The treatment of physical pain is big business. There are pain clinics, especially in the western world where individual clinics just focus on headache, back ache, leg pain, shoulder pain etc. Acupuncture has been a treatment for pain relief, and many in Nepal as elsewhere will swear by the effectiveness of this form of therapy in relieving pain. If you are one of those who are reaping benefits from this form of therapy, this article is not meant to discourage you from acupuncture. Please continue acupuncture.

Recently as reported in a prestigious journal called Pain (what else?), E. Ernst and colleagues carried out a review of published articles on acupuncture to ascertain if indeed acupuncture alleviated pain and if there were any risks involved. The final conclusion was not clear cut, at best the evidence for the effectiveness of acupuncture for pain is mixed, according to this review.

This study was a 'mega' review, a review of reviews, if you will. It covered a range of pain syndromes. Of the 36 reviews rated as good or excellent quality, 13 (36 per cent) reached a positive or tentatively positive conclusion, 14 (39 per cent) failed to show effectiveness and 9 ( 25 per cent) were inconclusive. In short, the results provided meager evidence that acupuncture is generally effective.

In the 36 per cent who felt that acupuncture worked for them, there was one factor that may have helped, that is the placebo effect, which is not easy to measure to begin with. This placebo effect could possibly be attributed to a consultation with a sympathetic doctor. Many think that health professionals in the 'alternative' branch of medicine (which includes acupuncture, homeopathy, ayurvedic medicine etc) in general better empathise with patients and treat them with a greater degree of compassion than practitioners of Western medicine. The alternative medicine doctors probably realise more clearly that the internal fear and pain of patients may be decreased with the doctor's voice, words, and smile. Perhaps the value of acupuncture is also attributable to the sympathy of the acupuncturists, rather than to their manipulative skills with needles. By the same token, devising trials to meet the standards of modern scientific medicine using double blind controlled trials to observe the true efficacy of acupuncture may not be practical or possible.

Importantly, at a minimum, because acupuncture primarily deals with needles which can potentially spread diseases, it is crucial to make sure that aseptic precautions with clean needles are practiced.