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 practioners 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.

Introduction
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.

Scientific Research
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
TCM theory is not based on science. Philosopher Robert Todd Carroll deemed acupuncture a pseudoscience because it "confuse(s) metaphysical claims with empirical claims". Carroll states that:
 * ...no matter how it is done, scientific research can never demonstrate that unblocking chi by acupuncture or any other means is effective against any disease. Chi is defined as being undetectable by the methods of empirical science.

A report for CSICOP on pseudoscience in China written by by Wallace Sampson and Barry L. Beyerstein said:
 * A few Chinese scientists we met maintained that although Qi is merely a metaphor, it is still a useful physiological abstraction (e.g., that the related concepts of Yin and Yang parallel modern scientific notions of endocrinologic and metabolic feedback mechanisms). They see this as a useful way to unite Eastern and Western medicine. Their more hard-nosed colleagues quietly dismissed Qi as only a philosophy, bearing no tangible relationship to modern physiology and medicine.

Stephen Barrett, founder of the website Quackwatch.org, writes:
 * ''"Chinese medicine," often called "Oriental medicine" or "traditional Chinese medicine (TCM)," encompasses a vast array of folk medical practices based on mysticism. It holds that the body's vital energy (chi or qi) circulates through channels, called meridians, that have branches connected to bodily organs and functions. ... Most acupuncturists espouse the traditional Chinese view of health and disease and consider acupuncture, herbal medicine, and related practices to be valid approaches to the full gamut of disease. Others reject the traditional approach and merely claim that acupuncture offers a simple way to achieve pain relief. Some acupuncturists ... claim that acupuncture can be used to treat conditions when the patient just "doesn't feel right," even though no disease is apparent.
 * In 1995, George A. Ulett, M.D., Ph.D., Clinical Professor of Psychiatry, University of Missouri School of Medicine, stated that "devoid of metaphysical thinking, acupuncture becomes a rather simple technique that can be useful as a nondrug method of pain control." He believes that the traditional Chinese variety is primarily a placebo treatment, but electrical stimulation of about 80 acupuncture points has been proven useful for pain control.

Ted Kaptchuk, author of The Web That Has No Weaver, refers to acupuncture as "prescientific". Regarding TCM theory, Kaptchuk states:
 * These ideas are cultural and speculative constructs that provide orientation and direction for the practical patient situation. There are few secrets of Oriental wisdom buried here. When presented outside the context of Chinese civilization, or of practical diagnosis and therapeutics, these ideas are fragmented and without great significance. The "truth" of these ideas lies in the way the physician can use them to treat real people with real complaints. (1983, pp.34-35)

According to the NIH consensus statement on acupuncture:
 * 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.