The Study:
This is a literature review of 18 databases searching for studies on pediatric acupuncture. The primary reported value was the number of adverse events (AEs) in the pediatric patients who received acupuncture. Of the 9537 references identified, 450 were assessed for inclusion and a final 37 studies were deemed appropriate for evaluation. Eligible studies were (1) contained original patient data published in a peer-reviewed journal, (2) included children from birth to 17 years, inclusively, (3) involved needle acupuncture, and (4) included assessment of AEs in a child.
279 AEs were identified; 25 were serious, 1 was moderate, and 253 were mild. Of the serious AEs, 12 were thumb deformities, 5 were infections, and 1 of each: cardiac rupture, pneumothorax, nerve impairment, subarachnoid hemorrhage, intestinal obstruction, hemoptysis, reversible coma, and overnight hospitalization. On review of the severe adverse events, the majority of them may have been secondary to acupuncture technique and not the acupuncture itself. The mild AEs included pain, bruising, bleeding, and worsening of symptoms. Overall incidence of mild AE In patients was 168 in 1422, or 11.8%.
Limitations:
This study was limited primarily by the English language. There may be multiple studies in Chinese or Japanese who were missed or not entered in PubMed due to the lack of translation. Therefore, the study may be missing multiple of cases with or without AEs.
What this Means:
Overall, acupuncture is safe in children. However, acupuncture still has its risks. Like in Western medical care, it is extremely important to ensure that your acupuncturist has appropriate training and credentials before getting treatment. It is also important to check that your acupuncturist has experience, uses sterile needles and cleans your points beforehand. Regardless, you or your child may still experience bruising, bleeding, or pain from the needles.
My Take:
Similar to taking a new medication, everyone responds to acupuncture in a different way. It is important to learn and understand the risks of ANY treatment before you get it, including acupuncture. Your new acupuncturist should briefly summarize the risks of the treatment and give you a consent form to read and sign beforehand. If you have any questions about the treatment, this educational pause is the time to ask! Your signature is proof that you understand and accept these risks.
Overall, acupuncture is safe in pediatric populations. While needle fear is real and understandable, it is important to remember that every medical treatment has risks – even though acupuncture’s risks may be more obvious (like needles in your skin). I know people who are scared of acupuncture but will pop pills without a second thought. With either the needles or the pills, it’s important to be clear what you’re treating, if the treatment will help, and what the risks are. But bleeding, pain, and other risks of acupuncture happen rarely and are largely minor.
I’m excited that this study was published, especially in such a high-impact journal. Hopefully, the use of CAM will slowly be accepted in the pediatric population. The ITPCU has actually been conducting a study looking at the acceptability and safety of acupuncture in our pediatric oncology population for multiple years. We’ve presented results from this study multiple times at various conferences, the last one being at the Society for Integrative Oncology (SIO) in 2012. Sagar, our research assistant, even won the Young Investigator Award for the presentation! In addition, we’ve published a paper on the safety of acupuncture in pediatric thrombocytopenic patients (patients with low platlets) (1). Stay tuned for more results of the study…it’s truly great clinical research.
1. Ladas EJ, Rooney D, Taromina K, Ndao DH, Kelly KM. The safety of acupuncture in children and adolescents with cancer therapy-related thrombocytopenia. Supportive Care in Cancer. 2010;18(11):1487-90.