Background

Acupuncture is one of the oldest medical procedures in the world and originated in China around 2,000 years ago. The word itself means needle penetration; it typically involves the insertion of metallic needles into the skin. The goal is to stimulate certain anatomical points of the body, and the method is generally very safe. Modalities other than needles, including manual pressure, electrical stimulation, magnets, heat and ultrasound, can be used as well. Acupuncture is commonly used in sports rehabilitation for pain relief but is also used to treat headache, fatigue and many mental health conditions.

The basis for acupuncture in traditional Chinese medicine is that illness results from imbalances in the energy flow, or qi (pronounced “chee”), of the body. The qi is thought to travel through meridians located on the body. Qi is closely related to the harmonious balance of the body, both internally and externally in relationship to the surrounding environment. One of the main goals of acupuncture is to restore the dynamic balance of the body.

Symptoms/Risks

Acupuncture is considered a low risk modality. There may be some discomfort with placement of the needles, however they tend to be very thin and well-tolerated by patients.

Sports Medicine Evaluation and Treatment

In a traditional acupuncture visit, practitioners will often use “four pillars of evaluation” that include inspection, auscultation (listening), inquiry (history taking) and palpation. After a diagnosis is reached, fine metal needles will be inserted at previously designated points in the body to restore balance and harmony in the body. There are said to be 14 meridians of the body with 365 points along those meridians where acupuncture may be performed.

Injury Prevention

Acupuncture has most often been used to promote healing and in the rehabilitation process after injuries. There are claims of injury prevention by improving the pliability of muscles and other soft tissues, however support in the standard medical literature is lacking in this area.

Return to Play

Studies have shown that acupuncture can significantly decrease pain and improve disability due to pain in patients with musculoskeletal conditions. The theories that acupuncture is based on are similar to other common treatments in sports medicine, including trigger point injections and dry needling. These techniques approach the pain from a Western medical view of the acupuncture points as places to stimulate nerves, muscles and connective tissue. This perspective sees these tender and hyper-irritable areas of muscles as causing both local pain and pain that travels to other areas.

Acupuncture is a complementary medicine treatment that has been used for centuries. While the exact mechanism is unknown and results in the medical literature have been a mix of more and less favorable outcomes, the treatment has undoubtedly provided pain relief for many patients. The combination of acupuncture, dry needling, or trigger point injections with other sports medicine treatments, such as physical therapy, can be used to help patients reduce pain in a safe and effective way.

AMSSM Member Authors
Christine Norton, MD and Daniel Divilbiss, MD

References
1. Khan K, Brukner P. Brukner & Khan’s Clinical Sports Medicine. 4th edition. New York, NY, USA. McGraw-Hill Education. 2011.
2. UpToDate - Acupuncture, Andrew C. Ahn, MD, MPH
3. Yuan, Q., Wang, P., Liu, L. et al. Acupuncture for musculoskeletal pain: A metaanalysis and meta-regression of sham-controlled randomized clinical trials. Sci Rep 2016;6:30675.