“Acupuncture (needling in the right place) is superior to both sham (so called ‘placebo’ or needling in the wrong way or wrong place) acupuncture and standard care (usual medical care) for the treatment of different types of chronic pain. This suggests that the effects of acupuncture are more than just placebo effect.”
In an article for Medscape Medical News, Pauline Anderson interviewed Dr. Andrew Vickers, attending research methodologist, Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Centre, New York. Dr Vickers is the author of a ground breaking study considering the effects of acupuncture in the treatment of chronic/longstanding pain (Arch Intern Med. published online September 10, 2012).
The basis of the study was to determine how individual patients responded to acupuncture for chronic pain affecting various parts of the body. What makes this study so relevant is that individual patient’s results were compared as opposed to combining or ‘pooling’ the results when making comparisons. This allows enhanced data quality, enabling different forms of outcomes to be combined, and allows the use of statistical techniques of increased precision, according to the authors.
The analysis found that about 50% of patients who got acupuncture had improvement in pain compared with 30% who didn't get acupuncture and 42.5% who had sham acupuncture.
As you may have noticed, those who had sham acupuncture also obtained good pain relief which raises the question – is there such a thing as ‘sham’ acupuncture?
If the physiological mechanisms of acupuncture are considered, it is likely that placing a needle anywhere in the body will have a specific pain relieving physiological effect over and above any placebo effect. My thoughts on the implications of such a theory I will reserve for another article.
Some 3 million Americans receive acupuncture treatments every year, most for relief of chronic pain. Dr. Vickers suggests a good proportion of those referrals are from doctors.
"Many doctors would be quite reasonably concerned about referring a patient for acupuncture for chronic pain due to a lack of evidence that it would benefit that patient," said Dr. Vickers.
"A proportion of those doctors with an interest in acupuncture may read this study and decide that this evidence is sufficiently robust that they now believe that such a referral would in fact help."
Dr. Vickers noted that many patients with chronic pain are very well managed on medication. Patients who don't get sufficient relief from medication or have side effects from those drugs can choose from a wide variety of other treatments, including physiotherapy, manipulation and behavioural therapy.
"How exactly acupuncture should be used amongst those other options is actually not clearly understood right now."
However, this study does provide further medical evidence to support the use of acupuncture in a medical setting.