Large randomized controlled trials have shown the effectiveness of acupuncture in comparison to various control treatments for low back pain, osteoarthrosis, shoulder pain, tension type headache, and migraine. For most of these diseases the cost-effectiveness of acupuncture has been proven. A few smaller controlled trials exist for tennis elbow and osteoarthrosis of the hip. The use of acupuncture for other locomotive disorders is based on textbook literature and expert opinion. Current data show that acupuncture is a relatively safe method. Internationally several guidelines for chronic low back pain have integrated acupuncture. In Germany acupuncture has been reimbursed by the state insurance system for chronic low back pain and osteoarthritis since 2007 and the estimated costs are between EUR 300-700 million annually. Acupuncture is offered by at least 12,000 medical doctors and acupuncture is mostly used for locomotive disorders.