The report states that acupuncture may be a reasonable option for a number of conditions, including postoperative pain, myofascial pain and low back pain. Less convincing evidence has been found for addiction, stroke rehabilitation, carpal tunnel syndrome, osteoarthritis and headache, although the report states that there are positive clinical reports for the use of acupuncture in these conditions as well. The consensus statement reports that considerable evidence shows that opioid peptides are released during acupuncture, which may partially explain the analgesic effects of acupuncture. Acupuncture stimulation may also activate the hypothalamus and pituitary glands. Studies have documented that acupuncture is associated with alterations in the secretion of neurotransmitters and neurohormones and changes in blood flow.
Evidence also indicates that acupuncture affects immune function.
The consensus statement mentions that some of the biologic effects of acupuncture have been observed in sham acupuncture, which underscores the importance of defining appropriate control groups when assessing the biologic changes in response to acupuncture. In addition, therapeutic outcomes may be influenced by other factors, such as the relationship between the clinician and the patient and the patient's expectations and belief systems. The consensus statement emphasizes that training and credentialing of acupuncture practitioners is an important issue for integrating this technique into medical practice, as is coverage by insurance providers. Educational standards have now been established for training acupuncturists, and a national credentialing agency now exists and is recognized by some of the major acupuncture organizations. In addition, a majority of states provide licensure or registration for acupuncture practitioners, but the scope of practice allowed under state requirements varies.