The design was a double blind, two-group parallel randomised controlled trial. The active intervention was an 830 nm (infrared), 10 mW, Ga-Al-As laser diode laser for acupuncture and a sham control. The primary outcome measures were changes in pain (visual analogue scale) and disability (Oswestry Disability Index) at the end of 5–10 treatment sessions. Secondary outcomes were patient global assessment, psychological distress (Depression Anxiety Stress Scale) and subjective wellbeing (Personal Wellbeing Index). Follow up was performed at 6 weeks and 6 months after completion of treatment.

100 participants were enrolled and treated in a general practice setting. Per protocol analysis of the primary outcome measures using ANOVA suggested that although there was a significant overall improvement in pain and disability after the course of treatments (p<0.01), there was no significant difference between the intervention and control group in both the primary and most secondary outcome measures.

This study did not show a specific effect for LA using infrared laser at 0.2 Joules per point for chronic low back pain. The overall intervention appeared effective because of placebo and other factors. As there was some concern about baseline inequality between the groups further research using tighter inclusion criteria should attempt to replicate the result and examine if a dose response may exist.

The acupuncture group (n = 134) received 10 acupuncture treatment sessions and advice on self-care; the control group (n = 133) received advice on self-care only. The study acupuncturists met the current membership criteria of the Norwegian Acupuncture Society, and had at least 3 years’ experience of practising TCM acupuncture. They were free to diagnose and select acupuncture points for each participant, after initial discussion.

Fifty per cent of the participants in the acupuncture group were diagnosed with Kidney Yin Xu as their primary TCM syndrome diagnosis. No statistically significant differences were demonstrated between the syndrome groups regarding the distribution of responders and non-responders, nor regarding the change in health-related quality of life scores. A core of common acupuncture points (SP6, HT6, KI7, KI6, CV4, LU7, LI4, and LR3) were used in all the syndromes, and in addition multiple idiosyncratic points. Core point selection and frequency of use did not differ between responders and non-responders. No serious adverse events were reported.

Factors other than the TCM syndrome diagnoses and the point selection may be of importance regarding the outcome of the treatment.

12 males with established radiation induced xerostomia were treated in three groups of four. Each received eight weekly sessions of acupuncture using four bilateral acupuncture points (Salivary Gland 2; Modified Point Zero; Shen Men and one point in the distal radial aspect of each index finger (LI1)). Sialometry and quality of life assessments were performed at baseline and at the end of treatment. A semi-structured interview was conducted a week after completing the intervention.

Adherence to and acceptability of the treatment and assessments was 100%. There were objective increases in the amounts of saliva produced for 6/12 patients post intervention and the majority also reported subjective improvements. Mean quality of life scores for domains related to salivation and xerostomia also showed improvement. At baseline 92% (11/12) patients reported experiencing a dry mouth "quite a bit/very much" as compared to 42% (5/12) after the treatment. Qualitative data revealed that the patients enjoyed the sessions.

The pilot study shows that a standardised group technique is deliverable and effective. The tools for objective and subjective assessment are appropriate and acceptable. Further examination in a randomised trial is now warranted.

An exploratory study was conducted on 40 healthy subjects: 20 cases (mean 55.90, SD 16.04) and 20 controls (mean 51, SD 11.91). Videocapillaroscopy was used to detect variations in oral microcirculation. This method permits an accurate and non-invasive in vivo study of the capillaries of the oral mucous. The site selected for this pilot study is the lower lip since it is the simplest to investigate and is more readily accessible. Assessments were carried out in three phases: t₀ before the application of the needles; t₁ one minute after the application; t₂ five minutes after the application; similar time points were used for the control group. Data were compared using the Mann-Whitney test.

The study showed characteristic changes in oral microcirculation induced by acupuncture. The tortuousness of capillary loops and in the diameter of the afferent loop changed significantly (p<0.05) over time in the acupuncture group but not in the controls.

The findings lend support to our expectation that acupuncture may generate significant variations in oral microcirculation in healthy adults. Further research is needed to confirm these findings and evaluate the therapeutic role of acupuncture in oral pathologies.

Sham needles were developed by blunting true acupuncture needles. Whiplash injured patients (<16 weeks duration) were randomly allocated to receive either true acupuncture or the "placebo" sham needle control. The true and sham needling interventions were delivered using the same standardised procedure. Patients were informed that they would receive either real or placebo needles, and asked (i) to state which treatment they believed they had received (treatment belief); (ii) to complete the four item Borkovec and Nau self-assessment credibility scale. Results were compared between groups and the analysis explored whether a patient’s previous experience of acupuncture was related to their treatment belief. Other outcomes of the study will be reported elsewhere.

20 patients received the true acupuncture and 21 received the sham. There was no significant difference between the treatment beliefs of the two groups (² = 1.51; p>0.2) nor in the mean item scores on the Borkovec and Nau credibility scale (t test, p values ranged from 0.38 to 0.87). Of the patients in the sham acupuncture group who had previous experience of acupuncture, none recorded receiving the sham intervention.

Within the context of this pilot study, the sham acupuncture intervention was found to be a credible control for acupuncture. This supports its use in a planned, definitive, randomised controlled trial on a similar whiplash injured population.

A total of 42 conventionally treated pregnant women were allocated by chance into two groups to be treated, or not, by acupuncture. They reported the severity of symptoms and the disability these were causing in daily aspects of life such as sleeping and eating, using a numerical rating scale. The study also observed the use of medications.

Six women dropped out (one in the acupuncture group and five in the control group). Significant improvements in symptoms were found in the study group. This group also used less medication and had a greater improvement in their disabilities when compared with the control group.

This study suggests that acupuncture may alleviate dyspepsia during pregnancy.

To review studies on acupuncture and moxibustion therapy for respiratory disease conducted in Japan.

The results of a literature search using "Igaku Chuo Zasshi Web" and the Medical Online Library, both of which are Japanese databases, covering the period between 1979 and 2006.

This study reviewed references cited in retrieved documents and selected original articles and case reports on acupuncture and moxibustion therapy for respiratory disease.

The search terms used were "acupuncture" and "respiratory disease", along with "respiratory", "asthma", "COPD", "bronchitis" and "common cold".

The study retrieved 34 papers on acupuncture treatment for respiratory disease written in Japanese (9 full papers, 19 case reports and 6 case series). The papers dealt with such conditions as asthma (14 trials), cough variant asthma (one trial), chronic obstructive pulmonary disease (seven trials), chronic bronchitis (one trial), usual/idiopathic interstitial pneumonia (one trial) and the common cold (two trials). The study also found eight trials dealing with cold prevention.

A small number of reports on acupuncture and moxibustion treatment for respiratory diseases were found in the Japanese databases. Future studies must use more rigorous evaluation methods, such as randomised controlled trials, to measure the effectiveness of acupuncture and moxibustion therapy for treating respiratory diseases.

A randomised trial of knee OA patients was conducted. Patients were randomly allocated into two groups of 35. The "six point group" received treatment at six acupuncture points, ST35, EX-LE4 (Neixiyan), ST36, SP9, SP10 and ST34, while the "two point group" received treatment at just the first pair of points, ST35 and EX-LE4. Both groups received twice weekly electroacupuncture on 10 occasions. Electrical stimulation was carried out at low-frequency of 3 Hz to all points, with the intensity as high as tolerable. Both groups were allowed to take a 200 mg celecoxib capsule per day for intolerable pain. Patients were assessed at baseline, week 5, week 9 and week 13, using a Thai language version of the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Global assessment of change after 10 treatments was also recorded.

Acupuncture at both six and two acupuncture points was associated with significant improvement. Mean total WOMAC score at weeks 5 and 13 of patients in both groups showed no significant difference statistically (p = 0.75 and p = 0.51). Moreover, the number of celecoxib capsules taken, global assessment of global change and body weight change of both groups also showed no statistical difference.

This evidence suggests that electroacupuncture to two local points may be sufficient to treat knee OA, but in view of some limitations to this study further research is necessary before this can be stated conclusively.

107 patients who were undergoing abdominal hysterectomy or laparascopic cholecystectomy were randomised to receive either electroacupuncture (n = 56) or no additional treatment (n = 46) during the operative period. We measured the use of patient-controlled analgesia and time in recovery as well as pain, postoperative nausea and vomiting, and sedation. 102 patients were included in the analysis. The majority of patients were female: the laparoscopic cholecystectomy group included 10 males. Adhesive dressings were placed over all acupuncture points in both groups, to ensure blinding of patients and assessors during the recovery period.

The electroacupuncture group had a longer duration of operation but the difference was not statistically significant. There were no significant differences between the groups for the requirement for patient-controlled analgesia or total time in recovery. Pain scores were marginally lower in the acupuncture group, but not significantly, and there were no differences between the groups in nausea or sedation scores.

Electroacupuncture at 10 Hz given under general anaesthetic has no effect on postoperative nausea or analgesic requirement. Future studies should investigate acupuncture given before or after surgery.

A prospective, randomised, patient- and assessor-blinded, sham controlled study was conducted on three consecutive days in a district general hospital. Credibility of both acupuncture and the Park sham device were assessed using the Borkovec and Nau questionnaire. Dyspnoea was measured on the modified Borg score and a 10 cm visual analogue scale, while anxiety was measured on a 10 cm visual analogue scale.

11 patients were recruited and nine completed the study. There were no adverse events with either intervention. Acupuncture was well tolerated and credibility scores were similar before and after real and sham acupuncture. Symptoms improved after both treatments, with no significant difference between groups.

In this pilot study acupuncture was well tolerated by subjects experiencing an acute exacerbation of COPD. Acupuncture treatment and the Park sham device were both credible. Although recruitment was slow, a further trial with a larger sample size is feasible and recommended.

Moxa, in the form of cigar shaped moxa "sticks" or "rolls", was tested under International Organization for Standardization conditions in a tobacco testing laboratory, and the quantities of a number of pre-determined volatiles measured. The smoke tested was "sidestream smoke", the smoke which arises from the burning tip of the moxa. The test results were then scaled up to reflect normal use and to provide direct comparisons with agreed national safety standards for both short- and long-term exposure levels.

Levels of only two volatiles produced were equivalent or greater than the safe exposure levels, as was the carbon monoxide level reported, both as a consequence of using worst case assumptions for comparison. Under normal operating conditions neither volatile nor carbon monoxide would present a safety hazard. One group of chemicals tested, the aromatic amines, with known carcinogenic properties have no agreed safety levels. Results for these in the study compared favourably with background levels reported in urban environments.

There are no immediate concerns arising from the continued use of moxa as a therapeutic modality in traditional Chinese medicine. Further testing may be required to establish whether current recommendations for ventilation and cleansing of treatment room surfaces may need to be revised. Stronger recommendations may also be necessary on the inadvisability of using moxa on broken skin.

This study explores the referral behaviour of GPs and other primary care users of the Gateway Clinic.

A pragmatic mixed-methods approach was used, combining mapping of GPs’ usage of the Gateway as taken from the clinic’s database between the years 2000 and 2005, a questionnaire survey of the referring primary care practitioners in 2005, and data, including a thematic analysis of the interview transcripts from semi-structured interviews of a purposive sample of those GPs who refer.

Doctors in the community refer a wide range of health problems to the Gateway Clinic. The most common referrals were musculoskeletal conditions (38–44%), general and unspecified conditions (11–14%), blood and immune system conditions (6–12%), psychological conditions (8–13%), neurological conditions (6–9%), gynaecological conditions (5–6%) and digestive conditions (5–6%). The health problems referred by local healthcare practitioners correlate strongly with the patient profile seen in private acupuncture practice. Between 2000 and 2005 numbers of healthcare practitioners increased by 218% resulting in a 300% increase in patient referrals made to the clinic; the mean frequency of referral per practitioner increased by 71%. Analysis of the qualitative data suggests that positive clinical experience encourages GPs to increase the range of conditions they refer leading to the development of informal referral guidelines.

The Gateway Clinic has become an increasingly popular referral resource. The influences that drive referral to the clinic are multiple and follow "tacit guidelines". GPs select patients on the basis of their individual clinical experience, informed by positive patient feedback and often only after more conventional medical treatment options have been exhausted.

Three primary care trusts (PCTs) were selected, and all practices within each trust were sent an email asking whether any member of the primary care team offered acupuncture, and if so how many appointments per week. Data on rates of referral to orthopaedic, physiotherapy, pain and rheumatology clinics were then sought from the PCT, both for the practices offering acupuncture and for the PCT as a whole. Similarly, data on costs of prescriptions for non-steroidal (NSAID) and non-opioid analgesic drugs were obtained from the Prescription Pricing Authority.

Out of the 109 practices surveyed, a total of 14 (13%) offered acupuncture services to some extent. There was wide variation in provision between the different PCTs. The eight practices which offered at least one appointment per week for every 2000 registered patients were included in the analysis. The mean values (and SDs) for the three PCTs and for the eight acupuncture practices, respectively, were as follows: for referral to various clinics: orthopaedic 32.3 (16.2) and 27.4 (10.87); pain clinic 1.6 (1.3) and 2.8 (1.6); physiotherapy 13.4 (14.5) and 29.5 (10.0); and rheumatology 4.7 (2.3) and 6.4 (3.0). The mean values for costs of non-opioid analgesics were £1820 (£442) and £2008 (£762); and for NSAIDs were £4148 (£269) and £4476 (£1366), respectively. There were no trends towards a reduction of clinic referral or prescription costs.

We have conducted the first survey of the effects of provision of acupuncture in UK general practice, using data provided by the NHS, and uncovered a wide variation in the availability of the service in different areas. We have been unable to demonstrate any consistent differences in the prescribing or referral rates that could be due to the use of acupuncture in these practices. The wide variation in the data means that if such a trend exists, a very large survey would be needed to identify it. However, we discovered inaccuracies and variations in presentation of data by the PCTs which have made the numerical input, and hence our results, unreliable. Thus the practicalities of access to data and the problems with data accuracy would preclude a nationwide survey.

144 consecutive patients with nociceptive pain for >3 months, aged 18–70 years were alternately allocated to: intramuscular acupuncture (n=59); periosteal acupuncture (n=55); or control group with information only (n=30). All patients were encouraged to stay active. Acupuncture was administered with eight treatments during five weeks, and two optional additional treatments after one month. Pain was estimated with a daily VAS in a pain diary and with an average weekly pain score. Clinically relevant pain relief was defined as at least a 30% decrease from the initial value. Physical functioning was evaluated with Disability Rating Index. All estimations were performed prior to treatment, one week after, and one, three and six months after treatment.

There were no differences between the effects of the two acupuncture methods. There were differences between each of the two acupuncture groups compared with the control group on all test occasions up to one month after treatment with respect to the pain diary and one week after treatment with respect to pain last week (P<0.05). Pain relief as measured by a pain diary was obtained in 29 patients in the intramuscular acupuncture group, 25 in the periosteal acupuncture group, and 5 patients in the control group. Six months after treatment, 46% of the intramuscular acupuncture patients and 45% of the periosteal acupuncture patients had obtained pain relief in terms of the pain diary. The corresponding figure for pain last week was 29% in each group.

Periosteal pecking was no more effective than standard intramuscular acupuncture, but both were more effective than information only.

One hundred and fourteen informed, consenting, healthy volunteers were recruited. An experienced acupuncturist applied one of the following needle pairs – penetrating/non-penetrating, non-penetrating/non-penetrating, penetrating/penetrating – randomly at bilateral TE5 points in subjects who were informed that they would receive either a non-penetrating or a penetrating needle. After the application of a pair of needles, the subjects reported for each arm on whether they identified the needle as non-penetrating or penetrating. The patients also rated skin penetration/penetration-like pain and the deep dull pain (de qi) associated with the needle application on a visual analogue scale (VAS). The chi squared goodness of fit test was used to determine the probability of the number of correctly and incorrectly identified needles. Statistical comparisons for VAS scores for skin penetration pain and de qi were made using Mann-Whitney’s U test.

Of the 114 non-penetrating needle applications, the subjects identified 64 incorrectly and 50 correctly, fitting a probability of 0.5 (²=1.72, P=0.19). Most interestingly, the subjects identified 36 (32%) of 114 penetrating needle applications incorrectly. Skin penetration/penetration-like pain and de qi scores did not differ significantly (P=0.87 and P=0.17, respectively) between the 114 non-penetrating and 114 penetrating needles.

The non-penetrating placebo needle was effective in masking fully informed subjects. When used together with the matched penetrating needle, it has potential for use in double blind (patient and practitioner blind) studies.

Nine patients with lumbar spinal canal stenosis for whom conventional acupuncture at the lumbar and lower limb muscles had no effect. Pudendal nerve electroacupuncture was performed eight times (once per week). VAS scores and continuous walking distance were used to evaluate changes in symptoms.

The following changes in symptoms occurred after pudendal nerve electroacupuncture: low back pain was improved from 45.3±17.4mm (mean ± SD) to 39.2±14.0mm, lower limb pain was improved from 61.1±5.6mm to 35.4±11.9mm, lower limb dysaesthesia was improved from 63.9±8.4mm to 46.9±16.2mm, and continuous walking distance was improved from 100.0±35.4m to 250.0±136.9m.

Pudendal nerve electroacupuncture may be an effective treatment for lumbar and lower limb symptoms due to spinal canal stenosis, and is potentially useful in patients who have not responded to conventional acupuncture.

Using rats (n=5), efferent electrical stimulation to the pudendal nerve was performed and sciatic nerve blood flow was measured with laser Doppler flowmetry. Simultaneously, changes in the blood pressure and cardiac rate were measured. Furthermore, the effect of atropine on these responses to the stimulation was also studied.

Electrical stimulation of the pudendal nerve significantly increased blood flow in the sciatic nerve transiently without increasing heart rate and systemic blood pressure. The significant increase in the sciatic nerve blood flow disappeared after administration of atropine.

Electrical stimulation of the pudendal nerve causes a transient and significant increase in sciatic nerve blood flow. This response is eliminated or attenuated by administration of atropine, indicating that it occurs mainly via cholinergic nerves.

Sprague-Dawley rats (n=100) anaesthetised with urethane (1.2g/kg ip) were used. Manual acupuncture with sparrow pecking (SP) at different doses (1, 10 or 30 pecks) was given to the right ventral hindlimb muscles (tibial anterior and extensor digitorum longus muscles) or the right dorsal hindlimb muscles (gastrocnemius, plantaris and soleus muscles). MBF with or without MA was measured using the radiolabelled microsphere technique. The blood pressure was recorded through the right common carotid artery until MBF measurement started. Denervation of hindlimb was conducted by cutting the sciatic and femoral nerves.

In normal rats, significantly increased MBF after MA were observed only in muscles which were penetrated by an acupuncture needle. The size of the increase depended on the number of times of pecking and seemed to be sustained at least until 60 minutes after MA. However, the increase was observed after both acute and chronic denervation. On the other hand, the mean arterial blood pressure (MAP) did not change significantly before, during or after MA.

These results suggest that MA could increase muscle blood flow locally in a dose-dependent manner and that this increase may be caused by local vasodilators, as well as the axon reflex. A further study is needed to elucidate the mechanism.

Using various search strategies, a professional librarian searched six electronic databases (PubMed, AMED, Science Direct College Edition, China Academic Journals, Acubriefs, and the in-house Journal Article Index maintained by the Oregon College of Oriental Medicine Library). English and Chinese language human studies with all study designs and for all clinical indications were included. Excluded were experimental and animal studies, electroacupuncture and transcranial magnetic stimulation. Data were extracted on clinical indication, study design, number, age and gender of subjects, magnetic devices used, acu-magnet dosing regimens (acu-point site of magnet application and frequency and duration of treatment), control devices and control groups, outcomes, and adverse events.

Three hundred and eight citations were retrieved and 50 studies met our inclusion criteria. We were able to obtain and translate (when necessary) 42 studies. The language of 31 studies was English and 11 studies were in Chinese. The 42 studies reported on 32 different clinical conditions in 6453 patients from 1986–2007. A variety of magnetic devices, dosing regimens and control devices were used. Thirty seven of 42 studies (88%) reported therapeutic benefit. The only adverse events reported were exacerbation of hot flushes and skin irritation from adhesives.

Based on this literature review we believe further investigation of acu-magnet therapy is warranted particularly for the management of diabetes and insomnia. The overall poor quality of the controlled trials precludes any evidence based treatment recommendations at this time.

Forty children (median six weeks of age) with excessive crying unresponsive to conventional therapies, were recruited from 21 Child Welfare Clinics within an area of western Sweden, and quasi-randomised to control or light needling treatment. Parents were unaware of which group their child was assigned to. Children were given light needling acupuncture on one point (LI4) on both hands for approximately 20 seconds on four occasions, or received the same care except needling. Parental assessment questionnaires were used pre- and post-treatment to assess crying intensity, frequency, duration of crying and pain related behaviour throughout the day in six hour periods.

Light needling resulted in a significant reduction in the rated crying intensity (assessed by a numeric rating scale, 0 to 10). For example, during the morning time period 0600–1200 hours, the median (range) rated crying intensity changed from 6 (1 to 9) pre-treatment to 2 (0 to 5) post-treatment (P=0.002), in the light needling group. The corresponding ratings for the children in the control group was 6 (0 to 10) and 5 (0 to 10) respectively. The difference between the groups was significant (P=0.016). There were also significant differences between the groups for the afternoon (1200–1800 hours), and evening (1800–midnight) time periods. Pain related behaviour like facial expression, was also significantly less pronounced in the light needling group as compared to the control group post-treatment, (P=0.027). The parents rated the light needling as more effective in improving symptoms than the control group (P<0.001).

Four treatments with light needling on one point in the hand may alleviate crying and pain related behaviour without any noted side effects.

Acupuncture naive patients with symptomatic and radiological evidence of osteoarthritis of the knee were randomly allocated to a course of either acupuncture or non-penetrating sham acupuncture using a sheathed ‘placebo’ needle system. Acupuncture points for pain and stiffness were selected according to acupuncture theory for treating Bi syndrome. Both manual and electrical stimulation were used. Response was assessed using the WOMAC index for osteoarthritis of the knee, self reported pain scale, the EuroQol score and plasma β-endorphin. The effectiveness of blinding was assessed.

There were 34 patients in each group. The primary end point was the change in WOMAC pain score after the course of treatment. Comparison between the two treatment groups found a significantly greater improvement with acupuncture (mean difference 60, 95% CI 5 to 116, P=0.035) than with sham. Within the acupuncture group there was a significant improvement in pain (baseline 294, mean change 95, 95% CI 60 to 130, P<0.001) which was not seen by those who had sham acupuncture (baseline 261, mean change 35, 95% CI-10 to 80, P=0.12). Similar effects within group, but not between groups, were seen with the secondary end points of WOMAC stiffness, WOMAC function, and self reported pain. One month after treatment the between group pain difference had been lost (mean difference 46; 95% CI –9 to 100, P=0.10) although the acupuncture group was still benefiting compared to baseline (mean difference 59; 95% CI 16 to 102, P=0.009). The EuroQol score, a generic measure of health related quality of life, was not altered by the treatments. A minority of patients correctly guessed their treatment group (41% in the acupuncture group and 44% in the control group). Plasma β-endorphin levels were not affected by either treatment.

Acupuncture gives symptomatic improvement for patients with osteoarthritis of the knee, and is significantly superior to non-penetrating sham acupuncture. The study did not confirm earlier reports of release of plasma β-endorphin during acupuncture.

Two studies were conducted (Experiment 1 and 2) in the Tsukuba University of Technology, Tsukuba, Japan. Experiment 1 examined the responses before, during and after acupuncture. Experiment 2 compared acupuncture and a no acupuncture control in a two period, repeated measurement crossover design. Twelve healthy male university students were recruited for Experiment 1 and nine healthy male university students for Experiment 2. The intervention was superficial acupuncture at the acupuncture point TE5. Following the insertion, gentle repetitive tapping stimulation was applied during the subject’s exhalation phase in a sitting position for 90 seconds. The main outcome measures in Experiment 1 were pupil diameter, heart rate, pulse wave and blood pressure. In both experiments, pupil diameter was measured for three minutes before acupuncture stimulation, during stimulation and for three minutes after stimulation.

In Experiment 1, a decrease in pupil diameter was observed after acupuncture stimulation (P=0.018) and a decrease in heart rate was observed during the stimulation (P=0.049). Moreover, a significant decrease of pulse wave amplitude was observed during and after acupuncture stimulation. In Experiment 2, a decrease in pupil diameter occurred after acupuncture stimulation (P=0.007), whereas no change occurred under the no acupuncture control.

It is thought that the pupillary constriction observed after gentle, superficial acupuncture stimulation may be attributed to an increase of parasympathetic nerve function. Further study is necessary in order to further clarify the duration of the observed response and to elucidate the mechanisms behind it.

Twenty nine women who had had mastectomy or segmentectomy with axillary dissection, presenting with lymphoedema and/or a decrease in movement amplitude of the upper limb ipsilateral to surgery were studied. The patients underwent 24 acupuncture sessions once a week from February to December 2004. The movement amplitude of shoulder flexion and abduction and circumferential measurements of the arm, forearm and wrist were evaluated before and after one, three and six months of treatment. Statistical analysis was performed by Friedman’s test.

Significant improvements in range of movement of shoulder flexion and abduction (P<0.001), degree of lymphoedema (P=0.016), and sense of heaviness and tightening (P<0.001) in the affected limb after six months of therapy were observed. For circumferential measurements of the arm, forearm and wrist, no significant improvement between the different periods of treatment was observed.

Acupuncture in rehabilitation after breast cancer surgery was shown to be associated with improvements in movement amplitude of the shoulder, symptoms of heaviness and tightness in the arm, and the degree of lymphoedema. However, controlled trials should be performed to ascertain whether the results were due to the natural history of the complaint or the acupuncture treatment.