Acupuncture is safe for children if a properly trained health care provider performs the treatment, new research suggests.
Researchers from the University of Alberta in Canada reviewed the literature looking for adverse effects caused by acupuncture in children from birth to 17 years old.
Of 37 reports included in the review, researchers found 25 cases where children experienced serious adverse effects, such as infections, intestinal blockage and coma, and 253 cases of mild adverse effects, such as bruising or bleeding. The reports included randomized controlled trials, cohort studies and case reports.
Overall, mild adverse effects occurred in nearly 12 percent of patients, according to the analysis.
Needle acupuncture is increasingly used to treat children for a variety of conditions including chronic pain and post-operative nausea, said study co-author Dr. Sunita Vohra, an associate professor of medicine at the university. While several studies have looked at the safety of acupuncture in adults, few have focused on children, she said.
While serious problems occurred after acupuncture treatment, many of those occurred in settings that were not typical of a modern day acupuncture practice, Vohra said. "Modern day standards around training and regulation, where it exists, mean that these sorts of serious harms … were rare," she said. "If you are looking at trained providers, acupuncture is safe for children."
Serious adverse effects
Indeed, most of the serious problems from acupuncture occurred outside of the United States and Canada, in places such as China, Taiwan, France and Japan.
In China, 12 cases of thumb deformity were reported from one clinic. In France, one child treated for tendonitis was subsequently diagnosed with HIV, and another child treated for asthma was hospitalized for a collapsed lung. A subsequent examination found lung scarring at the needling location.
In Japan, more than 70 needles were found embedded in a boy's body after he was treated for nerve impairment, fatigue, irregular heartbeat and constipation. One of those needles was found embedded in his spinal canal, which resulted in nerve impairment.
In the United States, a boy treated for spinal pain was subsequently diagnosed with a bacterial infection. A boy in Canada suffered a reversible coma and required surgery after acupuncture.
Most of these serious problems occurred in other countries or after treatment by health care providers with little training, said Brandon Horn, a licensed acupuncturist at Children's Hospital Los Angeles.
While all acupuncture carries some risk, most of "the serious adverse events occurred outside of the United States where they do aggressive things that aren't done here," Horn said. "California has very strict acupuncture standards — four years of training."
But does it work?
Acupuncture has become an important tool to treat a variety of conditions in children, and is used frequently in pain management, said Jeffrey Gold, director of the Pediatric Pain Management Clinic at Children's Hospital Los Angeles. "We definitely find it to be a very useful medical intervention, sometimes by itself and sometimes with other interventions," such as psychotherapy and medication, Gold said.
Between 65 and 70 percent of the kids who come in reporting that their pain is at a level of three to six on a 10 point scale "can bring their scores down to zero," at least temporarily, with acupuncture, Gold said.
More prospective studies — those that follow a group of patients forward in time — are needed to assess the risks and benefits of acupuncture in children, said study researcher Vohra. "It would certainly be very meaningful to do that kind of study in children," she said.
Gold agreed. "That's what the field needs for western practitioners to believe that acupuncture is worthwhile," he said. "There is some art to the practice in acupuncture, the challenge is to find out the best protocol."
The study was published online today (Nov. 21) in the journal Pediatrics.
Pass it on: Acupuncture in children is safe provided your medical practitioner has the proper training.