Acupuncture Point Localization Varies Among Acupuncturists

Abstract

Background: Studies assessing the point-specific effect of acupuncture or the characteristics of acupuncture points (APs) tend to yield inconclusive results. In order to identify a possible confounding factor, we aimed to examine the variability in AP localization by means of a survey. Material and Methods: Attendees of the 14th ICMART (International Council of Medical Acupuncture and Related Techniques) congress as well as DÄGfA (German Medical Society of Acupuncture) lecturers and students were asked to locate and mark the APs LI 10 and TH 5 on a research assistant’s arm. Identified points were transferred into a coordinate system, and the respective bivariate distribution function was calculated. Additionally, participants filled out a questionnaire about their acupuncture education and experience, the acupuncture style and point localization techniques used most frequently, and their estimation of the size of an AP. Results: The areas of the ellipses, theoretically containing 95% of AP localizations, varied between 44.49 and 5.18 cm². The largest distance between 2 identified points was 8.45 cm for LI 10 and 5.3 cm for TH 5. Apart from being trained at the same school, no other factor could be identified that determined the variability in AP localization. Conclusion: Our results indicate that congruity of AP localization among experienced acupuncturists might be low. Although there are some limitations to our results, this possible bias should be taken into account when conducting acupuncture trials and interpreting results of previous acupuncture studies.

Acupuncture analgesia: Is it verum or sham?

“…This begs the question whether the traditional concept of an acupuncture point does indeed exist, and what, if any, is its significance. Notwithstanding the fact that there is a considerable variation between practitioners in localisation of individual points 13 , the lack of understanding of acupuncture's mechanism and whether this is point-specific has hampered ongoing efforts in defining acupoint relevance. Recent neuroimaging research appears to indicate that there is, indeed, a difference in cerebral activation patterns between acupuncture at verum points and random skin 22 , but there is a need for further work in this area.…”

“…Clinical trials comparing verum and sham acupuncture frequently employ very similar techniques, including the use of needles 4 . Although earlier trials have compared the points described during acupuncture performed at Traditional Chinese Medicine (as verum) with acupuncture at other skin sites (as sham) [9][10][11][12] , recent research suggests that acupuncture point localisation is not uniform between practitioners 13 , and that this lack of precision may contribute to the variability in trial outcomes 14 . Some trials have utilised modified needles 15 , or needling with minimal pressure 16,17 as sham, but the lack of a generally-accepted mechanism as to how acupuncture works has resulted in uncertainty in interpreting the results of these trials 4 .…”

Does the Acupuncture Point Shaoshang (Lu11) in Humans Match with an Increased Density of Connexines?

“…The AP Lu11 has a clear anatomical localization, in contrast to numerous other APs which are much more difficult to localize [7][8][9]. This anatomical identification was, however, crucial to match the AP with the described changes of Cx density.…”

Neuroimaging and Neuromonitoring Effects of Electro and Manual Acupuncture on the Central Nervous System: A Literature Review and Analysis

“…These treatment programs also vary based on different clinical experiences, styles, and schools. Above this, studies showed that even if the same points were chosen in theory, point locations still varied between doctors [ 67 ].…”