Acupuncturists Should Know Anatomy

February 2000; Volume 3: 24

Source: Peuker ET, et al. Traumatic complications of acupuncture. Therapists need to know human anatomy. Arch Fam Med 1999;8:553-558.

To review the traumatic injuries that have been associated with acupuncture and to discuss how these adverse effects may be reduced by increased awareness of normal anatomy and anatomical variations, we undertook an extensive literature search accompanied by postmortem anatomical studies. Traumatic lesions after acupuncture have been described in thoracic and abdominal viscera, in the peripheral and central nervous systems, and in blood vessels. Deaths have been recorded from pneumothorax and cardiac tamponade. The frequency of adverse effects of acupuncture is unknown and they may be rare. Nevertheless, acupuncturists’ knowledge of normal anatomy and anatomical variations is essential for safe practice. Regulatory bodies and those responsible for training courses should test acupuncturists for this knowledge.

Comment

This thorough brief report notes that acupuncture treatment can penetrate the skin up to several centimeters. Acu-puncture treatments in the United States now number more than 10 million annually.

The authors provide 68 references to English-, French-, and German-language articles (including those reviewing the Asian experience) on adverse effects. The authors also "froze four fresh human cadavers, and took cross-sections at the level of acupuncture points lying within close proximity to vulnerable organs."

The most often reported injury was pneumothorax: Ninety incidents were found, including two fatal ones. Supraclavicular, infraclavicular, parasternal, and midclavicular points were particularly risky. Postmortem exams revealed that a puncture depth of 10-20 mm "can reach the lungs." Six cases of injury to the heart were found, two of which were fatal. Ten cases of injury to the spinal cord, including four caused by migration of needle fragments were also found. In contrast, lesions of abdominal viscera, the peripheral nerves, and blood vessels were rarely reported.

Case reports, of course, do not yield frequency, and may not yield causation. Underreporting is likely, and variables are many. But acupuncture is not all incense and history.

Recommendation

Acupuncture is not benign, and can have serious adverse effects. Make sure your acupuncturist knows anatomy, and uses it.