The practice of acupuncture originated in China 5,000 years ago. Today it is widely used throughout the world and is one of the main pillars of Chinese medicine. There are many different varieties of the practice of acupuncture, both in the Orient and in the West. The most common forms available to westerners are as follows. Traditional Chinese medicine (TCM) usually combines acupuncture with Chinese herbs. Classical acupuncture (also known as five element acupuncture) uses a different needling technique and relies on acupuncture independent of the use of herbs. Japanese acupuncture uses smaller needles than the other varieties. Medical acupuncture refers to acupuncture practiced by a conventional medical doctor. Auricular acupuncture treats the entire body through acupuncture points in the ears only. Electroacupuncture uses electrical currents attached to acupuncture needles. Aside from needles, other methods of stimulation are also considered forms of "acupuncture." These include the use of heat from the burning of herbs placed on specific points ("moxibustion") and the placement of herbal pastes on specific points. Research on the effectiveness of acupuncture has special challenges. These include the diversity of approaches, the practice of individualizing treatment for each patient, differing skill levels between practitioners, and difficulty separating out the effects of acupuncture from placebo effects (i.e., how the patient's beliefs and expectations affect his/her perception of symptoms). Based on acupuncture's long history of use as well as the limited research available, both the World Health Organization and the National Institutes of Health have identified many conditions for which it may be recommended. However, many common uses do not yet have formal scientific evidence to support them.
Various forms of therapeutic superficial tissue manipulation have been practiced for thousands of years across cultures. Chinese use of massage dates to 1600 BC, and Hippocrates made reference to the importance of physicians being experienced with "rubbing" as early as 400 BC. There are references to massage in ancient records of the Chinese, Japanese, Arabic, Egyptian, Indian, Greek, and Roman nations. References to massage are also found in the Bible and the Vedas. Terms for massage include the French word masser , the Greek word for "knead," a Hindu word for "press," and an Aramaic word that means "to press softly." The technique that is currently called Swedish massage was developed in the 19th Century by Per Henrik Ling (1776-1839) as a combined form of massage and gymnastic exercises. Many different therapeutic techniques can be classified as massage therapy. Most involve the application of fixed or moving pressure or manipulation of the muscles/connective tissues of clients. Practitioners may use their hands or other areas such as forearms, elbows, or feet. Lubricants may be added to aid the smoothness of massage strokes. Techniques used in Swedish massage include (1) superficial stroking in a direction away from the heart or deep stroking towards the heart; (2) kneading in a circular pattern using fingers and thumbs; (3) deep muscle stimulation; (4) rhythmic movements such as slapping or tapping; and (5) vibration. Sports massage is similar to Swedish massage but is adapted specifically for athletes. Classical massage aims to provide calmness, relaxation, encourage self-healing, and revitalization. Many other variations and styles of massage or touch exist, often developed in specific geographic regions. Scientific research of massage is limited, and existing studies use a variety of techniques and trial designs. Firm evidence-based conclusions about the effectiveness of massage cannot be drawn at this time for any health condition.