Acupuncture is Effective for Chronic Pain: A Meta-Analysis

Millions of Americans have chronic pain (1). While many have turned towards acupuncture for treatment (2), others still do not know that acupuncture can help, which is unfortunate due to the rise of the opioid epidemic (3).

In this article I will talk about a study on acupuncture for chronic pain. The results are promising and should be shared to inform potential recipients of acupuncture.

In 2012, Vicker et al published a meta-analysis in the Archives of Internal Medicine using data from 29 eligible studies (17,922 patients) to see if acupuncture is effective for treating chronic pain and whether it should be recommended.


What were the results?

Acupuncture is more effective than both sham and no-acupuncture control for chronic pain. Therefore, the authors believe acupuncture is a reasonable referral option.

The results showed that patients who had acupuncture vs. sham acupuncture had less pain. The scores were “0.23 (95% CI, 0.13-0.33), 0.16 (95% CI, 0.07-0.25), and 0.15 (95% CI, 0.07-0.24) SDs lower for back and neck pain, osteoarthritis, and chronic headache, respectively.” For acupuncture vs. no-acupuncture controls, the scores were “0.55 (95% CI, 0.51-0.58), 0.57 (95% CI, 0.50-0.64), and 0.42 (95% CI, 0.37-0.46) SDs” lower. (4)


What type of pain was studied? 

  • Nonspecific musculoskeletal pain (back and neck)
  • Shoulder pain
  • Chronic headache
  • Osteoarthritis

How is this study different from others?

This study is a meta-analysis, which is the most rigorous type of research that combines multiple studies for a more powerful, combined result. It also reduces the amount of bias and errors that would exist in a single, smaller study. (5)

Out of 955 studies, the authors selected and combined the results of 29 eligible studies (17,922 patients) using statistical methodology. The authors state that their eligibility criteria was very strict, creating findings with greater precision. (4)


Which studies were eligible?

The authors chose randomized controlled trials (RCTs) studying patients with back, neck, or shoulder pain, chronic headache, or osteoarthritis of at least 4 weeks.

Studies were only eligible if the outcomes were measured more than 4 weeks after the initial acupuncture treatment.

Studies were eliminated if they had poor methodology, such as inadequate concealed allocations (for all RCTs), or inadequate blinding (for RCTs with sham acupuncture control). To ensure the accuracy of the data, authors of the RCTs were asked to provide raw data. (4)


Are there any limitations to this study?

Performance and response bias were possible because the performance of acupuncture and sham acupuncture cannot be blinded. However, the authors argue that “this problem applies to almost all studies on non-drug interventions [such as] cognitive therapies, exercise, or manipulation.” (4)


Study Mentioned

Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for Chronic PainIndividual Patient Data Meta-analysis. Arch Intern Med. 2012;172(19):1444–1453. doi:10.1001/archinternmed.2012.3654

References

  1. https://nccih.nih.gov/health/pain/chronic.htm
  2. https://nccih.nih.gov/health/acupuncture
  3. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
  4. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1357513
  5. https://guides.mclibrary.duke.edu/ebmtutorial/study-types

Photo Credit Lesyaskripak

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