More Evidence Acupuncture Can Ease Chronic Pain

All studies included in the review were randomized controlled trials, considered the gold standard of research. As well, all involved a comparison between acupuncture and either "usual care" involving no acupuncture at all or the use of so-called "sham acupuncture."

Sham acupuncture involved the use of retractable or superficially inserted needles in some instances, or nonworking electrical or laser-based stimulation in others.

The result: When compared against sham interventions or no acupuncture at all, true acupuncture appeared to be "superior" at relieving all four types of pain in question.

Acupuncture was seen to provide more or less equivalent degrees of greater pain relief across all pain types.

How much greater? Vickers and his associates explained that, generally speaking, if a patient was to go on to experience a 30 percent drop in pain while undergoing standard care with no acupuncture intervention, those undergoing "sham acupuncture" seemed to experience about a 43 percent drop, while true acupuncture patients experienced a 50 percent fall-off.

The authors stressed that although the superiority of true acupuncture over sham acupuncture appeared to be relatively small, the real-world choice patients face is not between acupuncture or fake acupuncture but rather between acupuncture or no acupuncture at all. And in that context they suggested that their findings are "of major importance for clinical practice."

"Basically what we see here is that the pain relief difference from acupuncture versus no acupuncture is notable, and important, and difficult to ignore," Vickers said.

However, he cautioned that though the analysis suggests that acupuncture is a "reasonable" pain relief option, interested patients should make sure to seek out a qualified practitioner, perhaps by getting a reliable referral from their general practitioner.

For his part, Dr. Ed Ross, director of the pain management center at Brigham and Women's Hospital, in Boston, suggested that while acupuncture may work for some it may not work for all.

"There is clearly a response to acupuncture among a selected patient population," he said. "And for this seemingly small subset I think it's a viable treatment for chronic pain. However, in general, the studies that have looked into this have not been considered to be particularly scientifically rigorous. So it's been really difficult to say who will be in that subset that will benefit."

"So I would say try it, and if it works, great," Ross added. "But I also believe in an interdisciplinary approach to pain management. So acupuncture should be considered as only one part of a whole treatment plan."

Because costs for an acupuncture session vary so widely, neither expert could offer a price estimate. At present, most insurance does not cover acupuncture.

SOURCES: Andrew Vickers, D.Phil., attending research methodologist and statistician, Memorial Sloan-Kettering Cancer Center, New York City; Ed Ross, M.D., director, pain management center, Brigham and Women's Hospital, Boston; Sept. 10, 2012, Archives of Internal Medicine, online

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Published: September 2012