Acupuncture - areas of application, current evidence and proven indications

Acupuncture is often used in addition or exclusively for the treatment of diseases. This report deals with the question in which indications acupuncture is recommended and for which indications evidence exists on the effectiveness of acupuncture. These results are then compared with 25 approved indications from the Austrian Health Council (Oberster Sanitätsrat, OSR), an advisory committee for the Ministry of Health.

We identified WHO recommendations and recommendations from professional associations for the use of acupuncture through a web-based hand search and elaborated an overview of Cochrane Reviews based on a systematic literature search.

The WHO poses recommendations for the use of acupuncture for a total of 108 indications. The professional associations recommend acupuncture also in a wide range of applications. However the results of the overview of Cochrane Reviews (a total of 55 Cochrane Reviews were included) show the effectiveness of acupuncture for only 2 indications (migraine prophylaxis as well as pelvic and back pain during pregnancy). In 7 indications effectiveness could be given. For 4 indications (epilepsy, irritable bowel syndrome, nausea and vomiting in early pregnancy and assisted reproductive technology) the results of the overview of Cochrane Reviews indicate the ineffectiveness of acupuncture. For 42 indications no statement can be made due to missing or inconclusive evidence.

Regarding the 25 OSR indications, the comparison of the available evidence shows that effectiveness of acupuncture has been proven for some areas (headache and migraine, degenerative arthritis, back pain, diseases of the cervical spine, dysmenorrhoea, chronic pain). For allergic rhinitis, vomiting in pregnancy, irritable bowel syndrome and fibromyalgia acupuncture was ineffective. Concerning the other OSR-indications no statements on the effectiveness or ineffectiveness of acupuncture can be made.