ACUPUNCTURE is one of the most popular treatments in alternative medicine. An estimated 10 million treatments are given a year to more than 1 million American patients. Many acupuncturists lack medical skills to make a proper diagnosis or to recommend other treatments when such are more appropriate. It would be better if physicians learned modern scientific acupuncture and used it when indicated for the no-drug treatment of pain and other selected conditions.

Health is seen by traditional acupuncturists as a balance of two opposites, Yin and Yang, sometimes likened to the sympathetic and parasympathetic nervous systems. Diseases are associated with an imbalance of qi and consequently with a disturbance of energy. Acupuncture is aimed at correcting it. Therefore most medical conditions are viewed as amenable to treatment with acupuncture. Most disturbances are thought to be detectable before they develop into a disease state. Apparently healthy people are thus encouraged to benefit from preventative acupuncture. Viewed from a TCM perspective, acupuncture is a causal therapy in many instances.

Most clinical trials of acupuncture are under-powered. Some experts therefore hope that the large studies currently emerging from Germany will clarify some of the questions left open by systematic reviews. These three-armed randomized multicentre trials follow a similar design: patients were treated by German physicians experienced in acupuncture with either real acupuncture, or with minimal acupuncture (as a form of placebo), or they did not receive any acupuncture during the trial period. In addition, all patients received medical care as usual. One such study involved 302 patients with migraine headaches. To monitor therapeutic success, they completed headache diaries from 4 weeks before to 12 weeks after randomization and from weeks 21–24 after randomization. The results show that acupuncture was no more effective than minimal acupuncture but both generated better results than experienced by patients on the waiting list. Another RCT included 270 patients with tension-type headache. Its results were almost identical with those of the previous study. A further trial included 294 patients with osteoarthritis. After 8 weeks of treatment, pain and function were improved more with acupuncture than with minimal acupuncture or no acupuncture. However, these benefits decreased over time. Whilst these studies provide valuable information, they have been criticized, e.g. for the risk of patient de-blinding or for not having adopted the optimal treatment protocol or for the possibility that minimal acupuncture also had therapeutic effects and was therefore an unfair comparator. More importantly, they fail to conclusively answer the question whether acupuncture helps patients through a specific or a nonspecific effect.

Evidence-based acupuncture is a simple method for no-drug pain control and should be taught in medical schools and made available to all physicians. We believe existing state requirements for acupuncture certification should be specified as for "Oriental medical doctor" with no special certification required for physic