9 Questions

What is acupuncture?

What is de qi in acupuncture?

What is sham acupuncture?

What is moxibustion?

What is the history of acupuncture?

What is the current controversy surrounding acupuncture?

What is the most common adverse event associated with acupuncture in English-language case reports?

What is the recommended amount of specialized training for an acupuncturist before being licensed or certified by the World Health Organization?

What is the most frequently used alternative medicine in Switzerland since 2004?


Acupuncture is a pseudoscientific form of alternative medicine based on traditional Chinese medicine (TCM) that involves inserting thin needles into the body to relieve pain and treat various conditions, though there is little scientific evidence to support its efficacy. Acupuncture is most commonly used in combination with other forms of treatment. The global acupuncture market was worth US$24.55 billion in 2017, with Europe leading the market share. Acupuncture needles are typically made of stainless steel, and are usually disposed of after each use to prevent contamination. Needles vary in length and diameter, and may be stimulated manually or by electrical stimulation. The sensation of numbness, distension, or electrical tingling at the needling site is called de qi, and is considered important in Chinese acupuncture. Sham acupuncture, which uses non-penetrating needles or needling at non-acupuncture points, is often used in research trials to determine the specific effects of acupuncture, and it generally produces the same effects as real acupuncture. Publication bias is cited as a concern in the reviews of randomized controlled trials of acupuncture.Summary Title: Safety and Scientific Basis of Acupuncture


  • Accidents and infections can occur if acupuncture is not administered by a trained practitioner using sterile, single-use needles.
  • Contraindications to acupuncture include coagulopathy disorders, warfarin use, severe psychiatric disorders, and skin infections or trauma.
  • Serious complications following acupuncture, including infections, have been reported, but many are due to malpractice of acupuncturists.
  • Adverse events associated with acupuncture in English-language case reports are rare, but infections are the most common, caused by poor sterilization of needles.
  • Vascular injuries caused by acupuncture are rare, but cardiac tamponade is a serious complication that can be fatal.

Scientific basis

  • Acupuncture is a substantial part of traditional Chinese medicine (TCM), which is based on concepts such as a life force energy called qi and meridians.
  • Attempts to rationalize acupuncture in science are considered pseudoscience, and there is no consistent anatomical structure or function for acupuncture points or meridians.
  • TCM and its concept of disease do not strongly differentiate between the cause and effect of symptoms.

Moxibustion and cupping

  • Adverse events associated with moxibustion include bruising, burns, cellulitis, spinal epidural abscess, and superficial basal cell carcinoma.
  • Adverse events associated with cupping include keloid scarring, burns, bullae, acquired hemophilia A, stroke, factitious panniculitis, reversible cardiac hypertrophy, and iron deficiency anemia.

Children and pregnancy

  • Acupuncture on children is considered safe when administered by well-trained, licensed practitioners using sterile needles, but research on its safety is limited.
  • Acupuncture during pregnancy may cause mild and transient adverse events, but few serious adverse events have been reported.

Risk of forgoing conventional medical care

  • Unethical or na├»ve practitioners may induce patients to pursue ineffective treatment, risking financial resources and failing to diagnose a dangerous condition.A Brief History of Acupuncture

  • Acupuncture is one of the oldest practices of traditional Chinese medicine.

  • The exact origins of acupuncture are unclear, but it is believed to have begun in China around 600 BC.

  • Early acupuncture needles were much thicker than modern ones and often resulted in infection.

  • By the 4th century AD, most of the acupuncture sites in use today had been named and identified.

  • Acupuncture declined in China by the end of the Song dynasty (1279 AD) but was growing in popularity in other countries.

  • Korea is believed to be the first country in Asia to which acupuncture spread outside of China.

  • Acupuncture began to spread to Europe in the second half of the 17th century.

  • Western practitioners abandoned acupuncture's traditional beliefs and adopted a new set of ideas based on tapping needles into nerves.

  • Some modern practitioners support the use of acupuncture to treat pain but have abandoned the use of qi, meridians, yin, yang, and other mystical energies as explanatory frameworks.

  • Many acupuncturists attribute pain relief to the release of endorphins when needles penetrate, but no longer support the idea that acupuncture can affect a disease.

  • Mechanical deformation of the skin by acupuncture needles appears to result in the release of adenosine, which may mediate the anti-nociceptive effect of acupuncture.

  • Acupuncture is still controversial, and despite some evidence supporting its effectiveness in treating certain conditions, many scientists and medical professionals remain skeptical.History, Adoption, and Regulation of Acupuncture

History of Acupuncture:

  • The West created a belief system based on Travell trigger points that were believed to inhibit pain.
  • The first elaborate Western treatise on acupuncture was published in 1683 by Willem ten Rhijne.
  • The popularity of acupuncture rebounded in 1949 when Mao Zedong took power and sought to unite China behind traditional cultural values.
  • New practices were adopted in the 20th century, such as using a cluster of needles, electrified needles, or leaving needles inserted for up to a week.
  • Acupuncture research organizations such as the International Society of Acupuncture were founded in the 1940s and 1950s and acupuncture services became available in modern hospitals.
  • In 1992, the US Congress created the Office of Alternative Medicine, and in 1997, the National Institutes of Health declared support for acupuncture for some conditions.
  • Acupuncture became the most popular alternative medicine in the US.
  • Communist Party Chairman Mao Zedong, who initially believed acupuncture was superstitious, later reversed this position, arguing that the practice was based on scientific principles.
  • In 2010, UNESCO inscribed "acupuncture and moxibustion of traditional Chinese medicine" on the UNESCO Intangible Cultural Heritage List following China's nomination.

Adoption of Acupuncture:

  • Acupuncture is most heavily practiced in China and is popular in the US, Australia, and Europe.
  • In Switzerland, acupuncture has become the most frequently used alternative medicine since 2004.
  • An estimated 1 in 10 adults in Australia used acupuncture in 2004.
  • In the United Kingdom, a total of 4 million acupuncture treatments were administered in 2009.
  • Approximately half of users surveyed in Japan indicated a likelihood to seek such remedies in the future, while 37% did not.
  • By the early 2010s, more than 14 million Americans reported having used acupuncture as part of their health care.

Regulation of Acupuncture:

  • There are various government and trade association regulatory bodies for acupuncture in different countries.
  • The World Health Organization recommends that before being licensed or certified, an acupuncturist receive 200 hours of specialized training if they are a physician and 2,500 hours for non-physicians.
  • In Hong Kong, the practice of acupuncture is regulated by the Chinese Medicine Council.
  • In Canada, acupuncture licensing programs are available in some provinces, and standards set by the Chinese Medicine and Acupuncture Association of Canada are used in provinces without government regulation.
  • Licensing requirements for acupuncture vary greatly from state to state in the US.
  • In some states, acupuncture is regulated by a board of medical examiners, while in others by the board of licensing, health or education.
  • In Japan, acupuncturists are licensed by the Minister of Health, Labour and Welfare after passing an examination and graduating from a technical school or university.


Test your knowledge on the ancient practice of acupuncture with our informative quiz. Learn about the safety and scientific basis of acupuncture, as well as the history, adoption, and regulation of this traditional Chinese medicine. Challenge yourself on the contraindications and adverse events associated with acupuncture, as well as the potential benefits and controversies surrounding its use. Whether you're a seasoned acupuncture practitioner or just curious about this alternative form of medicine, our quiz will provide you with fascinating insights and valuable information.

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