Acupuncture for Military Personnel Health and Performance

Dear Editor:

The recent article, “Military Report More Complementary and Alternative Medicine Use than Civilians,” ¹ reports a higher utilization of alternative medicine and stress reduction therapies by military personnel as compared to general public. In the process, the authors assert that “Unmonitored use of CAM in the military may have negative consequences on health and military performance,” claiming that results of “large randomized, placebo-controlled trials of…acupuncture have been negative,” making the substitution of (this) CAM treatment for proven therapies “risky.” The authors cite two studies in support of this rather alarming statement: a 2006 trial of acupuncture for migraine ² and a 2007 study on patient expectations for chronic pain. ³

Goertz et al. do not cite the more recent and positively conclusive Cochrane Systematic Reviews of acupuncture for tension-type headache ⁴ and for migraine prophylaxis ⁵ They also do not cite the recent systematic review with meta-analysis showing that acupuncture is effective for chronic pain beyond placebo. ⁶ These systematic reviews demonstrate that acupuncture is, in fact, effective for tension headache, migraine prophylaxis, and chronic pain conditions; the authors' claim of negative consequences for acupuncture on military health and performance is not supported by current research. Their conclusion is also not in line with the articles on acupuncture published in Military Medicine.

In terms of safety, acupuncture has a “relative risk” that is low. Systematic reviews and surveys have clarified that acupuncture is safe when performed by appropriately trained practitioners, ^{7 –13} with infrequent minor side-effects such as feeling relaxed, elated, tired, or having point sensation or itching ¹¹ and rare serious complications such as infection or pulmonary embolism directly related to insufficient training. ^12,13 White ¹² surveyed 12 prospective studies of more than a million treatments reporting the risk of a serious adverse event with acupuncture estimated to be 0.05 per 10,000 treatments, and 0.55 per 10,000 individual patients, concluding that the risk of serious events occurring in association with acupuncture is very low, below that of many common medical treatments. Acupuncture is also safe for women who are pregnant ^14,15 and for children. ^7,16,17

Finally, it is now policy of the National Institute for Health and Clinical Excellence (NICE) in Great Britain to recommend acupuncture for the treatment of migraine headache. ¹⁸

Current evidence supports the safe use of acupuncture for the health and performance of military personnel.