Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis.
Kristen Sparrow • August 08, 2023
Researchers analyzed various studies to understand what the proof for acupuncture’s effectiveness for chronic pain really was. . They studied four chronic pain types: musculoskeletal pain, osteoarthritis, chronic headaches, and shoulder pain.
Researchers examined studies up to 2015, comparing real acupuncture to sham or no treatment. They used data from 39 trials (20,827 patients) and found acupuncture more effective than both sham and no treatment for all pain types, reducing pain around 50% compared to no treatment and 20% compared to sham. Benefits seemed to persist over time, with slight reduction after a year.
Secondary analysis indicated control group treatment significantly affected outcomes. Factors like sham type and control group treatment intensity influenced results. Acupuncture was deemed effective for chronic pain beyond placebo. While factors beyond needle insertion contributed, outcome variations linked more to control group treatment than acupuncture differences.
We’ve talked about acupuncture for headaches here.
For musculoskeletal pain here
For Osteoarthritis here
Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, Irnich D, Witt CM, Linde K; Acupuncture Trialists’ Collaboration. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018 May;19(5):455-474. doi: 10.1016/j.jpain.2017.11.005. Epub 2017 Dec 2. PMID: 29198932; PMCID: PMC5927830.
Abstract
Despite wide use in clinical practice, acupuncture remains a controversial treatment for chronic pain. Our objective was to update an individual patient data meta-analysis to determine the effect size of acupuncture for four chronic pain conditions. We searched MEDLINE and the Cochrane Central Registry of Controlled Trials randomized trials published up until December 31, 2015. We included randomized trials of acupuncture needling versus either sham acupuncture or no acupuncture control for non-specific musculoskeletal pain, osteoarthritis, chronic headache, or shoulder pain. Trials were only included if allocation concealment was unambiguously determined to be adequate. Raw data were obtained from study authors and entered into an individual patient data meta-analysis. The main outcome measures were pain and function. An additional 13 trials were identified, with data received for a total of 20,827 patients from 39 trials. Acupuncture was superior to both sham and no acupuncture control for each pain condition (all p<0.001) with differences between groups close to 0.5 standard deviations (SD) for comparison with no acupuncture control and close to 0.2 SDs in comparison with sham. We also found clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at one year. In secondary analyses, we found 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. We conclude that acupuncture is effective for the treatment of chronic pain, with treatment effects persisting over time. While factors in addition to the specific effects of needling at correct acupuncture point locations are important contributors to the treatment effect, decreases in pain following acupuncture cannot be explained solely in terms of placebo effects. Variations in the effect size of acupuncture in different trials are driven predominately by differences in treatments received by the control group rather than by differences in the characteristics of acupuncture treatment.
