Acupuncture Effective for Chronic Pain
Acupuncture therapy has been studied in patients with chronic pain.
LAS VEGAS—Acupuncture is an effective way to relieve some chronic pain conditions, according to a presentation at PAINWeek 2016.1
Richard Harris, PhD, an assistant professor in the department of anesthesiology at the University of Michigan and co-president for the Society for Acupuncture Research, reviewed the basic principles of acupuncture research during his discussion.
In his presentation, Dr Harris discussed results from a meta-analysis conducted by the Acupuncture Trialists' Collaboration, an international group of 31 physicians, clinical trialists, biostatisticians, acupuncturists, and other specialists established in 2006 to provide best evidence on the effects of acupuncture on chronic pain.2
For the analysis, the Collaborative obtained individual patient data sets from 29 randomized clinical trials of acupuncture in back pain, neck pain, headache, and osteoarthritis. The paper, published in the Archives of Internal Medicine in 2012, concluded that for all of the included conditions, patients who underwent acupuncture had less pain but that the effect size of acupuncture differed based on the control group. A moderate effect size was found for acupuncture over non-acupuncture controls, such as no treatment or wait lists, while a smaller yet statistically significant effect size was found for acupuncture over sham acupuncture techniques.
Dr Harris explained in his presentation that these data have significant clinical implications for patients. A patient with a baseline pain score of 60 on a scale of 0 to 100 would be expected to have a pain score of 45 after a non-acupuncture intervention, a score of 35 after a sham acupuncture intervention, and a score of 30 after true acupuncture.
The Acupuncture Trialists' Collaboration concluded that the differences in effect size by control group suggest that factors in addition to needling specific effects are important contributors to acupuncture's therapeutic effects.
“The total effects of acupuncture, as experienced by the patient in routine practice, include both the specific effects associated with correct needle insertion according to acupuncture theory, nonspecific physiologic effects of needling, and nonspecific psychological (placebo) effects related to the patient's belief that treatment will be effective,” wrote the authors.
Dr Harris' presentation also included a review of research on evidence from a neuroimaging trial his group conducted that showed the benefits of acupuncture compared with sham acupuncture.3
"What we found is that there are many areas of the brain where acupuncture needling changed the opioid receptor binding potential differently than sham acupuncturing," Dr Harris said, adding "all of the acupuncture-treated patients had an increase in their binding potential in the short term as well as the long term."
- Harris RE. Acupuncture analgesia: therapy or sham? Presented at: PAINWeek 2016. Las Vegas, NV; September 6-10, 2016.
- Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444-1453.
- Harris RE, Zubieta JK, Scott DJ, et al. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage. 2009; 47(3):1077-1085.