Acupuncture & Chinese Herbal Medicine

Ngaio Richard - AccupunctureAcupuncture is a part of Traditional Chinese Medicine (TCM), which originated in China over 2000 years ago. This science and art of healing has become widely accepted over the past three decades. It has now been established as a profession in Australia and has proved to be safe and effective.

Today both Acupuncture & Chinese Herbal Medicine are regulated by the Chinese Medicine Board of Australia which in partnership with AHPRA (Australian Health Practitioner Regulation Agency), the same body which oversees nurses, dentists & other allied health professions, works to protect the public and guide the profession.

TCM; simplified Chinese: 中医; traditional Chinese: 中醫; pinyin: zhōng yī; (literally “Chinese medicine”) is a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage (Tui na), exercise (qigong), and dietary therapy.[Wikipedia]

Chinese Herbs have been used for centuries. Plant/botanical elements  are by far the most common ingredients. Typically a formula is prepared as a decoction containing 4-18 substances. Some of these are considered as main herbs, others as ancillary. Other ingredients may be added in order to cancel out any toxicity or side effects of the main herbs.

In this practice, you may be prescribed your Chinese herbs in one of the following formats:

  • Patent medicine – a standardized herbal formula in the form of hard little pills. These are easy and convenient to administer & the most affordable type of medicines on the market. Great for mild illnesses.
  • Herbal extracts (granulated or powdered; may be in capsule form or loose) –  formulas constructed from herbal extracts are usually tailor-designed for you as an individual. Each formula contains single ingredients put together much like you would prepare a home-cooked meal using a recipe from a recipe book. Only in this case your herbalist (Ngaio) is writing the recipe just for you according to your current health needs. Your formula is then built according to this recipe (actually we call it a prescription).

How Is The Diagnosis Made?

Traditional Chinese Medicine (TCM) recognizes diagnosis of disease as being very specific to the individual.

Acupuncturists treat* patients instead of combating a disease, a symptom or a diagnosis.

Ngaio is a practitioner of Chinese medicine and apart from taking a thorough medical history from each patient, may use methods such as tongue, pulse or abdominal diagnosis to elicit important diagnostic information.

She may take western medical test results/diagnosis into account, however western medical test results are not a vital component of our diagnosis. At the end of the day our patients receive treatment based on their Chinese medical diagnosis. Chinese medicine teaches us to treat ‘the root’, not just ‘the branch’ – to target the source of the imbalance.

This means that she does not treat*, for example: ‘fertility or infertility’ – which would be like treating symptomatically. Likewise, nor does Chinese medicine treat dis-ease states such as, for example: anovulation, endometriosis, PCOS or amenorrhoea.

A practitioner may however, diagnose a woman who perhaps has a history of difficulty conceiving, or a diagnosis of eg; PCOS with a ‘Kidney Yang Deficiency’, and treat* her accordingly. In terms of Chinese medicine her difficulty conceiving may be regarded to be a result of her Kidney Yang Deficiency – which in this case would be the ‘root’ of her imbalance. She treats* the Deficiency, the Kidney Yang Deficiency. This is just an example – not to say that every woman who has difficulty conceiving has a Kidney Yang Deficiency, this is why individualised diagnosis and treatment is so vital in Chinese medicine.

Ngaio treats the patient – not ‘a disease’.

What she does is treat* the ground underlying your health imbalances. Much like the way your mechanic adjusts and tunes-up your car to keep you safe on the road, acupuncturists ‘tweak’ meridians so as to assist your body running smoothly. Another great Australian analogy is how we might bring in an excavator to dig out your dams and creeks which have become clogged – your acupuncturist/Chinese herbalist ‘works the excavator’, digging and re-shaping the lay of the land, and et voila! Your dam can now hold an abundance of deep clear water and your creeks are running freely, blockages are cleared, somehow health begins to flourish as a result of the natural forces unleashed, your ecosystem has been restored.

We treat the root, not just the branch. By treating the root of an imbalance, symptoms begin to change and dissipate.

The system of meridians Ngaio is trained to work with may be likened to the flow of water all the way from the mountain spring to the streams, to the creeks, onto the rivers and finally to the sea. This description may sound obscure or poetic to you. It is hard to translate the language of eastern medicines to the western mindset. The language may sound whimsical, but the actual experience of receiving treatment can be compelling.

(*see Definition of Terms)

 

How Long Does An Acupuncture Treatment Take?

Needles usually stay in between 20 to 35 minutes (less so for children). We need a little time prior to catch up on your progress since your last treatment, or to run through your initial consultation.

People are usually pleasantly relaxed after acupuncture and it is good if you do not have to ‘spring back into action’ immediately afterward, nor do involved mental work.

All in all, you should put aside a good hour for your treatment, plus a little time after you leave here to ‘come down’  – maybe another 1/2 hour.

 

What To Expect From Acupuncture?

Most people experiencing acupuncture for the very first time are pleasantly surprised to discover how relaxing the treatment is. All you really have to do is relax. No need to ‘do’ anything else. Some people float off to sleep, some dream vividly or see colours, some feel creatively stimulated, some don’t feel much at all, some experience strong emotions. It’s different each time.

While it may take a number of treatments before you see results in terms of any symptoms you brought in to have treated, most people feel relaxed from the first treatment. For some patients this may last several hours and sometimes even several days.

Most people experiencing acupuncture treatment for the first time are surprised to discover how relaxing it is and may report that they have a ‘greater sense of well-being’. Some of our clients feel the need to rest for a while after their treatment, while others may experience high energy. Both of these responses are common – your body is adjusting to treatment. Try to give yourself permission to listen to your body, this will help assist positive treatment outcomes.

As your treatment plan progresses and your treatments have gained momentum you should start to notice positive changes such as for example, a reduction in the severity/frequency of your symptoms, a greater sense of ‘well-being’, improved sleep/appetite/digestion, less anxiety, to name just a few.

If you are receiving treatment for women’s health you should be noticing positive changes as your treatment progresses, for example: your periods may become more regular, less painful, etc as your treatments progress.

This kind of treatment is an exercise in self-awareness, you are encouraged to pay more attention to your body and let us know what changes you are experiencing.

You may feel you need to rest the day after your treatment, while on the other hand you may experience high energy. Both these responses are normal and demonstrate that your body is falling back into balance. Go with these feelings and allow yourself to rest if you feel the need and try not to over-exert yourself if you feel exuberant!

 

What Are The Benefits Of Acupuncture?

Acupuncture is a form of natural healing which has the following major benefits:

  • Acupuncture treatment and also Chinese herbal medicine, are both integral aspects of Chinese medicine practice which offer a gentle way to bring ease to your mind and body.
  • This science and art of natural healing originated in ancient China, and has evolved over more than 2,000 years and continues to evolve.
  • Acupuncture treatment offers a holistic approach to illness, linking the body, mind and emotions.
  • Acupuncture treatment and Chinese herbs may be used on their own or can complement other treatments that you may be having.
  • In the Cochrane Central Register of Controlled Trials there are now more than 12,000 clinical trials of acupuncture listed, and around 2,000 new studies are being added every year. New research is ongoing in many parts of the world, the field is alive with activity and progress.
  • Acupuncture is considered safe in the hands of a well-trained practitioner and may help patients to manage a range of symptoms including pain, stress and fatigue, for example. It has been found to be cost effective for some conditions.
  • Assists prevention against disease

 

So What Conditions Can Acupuncture Assist? 

I have added this section because regardless of the original reason a patient comes to see me, nearly every woman / her partner / family member / friend experiences some kind of ‘general’ health issue, be it headaches or indigestion or a pulled muscle, etc.

In this era of ‘evidence based medicine’ the ancient fields of acupuncture and herbal medicine too are being forced to produce proof of efficacy. However there is an inherent incompatibility between the design of a randomised clinical trial and that of a traditionally based acupuncture/herbal medicine prescription which requires individualised tailoring to be effective. Traditionally trained acupuncture practitioners reason that clinical practice is more effective when allowed to maintain its integrity without being forced to conform to modern scientific methodologies.

So there is a conflict between these two paradigms that so far appears to be mostly irreconcilable. As you can imagine, this affects what is researched, how it is researched and also the results of that research.

Some researchers are working on finding a balance between these two opposites. Stay tuned! Meanwhile, read on..

I know that not everyone is interested in reading technical research. So below there is a short list and each heading includes a brief. If you want to read more of the technical stuff please just scroll down to the bottom of the page – it’s all there if you want to read it.

It is no longer possible to say that the effectiveness of acupuncture is because of the placebo effect, or that it is useful only for musculoskeletal pain.

The conditions listed below are from the body of current research evidence using human subjects and based on National Health and Medical Research Council Level 1 evidence (systematic reviews), also a small number of good quality Level 2 studies (these are randomised controlled trials). All these studies are less than 5 years old.

Acute pain

Acupuncture has been shown to be effective in relieving various types of acute pain, including studies where acupuncture was delivered in hospital Emergency Departments.

Allergic rhinitis (Hayfever)

Acupuncture has been shown to be effective in relieving signs and symptoms such as runny nose, sneezing, blocked nose, itchy nose & eyes plus unrefreshed sleep. Acupuncture is recommended as a treatment option for allergic rhinitis in the clinical practice guidelines of the Otolaryngology Head Neck Surgery Foundation in USA.

Anxiety

Acupuncture and acupressure have been shown to relieve anxiety in several contexts, including pre-surgical anxiety, student examination anxiety, anxiety during embryo transfer in IVF and anxiety during pregnancy.

Asthma in adults

Acupuncture and acupoint application in adults have been shown to be effective in improving peak flows, symptoms and quality of life in mild to moderate asthma, but evidence for the effectiveness of acupuncture for asthma in children is so far unclear.

Back or pelvic pain during pregnancy

Acupuncture has been shown to be effective in relieving low back pain and pelvic pain during pregnancy.

Cancer pain

Acupuncture has been shown to be effective in relieving various types of chronic pain including cancer-related pain.

Chemotherapy-induced nausea and vomiting

Acupuncture has been shown to reduce the frequency of chemotherapy-induced acute vomiting and also the use of rescue medication. Acupressure has been shown to decrease the frequency of nausea.

Chronic pain

Acupuncture has been shown to be effective in relieving various types of chronic pain.

Chronic prostatitis/pelvic pain syndrome

Acupuncture has been shown to be effective for relieving chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and may be comparable to usual care.

Carpal Tunnel Syndrome pain

Acupuncture has been shown to be effective in relieving carpal tunnel syndrome pain.

Dysmenorrhoea (period pain)

Acupuncture and moxibustion have been shown to relieve pain and improve some aspects of quality of life for women with dysmenorrhoea.

Elbow pain

Acupuncture has been shown to be effective in relieving lateral elbow pain (tennis elbow).

Functional Dyspepsia (commonly called Indigestion)

Acupuncture has been shown to be effective in relieving symptoms of functional dyspepsia.

Insomnia

Acupuncture has been shown to be effective in improving sleep quality and quality of life in primary insomnia, also in various types of secondary insomnia including menopausal, post-stroke, depression-related and cancer-related insomnia.

Irritable bowel syndrome

Acupuncture has been shown to be effective for irritable bowel syndrome. It is believed that this may be mediated by reduction of the pro-inflammatory neuropeptides substance P (SP) and vaso-active intestinal peptide (VIP).

Low back pain

Acupuncture has been shown to be effective in relieving both chronic and low back pain and has been given a strong recommendation for both in the clinical practice guidelines of the American College of Physicians.

Headache (tension-type and chronic)

Acupuncture has been shown to be effective in relieving and preventing tension-type and chronic headache.

Knee osteoarthritis pain

Acupuncture has been shown to be effective in relieving knee osteoarthritis pain and compares favourably (in a network meta-analysis) with other physical therapies.

Menopausal hot flushes & insomnia

Acupuncture has been shown to improve quality of life and symptoms such as hot flushes and insomnia in menopausal women.

Migraine prophylaxis

Acupuncture has been shown to be effective in both preventing and relieving migraine.

Neck pain

Acupuncture has been shown itself to be effective in relieving neck pain.

Perimenopausal & postmenopausal insomnia

Acupuncture has been shown to be effective in improving sleep quality in various types of primary & secondary insomnia including menopausal, peri-menopausal and post-menopausal.

Post-operative nausea & vomiting

Acupuncture and acupressure are effective in relieving post-operative nausea and vomiting (used alone or in combination with state-of-the-art antiemetics).

Post-operative pain

Acupuncture has been shown to be effective in relieving some types of post-operative pain.

Post-stroke insomnia

Acupuncture has been shown to be effective in improving sleep quality and quality of life in primary insomnia, as well in various types of secondary insomnia including post-stroke.

Post-stroke shoulder pain

Acupuncture has been shown to be effective in relieving shoulder pain including post-stroke shoulder pain.

Sciatica

Acupuncture has been shown to be effective in relieving sciatic pain and it compares favourably (in a network meta-analysis) with many other therapies.

Shoulder pain

Acupuncture has been shown to be effective in relieving shoulder pain.

 

REFERENCES

Acute pain

Cohen, M. M., Smit, De Villiers, Adrianopoulos, Nick, Ben-Meir, Ben, Taylor, David McD, Parker, Shefton J, Xue, Charlie C, Cameron, Peter A (2017). Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Medical Journal of Australia, 206(11), 494-499. doi:10.5694/mja16.00771

Grissa, M. H., Baccouche, H., Boubaker, H., Beltaief, K., Bzeouich, N., Fredj, N., . . . Nouira, S. (2016). Acupuncture vs intravenous morphine in the management of acute pain in the ED. Am J Emerg Med, 34(11), 2112-2116. doi:10.1016/j.ajem.2016.07.028

Schug, S. A., Palmer, G. M., Scott, D. A., Halliwell, R., & Trinca, J. (2016). Acute pain management: scientific evidence, fourth edition, 2015. Med J Aust, 204(8), 315-317.

Allergic rhinitis (Hayfever)

Xue, C. C., Zhang, A. L., Zhang, C. S., DaCosta, C., Story, D. F., & Thien, F. C. (2015). Acupuncture for seasonal allergic rhinitis: a randomized controlled trial. Ann Allergy Asthma Immunol, 115(4), 317-324.e311. doi:10.1016/j.anai.2015.05.017

McDonald JL, Smith PK, Smith CA, Changli Xue C, Golianu B, Cripps AW. Effect of acupuncture on house dust mite specific IgE, substance P, and symptoms in persistent allergic rhinitis. Ann Allergy Asthma Immunol. 2016 Jun;116(6):497-505.

Choi, S. M., Park, J. E., Li, S. S., Jung, H., Zi, M., Kim, T. H., . . . Baoyan, L. (2013). A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy, 68(3), 365-374.

Feng, SY; Han, MM; Fan, YP; Yang, GW; Liao, ZP; Liao, W; Li, HB. Acupuncture for the treatment of allergic rhinitis: A systematic review and meta-analysis. American Journal of Rhinology & Allergy, Volume 29, Number 1, January/February 2015, pp. 57-62(6)

Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R., . . . Nnacheta, L. C. (2015). Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg, 152(1 Suppl), S1-43. doi:10.1177/0194599814561600

Taw MB, Reddy WD, Omole FS, Seidman MD. Acupuncture and allergic rhinitis. Curr Opin Otolaryngol Head Neck Surg. 2015 Jun;23(3):216-20.

Anxiety

Au, D. W., Tsang, H. W., Ling, P. P., Leung, C. H., Ip, P. K., & Cheung, W. M. (2015). Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupunct Med, 33(5), 353-359. doi:10.1136/acupmed-2014-010720

Amorim, D., Amado, J., Brito, I., Fiuza, S. M., Amorim, N., Costeira, C., & Machado, J. (2018). Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complement Ther Clin Pract, 31, 31-37. doi:10.1016/j.ctcp.2018.01.008

Bazzan, A. J., Zabrecky, G., Monti, D. A., & Newberg, A. B. (2014). Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine. Expert Rev Neurother, 14(4), 411-423. doi:10.1586/14737175.2014.892420

Fleckenstein, J., Kruger, P., & Ittner, K. P. (2018). Effects of single-point acupuncture (HT7) in the prevention of test anxiety: Results of a RCT. PLoS One, 13(8), e0202659. doi:10.1371/journal.pone.0202659

Goyata, S. L., Avelino, C. C., Santos, S. V., Souza Junior, D. I., Gurgel, M. D., & Terra, F. S. (2016). Effects from acupuncture in treating anxiety: integrative review. Rev Bras Enferm, 69(3), 602-609. doi:10.1590/0034-7167.2016690325i

Kwon, C. Y., & Lee, B. (2018). Acupuncture or Acupressure on Yintang (EX-HN 3) for Anxiety: A Preliminary Review. Med Acupunct, 30(2), 73-79. doi:10.1089/acu.2017.1268

Smith, C. A., de Lacey, S., Chapman, M., Ratcliffe, J., Norman, R. J., Johnson, N. P., & Fahey, P. (2018). The effects of acupuncture on the secondary outcomes of anxiety, and quality of life for women undergoing IVF: a randomised controlled trial. Acta Obstet Gynecol Scand. doi:10.1111/aogs.13528

Smith, C. A., Shewamene, Z., Galbally, M., Schmied, V., & Dahlen, H. (2018). The effect of complementary medicines and therapies on maternal anxiety and depression in pregnancy: A systematic review and meta-analysis. J Affect Disord, 245, 428-439. doi:10.1016/j.jad.2018.11.054

Asthma in adults

Liu, C. F., & Chien, L. W. (2015). Efficacy of acupuncture in children with asthma: a systematic review. Ital J Pediatr, 41, 48. doi:10.1186/s13052-015-0155-1

Pai, H. J., Azevedo, R. S., Braga, A. L., Martins, L. C., Saraiva-Romanholo, B. M., Martins Mde, A., & Lin, C. A. (2015). A randomized, controlled, crossover study in patients with mild and moderate asthma undergoing treatment with traditional Chinese acupuncture. Clinics (Sao Paulo), 70(10), 663-669. doi:10.6061/clinics/2015(10)01

Su, L., Meng, L., Chen, R., Wu, W., Peng, B., & Man, L. (2016). Acupoint Application for Asthma Therapy in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Forsch Komplementmed, 23(1), 16-21. doi:10.1159/000443813

Back or pelvic pain during pregnancy

Close, C., Sinclair, M., Liddle, S. D., Madden, E., McCullough, J. E., & Hughes, C. (2014). A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy. J Adv Nurs, 70(8), 1702-1716. doi:10.1111/jan.12360

Martins, E. S., Tavares, T., Lessa, P. R. A., Aquino, P. S., Castro, R., & Pinheiro, A. K. B. (2018). Acupuncture treatment: multidimensional assessment of low back pain in pregnant women. Rev Esc Enferm USP, 52, e03323. doi:10.1590/s1980-220×2017040303323

Soliday, E., & Betts, D. (2018). Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. J Acupunct Meridian Stud, 11(1), 25-30. doi:10.1016/j.jams.2017.11.005

Cancer pain

Chiu, H. Y., Hsieh, Y. J., & Tsai, P. S. (2017). Systematic review and meta-analysis of acupuncture to reduce cancer-related pain. Eur J Cancer Care (Engl), 26(2). doi:10.1111/ecc.12457

Carpal Tunnel Syndrome pain

Hadianfard, M., Bazrafshan, E., Momeninejad, H., & Jahani, N. (2015). Efficacies of Acupuncture and Anti-inflammatory Treatment for Carpal Tunnel Syndrome. J Acupunct Meridian Stud, 8(5), 229-235. doi:10.1016/j.jams.2014.11.005

Chemotherapy-induced nausea and vomiting

Molassiotis, A., Russell, W., Hughes, J., Breckons, M., Lloyd-Williams, M., Richardson, J., . . . Ryder, W. (2013). The effectiveness and cost-effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: Assessment of Nausea in Chemotherapy Research (ANCHoR), a randomised controlled trial. Health Technol Assess, 17(26), 1-114. doi:10.3310/hta17260

Garcia MK, McQuade J, Lee R, Haddad R, Spano M, Cohen L. Acupuncture for symptom management in cancer care: an update. Curr Oncol Rep. 2014 Dec;16(12):418.

McKeon C, Smith, C.A., Hardy, J. & Chang, E. Acupunctrue and acupressure for chemotherapy-induced nausea and vomiting : a systematic review. Australian Journal of Acupuncture and Chinese Medicine. 2013;8(1):2-17.

Chronic pain

Chiu, H. Y., Hsieh, Y. J., & Tsai, P. S. (2017). Systematic review and meta-analysis of acupuncture to reduce cancer-related pain. Eur J Cancer Care (Engl), 26(2). doi:10.1111/ecc.12457

MacPherson, H., Vertosick, E. A., Foster, N. E., Lewith, G., Linde, K., Sherman, K. J., . . . Vickers, A. J. (2016). The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain. Pain. doi:10.1097/j.pain.0000000000000747

MacPherson, H., Vertosick, E., Lewith, G., Linde, K., Sherman, K. J., Witt, C. M., & Vickers, A. J. (2014). Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One, 9(4), e93739. doi:10.1371/journal.pone.0093739

MacPherson, H., Vickers, A., Bland, M., Torgerson, D., Corbett, M., Spackman, E., . . . Watt, I. (2017). Programme Grants for Applied Research Acupuncture for chronic pain and depression in primary care: a programme of research. Southampton (UK): NIHR Journals Library

Scottish Incollegiate Guidelines Network (SIGN). Management of Chronic Pain (SIGN publication no. 136). Scottish Incollegiate Guidelines Network (SIGN); 2013.

Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., . Linde, K. (2017). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. doi:10.1016/j.jpain.2017.11.005

Chronic prostatitis/pelvic pain syndrome

Chang SC, Hsu CH, Hsu CK, Yang SS, Chang SJ. The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: A systemic review and meta-analysis. Neurourol Urodyn. 2016 Jan 6.

Qin Z, Wu J, Zhou J, Liu Z. Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Medicine (Baltimore). 2016 Mar;95(11):e3095.

Dysmenorrhoea (period pain)

Abaraogu, U. O., & Tabansi-Ochuogu, C. S. (2015). As Acupressure Decreases Pain, Acupuncture May Improve Some Aspects of Quality of Life for Women with Primary Dysmenorrhea: A Systematic Review with Meta-Analysis. J Acupunct Meridian Stud, 8(5), 220-228.

Smith CA, Armour M, Zhu X, Li X, Lu ZY, Song J. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev. 2016;4:Cd007854.

Xu, T., Hui, L., Juan, Y. L., Min, S. G., & Hua, W. T. (2014). Effects of moxibustion or acupoint therapy for the treatment of primary dysmenorrhea: a meta-analysis. Altern Ther Health Med, 20(4), 33-42.

Elbow pain

Gadau, M., Yeung, W. F., Liu, H., Zaslawski, C., Tan, Y. S., Wang, F. C., . . . Zhang, S. P. (2014). Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials. BMC Complement Altern Med, 14, 136. doi:10.1186/1472-6882-14-136

Functional Dyspepsia (commonly called Indigestion)

Kim KN, Chung SY, Cho SH. Efficacy of acupuncture treatment for functional dyspepsia: A systematic review and meta-analysis. Complement Ther Med. 2015 Dec;23(6):759-66.

Lan L, Zeng F, Liu GJ, Ying L, Wu X, Liu M, et al. Acupuncture for functional dyspepsia. Cochrane Database Syst Rev. 2014(10):Cd008487.

Insomnia

Chiu, H. Y., Hsieh, Y. J., & Tsai, P. S. (2016). Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstet Gynecol, 127(3), 507-515. doi:10.1097/aog.0000000000001268

Choi, T. Y., Kim, J. I., Lim, H. J., & Lee, M. S. (2016). Acupuncture for Managing Cancer-Related Insomnia: A Systematic Review of Randomized Clinical Trials. Integr Cancer Ther. doi:10.1177/1534735416664172

Dong, B., Chen, Z., Yin, X., Li, D., Ma, J., Yin, P., … Xu, S. (2017). The Efficacy of Acupuncture for Treating Depression-Related Insomnia Compared with a Control Group: A Systematic Review and Meta-Analysis. BioMed Research International, 2017, 9614810.

Lan, Y., Wu, X., Tan, H. J., Wu, N., Xing, J. J., Wu, F. S., . . . Liang, F. R. (2015). Auricular acupuncture with seed or pellet attachments for primary insomnia: a systematic review and meta-analysis. BMC Complement Altern Med, 15, 103. doi:10.1186/s12906-015-0606-7

Lee, S. H., & Lim, S. M. (2016). Acupuncture for insomnia after stroke: a systematic review and meta-analysis. BMC Complement Altern Med, 16, 228. doi:10.1186/s12906-016-1220-z

Shergis, J. L., Ni, X., Jackson, M. L., Zhang, A. L., Guo, X., Li, Y., . . . Xue, C. C. (2016). A systematic review of acupuncture for sleep quality in people with insomnia. Complement Ther Med, 26, 11-20. doi:10.1016/j.ctim.2016.02.007

Irritable bowel syndrome

Lu, Z. Z., Yin, X.J., Teng, W.J., Chen, Y.H., Sun. J., Zhao, J.M., Wang, A.Q.Bao C.H. & Shi, Y. (2015). Comparative effect of EA and moxibustion on the expression of SP and VIP in patients with IBS. Journal of Traditional Chinese Medicine, 35(4), 402-410.

MacPherson, H., Tilbrook, H., Agbedjro, D., Buckley, H., Hewitt, C., & Frost, C. (2016). Acupuncture for irritable bowel syndrome: 2-year follow-up of a randomised controlled trial. Acupunct Med. doi:10.1136/acupmed-2015-010854

Low back pain

Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. AHRQ Comparative Effectiveness Reviews. Noninvasive Treatments for Low Back Pain. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016.

Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med, 166(7), 514-530. doi:10.7326/m16-2367

Wellington J. Noninvasive and alternative management of chronic low back pain (efficacy and outcomes). Neuromodulation. 2014 Oct;17 Suppl 2:24-30.

Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2124-38.

Taylor, P., Pezzullo, L., Grant, S. J., & Bensoussan, A. (2014). Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain. Pain Pract, 14(7), 599-606. doi:10.1111/papr.12116

Liu L, Skinner M, McDonough S, Mabire L, Baxter GD. Acupuncture for low back pain: an overview of systematic reviews. Evid Based Complement Alternat Med. 2015;2015:328196.

Headache (tension-type and chronic)

Coeytaux RR, Befus D. Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache. 2016 Jul;56(7):1238-40.

Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;4:Cd007587

Knee osteoarthritis pain

Manyanga T, Froese M, Zarychanski R, Abou-Setta A, Friesen C, Tennenhouse M, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014;14:312.

Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis Cartilage. 2013 Sep;21(9):1290-8.

Menopausal hot flushes & insomnia

Chiu, H. Y., Hsieh, Y. J., & Tsai, P. S. (2016). Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstet Gynecol, 127(3), 507-515. doi:10.1097/aog.0000000000001268

Chiu HY, Pan CH, Shyu YK, Han BC, Tsai PS. Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause. 2015 Feb;22(2):234-44.

Dodin S, Blanchet C, Marc I, Ernst E, Wu T, Vaillancourt C, et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst Rev. 2013(7):Cd007410

Migraine prophylaxis

Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016(6):Cd001218

Yang Y, Que Q, Ye X, Zheng G. Verum versus sham manual acupuncture for migraine: a systematic review of randomised controlled trials. Acupunct Med. 2016 Apr;34(2):76-83.

Neck pain

MacPherson, H., Tilbrook, H., Richmond, S., Woodman, J., Ballard, K., Atkin, K., . . . Watt, I. (2015). Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial. Ann Intern Med, 163(9), 653-662. doi:10.7326/m15-0667

Trinh K, Graham N, Irnich D, Cameron ID, Forget M. Acupuncture for neck disorders. Cochrane Database Syst Rev. 2016(5):Cd004870.

Perimenopausal & postmenopausal insomnia

Chiu, H. Y., Hsieh, Y. J., & Tsai, P. S. (2016). Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstet Gynecol, 127(3), 507-515. doi:10.1097/aog.0000000000001268

Chiu HY, Pan CH, Shyu YK, Han BC, Tsai PS. Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause. 2015 Feb;22(2):234-44.

Post-operative nausea & vomiting

Gan, T. J., Diemunsch, P., Habib, A. S., Kovac, A., Kranke, P., Meyer, T. A., . . . Tramer, M. R. (2014). Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 118(1), 85-113. doi:10.1213/ane.0000000000000002

Lee, A., Chan, S. K., & Fan, L. T. (2015). Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev(11), Cd003281. doi:10.1002/14651858.CD003281.pub4

Nilsson, I., Karlsson, A., Lindgren, L., Bergenheim, T., Koskinen, L. O., & Nilsson, U. (2015). The efficacy of P6 acupressure with sea-band in reducing postoperative nausea and vomiting in patients undergoing craniotomy: a randomized, double-blinded, placebo-controlled study. J Neurosurg Anesthesiol, 27(1), 42-50. doi:10.1097/ana.0000000000000089

Shin, H. C., Kim, J. S., Lee, S. K., Kwon, S. H., Kim, M. S., Lee, E. J., & Yoon, Y. J. (2016). The effect of acupuncture on postoperative nausea and vomiting after pediatric tonsillectomy: A meta-analysis and systematic review. Laryngoscope, 126(8), 1761-1767. doi:10.1002/lary.25883

Post-operative pain

Barlow T, Downham C, Barlow D. The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review. Complement Ther Med. 2013 Oct;21(5):529-34

Fransen M, Nairn L, Bridgett L, Crosbie J, March L, Parker Mbbs D, et al. Post-acute rehabilitation after total knee replacement: A multicentre randomized clinical trial comparing long-term outcomes. Arthritis Care Res (Hoboken). 2016 Nov 21.

Wu MS, Chen KH, Chen IF, Huang SK, Tzeng PC, Yeh ML, et al. The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis. PLOS ONE. 2016;11(3):e0150367.

Post-stroke insomnia

Lee, S. H., & Lim, S. M. (2016). Acupuncture for insomnia after stroke: a systematic review and meta-analysis. BMC Complement Altern Med, 16, 228. doi:10.1186/s12906-016-1220-z

Post-stroke shoulder pain

Lee, S. H., & Lim, S. M. (2016). Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2016, 3549878. doi:10.1155/2016/3549878

Sciatica

Ji, M., Wang, X., Chen, M., Shen, Y., Zhang, X., & Yang, J. (2015). The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2015, 192808. doi:10.1155/2015/192808

Lewis, R. A., Williams, N. H., Sutton, A. J., Burton, K., Din, N. U., Matar, H. E., . . . Wilkinson, C. (2015). Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. Spine J, 15(6), 1461-1477. doi:10.1016/j.spinee.2013.08.049

Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2015, 425108. doi:10.1155/2015/425108

Shoulder pain

Lee, S. H., & Lim, S. M. (2016). Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2016, 3549878. doi:10.1155/2016/3549878

Wang, K. F., Zhang, L. J., Lu, F., Lu, Y. H., & Yang, C. H. (2016). Can Ashi points stimulation have specific effects on shoulder pain? A systematic review of randomized controlled trials. Chin J Integr Med, 22(6), 467-472. doi:10.1007/s11655-015-2107-4