Acupressure

Acupressure (a portmanteau of "acupuncture" and "pressure") is a traditional Chinese medicine (TCM) technique based on the same ideas as acupuncture. Acupressure involves placing physical pressure by hand, elbow, or with the aid of various devices on different acupuncture points on the surface of the body. Traditional Chinese Medicine does not usually operate within a scientific paradigm but some practitioners make efforts to bring practices into an evidence-based medicine framework. There is no scientific consensus over whether or not evidence supports the efficacy of acupressure beyond a placebo. Reviews of existing clinical trials have been conducted by the Cochrane Collaboration and Bandolier according to the protocols of evidence-based medicine; for most conditions they have concluded a lack of effectiveness or lack of well-conducted clinical trials.

Traditional Chinese medicine's acupuncture theory predates use of the scientific method, and has received various criticisms based on scientific thinking. There is no known anatomical or histological basis for the existence of acupuncture points or meridians. Acupuncturists tend to perceive TCM concepts in functional rather than structural terms, i.e. as being useful in guiding evaluation and care of patients. Neuroimaging research suggests that certain acupuncture points have distinct effects that are not otherwise predictable anatomically.

Background
Acupoints used in treatment may or may not be in the same area of the body as the targeted symptom. The TCM theory for the selection of such points and their effectiveness is that they work by stimulating the meridian system to bring about relief by rebalancing yin, yang and qi (also spelled "chi"). This theory is based on the paradigm of TCM, not that of science.

Many East Asian martial arts also make extensive study and use of acupressure for self-defense and health purposes (chin na, tui na). The points or combinations of points are said to be used to manipulate or incapacitate an opponent. Also, martial artists regularly massage their own acupressure points in routines to remove blockages from their own meridians, claiming to thereby enhance their circulation and flexibility and keeping the points "soft" or less vulnerable to an attack. Attacking the acupressure points is one theme in the wuxia genre of movies and novels.

Acupressure might work via release of endogenous opioid analgesics such as enkephalin, endorphin and dynorphins leading to alleviation of pain. Acupressure is considered to be a safe form of therapy and side effects are rare.

Research
A randomised trial of Tapas Acupressure Technique for weight-loss maintenance found attendance at weight maintenance was 72% for TAT Tapas Acupressure Technique- higher than any other method studied and warranting further study. This study was supported by a grant (R21 AT01190-02) from the National Center for Complementary/Alternative Medicine, National Institutes of Health, USA. The abstract for this study can be accessed via: 

An acupressure wristband that is claimed to relieve the symptoms of motion sickness and other forms of nausea is available. The band is designed to provide pressure to the P6 acupuncture point, a point that has been extensively investigated. The Cochrane Collaboration, a group of evidence-based medicine (EBM) reviewers, reviewed the use of P6 for nausea and vomiting, and found it to be effective for reducing post-operative nausea, but not vomiting. 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. EBM reviewer Bandolier said that P6 acupressure in two studies showed 52% of patients with control having a success, compared with 75% with P6 acupressure. One author of an article published in the Scientific Review of Alternative Medicine disagreed.

A Cochrane Collaboration review found that massage provided some long-term benefit for low back pain, and said: It seems that acupressure or pressure point massage techniques provide more relief than classic (Swedish) massage, although more research is needed to confirm this.

Criticism of TCM theory
Clinical use of acupressure frequently relies on the conceptual framework of Traditional Chinese Medicine (TCM), which some scholars have characterized as pseudoscientific. There is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians. 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).


 * See Acupuncture: Criticism of TCM theory