Acupuncture Provides Relief For Chronic Pain, Say Researchers

Acupuncture for the treatment of chronic pain is better than placebo acupuncture (sham acupuncture) or no acupuncture at all, researchers from the Memorial Sloan-Kettering Cancer Center, New York, wrote in the JAMA journal Archives of Internal Medicine. This was their conclusion after gathering and analyzing data from 29 randomized controlled human studies.

The authors explained that acupuncture is used extensively for the treatment of chronic pain. However, its acceptance is mixed and there is controversy regarding its efficacy and value.

Several studies have shown that acupuncture can have a pain-lowering effect when administered by a qualified practitioner. In 2011, a German pain specialist, Dr. Winfried Meissner, found that acupuncture can help reduce pain in patients after surgery.

Other studies, however, have had unfavorable findings. In 2011, researchers from the Universities of Exeter & Plymouth, UK, and the Korea Institute of Oriental Medicine, found that there was very little compelling evidence that acupuncture reduces pain. They added that acupuncture was associated with some serious adverse events.

Andrew J. Vickers, D.Phil., and team carried out individual data meta-analyses, using information from several published randomized control studies from the USA, UK, Germany, Sweden and Spain involving 17,922 patients. Their aim was to find out what effect acupuncture has on some chronic pain conditions.

The authors wrote:

"We found acupuncture to be superior to both no-acupuncture control and sham acupuncture for the treatment of chronic pain. Although the data indicate that acupuncture is more than a placebo, the differences between true and sham acupuncture are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to therapeutic effects."

An acupuncturist inserting needles into a patient's skin

Placebo acupuncture involved pretending to stick needles into the patient with retractable needles that did not really perforate the skin, or ones that just went slightly into the surface, rather than penetrating deeper as occurs in proper acupuncture. Proper acupuncture was also compared to deactivated electrical simulation or detuned laser.

The people who were administered real acupuncture had pain scores 0.23, 0.16 and 0.15 lower (SDs, standard deviations) than those receiving the pretend acupuncture for back and neck pain.

The scientists concluded:

"Our results from individual patient data meta-analyses of nearly 18,000 randomized patients in high-quality RCTs provide the most robust evidence to date that acupuncture is a reasonable referral option for patients with chronic pain."

Accompanying Commentary in the Same Journal

In the same journal, Andrew L. Avins, M.D., M.P.H., of Kaiser-Permanente, Northern California Division of Research, Oakland, wrote that there is still an ambiguous relationship between conventional allopathic medical care and alternative and complementary medicine.

Dr. Avins wrote:

"At the end of the day, our patients seek our help to feel better and lead longer and more enjoyable lives. It's ideal to understand the mechanism of action, which carries the potential for developing more and better interventions. But the ultimate questions is: does this intervention work (or, more completely, do its benefits outweigh its risks and justify its costs)?.

"At least in the case of acupuncture, Vickers et al have provided some robust evidence that acupuncture seems to provide modest benefits over usual care for patients with diverse sources of chronic pain. Perhaps a more productive strategy at this point would be to provide whatever benefits we can for our patients, while we continue to explore more carefully all mechanisms of healing."

What is acupuncture?

Acupuncture started off in China thousands of years ago. There are some records showing that some acupuncture was practiced in Europe a few hundred years ago, however, it did not really enter what we know as Western Society until after the 1950s, after which it spread rapidly throughout Western Europe, Canada and the USA.

Acupuncture involves inserting thin needles through the skin at carefully located points of the body at varying depths. Neurologists and other medical specialists are not sure how acupuncture works scientifically.

Most practitioners, even conventional medicine practitioners, have mostly accepted that acupuncture does provide some pain relief, as well as alleviating symptoms of other conditions, such as nausea caused by chemotherapy, or insomnia.

Chinese medical theory says there are meridian points in the body through which "Chi" vital energy runs - these are the acupuncture points. However, there is no anatomical, histological or scientific proof to back up this theory.

Because of the invasive nature of acupuncture, creating case studies with proper scientific controls is extremely difficult. A clinical study involved a placebo (sham product) which is compared to the targeted treatment.

Acupuncture involves the insertion of needles and advice on self-care. The qualified acupuncturist will also carry out a physical exam and make an assessment of the patient's condition. A session lasts about 30 minutes. In most cases, treatment is carried out in weekly or fortnightly sessions.

The acupuncturist uses single-use disposable sterile needles, which are inserted into the skin. When the needle reaches its target depth, there may be some slight pain. Some needles are stimulated with electric currents or heated up after insertion. They remain in their targeted positions for approximately 20 minutes.