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Am Fam Physician. 2023;108(4):online

Author disclosure: No relevant financial relationships.

To the Editor: The article from Drs. Herman, Shih, and Cheng provided a welcome overview of the poorly understood sequelae of COVID-19.1 Long COVID (i.e., post–COVID-19 condition) is an increasingly prevalent, multifaceted constellation of symptoms that lacks conventional treatment options, presenting a challenge for family physicians.

Emerging research indicates that medical acupuncture is a useful treatment option for patients with many ailments. The military medical community has developed several acupuncture protocols to treat acute or chronic pain, headaches, and mood disturbances, symptoms often reported in patients who have long COVID.2 A 2017 review of medical acupuncture for these issues showed a 14% to 45% reduction in the need for benzodiazepines, muscle relaxers, nonsteroidal anti-inflammatory drugs, and pain medications.2 Patients also reported improvements in function and sense of well-being after receiving courses of acupuncture.2 Another study showed that acupuncture led to a 39% to 50% decrease in pain and a 43% to 56% subjective decrease in peripheral neuropathy, which commonly occur in patients with long COVID.3 Additional reports show promising support for medical acupuncture in treating long COVID symptoms.46 Some proposed mechanisms of long COVID include chronic inflammation, autonomic dysfunction, and disordered neural processing, which are often successfully treated with medical acupuncture.46 Acupuncture may also have a role in the treatment of chronic respiratory illness.6

Medical acupuncture is a holistic, minimally invasive treatment option that should be considered part of the multimodal treatment approach for patients with long COVID and other conditions. With appropriate training, medical acupuncture techniques can be easily implemented in primary care.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Defense Health Agency, U.S. Department of Defense, or the U.S. government.

In Reply: Thank you for providing greater awareness and education on the benefits of medical acupuncture. I have long been an advocate of acupuncture for medical conditions. I eagerly await additional studies on acupuncture and COVID, including randomized controlled trials, that can further direct treatment plans. The references you listed help support the case for using acupuncture in these patients; however, direct evidence specific to long COVID is not yet available. I have patients who have reported improvement in symptoms with medical acupuncture; therefore, acupuncture is part of my discussion with interested patients. I hope we continue to learn more and acquire further supporting evidence for the use of acupuncture in treating long COVID.

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This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

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