Editing Acupressure

{{short description|Alternative medicine technique similar to acupuncture}}
{{Manipulative methods|fringe}}
[[File:Acupuncture point Hegu (LI 4).jpg|260px|thumbnail|Acupuncture point [[HéGŭ L.I. 4|LI-4 (Hegu), known in Chinese as 合谷 (hégǔ)]]]]

'''Acupressure''' is an [[alternative medicine]] technique often used in conjunction with [[acupuncture]] or [[reflexology]]. It is based on the concept of "life energy" ([[qi]]), which purportedly flows through "meridians" in the body. There is no scientific evidence for the existence of acupuncture points, meridians, or [[qi]].<ref name="Dunning">{{Skeptoid|id=4411|number=411|title=Your Body's Alleged Energy Fields|access-date=3 September 2016}}</ref>

Although some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, [[insomnia]], [[low back pain]], [[migraine]]s, and [[constipation]], among other things, such studies have been found to have a high likelihood of [[bias]].<ref name=Lee>{{cite journal | vauthors = Lee EJ, Frazier SK | title = The efficacy of acupressure for symptom management: a systematic review | journal = Journal of Pain and Symptom Management | volume = 42 | issue = 4 | pages = 589–603 | date = October 2011 | pmid = 21531533 | pmc = 3154967 | doi = 10.1016/j.jpainsymman.2011.01.007 }}</ref> There is no reliable evidence for the effectiveness of acupressure.

== History and origin ==
There are different theories as to the origin of acupressure. One theory posits that it originated in India and then was brought to China. Another theory posits that it originated in China.

=== Indian theory ===
Acupressure therapy was prevalent in India. After the [[Chinese Buddhism#Han Dynasty (206 BCE–220 CE)|spread of Buddhism to China]], the acupressure therapy was also integrated into common medical practice in China, and it came to be known as acupuncture. Scholars note these similarities because the major points of Indian acupressure and Chinese acupuncture are similar to each other.<ref>{{cite book|title=Ayurvedic Massage: For Health and Healing|url=https://books.google.com/books?id=hIFqoZY7Uj0C|page=121|publisher=Abhinav Publications|year=2000|author=S.V. Govindan| isbn=9788170173939 }}</ref><ref>{{cite book|url=https://books.google.com/books?id=wGQUBAAAQBAJ&pg=PA27 |title=Asian Medicine and Globalization |page=27|author=Joseph S. Alter|publisher=[[University of Pennsylvania Press]]|year=2013|isbn=9780812205251}}</ref>

=== Chinese theory ===
The [[Huangdi Neijing]] is perhaps the oldest known medical textbook in the world. The [[Lingshu Jing]] section mentions acupressure and acupuncture. A case described in the book is the healing of an abscess with a stone needle. <ref>San, Tse Ching, et al. (1985). The science of acupuncture . Jakarta: RSCM. p. 13.</ref>

== Effectiveness ==
{{Main|Acupuncture#Criticism of traditional Chinese medicine theory}}

A 2011 [[systematic review]] of 43 studies of acupressure's effectiveness at treating symptoms found that the nature of these 43 studies "indicated a significant likelihood of bias."<ref name="Lee"/> Thirty-five of the 43 studies had concluded that acupressure was effective at treating certain symptoms. The authors of this systematic review concluded that this "review of clinical trials from the past decade did not provide rigorous support for the efficacy of acupressure for symptom management. Well-designed, randomized controlled studies are needed to determine the utility and efficacy of acupressure to manage a variety of symptoms in a number of patient populations."<ref name="Lee"/>

A 2011 Cochrane review of four trials using acupuncture and nine studies using acupressure to control pain in childbirth concluded that "acupuncture or acupressure may help relieve pain during labour, but more research is needed".<ref>{{Cite journal |last1=Smith |first1=Caroline A. |last2=Collins |first2=Carmel T. |last3=Levett |first3=Kate M. |last4=Armour |first4=Mike |last5=Dahlen |first5=Hannah G. |author-link5=Hannah Dahlen |last6=Tan |first6=Aidan L. |last7=Mesgarpour |first7=Bita |date=7 February 2020 |title=Acupuncture or acupressure for pain management during labour |journal=The Cochrane Database of Systematic Reviews |volume=2 |issue=2 |pages=CD009232 |doi=10.1002/14651858.CD009232.pub2 |issn=1469-493X |pmc=7007200 |pmid=32032444}}</ref> Another [[Cochrane Collaboration]] review found that massage provided some long-term benefit for [[low back pain]], and stated: "It seems that acupressure or pressure point massage techniques provide more relief than classic (Swedish) massage, although more research is needed to confirm this."<ref>{{cite journal | vauthors = Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M | title = Massage for low-back pain | journal = The Cochrane Database of Systematic Reviews | issue = 9 | pages = CD001929 | date = September 2015 | volume = 2015 | pmid = 26329399 | doi = 10.1002/14651858.CD001929.pub3 | pmc = 8734598 }}</ref>

An acupressure wristband that is claimed to relieve the symptoms of [[motion sickness]] and other forms of [[nausea]] provides pressure to the P6 acupuncture point, a point that has been extensively investigated.<ref name=Dent>{{cite journal | vauthors = Dent HE, Dewhurst NG, Mills SY, Willoughby M | title = Continuous PC6 wristband acupressure for relief of nausea and vomiting associated with acute myocardial infarction: a partially randomised, placebo-controlled trial | journal = Complementary Therapies in Medicine | volume = 11 | issue = 2 | pages = 72–7 | date = June 2003 | pmid = 12801491 | doi = 10.1016/s0965-2299(03)00058-x }}</ref> The [[Cochrane Collaboration]] reviewed the use of P6 for nausea and vomiting, and found it to be effective for reducing post-operative nausea, but not vomiting.<ref>{{cite journal | vauthors = Lee A, Chan SK, Fan LT | title = Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting | journal = The Cochrane Database of Systematic Reviews | issue = 11 | pages = CD003281 | date = November 2015 | volume = 2016 | pmid = 26522652 | pmc = 4679372 | doi = 10.1002/14651858.CD003281.pub4 }}</ref> The Cochrane review included various means of stimulating P6, including acupuncture, electro-acupuncture, transcutaneous nerve stimulation, laser stimulation, [[acustimulation]] device and acupressure; it did not comment on whether one or more forms of stimulation were more effective; it found low-quality evidence supporting stimulation of P6 compared with sham, with 2 out of 59 trials having low risk of bias. EBM reviewer [[Bandolier (journal)|Bandolier]] said that P6 in two studies showed 52% of patients with control having a success, compared with 75% with P6.<ref>{{Cite web|url=http://www.medicine.ox.ac.uk/bandolier/band59/b59-4.html|title=Nausea and vomiting in early pregnancy |date=1999 |archive-url=https://archive.today/20121223133618/http://www.medicine.ox.ac.uk/bandolier/band59/b59-4.html|archive-date=2012-12-23|url-status=dead }}</ref>

[[Quackwatch]] includes acupressure in a list of methods which have no "rational place" as massage therapy and states that practitioners "may also use irrational diagnostic methods to reach diagnoses that do not correspond to scientific concepts of health and disease."<ref name=Quackwatch>{{cite web|url=http://www.quackwatch.com/01QuackeryRelatedTopics/massage.html|title=Massage Therapy: Riddled with Quackery| first = Stephen | last = Barrett | name-list-style = vanc |publisher=Quackwatch|date=March 9, 2006|access-date=3 June 2013}}</ref>

Clinical use of acupressure frequently relies on the conceptual framework of [[traditional Chinese medicine]]. There is no physically verifiable [[anatomical]] or [[histological]] basis for the existence of [[acupuncture point]]s or [[meridian (Chinese medicine)|meridians]].<ref name="Mann_drunkard">{{cite book | vauthors = Mann F | author-link = Felix Mann | quote =  ... acupuncture points are no more real than the black spots that a drunkard sees in front of his eyes. | title = Reinventing Acupuncture: A New Concept of Ancient Medicine | publisher = Butterworth Heinemann | location = London | date = 1996 | page = 14 }} Quoted by {{cite journal | first = Matthew | last = Bauer | name-list-style = vanc | url = http://www.chinesemedicinetimes.com/section.php?xSec=122 | journal = Chinese Medicine Times | archive-url=https://web.archive.org/web/20090122104312/http://www.chinesemedicinetimes.com/section.php?xSec=122 | archive-date=2009-01-22 | url-status = dead | volume = 1 | issue = 4 | date = August 2006 | title = The Final Days of Traditional Beliefs? - Part One }}</ref> Proponents reply that TCM is a [[prescientific system]] that continues to have practical relevance. Acupuncturists tend to perceive TCM concepts in functional rather than structural terms (e.g., as being useful in guiding evaluation and care of patients).<ref name="NIH_funct">{{cite web | work = NIH Consensus statement | quote = Despite considerable efforts to understand the anatomy and physiology of the 'acupuncture points', the definition and characterization of these points remains controversial. Even more elusive is the basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and the five phases theory, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture | title = Acupuncture. | publisher = National Institutes of Health: Consensus Development Conference Statement | date = November 1997 | url = http://consensus.nih.gov/1997/1997Acupuncture107html.htm | access-date = 30 January 2007 | archive-date = 25 August 2011 | archive-url = https://web.archive.org/web/20110825052220/http://consensus.nih.gov/1997/1997Acupuncture107html.htm | url-status = dead }}</ref> Trials using placebo have not demonstrated any statistically significant effect but concluded that acupressure is safe to use along with conventional treatment.<ref name=Dent/><ref>{{cite journal | vauthors = Colquhoun D, Novella SP | title = Acupuncture is theatrical placebo | journal = Anesthesia and Analgesia | volume = 116 | issue = 6 | pages = 1360–3 | date = June 2013 | pmid = 23709076 | doi = 10.1213/ANE.0b013e31828f2d5e | s2cid = 207135491 | doi-access = free }}</ref><ref>{{Cite book | title = Evidence-based Non-pharmacological Therapies for Palliative Cancer Care | author = William Chi-Sing Cho | publisher = Springer Science & Business Media | date = 2013 | isbn = 9789400758339}}</ref>

== Instruments ==
There are several different instruments for applying nonspecific pressure by rubbing, rolling, or applying pressure on the reflex zones of the body. The acuball is a small ball made of rubber with protuberances that is heatable. It is used to apply pressure and relieve muscle and joint pain. The energy roller is a small cylinder with protuberances. It is held between the hands and rolled back and forth to apply acupressure. The foot roller (also "krupa chakra") is a round, cylindrical roller with protuberances. It is placed on the floor, and the foot is rolled back and forth over it. The power mat (also pyramid mat) is a mat with small pyramid-shaped bumps that you walk on. The spine roller is a bumpy roller containing magnets that is rolled up and down the spine. The Teishein is one of the original nine classical acupuncture needles described in the original acupuncture texts. Even though it is described as an acupuncture needle, it did not pierce the skin. It is used to apply rapid percussion pressure to the points being treated.<ref name="medicinaalternativa">{{cite book | last = Sharma | first = Rajeev | name-list-style = vanc | title = Medicina Alternativa | publisher = Alpha Science Int'l Ltd | year = 2003 | url = https://books.google.com/books?id=iyl2XMxr6iAC&q=acuball&pg=PA198 | access-date = 2009-01-05 | pages = 196–200 | isbn = 9781842651414 }}</ref>

== See also ==
* [[Reflexology]]
* [[Shiatsu]], Japanese equivalent
* [[Cupping therapy]]
* [[List of acupuncture points]]

== References ==
{{Reflist}}

== External links ==

{{Acupuncture}}
{{Pseudoscience|state=autocollapse}}
{{Authority control}}

[[Category:Acupuncture]]
[[Category:Manual therapy]]