....I bet when they go in for a root canal the only needle they want to see is a shot of novocaine. --Cecil Adams

Acupuncture is a traditional Chinese medical technique for unblocking chi (ch'i or qi) by inserting needles at particular points on the body to balance the opposing forces of yin and yang. Chi is an energy that allegedly permeates all things. It is believed to flow through the body along 14 main pathways called meridians. When yin and yang are in harmony, chi flows freely within the body and a person is healthy. When a person is sick, diseased, or injured, there is an obstruction of chi along one of the meridians. Traditional Chinese medicine has identified some 500 specific points where needles are to be inserted for specific effects.

Acupuncture has been practiced in China for more than 4,000 years. Today, the needles are twirled, heated, or even stimulated with weak electrical current, ultrasound, or certain wavelengths of light. But no matter how it is done, scientific research can never demonstrate that unblocking chi by acupuncture or any other means is effective against any disease. Chi is defined as being undetectable by the methods of empirical science.

A variation of traditional acupuncture is called auriculotherapy or ear acupuncture. It is a method of diagnosis and treatment based on the unsubstantiated belief that the ear is the map of the bodily organs. For example, a problem with an organ such as the liver is to be treated by sticking a needle into a certain point on the ear that is supposed to be the corresponding point for that organ. (Similar notions about a part of the body being an organ map are held by those who practice iridology [the iris is the map of the body] and reflexology [the foot is the map of the body].) Staplepuncture, a variation of auriculotherapy, puts staples at key points on the ear hoping to do such things as help people stop smoking.

Traditional Chinese medicine is not based on knowledge of modern physiology, biochemistry, nutrition, anatomy, or any of the known mechanisms of healing. Nor is it based on knowledge of cell chemistry, blood circulation, nerve function, or the existence of hormones or other biochemical substances. There is no correlation between the meridians used in traditional Chinese medicine and the actual layout of the organs and nerves in the human body. The National Council Against Health Fraud (NCAHF) claims that of the 46 medical journals published by the Chinese Medical Association, not one is devoted to acupuncture or other traditional Chinese medical practices. Nevertheless, it is estimated that somewhere between 10 and 15 million Americans spend approximately $500 million a year on acupuncture for treatment of depression, AIDS, allergies, asthma, arthritis, bladder and kidney problems, constipation, diarrhea, colds, flu, bronchitis, dizziness, smoking, fatigue, gynecologic disorders, headaches, migraines, paralysis, high blood pressure, PMS, sciatica, sexual dysfunction, stress, stroke, tendinitis, and vision problems.

Empirical studies on acupuncture are in their infancy. Such studies ignore notions based on metaphysics such as unblocking chi along meridians and seek to find causal connections between sticking needles into traditional acupuncture points and physical effects. Even so, many traditional doctors and hospitals are offering acupuncture as a "complementary" therapy. The University of California at Los Angeles medical school has one of the largest acupuncture training courses in the United States for licensed physicians. The 200-hour program teaches nearly 600 physicians a year. According to the American Academy of Medical Acupuncture, about 4,000 U.S. physicians have training in acupuncture.

In March 1996, the Food and Drug Administration (FDA) classified acupuncture needles as medical devices for general use by trained professionals. Until then, acupuncture needles had been classified as Class III medical devices, meaning their safety and usefulness was so uncertain that they could only be used in approved research projects. Because of that "experimental" status, many insurance companies, as well as Medicare and Medicaid, had refused to cover acupuncture. This new designation has meant both more practice of acupuncture and more research being done using needles. It also means that insurance companies may not be able to avoid covering useless or highly questionable acupuncture treatments for a variety of ailments. Nevertheless, Wayne B. Jonas, director of the Office of Alternative Medicine at the National Institutes of Health in Bethesda, MD, has said that the reclassification of acupuncture needles is "a very wise and logical decision." The Office of Alternative Medicine is very supportive (i.e. willing to spend good amounts of tax dollars) on new studies of the effectiveness of acupuncture.

The most frequently offered defense of acupuncture by its defenders commits the pragmatic fallacy. It is argued that acupuncture works! What does this mean? It certainly does not mean that sticking needles into one's body opens up blocked chi. At most, it means that it relieves some medical burden. Most often it simply means that some customer is satisfied, that is, feels better at the moment. The NCAHF issued a position paper on acupuncture that asserts, "Research during the past twenty years has failed to demonstrate that acupuncture is effective against any disease" and that "the perceived effects of acupuncture are probably due to a combination of expectation, suggestion, counter-irritation, operant conditioning, and other psychological mechanisms." In short, most of the perceived beneficial effects of acupuncture are probably due to mood change, the placebo effect, and the regressive fallacy. Just because the pain went away after the acupuncture doesn't mean the treatment was the cause. Much chronic pain comes and goes. An alternative treatment such as acupuncture is sought only when the pain is near its most severe level. Natural regression will lead to the pain becoming less once it has reached its maximum level of severity. Also, much of the support for acupuncture is anecdotal in the form of testimonial evidence from satisfied customers. Unfortunately, for every anecdote of someone whose pain was relieved by acupuncture there may well be another anecdote of someone whose pain was not relieved by acupuncture But nobody is keeping track of the failures (confirmation bias).

Nevertheless, it is possible that sticking needles into the body may have some beneficial effects. The most common claim of success by acupuncture advocates is in the area of pain control. Studies have shown that many acupuncture points are more richly supplied with nerve endings than are the surrounding skin areas. Some research indicates sticking needles into certain points affects the nervous system and stimulates the body's production of natural painkilling chemicals such as endorphins and enkephalins, and triggers the release of certain neural hormones including serotonin. Another theory suggests that acupuncture blocks the transmission of pain impulses from parts of the body to the central nervous system.

There are difficulties that face any study of pain. Not only is pain measurement entirely subjective, but traditional acupuncturists evaluate success of treatment almost entirely subjectively, relying on their own observations and reports from patients, rather than objective laboratory tests. Furthermore, many individuals who swear by acupuncture (or therapeutic touch, reiki, iridology, meditation, mineral supplements, etc.) often make several changes in their lives at once, thereby making it difficult to isolate significant causal factors in a control group study.

Some of the acupuncture studies supported by the Office of Alternative Medicine at the National Institutes of Health try to mimic traditional control group studies, but no control study will reveal if chi was unblocked or if yin and yang are in or out of harmony. Control studies using objective measurements of treatment success could determine, however, how much of the success of acupuncture is due to nothing more than subjective assessment by interested parties. Such studies could also determine whether any effects of acupuncture are short-term or long-term.

Finally, acupuncture is not without risks. There have been some reports of lung and bladder punctures, some broken needles, and some allergic reactions to needles containing substances other than surgical steel. Acupuncture may be harmful to the fetus in early pregnancy since it may stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin, which affect labor. There is always the possibility of infection from unsterilized needles. And some patients will suffer simply because they avoided a known effective treatment of modern medicine.