However, the evidence provided did not fully substantiate the dual approach in SCI-induced neuropathy, Edzard Ernst, MD, PhD, from the Peninsula school of medicine at the University of Exeter, UK, told Clinical Pain Advisor.

“This is a rather flimsy review published in a pro alt med journal. It lacks critical assessment on the totality of the available evidence,” Dr Ernst said of the study.

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“Clinicians should treat patients according to the best evidence currently available [and] I am not sure that the proposed treatment falls into this category,” Dr Ernst added.

A frequent critic of acupuncture, Dr. Ernst has charged that its use is characterized by poor quality research, unproven efficacy, adverse effects, and a lack of cost-effectiveness due the frequency of required treatments.2

Dr. Ximenes disagreed, stating that the evidence presented for combined pharmacotherapy and acupuncture is “more than sufficient.”

“The only risk I can see is inadvertent puncture of structures such as the lungs, leading to adverse events such as pneumothorax, but this is rare in trained hands. Acupuncture is a forgiving modality. You may not always get positive results but negative ones are rare,” Dr Ximenes concluded.


1. Gwak YS, Kim HY, Lee BH, Chae HY. Combined approaches for the relief of spinal cord injury-induced neuropathic pain. Complement Ther Med. 2016;25:27-33.

2. Ernst, E. Acupuncture: Poor Evidence, Poorer Journalism. Edzard Ernst. 2016. Available at: Accessed January 25, 2016.