Integrative Medicine

  • Peter I-Kung WuEmail author
  • Lucy Chen


Integrative medicine combines conventional medicine with select practices from complementary and alternative medicine (CAM), for which there is growing high-quality, scientific evidence for their safety and efficacy to manage numerous medical conditions, including acute and chronic pain. Chronic pain is a leading indication for the use of CAM, which offers a multimodal approach to treat the multifaceted nature of pain with minimal complications. Among various CAMs, acupuncture has been the most studied, with clinical evidence from randomized, controlled trials (RCTs) demonstrating its benefit for conditions that most commonly lead patients to present to a Pain Clinic, including low back pain, neck and shoulder pain, headache, and a variety of other chronic pain disorders. The mechanisms of action of acupuncture remain incompletely understood; however, studies continue to elucidate its physiologic effects as well as evaluate its effectiveness for managing painful clinical conditions. With their utility for managing pain with minimal adverse effects compared to pharmacologic therapy, CAMs such as acupuncture provide a powerful tool to address the current overuse and abuse of opioid medications.


Integrative Medicine Complementary Alternative Traditional Chinese Medicine Acupuncture Pain Opioid Spine Auricular Trigger point 


  1. 1.
    Integrative medicine defined [Internet]. Tampa: American Board of Physician Specialties; c2018 [cited 2018 March 1]. Available from:
  2. 2.
    Creating a new generation of doctors [Internet]. Tampa: American Board of Physician Specialties; c2018 [cited 2018 March 1]. Available from:
  3. 3.
    What is CAM? [Internet]. Bethesda: National Center for Complementary and Alternative Medicine; c2009 [cited 2018 March 1]. Available from:
  4. 4.
    Nahin RL, Barnes PM, Stussman BJ, Bloom B. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Rep. 2009;18:1–14.Google Scholar
  5. 5.
    NIH complementary and integrative health agency gets new name [Internet]. Bethesda: National Center for Complementary and Integrative Health (NCCIH); c2014 [cited 2018 March 1]. Available from:
  6. 6.
    Loudon I. A brief history of homeopathy. J R Soc Med. 2006;99(12):607–10.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–68.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Wu PI, Meleger A, Witkower A, Mondale T, Borg-Stein J. Nonpharmacologic options for treating acute and chronic pain. PM R. 2015;7(11 Suppl):S278–94.PubMedGoogle Scholar
  9. 9.
    Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA. 1998;280(18):1569–75.PubMedGoogle Scholar
  10. 10.
    Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002–2012. Natl Health Stat Report. 2015;(79):1–16.Google Scholar
  11. 11.
    Astin JA. Why patients use alternative medicine: results of a national study. JAMA. 1998;279(19):1548–53.PubMedGoogle Scholar
  12. 12.
    Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. Adv Data. 2004;(343):1–19.Google Scholar
  13. 13.
    Wolsko PM, Eisenberg DM, Davis RB, Kessler R, Phillips RS. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine (Phila Pa 1976). 2003;28(3):292–7; discussion 298.Google Scholar
  14. 14.
    Chen L, Michalsen A. Management of chronic pain using complementary and integrative medicine. BMJ. 2017;357:j1284.PubMedGoogle Scholar
  15. 15.
    Acupuncture Needle, 21 C.F.R. § 880.5580 (1996) [Internet]. Silver Spring: U.S. Food and Drug Administration; c1996 [cited 2018 March 10]. Available from:
  16. 16.
    NIH Consensus Conference. Acupuncture. JAMA. 1998;280(17):1518–24.Google Scholar
  17. 17.
    Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478–91.Google Scholar
  18. 18.
    FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain (May 2017) [Internet]. Silver Spring: U.S. Food and Drug Administration; c2017 [cited 2018 March 10]. Available from:
  19. 19.
    FDA’s Opioid Analgesic REMS Education Blueprint for Health Care Providers Involved in the Treatment and Monitoring of Patients with Pain [Internet]. Silver Spring: U.S. Food and Drug Administration; c2018 [cited 2018 March 10]. Available from:
  20. 20.
    Chon TY, Lee MC. Acupuncture. Mayo Clin Proc. 2013;88(10):1141–6.PubMedGoogle Scholar
  21. 21.
    Berman BM, Langevin HM, Witt CM, Dubner R. Acupuncture for chronic low back pain. N Engl J Med. 2010;363(5):454–61.PubMedGoogle Scholar
  22. 22.
    Reston J. Now, about my operation in Peking; now, let me tell you about my appendectomy in Peking. New York Times. 1971 July 26. p. 1.Google Scholar
  23. 23.
    Ernst E. Acupuncture. Lancet Oncol. 2010;11(1):20.PubMedGoogle Scholar
  24. 24.
    Chen L. Acupuncture and complementary integrative approaches in pain management. In: Cheng J, Rosenquist RW, editors. Fundamentals of pain medicine. Cham: Springer; 2018.Google Scholar
  25. 25.
    Ahn AC, Park M, Shaw JR, McManus CA, Kaptchuk TJ, Langevin HM. Electrical impedance of acupuncture meridians: the relevance of subcutaneous collagenous bands. PLoS One. 2010;5(7):e11907.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Hwang YC. Anatomy and classification of acupoints. Probl Vet Med. 1992;4(1):12–5.PubMedGoogle Scholar
  27. 27.
    Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec. 2002;269(6):257–65.PubMedGoogle Scholar
  28. 28.
    Cheng KJ. Neurobiological mechanisms of acupuncture for some common illnesses: a clinician’s perspective. J Acupunct Meridian Stud. 2014;7(3):105–14.PubMedGoogle Scholar
  29. 29.
    Zhou W, Benharash P. Effects and mechanisms of acupuncture based on the principle of meridians. J Acupunct Meridian Stud. 2014;7(4):190–3.PubMedGoogle Scholar
  30. 30.
    Pomeranz B, Paley D. Electroacupuncture hypalgesia is mediated by afferent nerve impulses: an electrophysiological study in mice. Exp Neurol. 1979;66(2):398–402.PubMedGoogle Scholar
  31. 31.
    Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–9.Google Scholar
  32. 32.
    Melzack R. Myofascial trigger points: relation to acupuncture and mechanisms of pain. Arch Phys Med Rehabil. 1981;62(3):114–7.PubMedGoogle Scholar
  33. 33.
    Zhao CH, Stillman MJ, Rozen TD. Traditional and evidence-based acupuncture in headache management: theory, mechanism, and practice. Headache. 2005;45(6):716–30.PubMedGoogle Scholar
  34. 34.
    Chiang C, Chang C, Chu H, Yang L. Peripheral afferent pathway for acupuncture analgesia. Sci Sin. 1973;16:210–7.Google Scholar
  35. 35.
    Omura Y. Connections found between each meridian (heart, stomach, triple burner, etc.) & organ representation area of corresponding internal organs in each side of the cerebral cortex; release of common neurotransmitters and hormones unique to each meridian and corresponding acupuncture point & internal organ after acupuncture, electrical stimulation, mechanical stimulation (including shiatsu), soft laser stimulation or QI Gong. Acupunct Electrother Res. 1989;14(2):155–86.PubMedGoogle Scholar
  36. 36.
    Harris RE, Zubieta JK, Scott DJ, Napadow V, Gracely RH, Clauw DJ. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage. 2009;47(3):1077–85.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Hsieh JC, Stahle-Backdahl M, Hagermark O, Stone-Elander S, Rosenquist G, Ingvar M. Traumatic nociceptive pain activates the hypothalamus and the periaqueductal gray: a positron emission tomography study. Pain. 1996;64(2):303–14.PubMedGoogle Scholar
  38. 38.
    Hui KK, Liu J, Marina O, Napadow V, Haselgrove C, Kwong KK, et al. The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. Neuroimage. 2005;27(3):479–96.PubMedGoogle Scholar
  39. 39.
    Fang J, Jin Z, Wang Y, Li K, Kong J, Nixon EE, et al. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Hum Brain Mapp. 2009;30(4):1196–206.PubMedGoogle Scholar
  40. 40.
    Chae Y, Chang DS, Lee SH, Jung WM, Lee IS, Jackson S, et al. Inserting needles into the body: a meta-analysis of brain activity associated with acupuncture needle stimulation. J Pain. 2013;14(3):215–22.PubMedGoogle Scholar
  41. 41.
    Yan B, Li K, Xu J, Wang W, Li K, Liu H, et al. Acupoint-specific fMRI patterns in human brain. Neurosci Lett. 2005;383(3):236–40.PubMedGoogle Scholar
  42. 42.
    Napadow V, Makris N, Liu J, Kettner NW, Kwong KK, Hui KK. Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Hum Brain Mapp. 2005;24(3):193–205.PubMedGoogle Scholar
  43. 43.
    Kong J, Ma L, Gollub RL, Wei J, Yang X, Li D, et al. A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods. J Altern Complement Med. 2002;8(4):411–9.PubMedGoogle Scholar
  44. 44.
    Goldman N, Chen M, Fujita T, Xu Q, Peng W, Liu W, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci. 2010;13(7):883–8.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Han JS, Terenius L. Neurochemical basis of acupuncture analgesia. Annu Rev Pharmacol Toxicol. 1982;22:193–220.PubMedGoogle Scholar
  46. 46.
    Yu Y, Zhou S, Liu LG. [Distribution of met-enkephalin and its changes in cervical spinal cord and medulla oblongata of dog during operation under acupuncture anaesthesia]. Zhen Ci Yan Jiu. 1985;10(4):289–94.Google Scholar
  47. 47.
    Clement-Jones V, McLoughlin L, Tomlin S, Besser GM, Rees LH, Wen HL. Increased beta-endorphin but not met-enkephalin levels in human cerebrospinal fluid after acupuncture for recurrent pain. Lancet. 1980;2(8201):946–9.PubMedGoogle Scholar
  48. 48.
    Napadow V, Ahn A, Longhurst J, Lao L, Stener-Victorin E, Harris R, et al. The status and future of acupuncture mechanism research. J Altern Complement Med. 2008;14(7):861–9.PubMedPubMedCentralGoogle Scholar
  49. 49.
    Pintov S, Lahat E, Alstein M, Vogel Z, Barg J. Acupuncture and the opioid system: implications in management of migraine. Pediatr Neurol. 1997;17(2):129–33.PubMedGoogle Scholar
  50. 50.
    Pomeranz B, Chiu D. Naloxone blockade of acupuncture analgesia: endorphin implicated. Life Sci. 1976;19(11):1757–62.PubMedGoogle Scholar
  51. 51.
    Eriksson SV, Lundeberg T, Lundeberg S. Interaction of diazepam and naloxone on acupuncture induced pain relief. Am J Chin Med. 1991;19(1):1–7.PubMedGoogle Scholar
  52. 52.
    Mayer DJ, Price DD, Rafii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res. 1977;121(2):368–72.PubMedGoogle Scholar
  53. 53.
    Chen L, Zhang J, Li F, Qiu Y, Wang L, Li YH, et al. Endogenous anandamide and cannabinoid receptor-2 contribute to electroacupuncture analgesia in rats. J Pain. 2009;10(7):732–9.PubMedGoogle Scholar
  54. 54.
    Guo HF, Wang XM, Tian JH, Huo YP, Han JS. [2 Hz and 100 Hz electroacupuncture accelerate the expression of genes encoding three opioid peptides in the rat brain]. Sheng Li Xue Bao. 1997;49(2):121–7.Google Scholar
  55. 55.
    Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci. 2003;26(1):17–22.PubMedGoogle Scholar
  56. 56.
    Han JS, Chen XH, Sun SL, Xu XJ, Yuan Y, Yan SC, et al. Effect of low- and high-frequency TENS on Met-enkephalin-Arg-Phe and dynorphin A immunoreactivity in human lumbar CSF. Pain. 1991;47(3):295–8.PubMedGoogle Scholar
  57. 57.
    Chen XH, Han JS. Analgesia induced by electroacupuncture of different frequencies is mediated by different types of opioid receptors: another cross-tolerance study. Behav Brain Res. 1992;47(2):143–9.PubMedGoogle Scholar
  58. 58.
    Huang C, Wang Y, Chang JK, Han JS. Endomorphin and mu-opioid receptors in mouse brain mediate the analgesic effect induced by 2 Hz but not 100 Hz electroacupuncture stimulation. Neurosci Lett. 2000;294(3):159–62.PubMedGoogle Scholar
  59. 59.
    Han Z, Jiang YH, Wan Y, Wang Y, Chang JK, Han JS. Endomorphin-1 mediates 2 Hz but not 100 Hz electroacupuncture analgesia in the rat. Neurosci Lett. 1999;274(2):75–8.PubMedGoogle Scholar
  60. 60.
    Xu M, Aiuchi T, Nakaya K, Arakawa H, Maeda M, Tsuji A, et al. Effect of low-frequency electric stimulation on in vivo release of cholecystokinin-like immunoreactivity in medial thalamus of conscious rat. Neurosci Lett. 1990;118(2):205–7.PubMedGoogle Scholar
  61. 61.
    Yano T, Kato B, Fukuda F, Shinbara H, Yoshimoto K, Ozaki A, et al. Alterations in the function of cerebral dopaminergic and serotonergic systems following electroacupuncture and moxibustion applications: possible correlates with their antistress and psychosomatic actions. Neurochem Res. 2004;29(1):283–93.PubMedGoogle Scholar
  62. 62.
    Yoshimoto K, Fukuda F, Hori M, Kato B, Kato H, Hattori H, et al. Acupuncture stimulates the release of serotonin, but not dopamine, in the rat nucleus accumbens. Tohoku J Exp Med. 2006;208(4):321–6.PubMedGoogle Scholar
  63. 63.
    Murotani T, Ishizuka T, Nakazawa H, Wang X, Mori K, Sasaki K, et al. Possible involvement of histamine, dopamine, and noradrenalin in the periaqueductal gray in electroacupuncture pain relief. Brain Res. 2010;1306:62–8.PubMedGoogle Scholar
  64. 64.
    Hou JG, Liu HL, He TX, Wang ZM, Mao XF, Du XZ, et al. [Study of the acupuncture effect on monoamine transmitters in rabbit plasma and brain tissue by high performance liquid chromatography with electrochemical detection]. Se Pu. 2002;20(2):140–3.Google Scholar
  65. 65.
    Gan P, Cheng JS, Ng YK, Ling EA. Role of GABA in electro-acupuncture therapy on cerebral ischemia induced by occlusion of the middle cerebral artery in rats. Neurosci Lett. 2005;383(3):317–21.PubMedGoogle Scholar
  66. 66.
    Fu LW, Longhurst JC. Electroacupuncture modulates vlPAG release of GABA through presynaptic cannabinoid CB1 receptors. J Appl Physiol (1985). 2009;106(6):1800–9.Google Scholar
  67. 67.
    Li A, Lao L, Wang Y, Xin J, Ren K, Berman BM, et al. Electroacupuncture activates corticotrophin-releasing hormone-containing neurons in the paraventricular nucleus of the hypothalammus to alleviate edema in a rat model of inflammation. BMC Complement Altern Med. 2008;8:20.PubMedPubMedCentralGoogle Scholar
  68. 68.
    Ben H, Li L, Gao XY, He W, Rong PJ. [Comparison of NO contents and cutaneous electric conduction quantity at the acupoints and the non-acupoints]. Zhen Ci Yan Jiu. 2009;34(6):383–6, 392.Google Scholar
  69. 69.
    Son YS, Park HJ, Kwon OB, Jung SC, Shin HC, Lim S. Antipyretic effects of acupuncture on the lipopolysaccharide-induced fever and expression of interleukin-6 and interleukin-1 beta mRNAs in the hypothalamus of rats. Neurosci Lett. 2002;319(1):45–8.PubMedGoogle Scholar
  70. 70.
    Chang FC, Tsai HY, Yu MC, Yi PL, Lin JG. The central serotonergic system mediates the analgesic effect of electroacupuncture on ZUSANLI (ST36) acupoints. J Biomed Sci. 2004;11(2):179–85.PubMedGoogle Scholar
  71. 71.
    Chen L. The role of acupuncture in pain management. In: Chen L, editor. Acupuncture in modern medicine. London: IntechOpen; 2013. p. 235–53.Google Scholar
  72. 72.
    Kong J, Kaptchuk TJ, Polich G, Kirsch I, Vangel M, Zyloney C, et al. Expectancy and treatment interactions: a dissociation between acupuncture analgesia and expectancy evoked placebo analgesia. Neuroimage. 2009;45(3):940–9.PubMedGoogle Scholar
  73. 73.
    Liu T. Acupuncture: what underlies needle administration? Evid Based Complement Alternat Med. 2009;6(2):185–93.PubMedGoogle Scholar
  74. 74.
    Luo X, Pietrobon R, Sun SX, Liu GG, Hey L. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine (Phila Pa 1976). 2004;29(1):79–86.Google Scholar
  75. 75.
    Leibing E, Leonhardt U, Koster G, Goerlitz A, Rosenfeldt JA, Hilgers R, et al. Acupuncture treatment of chronic low-back pain – a randomized, blinded, placebo-controlled trial with 9-month follow-up. Pain. 2002;96(1–2):189–96.PubMedGoogle Scholar
  76. 76.
    Witt CM, Jena S, Selim D, Brinkhaus B, Reinhold T, Wruck K, et al. Pragmatic randomized trial evaluating the clinical and economic effectiveness of acupuncture for chronic low back pain. Am J Epidemiol. 2006;164(5):487–96.PubMedGoogle Scholar
  77. 77.
    Molsberger AF, Mau J, Pawelec DB, Winkler J. Does acupuncture improve the orthopedic management of chronic low back pain–a randomized, blinded, controlled trial with 3 months follow up. Pain. 2002;99(3):579–87.PubMedGoogle Scholar
  78. 78.
    Cho YJ, Song YK, Cha YY, Shin BC, Shin IH, Park HJ, et al. Acupuncture for chronic low back pain: a multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. Spine (Phila Pa 1976). 2013;38(7):549–57.Google Scholar
  79. 79.
    Haake M, Muller HH, Schade-Brittinger C, Basler HD, Schafer H, Maier C, et al. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007;167(17):1892–8.PubMedGoogle Scholar
  80. 80.
    Leibing E, Pfingsten M, Leichsenring F. Comment on: Molsberger AF, Mau J, Pawelec DB, Winkler J. Does acupuncture improve the orthopedic management of chronic low back pain? Pain. 2002; 99:579–87. Pain. 2003;104(1–2):425–6; author reply 426–7.PubMedGoogle Scholar
  81. 81.
    Ernst E. Acupuncture ineffective, attention effective? Arch Intern Med. 2008;168(5):551; author reply 551–2.PubMedGoogle Scholar
  82. 82.
    Moffet HH. Acupuncture trial lacks a priori rationale to refute null hypothesis. Arch Intern Med. 2008;168(5):550–1.PubMedGoogle Scholar
  83. 83.
    Linde K, Niemann K, Schneider A, Meissner K. How large are the nonspecific effects of acupuncture? A meta-analysis of randomized controlled trials. BMC Med. 2010;8:75.PubMedPubMedCentralGoogle Scholar
  84. 84.
    Xiang Y, He JY, Li R. Appropriateness of sham or placebo acupuncture for randomized controlled trials of acupuncture for nonspecific low back pain: a systematic review and meta-analysis. J Pain Res. 2018;11:83–94.PubMedGoogle Scholar
  85. 85.
    Le Bars D, Dickenson AH, Besson JM. Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat. Pain. 1979;6(3):283–304.PubMedGoogle Scholar
  86. 86.
    Bing Z, Villanueva L, Le Bars D. Acupuncture and diffuse noxious inhibitory controls: naloxone-reversible depression of activities of trigeminal convergent neurons. Neuroscience. 1990;37(3):809–18.PubMedGoogle Scholar
  87. 87.
    Schliessbach J, van der Klift E, Siegenthaler A, Arendt-Nielsen L, Curatolo M, Streitberger K. Does acupuncture needling induce analgesic effects comparable to diffuse noxious inhibitory controls? Evid Based Complement Alternat Med. 2012;2012:785613.PubMedGoogle Scholar
  88. 88.
    Yuan J, Purepong N, Kerr DP, Park J, Bradbury I, McDonough S. Effectiveness of acupuncture for low back pain: a systematic review. Spine (Phila Pa 1976). 2008;33(23):E887–900.Google Scholar
  89. 89.
    Rubinstein SM, van Middelkoop M, Kuijpers T, Ostelo R, Verhagen AP, de Boer MR, et al. A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain. Eur Spine J. 2010;19(8):1213–28.PubMedPubMedCentralGoogle Scholar
  90. 90.
    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;38(24):2124–38.Google Scholar
  91. 91.
    Thomas KJ, MacPherson H, Ratcliffe J, Thorpe L, Brazier J, Campbell M, et al. Longer term clinical and economic benefits of offering acupuncture care to patients with chronic low back pain. Health Technol Assess. 2005;9(32):iii–v, ix–x, 1–109.PubMedGoogle Scholar
  92. 92.
    Chou R, Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147(7):492–504.PubMedGoogle Scholar
  93. 93.
    Grant DJ, Bishop-Miller J, Winchester DM, Anderson M, Faulkner S. A randomized comparative trial of acupuncture versus transcutaneous electrical nerve stimulation for chronic back pain in the elderly. Pain. 1999;82(1):9–13.PubMedGoogle Scholar
  94. 94.
    Inoue M, Hojo T, Nakajima M, Kitakoji H, Itoi M. Comparison of the effectiveness of acupuncture treatment and local anaesthetic injection for low back pain: a randomised controlled clinical trial. Acupunct Med. 2009;27(4):174–7.PubMedGoogle Scholar
  95. 95.
    Kumnerddee W. Effectiveness comparison between Thai traditional massage and Chinese acupuncture for myofascial back pain in Thai military personnel: a preliminary report. J Med Assoc Thai. 2009;92(Suppl 1):S117–23.PubMedGoogle Scholar
  96. 96.
    Cherkin DC, Eisenberg D, Sherman KJ, Barlow W, Kaptchuk TJ, Street J, et al. Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch Intern Med. 2001;161(8):1081–8.PubMedGoogle Scholar
  97. 97.
    Standaert CJ, Friedly J, Erwin MW, Lee MJ, Rechtine G, Henrikson NB, et al. Comparative effectiveness of exercise, acupuncture, and spinal manipulation for low back pain. Spine (Phila Pa 1976). 2011;36(21 Suppl):S120–30.Google Scholar
  98. 98.
    Furlan AD, van Tulder M, Cherkin D, Tsukayama H, Lao L, Koes B, et al. Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the cochrane collaboration. Spine (Phila Pa 1976). 2005;30(8):944–63.Google Scholar
  99. 99.
    Hamza MA, Ghoname EA, White PF, Craig WF, Ahmed HE, Gajraj NM, et al. Effect of the duration of electrical stimulation on the analgesic response in patients with low back pain. Anesthesiology. 1999;91(6):1622–7.PubMedGoogle Scholar
  100. 100.
    Cherkin DC, Sherman KJ, Avins AL, Erro JH, Ichikawa L, Barlow WE, et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med. 2009;169(9):858–66.PubMedPubMedCentralGoogle Scholar
  101. 101.
    Shin JS, Ha IH, Lee J, Choi Y, Kim MR, Park BY, et al. Effects of motion style acupuncture treatment in acute low back pain patients with severe disability: a multicenter, randomized, controlled, comparative effectiveness trial. Pain. 2013;154(7):1030–7.PubMedGoogle Scholar
  102. 102.
    Yun M, Shao Y, Zhang Y, He S, Xiong N, Zhang J, et al. Hegu acupuncture for chronic low-back pain: a randomized controlled trial. J Altern Complement Med. 2012;18(2):130–6.PubMedGoogle Scholar
  103. 103.
    Tsui ML, Cheing GL. The effectiveness of electroacupuncture versus electrical heat acupuncture in the management of chronic low-back pain. J Altern Complement Med. 2004;10(5):803–9.PubMedGoogle Scholar
  104. 104.
    Bahrami-Taghanaki H, Liu Y, Azizi H, Khorsand A, Esmaily H, Bahrami A, et al. A randomized, controlled trial of acupuncture for chronic low-back pain. Altern Ther Health Med. 2014;20(3):13–9.PubMedGoogle Scholar
  105. 105.
    Blossfeldt P. Acupuncture for chronic neck pain--a cohort study in an NHS pain clinic. Acupunct Med. 2004;22(3):146–51.PubMedGoogle Scholar
  106. 106.
    Giles LG, Muller R. Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine (Phila Pa 1976). 2003;28(14):1490–502; discussion 1502–3.Google Scholar
  107. 107.
    Irnich D, Behrens N, Molzen H, Konig A, Gleditsch J, Krauss M, et al. Randomised trial of acupuncture compared with conventional massage and “sham” laser acupuncture for treatment of chronic neck pain. BMJ. 2001;322(7302):1574–8.PubMedPubMedCentralGoogle Scholar
  108. 108.
    Konig A, Radke S, Molzen H, Haase M, Muller C, Drexler D, et al. [Randomised trial of acupuncture compared with conventional massage and “sham” laser acupuncture for treatment of chronic neck pain – range of motion analysis]. Z Orthop Ihre Grenzgeb. 2003;141(4):395–400.Google Scholar
  109. 109.
    White P, Lewith G, Prescott P, Conway J. Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial. Ann Intern Med. 2004;141(12):911–9.PubMedGoogle Scholar
  110. 110.
    Liang ZH, Yang YH, Yu P, Zhu XP, Wu ZL, Zhang JF, et al. [Logistic regression analysis on therapeutic effect of acupuncture on neck pain caused by cervical spondylosis and factors influencing therapeutic effect]. Zhongguo Zhen Jiu. 2009;29(3):173–6.Google Scholar
  111. 111.
    He D, Veiersted KB, Hostmark AT, Medbo JI. Effect of acupuncture treatment on chronic neck and shoulder pain in sedentary female workers: a 6-month and 3-year follow-up study. Pain. 2004;109(3):299–307.PubMedGoogle Scholar
  112. 112.
    He D, Hostmark AT, Veiersted KB, Medbo JI. Effect of intensive acupuncture on pain-related social and psychological variables for women with chronic neck and shoulder pain–an RCT with six month and three year follow up. Acupunct Med. 2005;23(2):52–61.PubMedGoogle Scholar
  113. 113.
    Franca DL, Senna-Fernandes V, Cortez CM, Jackson MN, Bernardo-Filho M, Guimaraes MA. Tension neck syndrome treated by acupuncture combined with physiotherapy: a comparative clinical trial (pilot study). Complement Ther Med. 2008;16(5):268–77.PubMedGoogle Scholar
  114. 114.
    Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN. Acupuncture for patients with chronic neck pain. Pain. 2006;125(1–2):98–106.PubMedGoogle Scholar
  115. 115.
    Ga H, Choi JH, Park CH, Yoon HJ. Acupuncture needling versus lidocaine injection of trigger points in myofascial pain syndrome in elderly patients–a randomised trial. Acupunct Med. 2007;25(4):130–6.PubMedGoogle Scholar
  116. 116.
    Irnich D, Behrens N, Gleditsch JM, Stor W, Schreiber MA, Schops P, et al. Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, double-blind, sham-controlled crossover trial. Pain. 2002;99(1–2):83–9.PubMedGoogle Scholar
  117. 117.
    Liu L, Skinner MA, McDonough SM, Baxter GD. Traditional Chinese Medicine acupuncture and myofascial trigger needling: the same stimulation points? Complement Ther Med. 2016;26:28–32.PubMedGoogle Scholar
  118. 118.
    Fan AY, Xu J, Li YM. Evidence and expert opinions: dry needling versus acupuncture (I): the American Alliance for Professional Acupuncture Safety (AAPAS) white paper 2016. Chin J Integr Med. 2017;23(1):3–9.PubMedGoogle Scholar
  119. 119.
    Fan AY, Xu J, Li YM. Evidence and expert opinions: dry needling versus acupuncture (II): the American Alliance for Professional Acupuncture Safety (AAPAS) white paper 2016. Chin J Integr Med. 2017;23(2):83–90.PubMedGoogle Scholar
  120. 120.
    Trinh K, Graham N, Gross A, Goldsmith C, Wang E, Cameron I, et al. Acupuncture for neck disorders. Spine (Phila Pa 1976). 2007;32(2):236–43.Google Scholar
  121. 121.
    Fu LM, Li JT, Wu WS. Randomized controlled trials of acupuncture for neck pain: systematic review and meta-analysis. J Altern Complement Med. 2009;15(2):133–45.PubMedGoogle Scholar
  122. 122.
    Yuan QL, Guo TM, Liu L, Sun F, Zhang YG. Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis. PLoS One. 2015;10(2):e0117146.PubMedPubMedCentralGoogle Scholar
  123. 123.
    Willich SN, Reinhold T, Selim D, Jena S, Brinkhaus B, Witt CM. Cost-effectiveness of acupuncture treatment in patients with chronic neck pain. Pain. 2006;125(1–2):107–13.PubMedGoogle Scholar
  124. 124.
    Linde K, Streng A, Hoppe A, Brinkhaus B, Witt CM, Hammes M, et al. Treatment in a randomized multicenter trial of acupuncture for migraine (ART migraine). Forsch Komplementmed. 2006;13(2):101–8.PubMedGoogle Scholar
  125. 125.
    Endres HG, Diener HC, Molsberger A. Role of acupuncture in the treatment of migraine. Expert Rev Neurother. 2007;7(9):1121–34.PubMedGoogle Scholar
  126. 126.
    Facco E, Liguori A, Petti F, Zanette G, Coluzzi F, De Nardin M, et al. Traditional acupuncture in migraine: a controlled, randomized study. Headache. 2008;48(3):398–407.PubMedGoogle Scholar
  127. 127.
    Melchart D, Thormaehlen J, Hager S, Liao J, Linde K, Weidenhammer W. Acupuncture versus placebo versus sumatriptan for early treatment of migraine attacks: a randomized controlled trial. J Intern Med. 2003;253(2):181–8.PubMedGoogle Scholar
  128. 128.
    Streng A, Linde K, Hoppe A, Pfaffenrath V, Hammes M, Wagenpfeil S, et al. Effectiveness and tolerability of acupuncture compared with metoprolol in migraine prophylaxis. Headache. 2006;46(10):1492–502.PubMedGoogle Scholar
  129. 129.
    Ebneshahidi NS, Heshmatipour M, Moghaddami A, Eghtesadi-Araghi P. The effects of laser acupuncture on chronic tension headache–a randomised controlled trial. Acupunct Med. 2005;23(1):13–8.PubMedGoogle Scholar
  130. 130.
    Endres HG, Bowing G, Diener HC, Lange S, Maier C, Molsberger A, et al. Acupuncture for tension-type headache: a multicentre, sham-controlled, patient-and observer-blinded, randomised trial. J Headache Pain. 2007;8(5):306–14.PubMedPubMedCentralGoogle Scholar
  131. 131.
    Melchart D, Streng A, Hoppe A, Brinkhaus B, Witt C, Wagenpfeil S, et al. Acupuncture in patients with tension-type headache: randomised controlled trial. BMJ. 2005;331(7513):376–82.PubMedPubMedCentralGoogle Scholar
  132. 132.
    Wang K, Svensson P, Arendt-Nielsen L. Effect of acupuncture-like electrical stimulation on chronic tension-type headache: a randomized, double-blinded, placebo-controlled trial. Clin J Pain. 2007;23(4):316–22.PubMedGoogle Scholar
  133. 133.
    Coeytaux RR, Kaufman JS, Kaptchuk TJ, Chen W, Miller WC, Callahan LF, et al. A randomized, controlled trial of acupuncture for chronic daily headache. Headache. 2005;45(9):1113–23.PubMedGoogle Scholar
  134. 134.
    Melchart D, Weidenhammer W, Streng A, Hoppe A, Pfaffenrath V, Linde K. Acupuncture for chronic headaches–an epidemiological study. Headache. 2006;46(4):632–41.PubMedGoogle Scholar
  135. 135.
    Witt CM, Reinhold T, Jena S, Brinkhaus B, Willich SN. Cost-effectiveness of acupuncture treatment in patients with headache. Cephalalgia. 2008;28(4):334–45.PubMedGoogle Scholar
  136. 136.
    Wonderling D, Vickers AJ, Grieve R, McCarney R. Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care. BMJ. 2004;328(7442):747.PubMedPubMedCentralGoogle Scholar
  137. 137.
    Li Y, Liang F, Yang X, Tian X, Yan J, Sun G, et al. Acupuncture for treating acute attacks of migraine: a randomized controlled trial. Headache. 2009;49(6):805–16.PubMedGoogle Scholar
  138. 138.
    Wang LP, Zhang XZ, Guo J, Liu HL, Zhang Y, Liu CZ, et al. Efficacy of acupuncture for acute migraine attack: a multicenter single blinded, randomized controlled trial. Pain Med. 2012;13(5):623–30.PubMedGoogle Scholar
  139. 139.
    Allais G, De Lorenzo C, Quirico PE, Airola G, Tolardo G, Mana O, et al. Acupuncture in the prophylactic treatment of migraine without aura: a comparison with flunarizine. Headache. 2002;42(9):855–61.PubMedGoogle Scholar
  140. 140.
    Yang CP, Chang MH, Liu PE, Li TC, Hsieh CL, Hwang KL, et al. Acupuncture versus topiramate in chronic migraine prophylaxis: a randomized clinical trial. Cephalalgia. 2011;31(15):1510–21.PubMedGoogle Scholar
  141. 141.
    Naderinabi B, Saberi A, Hashemi M, Haghighi M, Biazar G, Abolhasan Gharehdaghi F, et al. Acupuncture and botulinum toxin A injection in the treatment of chronic migraine: a randomized controlled study. Caspian J Intern Med. 2017;8(3):196–204.PubMedPubMedCentralGoogle Scholar
  142. 142.
    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.Google Scholar
  143. 143.
    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.PubMedPubMedCentralGoogle Scholar
  144. 144.
    Deare JC, Zheng Z, Xue CC, Liu JP, Shang J, Scott SW, et al. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013;5:CD007070.PubMedCentralGoogle Scholar
  145. 145.
    Karatay S, Okur SC, Uzkeser H, Yildirim K, Akcay F. Effects of acupuncture treatment on fibromyalgia symptoms, serotonin, and substance P levels: a randomized sham and placebo-controlled clinical trial. Pain Med. 2018;19(3):615–28.PubMedGoogle Scholar
  146. 146.
    Casimiro L, Barnsley L, Brosseau L, Milne S, Robinson VA, Tugwell P, et al. Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005;4:CD003788.Google Scholar
  147. 147.
    Lee JA, Son MJ, Choi J, Jun JH, Kim JI, Lee MS. Bee venom acupuncture for rheumatoid arthritis: a systematic review of randomised clinical trials. BMJ Open. 2014;4(11):e006140.PubMedPubMedCentralGoogle Scholar
  148. 148.
    Lee WB, Woo SH, Min BI, Cho SH. Acupuncture for gouty arthritis: a concise report of a systematic and meta-analysis approach. Rheumatology (Oxford). 2013;52(7):1225–32.Google Scholar
  149. 149.
    Amezaga Urruela M, Suarez-Almazor ME. Acupuncture in the treatment of rheumatic diseases. Curr Rheumatol Rep. 2012;14(6):589–97.PubMedPubMedCentralGoogle Scholar
  150. 150.
    Phang JK, Kwan YH, Goh H, Tan VIC, Thumboo J, Ostbye T, et al. Complementary and alternative medicine for rheumatic diseases: a systematic review of randomized controlled trials. Complement Ther Med. 2018;37:143–57.PubMedGoogle Scholar
  151. 151.
    Manheimer E, Cheng K, Linde K, Lao L, Yoo J, Wieland S, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev. 2010;1:CD001977.Google Scholar
  152. 152.
    Zhang Q, Yue J, Golianu B, Sun Z, Lu Y. Updated systematic review and meta-analysis of acupuncture for chronic knee pain. Acupunct Med. 2017;35(6):392–403.PubMedGoogle Scholar
  153. 153.
    Zhao L, Cheng K, Wang L, Wu F, Deng H, Tan M, et al. Effectiveness of moxibustion treatment as adjunctive therapy in osteoarthritis of the knee: a randomized, double-blinded, placebo-controlled clinical trial. Arthritis Res Ther. 2014;16(3):R133.PubMedPubMedCentralGoogle Scholar
  154. 154.
    Manheimer E, Lim B, Lao L, Berman B. Acupuncture for knee osteoarthritis–a randomised trial using a novel sham. Acupunct Med. 2006;24(Suppl):S7–14.PubMedGoogle Scholar
  155. 155.
    Choi TY, Lee MS, Kim JI, Zaslawski C. Moxibustion for the treatment of osteoarthritis: an updated systematic review and meta-analysis. Maturitas. 2017;100:33–48.PubMedGoogle Scholar
  156. 156.
    Yurtkuran M, Alp A, Konur S, Ozcakir S, Bingol U. Laser acupuncture in knee osteoarthritis: a double-blind, randomized controlled study. Photomed Laser Surg. 2007;25(1):14–20.PubMedGoogle Scholar
  157. 157.
    Cox J, Varatharajan S, Cote P, Optima C. Effectiveness of acupuncture therapies to manage musculoskeletal disorders of the extremities: a systematic review. J Orthop Sports Phys Ther. 2016;46(6):409–29.PubMedGoogle Scholar
  158. 158.
    Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, et al. Acupuncture for lateral elbow pain. Cochrane Database Syst Rev. 2002;1:CD003527.Google Scholar
  159. 159.
    Tang H, Fan H, Chen J, Yang M, Yi X, Dai G, et al. Acupuncture for lateral epicondylitis: a systematic review. Evid Based Complement Alternat Med. 2015;2015:861849.PubMedPubMedCentralGoogle Scholar
  160. 160.
    Kim TH, Lee MS, Kim KH, Kang JW, Choi TY, Ernst E. Acupuncture for treating acute ankle sprains in adults. Cochrane Database Syst Rev. 2014;6:CD009065.Google Scholar
  161. 161.
    Kibar S, Konak HE, Evcik D, Ay S. Laser acupuncture treatment improves pain and functional status in patients with subacromial impingement syndrome: a randomized, double-blind, sham-controlled study. Pain Med. 2017;18(5):980–7.PubMedGoogle Scholar
  162. 162.
    Asheghan M, Aghda AK, Hashemi E, Hollisaz M. Investigation of the effectiveness of acupuncture in the treatment of frozen shoulder. Mater Sociomed. 2016;28(4):253–7.PubMedPubMedCentralGoogle Scholar
  163. 163.
    Chau JPC, Lo SHS, Yu X, Choi KC, Lau AYL, Wu JCY, et al. Effects of acupuncture on the recovery outcomes of stroke survivors with shoulder pain: a systematic review. Front Neurol. 2018;9:30.PubMedPubMedCentralGoogle Scholar
  164. 164.
    Ju ZY, Wang K, Cui HS, Yao Y, Liu SM, Zhou J, et al. Acupuncture for neuropathic pain in adults. Cochrane Database Syst Rev. 2017;12:CD012057.PubMedGoogle Scholar
  165. 165.
    Lu Z, Moody J, Marx BL, Hammerstrom T. Treatment of chemotherapy-induced peripheral neuropathy in integrative oncology: a survey of acupuncture and oriental medicine practitioners. J Altern Complement Med. 2017;23(12):964–70.PubMedGoogle Scholar
  166. 166.
    Han X, Wang L, Shi H, Zheng G, He J, Wu W, et al. Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma. BMC Cancer. 2017;17(1):40.PubMedPubMedCentralGoogle Scholar
  167. 167.
    Bao T, Goloubeva O, Pelser C, Porter N, Primrose J, Hester L, et al. A pilot study of acupuncture in treating bortezomib-induced peripheral neuropathy in patients with multiple myeloma. Integr Cancer Ther. 2014;13(5):396–404.PubMedPubMedCentralGoogle Scholar
  168. 168.
    Trevelyan EG, Turner WA, Summerfield-Mann L, Robinson N. Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study. Trials. 2016;17(1):519.PubMedPubMedCentralGoogle Scholar
  169. 169.
    Qin Z, Liu X, Wu J, Zhai Y, Liu Z. Effectiveness of acupuncture for treating sciatica: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2015;2015:425108.PubMedPubMedCentralGoogle Scholar
  170. 170.
    Zhang X, Wang Y, Wang Z, Wang C, Ding W, Liu Z. A randomized clinical trial comparing the effectiveness of electroacupuncture versus medium-frequency electrotherapy for discogenic sciatica. Evid Based Complement Alternat Med. 2017;2017:9502718.PubMedPubMedCentralGoogle Scholar
  171. 171.
    Qiu L, Hu XL, Zhao XY, Zheng X, Zhang J, Zhang M, et al. [A randomized controlled clinical trial of treatment of lumbar disc herniation-induced sciatica by acupuncture stimulation of sciatic nerve trunk]. Zhen Ci Yan Jiu. 2016;41(5):447–50.Google Scholar
  172. 172.
    He BS, Li Y, Gui T. Preliminary clinical evaluation of acupuncture therapy in patients with postpartum sciatica. J Midwifery Womens Health. 2018;63(2):214–20.PubMedGoogle Scholar
  173. 173.
    Nakajima M, Inoue M, Itoi M, Kitakoji H. Clinical effect of acupuncture on cervical spondylotic radiculopathy: results of a case series. Acupunct Med. 2013;31(4):364–7.PubMedGoogle Scholar
  174. 174.
    Cho TH, Park KM. Complex regional pain syndrome type 1 relieved by acupuncture point injections with placental extract. J Acupunct Meridian Stud. 2014;7(3):155–8.PubMedGoogle Scholar
  175. 175.
    Hommer DH. Chinese scalp acupuncture relieves pain and restores function in complex regional pain syndrome. Mil Med. 2012;177(10):1231–4.PubMedGoogle Scholar
  176. 176.
    Kim JM, Jeon HJ, Kim HJ, Cho CK, Yoo HS. Bee venom pharmacopuncture: an effective treatment for complex regional pain syndrome. J Pharm. 2014;17(4):66–9.Google Scholar
  177. 177.
    Sprague M, Chang JC. Integrative approach focusing on acupuncture in the treatment of chronic complex regional pain syndrome. J Altern Complement Med. 2011;17(1):67–70.PubMedGoogle Scholar
  178. 178.
    Deng G, Giralt S, Chung DJ, Landau H, Siman J, Search B, et al. Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial. Support Care Cancer. 2018;26(2):657–65.PubMedGoogle Scholar
  179. 179.
    Lam TY, Lu LM, Ling WM, Lin LZ. A pilot randomized controlled trial of acupuncture at the Si Guan Xue for cancer pain. BMC Complement Altern Med. 2017;17(1):335.PubMedPubMedCentralGoogle Scholar
  180. 180.
    Hu C, Zhang H, Wu W, Yu W, Li Y, Bai J, et al. Acupuncture for pain management in cancer: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2016;2016:1720239.PubMedPubMedCentralGoogle Scholar
  181. 181.
    Chiu HY, Hsieh YJ, Tsai PS. Systematic review and meta-analysis of acupuncture to reduce cancer-related pain. Eur J Cancer Care (Engl). 2017;26(2):e12457.Google Scholar
  182. 182.
    Ramnero A, Hanson U, Kihlgren M. Acupuncture treatment during labour–a randomised controlled trial. BJOG. 2002;109(6):637–44.PubMedGoogle Scholar
  183. 183.
    Skilnand E, Fossen D, Heiberg E. Acupuncture in the management of pain in labor. Acta Obstet Gynecol Scand. 2002;81(10):943–8.PubMedGoogle Scholar
  184. 184.
    Smith CA, Collins CT, Crowther CA, Levett KM. Acupuncture or acupressure for pain management in labour. Cochrane Database Syst Rev. 2011;7:CD009232.Google Scholar
  185. 185.
    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. 2017;36(2):474–81.PubMedGoogle Scholar
  186. 186.
    Smith CA, Armour M, Zhu X, Li X, Lu ZY, Song J. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev. 2016;4:CD007854.PubMedGoogle Scholar
  187. 187.
    Zhu X, Hamilton KD, McNicol ED. Acupuncture for pain in endometriosis. Cochrane Database Syst Rev. 2011;9:CD007864.Google Scholar
  188. 188.
    Kotani N, Hashimoto H, Sato Y, Sessler DI, Yoshioka H, Kitayama M, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology. 2001;95(2):349–56.PubMedGoogle Scholar
  189. 189.
    Usichenko TI, Dinse M, Hermsen M, Witstruck T, Pavlovic D, Lehmann C. Auricular acupuncture for pain relief after total hip arthroplasty – a randomized controlled study. Pain. 2005;114(3):320–7.PubMedGoogle Scholar
  190. 190.
    Usichenko TI, Dinse M, Lysenyuk VP, Wendt M, Pavlovic D, Lehmann C. Auricular acupuncture reduces intraoperative fentanyl requirement during hip arthroplasty–a randomized double-blinded study. Acupunct Electrother Res. 2006;31(3–4):213–21.PubMedGoogle Scholar
  191. 191.
    Lin JG, Lo MW, Wen YR, Hsieh CL, Tsai SK, Sun WZ. The effect of high and low frequency electroacupuncture in pain after lower abdominal surgery. Pain. 2002;99(3):509–14.PubMedGoogle Scholar
  192. 192.
    Sim CK, Xu PC, Pua HL, Zhang G, Lee TL. Effects of electroacupuncture on intraoperative and postoperative analgesic requirement. Acupunct Med. 2002;20(2–3):56–65.PubMedGoogle Scholar
  193. 193.
    Liu XL, Tan JY, Molassiotis A, Suen LK, Shi Y. Acupuncture-point stimulation for postoperative pain control: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2015;2015:657809.PubMedPubMedCentralGoogle Scholar
  194. 194.
    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.PubMedPubMedCentralGoogle Scholar
  195. 195.
    Xiang A, Cheng K, Shen X, Xu P, Liu S. The immediate analgesic effect of acupuncture for pain: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2017;2017:3837194.PubMedPubMedCentralGoogle Scholar
  196. 196.
    Yeh CH, Chiang YC, Hoffman SL, Liang Z, Klem ML, Tam WW, et al. Efficacy of auricular therapy for pain management: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2014;2014:934670.PubMedPubMedCentralGoogle Scholar
  197. 197.
    Estores I, Chen K, Jackson B, Lao L, Gorman PH. Auricular acupuncture for spinal cord injury related neuropathic pain: a pilot controlled clinical trial. J Spinal Cord Med. 2017;40(4):432–8.PubMedGoogle Scholar
  198. 198.
    Murakami M, Fox L, Dijkers MP. Ear acupuncture for immediate pain relief-a systematic review and meta-analysis of randomized controlled trials. Pain Med. 2017;18(3):551–64.PubMedGoogle Scholar
  199. 199.
    Tsai SL, Fox LM, Murakami M, Tsung JW. Auricular acupuncture in emergency department treatment of acute pain. Ann Emerg Med. 2016;68(5):583–5.PubMedGoogle Scholar
  200. 200.
    Goertz CM, Niemtzow R, Burns SM, Fritts MJ, Crawford CC, Jonas WB. Auricular acupuncture in the treatment of acute pain syndromes: a pilot study. Mil Med. 2006;171(10):1010–4.PubMedGoogle Scholar
  201. 201.
    Fox LM, Murakami M, Danesh H, Manini AF. Battlefield acupuncture to treat low back pain in the emergency department. Am J Emerg Med. 2018;36(6):1045–8.PubMedGoogle Scholar
  202. 202.
    Ernst E, White AR. Prospective studies of the safety of acupuncture: a systematic review. Am J Med. 2001;110(6):481–5.PubMedGoogle Scholar
  203. 203.
    MacPherson H, Thomas K, Walters S, Fitter M. A prospective survey of adverse events and treatment reactions following 34,000 consultations with professional acupuncturists. Acupunct Med. 2001;19(2):93–102.PubMedGoogle Scholar
  204. 204.
    White A, Hayhoe S, Hart A, Ernst E. Survey of adverse events following acupuncture (SAFA): a prospective study of 32,000 consultations. Acupunct Med. 2001;19(2):84–92.PubMedGoogle Scholar
  205. 205.
    Melchart D, Weidenhammer W, Streng A, Reitmayr S, Hoppe A, Ernst E, et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Arch Intern Med. 2004;164(1):104–5.PubMedGoogle Scholar
  206. 206.
    White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004;22(3):122–33.PubMedGoogle Scholar
  207. 207.
    Brokaw JJ, Tunnicliff G, Raess BU, Saxon DW. The teaching of complementary and alternative medicine in U.S. medical schools: a survey of course directors. Acad Med. 2002;77(9):876–81.PubMedGoogle Scholar
  208. 208.
    Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444–53.PubMedPubMedCentralGoogle Scholar
  209. 209.
    Que Q, Ye X, Su Q, Weng Y, Chu J, Mei L, et al. Effectiveness of acupuncture intervention for neck pain caused by cervical spondylosis: study protocol for a randomized controlled trial. Trials. 2013;14:186.PubMedPubMedCentralGoogle Scholar
  210. 210.
    Xiang A, Xu M, Liang Y, Wei J, Liu S. Immediate relief of herniated lumbar disc-related sciatica by ankle acupuncture: a study protocol for a randomized controlled clinical trial. Medicine (Baltimore). 2017;96(51):e9191.Google Scholar
  211. 211.
    Lee S, Park J, Kim J, Kang JW, Choi DY, Park SJ, et al. Acupuncture for postoperative pain in laparoscopic surgery: a systematic review protocol. BMJ Open. 2014;4(12):e006750.PubMedPubMedCentralGoogle Scholar
  212. 212.
    Jung JY, Cho JH, Chung SH. Acupuncture for postoperative pain following total knee arthroplasty: a systematic review protocol. BMJ Open. 2015;5(11):e009573.PubMedPubMedCentralGoogle Scholar
  213. 213.
    Lee HJ, Seo JC, Kwak MA, Park SH, Min BM, Cho MS, et al. Acupuncture for low back pain due to spondylolisthesis: study protocol for a randomized controlled pilot trial. Trials. 2014;15:105.PubMedPubMedCentralGoogle Scholar
  214. 214.
    Lee HJ, Seo JC, Park SH, Kwak MA, Shin IH, Min BM, et al. Acupuncture in patients with a vertebral compression fracture: a protocol for a randomized, controlled, pilot clinical trial. J Pharm. 2015;18(1):79–85.Google Scholar
  215. 215.
    He Y, Liu Y, May BH, Zhang AL, Zhang H, Lu C, et al. Effectiveness of acupuncture for cancer pain: protocol for an umbrella review and meta-analyses of controlled trials. BMJ Open. 2017;7(12):e018494.PubMedPubMedCentralGoogle Scholar
  216. 216.
    Armour M, Smith CA, Schabrun S, Steiner GZ, Zhu X, Lawson K, et al. Manual acupuncture plus usual care versus usual care alone in the treatment of endometriosis-related chronic pelvic pain: study protocol for a randomised controlled feasibility study. Pilot Feasibility Stud. 2017;4:10.PubMedPubMedCentralGoogle Scholar
  217. 217.
    Cho Y, Lee S, Kim J, Kang JW, Lee JD. Thread embedding acupuncture for musculoskeletal pain: a systematic review and meta-analysis protocol. BMJ Open. 2018;8(1):e015461.PubMedPubMedCentralGoogle Scholar
  218. 218.
    Leem J, Lee S, Park Y, Seo BK, Cho Y, Kang JW, et al. Effectiveness and safety of moxibustion treatment for non-specific lower back pain: protocol for a systematic review. BMJ Open. 2017;7(6):e014936.PubMedPubMedCentralGoogle Scholar
  219. 219.
    Lee JA, Son MJ, Choi J, Yun KJ, Jun JH, Lee MS. Bee venom acupuncture for rheumatoid arthritis: a systematic review protocol. BMJ Open. 2014;4(4):e004602.PubMedPubMedCentralGoogle Scholar
  220. 220.
    Lee S, Kim JH, Shin KM, Kim JE, Kim TH, Kang KW, et al. Electroacupuncture to treat painful diabetic neuropathy: study protocol for a three-armed, randomized, controlled pilot trial. Trials. 2013;14:225.PubMedPubMedCentralGoogle Scholar
  221. 221.
    Kim JH, Kim EJ, Seo BK, Lee S, Lee S, Jung SY, et al. Electroacupuncture for chemotherapy-induced peripheral neuropathy: study protocol for a pilot multicentre randomized, patient-assessor-blinded, controlled trial. Trials. 2013;14:254.PubMedPubMedCentralGoogle Scholar
  222. 222.
    Jun MH, Kim YM, Kim JU. Modern acupuncture-like stimulation methods: a literature review. Integr Med Res. 2015;4(4):195–219.PubMedPubMedCentralGoogle Scholar
  223. 223.
    Vase L, Baram S, Takakura N, Takayama M, Yajima H, Kawase A, et al. Can acupuncture treatment be double-blinded? An evaluation of double-blind acupuncture treatment of postoperative pain. PLoS One. 2015;10(3):e0119612.PubMedPubMedCentralGoogle Scholar
  224. 224.
    Zhang GS, Zhang CS, Tan HY, Wang Y, DaCosta C, Zhang AL, et al. Systematic review of acupuncture placebo devices with a focus on the credibility of blinding of healthy participants and/or acupuncturists. Acupunct Med. 2018;36(4):204–14.PubMedGoogle Scholar
  225. 225.
    Zhang CS, Tan HY, Zhang GS, Zhang AL, Xue CC, Xie YM. Placebo devices as effective control methods in acupuncture clinical trials: a systematic review. PLoS One. 2015;10(11):e0140825.PubMedPubMedCentralGoogle Scholar
  226. 226.
    Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain–United States, 2016. JAMA. 2016;315(15):1624–45.PubMedPubMedCentralGoogle Scholar
  227. 227.
    Niemtzow RC. The opioid crisis: our acupuncture challenges and responsibilities. Med Acupunct. 2018;30(1):1–2.PubMedPubMedCentralGoogle Scholar
  228. 228.
    Penney LS, Ritenbaugh C, DeBar LL, Elder C, Deyo RA. Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study. BMC Fam Pract. 2017;17(1):164.PubMedPubMedCentralGoogle Scholar
  229. 229.
    Fan AY, Miller DW, Bolash B, Bauer M, McDonald J, Faggert S, et al. Acupuncture’s role in solving the opioid epidemic: evidence, cost-effectiveness, and care availability for acupuncture as a primary, non-pharmacologic method for pain relief and management-white paper 2017. J Integr Med. 2017;15(6):411–25.PubMedGoogle Scholar
  230. 230.
    Crawford P, Penzien DB, Coeytaux R. Reduction in pain medication prescriptions and self-reported outcomes associated with acupuncture in a military patient population. Med Acupunct. 2017;29(4):229–31.PubMedPubMedCentralGoogle Scholar
  231. 231.
    Tedesco D, Gori D, Desai KR, Asch S, Carroll IR, Curtin C, et al. Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis. JAMA Surg. 2017;152(10):e172872.PubMedPubMedCentralGoogle Scholar
  232. 232.
    Baker TE, Chang G. The use of auricular acupuncture in opioid use disorder: a systematic literature review. Am J Addict. 2016;25(8):592–602.PubMedGoogle Scholar
  233. 233.
    Kattalai Kailasam V, Anand P, Melyan Z. Establishing an animal model for National Acupuncture Detoxification Association (NADA) auricular acupuncture protocol. Neurosci Lett. 2016;624:29–33.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery, Division of Physical Medicine and RehabilitationUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Department of Anesthesia, Critical Care and Pain MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  3. 3.Department of Anesthesia, Critical Care and Pain MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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