a b s t r a c t
Acupuncture is commonly used for pain control, but doubts about its effectiveness and safety remain.
This review was aimed at critically evaluating systematic reviews of acupuncture as a treatment of pain
and at summarizing reports of serious adverse effects published since 2000. Literature searches were carried
out in 11 databases without language restrictions. Systematic reviews were considered for the evaluation
of effectiveness and case series or case reports for summarizing adverse events. Data were
extracted according to predefined criteria. Fifty-seven systematic reviews met the inclusion criteria. Four
were of excellent methodological quality. Numerous contradictions and caveats emerged. Unanimously
positive conclusions from more than one high-quality systematic review existed only for neck pain.
Ninety-five cases of severe adverse effects including 5 fatalities were included. Pneumothorax and infections
were the most frequently reported adverse effects. In conclusion, numerous systematic reviews
have generated little truly convincing evidence that acupuncture is effective in reducing pain. Serious
adverse effects continue to be reported.