15. February 2018 · Comments Off · Categories: Acupuncture, Pain Management

The Acupuncture Now Foundation (a non-profit organisation dedicated to educating the public, healthcare providers and health policymakers about acupuncture) has submitted an extensive document to the Food and Drug Administration (FDA – the US government agency responsible for protecting and promoting public health). The 34-page position paper summarises the most pertinent information regarding the potential of acupuncture for treating common pain conditions and reducing dependency on harmful medications. They review the current body of research as well as providing an overview of the potential benefits and limitations of expanding acupuncture’s role in pain management. The paper contains up-to-date research summaries on chronic and acute pain, plus summaries of four landmark studies. The authors intend it to be a useful resource for those preparing evidence summaries to government agencies, health insurance companies and health policy decision-makers.

Acupuncture in Pain Management: Strengths and Weaknesses of a Promising Non-Pharmacologic Therapy in the Age of the Opioid Epidemic. 2017.

15. February 2018 · Comments Off · Categories: Acupuncture, Pain

The largest-ever pragmatic randomised trial of acupuncture carried out in hospital emergency departments has found that it is a safe and effective alternative to pain-relieving drugs for acute pain. A total of 1964 patients presenting at four Australian hospital emergency departments with back pain, migraine and ankle sprain were randomised to acupuncture alone, acupuncture plus pharmacotherapy or pharmacotherapy alone. The results showed that although neither acupuncture nor standard pharmacotherapy afforded patients clinically relevant reduction in pain within an hour, patients still found both treatments to be acceptable, and the effectiveness of acupuncture alone was comparable with that of pharmacotherapy.

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Med J Aus. 2017; 206 (11): 494.

A systematic review by American authors also supports acupuncture as an effective treatment for acute pain in the hospital emergency department. Meta-analyses were performed on data from 14 randomised controlled trials (representing 1210 patients) which compared acupuncture with sham, acupuncture with standard analgesia and acupuncture as an adjunct to standard care. Acupuncture was judged to be more clinically effective compared to sham and non-inferior to conventional drug therapy for acute pain. Limited data was also found that indicated superior results if acupuncture was added as an adjunct to standard analgesia. Acupuncture was also associated with improved patient satisfaction, lower cost and fewer adverse effects.

Does acupuncture have a role in providing analgesia in the emergency setting? A systematic review and meta-analysis. Emerg Med Australas. 2017 Jul 26. [Epub ahead of print].

15. February 2018 · Comments Off · Categories: Acupuncture, Pain

Acupuncture is still effective for pain relief a year after treatment has ended, according to a paper by Prof Hugh MacPherson and international colleagues from the Acupuncture Trialists’ Collaboration. Using a large individual patient data set from high-quality randomised trials of acupuncture for chronic pain (20 trials, including 6376 patients) the authors determined the trajectory of pain scores over time, after acupuncture for conditions including musculoskeletal pain (low back, neck, shoulder), osteoarthritis of the knee and headache. In trials comparing acupuncture to a no-acupuncture control, effect sizes diminished by a nonsignificant amount (0.011 SD per three months) after treatment ended. This suggests that approximately 90 percent of the benefit of acupuncture relative to controls would be sustained at 12 months. For trials comparing acupuncture to sham, they observed a smaller, but still significant, reduction in effect size (0.025 SD per three months), suggesting approximately a 50 percent diminution at 12 months. The authors recommend that studies of the cost-effectiveness of acupuncture should take these findings into account.

The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain. 2017 May;158(5):784-793.

10. October 2017 · Comments Off · Categories: Acupuncture, Depression, Insomnia

Acupuncture could be a viable alternative to medication for treating depression-related insomnia, report the authors of a meta-analysis from China. Eighteen randomised-controlled clinical trials with 1678 participants were analysed. The results showed that acupuncture treatment led to significant improvements in sleep scores compared with western medicine. Acupuncture combined with western medicine produced a better effect on sleep quality compared with western medicine alone. Acupuncture and western medicine improved depression scores by an equal amount, and acupuncture combined with western medicine was more effective than western medicine alone.
The Efficacy of Acupuncture for Treating Depression-Related Insomnia Compared with a Control Group: A Systematic Review and Meta-Analysis. Biomed Res Int. 2017;2017:9614810.

UK researchers examining economic data on 12 non-pharmacological interventions for osteoarthritis of the knee (KOA) have found acupuncture and transcutaneous electrical nerve stimulation (TENS) to be cost-effective. The authors applied network meta-analysis to data from 88 randomised controlled trials including 7,507 patients. They based their cost-effectiveness estimations on a threshold of £20–30,000 per QALY (quality-adjusted life year – a measure of disease burden used to assess the value for money of medical interventions), as this is used by the UK’s National Institute for Health and Care Excellence (NICE) to assess whether treatments represent a cost-effective use of UK NHS resources. When all trials were considered, TENS was found to be cost-effective at the NICE threshold, with an incremental cost-effectiveness ratio of £2,690 per QALY versus usual care (meaning one quality-adjusted life year would be gained for each additional £2,690 spent on TENS). When only higher quality trials were considered, acupuncture was found to be cost-effective (with an incremental cost-effectiveness ratio of £13,502 per QALY versus TENS). The authors further noted that, while acupuncture is not currently recommended by NICE as a treatment for KOA, based on their calculations some interventions that are recommended by NICE (insoles, braces and manual therapy) are unlikely to be cost-effective and therefore should not be prioritised for commissioning within the NHS.
Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLoS One. 2017 Mar 7;12(3):e0172749.

10. October 2017 · Comments Off · Categories: Acupuncture, Multiple Sclerosis

Acupuncture treatment can improve walking gait in patients with multiple sclerosis, report Portuguese investigators. Gait impairment was evaluated using the 25-foot walk test in 20 individuals with relapsing-remitting multiple sclerosis, who were then randomised to either verum or sham acupuncture. Verum acupuncture was administered at Liangqiu ST-34 Weizhong BL-40 and Chengshan BL-57, while sham acupuncture consisted of needling at non-acupuncture points located two cun laterally to the verum points. Verum acupuncture led to a significant decrease in time taken to walk 25 feet. By contrast, differences in time to walk 25 feet were not statistically significant for sham acupuncture. Following verum acupuncture, 95% of patients showed an improvement in 25-foot walk test, compared with only 45 % for sham acupuncture.
Effects of Acupuncture on Gait of Patients with Multiple Sclerosis. J Altern Complement Med. 2017 Apr 14. doi: 10.1089/acm.2016.0355. [Epub ahead of print].

10. October 2017 · Comments Off · Categories: Acupuncture, Kidney Disease

Acupuncture improves renal function markers in patients with chronic kidney disease (CKD), according to research from Taiwan. Fifty nine patients with CKD were randomised into acupuncture and sham treatment groups. In the acupuncture group, manual acupuncture was applied to bilateral Hegu L.I.-4, Zusanli ST-36 and Taixi KID-3 to obtain qi, and electroacupuncture (2 Hz) was applied to two acupoint pairs (right Zusanli ST-36 and Taixi KID-3 and left Zusanli ST-36 and Taixi KID-3) once per week for 12 weeks. In the sham group, needles were inserted 1.5 cm lateral to the acupoints, and no electrical stimulation was applied. Levels of serum creatinine and estimated glomerular filtration rate (eGFR) were found to have improved significantly in the acupuncture group compared with the control group after 12 weeks of treatment, suggesting that acupuncture is beneficial for renal function in patients with CKD.
Acupuncture on Renal Function in Patients with Chronic Kidney Disease: A Single-Blinded, Randomized, Preliminary Controlled Study. J Altern Complement Med. 2017 Apr 19. doi: 10.1089/acm.2016.0119. [Epub ahead of print].

10. October 2017 · Comments Off · Categories: Acupuncture, Cancer, Gastric Cancer

Patients with advanced gastric cancer experience a significant reduction in gastrointestinal symptoms induced by chemotherapy when treated with acupuncture, report Chinese clinicians. A cohort of 56 chemotherapy patients was randomly divided into an experimental group and a control group. Those in the experimental group received 30 minutes of acupuncture (at Zusanli ST-36, Shangjuxu ST-37, Tianshu ST-25, Sanyinjiao SP-6, and Neiguan P-6) daily for two weeks. Nausea duration, vomiting frequency, abdominal pain and diarrhoea were all significantly reduced, while quality-of-life scores were higher in the experimental group compared with controls.
The effect of acupuncture on chemotherapy-associated gastrointestinal symptoms in gastric cancer. Curr Oncol. 2017 Feb;24(1):e1-e5.

29. August 2017 · Comments Off · Categories: Acupuncture, Intensive Care Unit, Pain

Acupuncture is a feasible treatment for relieving pain in intensive care unit (ICU) patients, American researchers report. Forty six patients admitted to an ICU who were experiencing pain and/or nausea received three 20 minute acupuncture treatments in addition to usual care. Needling was carried out at eight predetermined points (unilateral Hegu L.I.-4, Taichong LIV-3, Neiguan P-6 and Zusanli ST-36, plus unilateral auricular points Shenmen, Sympathetic, Stomach and Thalamus). Self-reported pain levels were found to have decreased by a mean of 2.36 points on a 10 point scale immediately following acupuncture, which is above the commonly accepted threshold for clinically relevant analgesia. In addition, nearly half (49%) of all participants spontaneously reported an anxiolytic effect from acupuncture. A significant decrease in morphine usage after each treatment was also observed. The decrease in mean self-reported nausea scores was not statistically significant.
Acupuncture for Pain and Nausea in the Intensive Care Unit: A Feasibility Study in a Public Safety Net Hospital. J Altern Complement Med. 2017 Apr 25. [Epub ahead of print].

29. August 2017 · Comments Off · Categories: Acupuncture, Fybromyalgia

Fibromyalgia patients who exhibit greater sensitivity to pain are more likely to respond to sham acupuncture, and more likely to experience a worsening of pain after verum acupuncture, report US researchers. A cohort of 114 fibromyalgia patients received baseline pressure pain testing and were then randomised to either verum or sham acupuncture. Verum acupuncture consisted of needling nine acupuncture points (Baihui DU-20, right ear Shenmen, left Quchi L.I.-11, right Hegu L.I.-4, left Yanglingquan GB-34, left Zusanli ST-36, left Sanyinjiao SP-6 and right Taichong LIV-3), while sham treatment involved needling at non-acupuncture points. Participants received one to three treatments a week week for a total of 18 treatments. Participants who had higher pressure pain thresholds at baseline demonstrated a greater reduction in clinical pain following verum acupuncture, while participants who had lower baseline pain pressure thresholds showed a better analgesic response to sham acupuncture. In addition, patients with lower pressure pain thresholds reported exacerbated pain following verum acupuncture.
Evoked Pressure Pain Sensitivity Is Associated with Differential Analgesic Response to Verum and Sham Acupuncture in Fibromyalgia. Pain Med. 2017 Mar 15. doi: 10.1093/pm/pnx001. [Epub ahead of print].