Acupuncture is of benefit for some types of chronic pain. An international research collaboration, involving the University of York, has shown that acupuncture is an effective treatment for chronic pain in patients with chronic back and neck pain, osteoarthritis, shoulder pain, and chronic headache.
Dr Hugh MacPherson, Senior Research Fellow in the Department of Health Sciences at York, together with investigators at the Memorial Sloan-Kettering Cancer Centre in Boston and researchers from the Universities of Keele and Southampton, have analysed raw individual patient data – an approach that allows for more statistically precise results – for 17,922 participants enrolled in 29 high quality, randomised trials. The trials took place over a number of years and measured how well acupuncture relieved chronic pain associated with these four pain conditions.
The trials, one of which took place in York, compared the pain relief benefit of acupuncture to either usual care alone, to sham (placebo) acupuncture in which the needles are inserted superficially or at a non-traditional site, while others compared all three methods. The study, published in the Archives of Internal Medicine, shows that for each of the four conditions, acupuncture’s pain relief benefit was statistically superior to both usual care and placebo acupuncture.
The meta-analysis is ongoing as more high-quality, randomised acupuncture trials are completed. The research was supported by grants from the National Center for Complementary and Alternative Medicine at the National Institutes of Health, the Samueli Institute and the National Institute for Health Research (NIHR) in England.
Acupuncture is an ancient Chinese form of treatment that involves the insertion of fine disposable needles into acupuncture points on the body. It usually involves a series of six to ten treatment sessions with ten to twelve needles to obtain sustained benefit for pain. It is available in the UK both privately and through the NHS for pain relief and it is estimated that British people receive four million acupuncture sessions each year, half of which are for pain relief.
Dr MacPherson believes these definitive findings will give acupuncture recognition and encourage clinicians to recommend it as a safe and effective treatment.
He says: “The uncertainty as to whether acupuncture is simply a placebo has led to some discomfort about referring patients with chronic pain to an acupuncturist, however the results from this new study show unequivocally that acupuncture is more than a placebo.
While the pain relieving effect of true acupuncture was found to be slightly better than that of placebo acupuncture, the pain relief difference between acupuncture and usual care alone was found to be much larger, and it is this difference that is most relevant to doctors and patients. If you are going to have acupuncture, then you definitely want to receive the real thing, as our evidence shows that placebo acupuncture performs less well.”
According to attending research methodologist and lead author on the study, Dr Andrew Vickers, of Memorial Sloan-Kettering, many of the estimated three million American adults who receive acupuncture treatment each year use it to ease chronic pain, but its clinical impact has never been convincingly demonstrated.
Dr Vickers says: “There are very few treatments for chronic pain supported by the findings of an individual patient data meta-analysis such as ours, which uses a large number of patients taking part in high quality, randomised trials, and we hope these findings will inform future clinical and policy decisions for acupuncture.”