it may be used alone or in conjunction with other Traditional Chinese herbal medicine, moxibustion (the heating of specific acupuncture points using the herb Artemisia), or tui na (Chinese massage). Western medical acupuncture is also known as dry needling.

Claims
The aim is to insert the needle into your body’s trigger points to improve pain and function. The theory is that it relieves pain by diverting or changing how the messages from tissues to the brain are processed and by stimulating the body’s painkillers (endorphins and encephalins).

Evidence
Four systematic Cochrane reviews concluded that acupuncture is effective for neck disorders and peripheral joint osteoarthritis.

A 500-page report commissioned by ACC in 2018 concluded that there was some evidence for slight short-term relief of some pain conditions, such as some forms of neck pain, some forms of elbow pain, low back pain, some forms of knee pain, and heel pain.

Low-back pain
Another Cochrane review found that the data does not allow firm conclusions regarding the effectiveness of acupuncture for acute low back pain. For chronic low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment (similar to a placebo) immediately after treatment and in the short term only. Acupuncture is not more effective than other conventional and “alternative” treatments. The data suggest that acupuncture and dry-needling may be helpful adjuncts to other chronic low back pain therapies.

Rheumatoid arthritis
A 2022 systematic review and meta-analysis on the effects of acupuncture and related techniques on patients with rheumatoid arthritis was published in the Journal of the Chinese Medical Association. It found reliable evidence in favour of acupuncture and associated techniques alongside western medicine to treat rheumatoid arthritis. Related methods were those commonly used alongside acupuncture in TCM; moxibustion and electro-acupuncture. Western medicine included non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, glucocorticoids, and biological agents.

Fibromyalgia
A Cochrane review of acupuncture and fibromyalgia concluded that there is low to moderate‐level evidence that compared with no treatment and standard therapy, acupuncture improves pain and stiffness in people with fibromyalgia. There is moderate‐level evidence that the effect of acupuncture does not differ from sham acupuncture in reducing pain or fatigue or improving sleep or global well‐being. EA is probably better than MA for pain and stiffness reduction and improving global well‐being, sleep and fatigue. The effect lasts up to one month but is not maintained at six months follow‐up. MA probably does not improve pain or physical functioning. People with fibromyalgia may consider using EA alone or with exercise and medication. The small sample size, scarcity of studies for each comparison, and lack of ideal sham acupuncture weaken the level of evidence and its clinical implications.

Safety
Acupuncture can be used safely. Systematic reviews have reported minor adverse effects, including increased pain, bruising, fainting, worsening of symptoms, local swelling and dizziness.

More severe side effects have been noted to occur when an un-registered practitioner performs acupuncture.

You can take steps to increase the safety and chance of benefiting from acupuncture.

How can I access acupuncture?
You do not need a referral. Some registered practitioners offer ACC-subsidised appointments, and your health insurance can cover some in some instances. We recommend that you choose a practitioner who is registered with a professional organisation.

What to expect at a session
A visit to an Acupuncturist will usually take up to an hour. The TCM practitioner considers every aspect of the patient’s life before the points are selected. Then very fine needles are inserted into points in the body and left for about 10-25 minutes. The needles may be twirled while they are in place.

Very often, people go into a state of deep relaxation whilst the needles are in place, and many drift off into a brief but sound sleep.

It is likely that the TCM acupuncture practitioner will also offer dietary and lifestyle advice or suggest a course of exercise.

Professional bodies

New Zealand Acupuncturist Standards Authority

Acupuncture NZ