Acupuncture for the prevention of tension-type headache
The latest Cochrane review
on acupuncture for the prevention of tension type headache incorporated twelve randomised controlled trials studying adult patients with episodic or chronic tension type headache. Their primary outcome measure was demonstration of response (at least 50% reduction in headache frequency following treatment completion). Of the trials comparing acupuncture to usual care, 48% of participants receiving acupuncture experienced at least 50% reduction in headache frequency, versus 19% receiving usual care. Of the trials comparing real to placebo acupuncture*, 51% reported a response to treatment, vs 43% of those in the placebo group. Both differences were statistically significant, with similar results at 6 month follow-up for the acupuncture versus placebo trials. These results suggest Acupuncture is an effective treatment for frequent episodic or chronic tension-type headaches in adults.
*Placebo acupuncture is also known as 'sham intervention' / 'sham acupuncture', and comprises interventions mimicking 'true' acupuncture, but missing at least one important aspect of acupuncture theory, such as correct point location or skin penetration.
Acupuncture for the prevention of episodic migraine
The latest Cochrane review
on acupuncture for the prevention of episodic migraine incorporated twenty two randomised controlled trials studying adult patients with episodic migraine. Their primary outcome measure was headache frequency. Of the trials comparing acupuncture to no acupuncture, 48% of participants receiving acupuncture experienced at least 50% reduction in headache frequency, versus 17% receiving no acupuncture. Of the trials comparing real to placebo acupuncture, 50% reported a response to treatment, vs 41% of those in the placebo group. Of the trials comparing acupuncture to prophylactic medication, headache frequency at least halved in 57% of those receiving acupuncture, versus 46% of those receiving prophylactic medication. All effects were statistically significant after treatment, and maintained at follow up (3-12 months) for the comparison with no acupuncture and comparison with placebo acupuncture trials. These results suggest Acupuncture is an effective treatment for episodic migraine in adults.
Acupuncture for low back pain
A Cochrane review
assessing the effects of acupuncture for treatment of low back pain reported that for chronic nonspecific low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or placebo treatment, immediately after treatment and in the short term. The authors added that when combined with conventional therapies, acupuncture improved pain and function more than conventional methods alone. The study comprised 35 Randomised Controlled Trials covering a total of 2861 patients. The average improvement in chronic pain (with scores measured using numerical pain intensity scores) was 32% with acupuncture, versus 22% with placebo and 6% with no treatment.
Acupuncture for chronic knee pain
A systematic review
of thirteen randomised controlled trials studying the effects of acupuncture in adults with chronic knee pain or knee osteoarthritis, reported that acupuncture may be an effective treatment. The study, published in the journal Rheumatology, combined the data of 5 RCTs (including 1334 patients), and found significant improvements in those receiving acupuncture versus placebo, in measures of both pain and physical function. These improvements were still significant at long term follow up.
Acupuncture in patients with osteoarthritis of the knee: a randomised trial
A group of 294 patients with knee osteoarthritis were randomly assigned to receive either acupuncture, placebo (superficial needling at non-acupuncture points), or a waiting list control. Treatment comprised 12 sessions over a course of 8 weeks. The primary outcome measured was an index that assesses levels of pain, stiffness and function in osteoarthritis, known as the WOMAC (Western Ontario and McMaster Universities Osteoarthritis ) Index. The findings
, published in the journal The Lancet, revealed that after 8 weeks of treatment, WOMAC scores were significantly reduced in true versus placebo acupuncture by average 8.8 points, and in true acupuncture versus waiting list control by an average of 22.7 points. Long term significance (at 52 weeks) was maintained for comparison to waiting list control only. These results show that acupuncture may improve joint pain and function more than placebo acupuncture / no acupuncture in patients with osteoarthritis of the knee, albeit with a benefit that decreases over time.