The most rigorous and detailed analysis of the treatment to date — found that acupuncture can ease migraines and arthritis and multiple other forms of chronic pain. The researchers, who published their results in Archives of Internal Medicine in October of 2012, found that acupuncture outperformed sham treatments and standard care when used by people suffering from osteoarthritis, migraines and chronic back, neck and shoulder pain. Dr. Andrew J. Vickers, attending research methodologist at Memorial Sloan-Kettering Cancer Center in New York and the lead author of the study stated “We think there’s firm evidence supporting acupuncture for the treatment of chronic pain.”

Acupuncture, which involves inserting needles at various places on the body to stimulate so-called acupoints, is among the most widely practiced forms of alternative medicine in the country and is offered by many hospitals. Most commonly the treatment is sought by adults looking for relief from chronic pain, though it is also used with growing frequency in children. According to government estimates, about 150,000 children in the United States underwent acupuncture in 2007.

The meta-analysis included studies that compared acupuncture with usual care, like over-the-counter pain relievers and other standard medicines. It also included studies that used sham acupuncture treatments, in which needles were inserted only superficially, for example, or in which patients in control groups were treated with needles that covertly retracted into handles.

Ultimately, Dr. Vickers and a team of scientists from around the world suggest that people undergoing the treatment are getting more than just a psychological boost. At least in the case of acupuncture, he wrote, the new study provides “robust evidence” that it provides “modest benefits over usual care for patients with diverse sources of chronic pain.”

According to the most recent statistics from the National Health Interview Survey, a large ongoing study that tracks healthcare habits in the U.S, more than 14 million Americans have tried acupuncture. The study found that nearly six percent of Americans have received acupuncture. “Use of acupuncture has been percolating for quite a while and it’s now becoming much more mainstream in medicine,” said Dr. Houman Danesh, director of integrative pain management at Mt. Sinai Hospital in New York during an interview with ABC News in April of 2014. So mainstream in fact, that it’s one of the few so-called “complimentary” or alternative medicine approaches covered by most health insurance plans.

Even the military uses auricular acupuncture, a form of acupuncture that involves gently inserting small needles into various places on the ear that correspond with pain points elsewhere on the body. Chronic pain is one of the most serious health problems in the U.S., affecting an estimated 100 million Americans, according to a 2011 Institute of Medicine report. Research studies consistently show that acupuncture can be an effective form of pain management, with some studies finding it even more effective than pain-relieving drugs or surgery. Danesh said that many of the meridian points happen to coincide with trigger points, spots on the body where pain radiates away from the center when pressed.

"One thought is that acupuncture may ease the stress on trigger points thereby lessening pain in that area,” he said. Meridian points also track closely with major nerve centers, Danesh said. It could be that the needles stimulate the nerves, causing them to release feel-good chemicals known as endorphins. People in pain often have low levels of endorphins, Danesh pointed out, and a release of those endorphins can suppress the sensation of pain.

According to the latest research, acupuncture does have real effects on the human body, which scientists are documenting using high-tech tools. Neuroimaging studies show that it seems to calm areas of the brain that register pain and activate those involved in rest and recuperation. Doppler ultrasound shows that acupuncture increases blood flow in treated areas. Thermal imaging shows that it can make inflammation subside. The use of acupuncture continues to spread—often alongside conventional medicine. U.S. Navy, Air Force and Army doctors are using acupuncture to treat musculoskeletal problems, pain and stress in stateside hospitals and combat zones in Iraq and Afghanistan. Delegations from Acupuncturists Without Borders are holding communal ear-needling sessions to reduce stress among earthquake victims in Haiti. Major medical centers—from M.D. Anderson in Houston to Memorial Sloan-Kettering in New York—use acupuncture to counteract the side effects of chemotherapy.

The most common uses are for chronic pain conditions like arthritis, lower back pain and headaches, as well as fatigue, anxiety and digestive problems, often when conventional medicine fails. Studies in the early 1980s found that acupuncture works in part by stimulating the release of endorphins, the body's natural feel-good chemicals, much like vigorous exercise does. Now, a growing body of research suggests that it may have several mechanisms of action. Those include stimulating blood flow and tissue repair at the needle sites and sending nerve signals to the brain that regulate the perception of pain and reboot the autonomic nervous system, which governs unconscious functions such as heart beat, respiration and digestion, according to Alejandro Elorriaga, director of the medical acupuncture program at McMaster University in Ontario, which teaches a contemporary version to physicians.

What's more, an odd phenomenon occurs when acupuncture needles are inserted into the body and rotated: Connective tissue wraps around them like spaghetti around a fork, according to ultrasound studies at the University of Vermont. Helene Langevin, research associate professor of neurology, says this action stretches cells in the connective tissue much like massage and yoga do, and may act like acupuncture meridians to send signals throughout the body.

This individual patient data meta-analysis of 29 randomized, controlled trials studying 17,922 patients substantiates that acupuncture is a safe and effective treatment for many types of chronic pain including: back pain, neck pain, osteoarthritis, chronic headache, and shoulder pain. The levels of decreased pain were shown to be statistically significant and superior to that of placebo.

Arch Intern Med. 2012;172(19):1444-1453

In a randomized, controlled clinical study, 23 patients were treated with acupuncture. There were significant reductions in pain intensity and improvements in the function of the arm and in maximal strength in the treatment group. In the treatment of chronic epicondylopathia lateralis humeri, acupuncture in which real acupuncture points were selected and stimulated was superior to non‐specific acupuncture with respect to reduction in pain and improvement in the functioning of the arm. These changes are particularly marked at early follow‐up.

Rheumatology (2002) 41 (2): 205-209

Thirty-one possibly relevant studies were identified and 18 randomly controlled trials were included. Ten trials tested manual acupuncture and eight trials tested electro-acupuncture. Overall, ten studies demonstrated greater pain reduction in acupuncture groups compared with controls. These randomly controlled trials suggest specific effects of acupuncture for pain control in patients with peripheral joint osteoarthritis. Considering its favourable safety profile, acupuncture seems an option worthy of consideration particularly for knee osteoarthritis.

Rheumatology (2006) 45 (11): 1331-1337

In a single-blind placebo-controlled study design we investigated the efficacy of acupuncture additionally applied to drug treatment in major depression. Methods: We randomly included 70 inpatients with a major depressive episode in three different treatment groups. Acupuncture was applied three times a week over a period of 4 weeks. Psychopathology was rated by judges blind to verum/placebo conditions twice a week over 8 weeks. Results: Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin alone.

Journal of Affective Disorders Volume 57, Issues 1–3, January–March 2000, Pages 73–81

A random controlled clinical study of patients over 60 with chronic low back pain. The subjects were randomized to two groups. The control group of subjects continued their usual care as directed by their physicians, i.e. NSAIDs, muscle relaxants, paracetamol and back exercises. Subjects in the acupuncture group in addition received biweekly acupuncture for 5 weeks. Fewer acupuncture subjects had medication-related side-effects compared with the control group. The study concluded acupuncture is an effective, safe adjunctive treatment for chronic LBP in older patients.

Rheumatology (2003) 42 (12): 1508-1517

In this study, 18 anxious adult subjects who complained of insomnia were assessed in an open prepost clinical trial study. Five weeks of acupuncture treatment was associated with a significant nocturnal increase in endogenous melatonin secretion and significant improvements in polysomnographic measures of total sleep time and sleep. Significant reductions in state and trait anxiety scores were also found. These objective findings are consistent with clinical reports of acupuncture's relaxant effects. Acupuncture treatment may be of value for some categories of anxious patients with insomnia.

The Journal Of Neuropsychiatry Volume 16 Issue 1, February 2004, pp. 19-28

A randomized, controlled study that investigated immunologic effects of Chinese acupuncture on patients with allergic asthma. In the TCM group, significantly more patients indicated an improvement in general well-being after acupuncture treatment. The control group, however, showed no significant changes. The results imply that asthma patients benefit from acupuncture treatment given in addition to conventional therapy. Furthermore, acupuncture performed in accordance with the principles of TCM showed significant immune-modulating effects.

The Journal of Alternative and Complementary Medicine. December 2000, 6(6): 519-525. doi:10.1089/acm.2000.6.519.

A controlled, randomized clinical trial of patients receiving true acupuncture compared with a control group of patients who received simulated acupuncture. All patients met American College of Rheumatology criteria for fibromyalgia and had tried conservative symptomatic treatments other than acupuncture. This study found that acupuncture significantly improved symptoms of fibromyalgia. Symptoms were significantly improved in the acupuncture group compared with the control group. Symptomatic improvement was not restricted to pain relief and was most significant for fatigue and anxiety.

Mayo Clinic Proceedings June 2006Volume 81, Issue 6, Pages 749–757

12 randomized, controlled trial studies conducted with 869 participants demonstrating that acupuncture improves hot flash frequency and severity, menopause-related symptoms, and quality of life (in the vasomotor domain) in women experiencing natural menopause.

Menopause February 2015 - Volume 22 - Issue 2 - p 234–244

An international standard randomized controlled study of patients with shoulder pain. The study demonstrated that single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain, compared with physiotherapy as the sole treatment. This improvement is accompanied by a reduction in the consumption of pain medications. By the end of the treatment, the patients in the acupuncture group had decreased their consumption of analgesics significantly compared with those in the control group.

Rheumatology (2008) 47 (6): 887-893.

In a randomized controlled trial plus a nonrandomized cohort, the authors investigated the effectiveness and costs of acupuncture in addition to routine care in the treatment of chronic low back pain and assessed whether the effects of acupuncture differed in randomized and nonrandomized patients. Back pain, function, and quality of life improved in those patients given acupuncture, and acupuncture plus routine care was associated with marked clinical improvements in these patients and was relatively cost-effective.

Am. J. Epidemiol. (1 September 2006) 164 (5): 487-496.

The study was designed to evaluate the pain relieving effect of acupuncture for pelvic and low-back pain during the last trimester of pregnancy. 72 pregnant women reporting pelvic or low-back pain were randomized during pregnancy weeks 24–37 to an acupuncture group. The acupuncture patients were less bothered than initially by pain during activity compared with that of control patients. The study concluded that acupuncture relieves low-back and pelvic pain without adverse effects in pregnancy.

Acta Obstetricia et Gynecologica Scandinavica Volume 83, Issue 3, pages 246–250, March 2004

The study was carried out to examine whether acupuncture treatment can reduce chronic pain in the neck and shoulders and related headache, and also to examine whether possible effects are long-lasting. The intensity and frequency of pain fell more for those that received acupuncture compared to the control group during the treatment period. Three years after the treatments, patients still reported less pain than before the treatments. Three years after the treatments the effect still lasted for those that received acupuncture, while the degree of headache for the control group was back to the pre-treatment level . The study demonstrates adequate acupuncture treatment reduces chronic pain in the neck and shoulders and related headache.

Pain Volume 109, Issue 3, June 2004, Pages 299–307

This systematic review on postoperative nausea and vomiting, chemotherapy-induced nausea and vomiting, and pregnancy-related nausea and vomiting exist demonstrated in 40 randomised controlled trials that acupuncture has some effect in preventing or attenuating nausea and vomiting.

Autonomic Neuroscience Volume 129, Issues 1–2, 30 October 2006, Pages 107–117

In 22 randomized controlled trials, including a total of 1041 patients with headaches, the evidence suggests that acupuncture is a safe and effective treatment for several types of recurrent headaches including: migraines, tension-headaches, and various headaches. The majority of the trials comparing true and sham acupuncture showed at least a trend in favor of true acupuncture.

Cephalalgia November 1999 vol. 19 no. 9 779-786

This study treated 52 sportsmen with rotator cuff tendonitis in a randomised single-blind clinical trial using a new placebo-needle as control. Patients were treated for 4 weeks. Acupuncture was shown to be more effective than the placebo in the treatment of pain. The acupuncture-group reported more pain relief and improved more than the control-group.

Pain Volume 83, Issue 2, 1 November 1999, Pages 235–241

In an extensive analysis of data from nearly 18,000 individuals involved in 29 high-quality clinical trials, Memorial Sloan Kettering health outcomes researcher Andrew Vickers and colleagues have determined that acupuncture is an effective treatment for chronic back and neck pain, osteoarthritis, shoulder pain, and headaches. In addition, this study found its effectiveness over standard treatment without acupuncture is much greater. Dr. Vickers says. “Our findings provide the most-robust evidence to date that doctors are justified in making referrals to acupuncture for their patients with chronic pain. I hope that our findings help inform future clinical and policy decisions for acupuncture.”

Archives of Internal Medicine September 2010

In a randomized, controlled multicenter trial, 46 specialized physicians in 6 hospital clinics and 32 private outpatient clinics treated 422 patients with seasonal allergies with acupuncture. Acupuncture led to statistically significant improvements in disease-specific quality of life and antihistamine use measures after 8 weeks of treatment compared with the control group.

Ann Intern Med. 2013;158(4):225-234.

This randomized, multicenter, blinded, parallel-group trial, concluded that “Low back pain improved after acupuncture treatment for at least 6 months. Effectiveness of acupuncture was almost twice that of conventional therapy.”

Arch Intern Med. 2007;167(17):1892-1898

The majority of participants in the study showed a statistically significant positive change in the Moire topography criteria (facial elasticity) with no significant side-effects.

Evidence-Based Complimentary and Alternative Medicine 2013