Acupuncture beats placebo for pain relief

U. SOUTHAMPTON (UK) — Acupuncture is an effective treatment for chronic pain, according to a new study comparing real acupuncture with a placebo version and usual care alone.

Researchers from the University of Southampton, with colleagues in the UK and the US, analyzed raw individual patient data.

This approach allows for more statistically precise results—for 17,922 participants enrolled in 29 high quality, randomized trials, which took place over a number of years, that measured how well acupuncture relieved chronic pain associated with chronic back and neck pain, osteoarthritis, shoulder pain, and chronic headache.

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The trials 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 for each of the four conditions, acupuncture’s pain relief benefit was statistically superior to both usual care and placebo acupuncture.

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 four to eight treatment sessions with six to 10 needles to obtain sustained benefit for pain.

According to lead author Andrew Vickers of the Memorial Sloan-Kettering Cancer Center, 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. Vickers is also attending research methodologist of the study.

“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, randomized trials and we hope these findings will inform future clinical and policy decisions for acupuncture,” says Vickers.

In the UK, acupuncture is available both privately and through the National Health Service for pain relief and it is estimated that more than half a million British people each year have acupuncture for pain relief.

George Lewith, professor of health research at the University of Southampton and a study co-author, believes these definitive findings will give acupuncture recognition as a treatment and encourage clinicians to recommend it as a safe and effective treatment.

“Acupuncture is a treatment that is not readily recommended by clinicians but these results will confirm that the effects of acupuncture are beneficial for the patient,” he says.

“We have shown that the pain relief effect of true acupuncture was slightly better than that of placebo acupuncture, which suggests differences between styles or practitioners of acupuncture are unlikely. However the pain relief difference between acupuncture and usual care alone was much larger and it is this difference that is most relevant to doctors and patients.”

Hugh MacPherson, senior research fellow at the University of York, adds: “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.”

The meta-analysis is ongoing as more high-quality, randomized 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 in England. Researchers from the Universities of Keele and York also contributed to the study.

Source: University of Southampton