Acupuncture for chronic pain

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Acupuncture is widely used to manage chronic pain, but the effectiveness is still debating. Recent research analysed the data from previous research using large amount of induvial patient data from high quality control trials of acupuncture for chronic pain and. The research studied the effectiveness of acupuncture and the cause of the factors that affects the effects. The available individual patient data set included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck, and shoulder), osteoarthritis of the knee, and headache/migraine. The result has shown that acupuncture is effective to treat these chronic pain condition and reduce the pain significantly. Also the effect of acupuncture lasts over 12 months as far as the research goes. The update to the research has shown that acupuncture was superior to sham as well as no acupuncture control for each pain condition including randomized trials of acupuncture needling versus either sham acupuncture or no acupuncture control for nonspecific musculoskeletal pain, osteoarthritis, chronicheadache, or shoulder pain. There is clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at 1 year. There is no obvious association between trial outcome and characteristics of acupuncture treatment, but effect sizes of acupuncture were associated with the type of control group, with smaller effects sizes for sham controlled trials that used a penetrating needle for sham, and for trials that had high intensity of intervention in the control arm. Of course, the specific effects of needling at correct acupuncture point locations are most important to the treatment effect. The conclusion is that acupuncture is effective for the treatment of chronic pain, with treatment effects persisting over time. Although factors in addition to, decreases in pain after acupuncture cannot be explained solely in terms of placebo effects. Variations in the effect size of acupuncture in different trials are driven predominantly by differences in treatments received by the control group rather than by differences in the characteristics of acupuncture treatment.

References

Vickers AJ et al J Pain. 2018 May;19(5):455-474. doi: 10.1016/j.jpain.2017.11.005. Epub 2017 Dec 2.

MacPherson H et al Pain. 2017 May;158(5):784-793. doi: 10.1097/j.pain.0000000000000747.
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