This was posted in 2011 in the NY Times Well Blog
Acupuncture Is Safe in Children, Study Finds
Can acupuncture help children?
Is acupuncture safe for children?
According to a large new study in the journal Pediatrics, the short answer is yes — in the hands of a trained practitioner. The study, the first large-scale systematic review on the safety of pediatric acupuncture, found that about one in 10 children had experienced mild side effects, like bruising and pain and numbness at the puncture site. More serious side effects, like infections and nerve impairment, were rare.
Large studies in the past have generally focused on acupuncture in adults and found similar complication rates, with serious side effects occurring in about five of every million treatment sessions.
Acupuncture is one of the most common alternative medicines in the United States, practiced by about three million people — mostly adults — every year. But it is also used with growing frequency in children to relieve pain, migraines and other complaints. About 150,000 children in the United States underwent acupuncture in 2007, according to government estimates. Whether acupuncture poses any particular hazards to children, however, has not been entirely clear.
In the latest study, researchers at the University of Alberta in Canada focused specifically on children, combing through data from 37 international studies. The authors cast a wide net, pooling data from high-quality randomized trials conducted over the past few decades as well as single case reports of injuries.
Over all, out of 1,422 children and teenagers who were included in the analysis, 168 experienced “mild” side effects. More serious problems were rare and tended to be limited to clinics that did not adhere to strict safety standards, including 12 cases of “deformity” from damage to a muscle in the thumb, all reported from the same clinic in China between 1983 and 1989. In another case, a 15-year-old boy in the United States had to be treated with “an extended course” of antibiotics when he developed a fever after undergoing acupuncture and chiropractic treatment for back pain.
“I would say the circumstances in which the serious harms happened do not reflect the modern-day standard of training and credentialing,” said Dr. Sunita Vohra, a professor of medicine at the University of Alberta and an author of the study. “That kind of practice is not what would be expected in most places.” Most American states and Canadian provinces now regulate acupuncture to ensure certain standards of safety and certification, though the regulations vary by state.
The research, financed in part by the Canadian Institutes of Health Research, did not try to answer whether acupuncture is actually effective in children. While some studies have shown that acupuncture can ease chronic neck and back pain and migraine symptoms in adults, “the amount of research done in kids is pretty minimal,” said Michael Waterhouse, the head of acupuncture at the University of California, Los Angeles, pediatric pain program. He added that the results he sees in children who are treated with acupuncture at U.C.L.A. “are as good as the results we get in adults,” though more research is needed.
“There have been some small studies on migraine showing it’s helpful in reducing their frequency and increasing endorphin levels, but that has not been repeated,” he added.
One study from Harvard Medical School in 2000 looked at the effects of acupuncture on a group of about 50 children, most of them teenagers seeking relief from migraines or endometriosis, a condition that can cause painful menstruation. “Most families found acupuncture pleasant and helpful, even for pain that had been very resistant to standard treatment,” the authors wrote. “Although some began with anxiety about the needles and misgivings about the treatment, many developed more positive attitudes over the course of treatment.”
The researchers nonetheless said they believed more research was needed before the results could be generalized to other young patients. “Most of the patients in this study were adolescents; younger children’s experiences might be quite different,” they wrote. “Future studies will need to examine children’s and families’ experience with acupuncture for the entire spectrum of illnesses for which it is used.”