The efficacy, safety and training of acupuncture

Randomised controlled trials have demonstrated that acupuncture is more effective than sham acupuncture (or other experimental control interventions) for nausea and vomiting, back pain, dental pain and migraine. For other conditions, the evidence is uncertain. In terms of safety, few major adverse reactions to acupuncture treatment are reported in comparison to adverse reactions to orthodox interventions. For example, non-steroidal antiinflammatory drugs (NSAIDs) prescribed for back pain and arthritis have been estimated to cause one death in every 1,200 patients who take them orally for atleast 2 months. Extrapolated to an annual estimate, approximately 2,000 deaths occur in the UK which would not otherwise have taken place had the patients not taken the NSAIDs (Tramer et al., 2000).

Opportunities for training in acupuncture, both for medically qualified and non-medically qualified individuals, have increased in recent years. The advent of validated degree courses and the emergence of CAM (elective) modules in the medical curriculum are evidence of greater acceptance, where previously attitudes may have been radically different. All acupuncture courses (eg undergraduate courses, weekend courses) should contain basic anatomy and physiology modules, with particular emphasis on the location and depth of major organs, and first aid skills.