Acupuncture
Injury type: Acute/ Chronic
Category: Complementary and Alternative Therapies
Rating: No Research
What is it?
Acupuncture is a treatment modality of Traditional Chinese Medicine (TCM) which dates back thousands of years in China. Acupuncture treatment involves the insertion of fine, sterile needles into specific sites (acupuncture points) along the body’s meridians (a network of invisible channels through the body), which purport to clear energy blockages and encourage the normal flow of qi or “life energy” through the individual. The practitioner may also stimulate the acupuncture points using other methods, including moxibustion, cupping, laser therapy, electro-stimulation and massage, in order to re-establish the flow of qi.
How does it work?
Animal and human studies have demonstrated that acupuncture may cause multiple biological responses. These proposed changes include influencing the nervous system, neurotransmitters and endogenous substances which respond to needling stimulation and electro-acupuncture that influence pain relief and regulation of the nervous system.From a TCM perspective, it is believed that when the person is in good health, an abundant supply of qi flows through the body’s meridians. If the flow of qi in the meridians becomes blocked or there is an inadequate supply, then the body fails to maintain harmony, balance and order, with disease or illness often following. Thus, acupuncture is thought to restore the flow of qi through the body.
Is it effective?
There have been some high quality studies exploring the effectiveness of acupuncture for neck pain in general. For example, a review of systematic reviews1 revealed moderate evidence for effectiveness in a medium size population for using acupuncture in patients sustaining neck pain. More recently, nine fair- to poor-quality trials evaluating acupuncture for chronic neck pain were included in a systematic review2. Collectively, acupuncture was associated with small improvements in short- and intermediate-term functions, when compared to sham, placebo or usual care. However, there were no differences in short-, intermediate- or long-term pain, compared to sham or placebo interventions.
In contrast, recent studies investigating the effectiveness of acupuncture for whiplash appear to be scarce. A recent narrative review3 identified a single primary research study examining the effect of acupuncture for chronic whiplash. Although this primary study concluded that acupuncture is effective in alleviating pain, the authors of the review noted a short treatment duration and a lack of additional follow-up at post intervention. Another updated systematic review4 identified little new research evidence on the effectiveness of acupuncture for grades I-II whiplash. Based on the pre-existing evidence and this update, the review concluded that needle electroacupuncture is ‘likely not helpful/ not worth considering’ for recent or persistent whiplash; whereas for acupuncture in general, the review stated ‘not enough or inconsistent evidence to make determination’ about its utilisation. Similarly, a rapid review5 synthesising evidence from highest level of primary studies, systematic reviews, and well-conducted clinical practice guidelines reported that acupuncture is not recommended for the initial management of whiplash across multiple guidelines. Another systematic review of existing whiplash related clinical practice guidelines6 identified several guidelines addressing recommendations associated with acupuncture. In particular, while two guidelines found no evidence to support or refute its use, one guideline recommended for consideration in all grades of whiplash.
Are there any disadvantages?
Serious adverse reactions to acupuncture treatment are rare. Infrequent minor side effects may include bruising or some discomfort around the site of needling. Acupuncture is safe in the hands of a competent practitioner.
Where do you get it?
Acupuncture should be provided only by an Acupuncturist belonging to a professional association. Acupuncturists can be found listed by their professional association in the Yellow Pages.
Recommendations
The use of acupuncture following whiplash cannot be recommended because of a lack of current research evidence. More research is required.