Acupuncture: searching for benefits.

(1) Acupuncture has been assessed in hundreds of published comparative trials involving thousands of patients in a variety of situations. (2) Most of these trials are handicapped by their poor methodological quality. (3) Systematic reviews have found evidence of specific benefit in the treatment of nausea and vomiting, both postoperatively and during pregnancy. Unfortunately, the practical implications of these results are limited, notably because various methods were used to stimulate the relevant acupuncture points (needle insertion, finger pressure, electrical stimulation). (4) In other clinical uses it is either impossible to draw conclusions, or the conclusions are negative. Acupuncture should be assessed more rigorously as an analgesic method, especially in the treatment of recurrent headache, neck pain, and dental care. (5) The complications of acupuncture, although infrequent, cannot be overlooked, as they can be severe (especially infections and pneumothorax). Most of these risks might be avoided by the use of more rigorous techniques.