Acupuncture No Better than Placebo for Pain

Systematic review finds little truly convincing evidence that acupuncture is effective in reducing pain, but does find many cases of adverse effects.

A study that evaluated 57 systematic reviews of the use of acupuncture for the treatment of pain found that there is little-to-no high-quality evidence indicating that acupuncture is an effective therapy for pain.

Researchers from the Universities of Exeter & Plymouth and the Korea Institute of Oriental Medicine published these results in the April issue of PAIN. Titled “Acupuncture: Does It Alleviate Pain and Are There Serious Risks? A Review of Reviews,” the article notes that this study “was aimed at critically evaluating systematic reviews of acupuncture as a treatment of pain and at summarizing reports of serious adverse effects published since 2000.” Of 57 systematic reviews identified during a search of 11 databases, only four were of excellent methodological quality. The researchers reported that “numerous contradictions and caveats emerged” during the study, finding “unanimously positive conclusions from more than one high-quality systematic review” only for the use of acupuncture as a treatment for neck pain.

They also reported finding many cases of severe adverse effects in conjunction with the use of acupuncture as a remedy for pain, with pneumothorax and infections among the most frequently reported adverse effects.

The authors note that theirs is the latest in a long line of inquiries that have failed to produce solid evidence in support of the use of acupuncture as part of an effective pain management program, concluding that “numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain. Serious adverse effects continue to be reported.”

According to a news release that accompanied publication of these results, the researchers found that “recent results from high-quality randomized controlled trials have shown that various forms of acupuncture, including so-called ‘sham acupuncture,’ during which no needles actually penetrate the skin, are equally effective for chronic low back pain, and more effective than standard care.” The authors attributed this to such factors as “therapist conviction, patient enthusiasm or the acupuncturist's communication style.”

The news release also includes a rather damning quote from a commentary by Harriet Hall, MD, published in the same issue of PAIN: "Importantly, when a treatment is truly effective, studies tend to produce more convincing results as time passes and the weight of evidence accumulates. When a treatment is extensively studied for decades and the evidence continues to be inconsistent, it becomes more and more likely that the treatment is not truly effective. This appears to be the case for acupuncture. In fact, taken as a whole, the published (and scientifically rigorous) evidence leads to the conclusion that acupuncture is no more effective than placebo." (emphasis added)

Gilbert Ross, MD, Executive Medical Director of the American Council on Science and Health, said this article seems “like a fairly clear report: meta-analysis of numerous studies shows that the pain benefit from acupuncture is no greater than a placebo effect, while contributing significant numbers of unjustifiable side-effects and complications. So why do it?”

HCPLive wants to know:

What are your thoughts on the use of acupuncture to treat patients for pain?

Do you use this treatment with your patients and/or refer them to practitioners who will perform this therapy?

Does this study change your thinking on the effectiveness of this intervention?

What do you say to patients and/or colleagues who swear by acupuncture as a treatment for pain?

Leave a comment below!