| Chronic pain, especially of the back, is one of the most common indications
for which people seek acupuncture therapy. Researchers have sought to
prove or disprove its benefit, however, have been unsuccessful in reaching any
conclusions. To scientifically prove or validate a treatment or therapy,
one must produce reproducible data from randomized, double-blinded studies of a
statistically-significant patient population.
Although numerous studies have set out to scientifically explain and prove
the effects of acupuncture in chronic pain, most research is flawed,
non-reproducible or not significant. One of the major barriers to accurate
assessment of the effects of acupuncture is the controversial choice of
placebo. For a discussion of the placebo controversy, click here.
Other barriers include the number of patients, multiple etiologies of pain,
difficult to blind, variations in acupuncture and benefit assessment.
Below are brief synopses of some published studies and meta-analyses of the
efficacy of acupuncture.
Studies or analyses supporting the use of acupuncture
- A study reported by Lee and Andersen in 1975 demonstrated patients
undergoing acupuncture for chronic pain had relief, although relief was
independent of the use of acupuncture points. The data came from 971
treatments in 261 patients. No placebo was used. Their data also
support increasing relief with subsequent treatments. Although their
work suggests benefit from the use of acupuncture, their study was neither
randomized nor controlled, and only the patients were blinded.
- A meta-analysis of randomized controlled trials was presented by Ernst and
White in 1998 which indicated acupuncture to be superior to control methods,
but not placebo. Twelve studies were included, but only nine had
suitable data. Usable data came from studies employing traditional
acupoints and different controls. They found that the results of 4 sham
controlled, evaluator-blinded studies did not show acupuncture to be better
than placebo.
- A study reported by Ming-Ting Wu, et al in 1999 compared heart rate and
brain activity using Functional MRI while patients received acupuncture at
true Li and ST points and at random points. All patients received both true
and false needling with a 20 minute interval between them. One group just
tested Li points and the other only tested ST points. Results demonstrated a
decrease in heart rate with all true points and an increase in activation of
the hypothalamus and nucleus accumbens, with a deactivation of the rostral
anterior cigulate cortex, amygdala, and hippocampal complex. There was no
change in physiology with the false points. This may help to explain the
analgesic effects of acupuncture.
- A review by Kaptchuck in 2002 demonstrated acupuncture to be beneficial
for nausea associated with pregnancy and post surgery or chemotherapy. There
is also some evidence of benefit with dental pain. There continues to be
inconclusive evidence supporting acupuncture for chronic back pain. Several
Randomized control trials, meta analysis, and systematic reviews have been
completed and many more are in the process to find a answer to the
effectiveness of acupuncture.
Studies or analyses not supporting the use of acupuncture
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