WebMD Medical News
Louise Chang, MD
Sept. 10, 2012 -- About 3 million Americans visit acupuncturists each year, most of them for the relief of chronic pain. Now a new study shows the relief they get may be modest -- but real.
The study is a review of previous acupuncture studies that compared the ancient Chinese practice to standard pain care or to sham acupuncture. In the latter, patients are needled in a manner different from (or at spots on the body not tied to) traditional acupuncture.
The researchers found that people who got acupuncture ended up having less pain than those who didn't receive it. And the result was similar among different sources of pain, whether it was chronic back and neck pain, osteoarthritis, or headache.
In the end, their results translate to about 30% less pain compared to people taking pain medications and other standard treatments for pain.
An editorial published alongside the study estimates that 60 such reviews on acupuncture had been done already. What sets this study apart from earlier efforts was the exhaustive nature of the work that went into it.
Researcher Andrew Vickers, PhD, says that the study took six to seven years to complete and involved about 40 people, including pain management specialists, acupuncturists, patient advocates, statisticians, and other experts from the U.S. and Europe.
“This was a very, very large collaboration,” says Vickers, of Memorial Sloan-Kettering Cancer Center in New York. “And we did the most rigorous work we could do.”
Vickers and his colleagues reviewed nearly 1,000 studies. In the end, they selected 29, which he says were of the highest quality. Rather than simply tallying up the results of those studies, the researchers obtained the raw data from each of them and reanalyzed all of it. By the time they were done, they had examined data from nearly 18,000 participants from the United States, the United Kingdom, Germany, Spain, and Sweden.
Robert Duarte, MD, says that previous studies have shown similar results to this one.
“This is not something new,” says Duarte, director of the Pain Center at the Cushing Neuroscience Institute in Great Neck, N.Y. “The significance of this study is in its size.”
Duarte, who reviewed the study for WebMD, has practiced acupuncture for 19 years. He says that a good number of his patients benefit from it. Because there are limited options for pain management, even small amounts of relief are welcome.
“It’s better than nothing, and that is something,” says Duarte. “Even a modest benefit from acupuncture may lessen the need for medication and decrease the risk of side effects from medications and other interventions.”
According to the study, acupuncture showed a small but noteworthy advantage over sham acupuncture. That led the authors to conclude that there is a benefit beyond the placebo effect. However, the modest differences between real and fake acupuncture -- and the fact that sham acupuncture showed better results than standard care raise questions about what is actually at work when a patient is stuck with a needle.
“These effects may be real relief,” says Rick Hecht, MD, research director at the Osher Center for Integrative Medicine at the University of California, San Francisco. “There may be active ingredients that are still there even though the needles are not going into specific points and specific depths. What is doing it, you can’t tell, though other research is being done to break down the issue.”
Hecht was not involved in the study.
To Duarte, the fact that sham acupuncture shows benefits indicates that "sham" may be misleading.
“The word ‘sham’ implies it is a sham, but it may be beneficial,” he says. “Maybe the traditional acupuncture points are not as important as once thought.”
SOURCES:Vickers, A. Archives of Internal Medicine, Sept. 10, 2012.Avins, A. Archives of Internal Medicine, Sept. 10, 2012.Andrew Vickers, PhD, Memorial Sloan-Kettering Cancer Center, New York City, N.Y.Robert Duarte, MD, director, Pain Center, Cushing Neuroscience Institute, Great Neck, N.Y.Rick Hecht, MD, researcher director, Osher Center for Integrative Medicine, UCSF.
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