Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta‐analyses

@article{Hopton2010AcupunctureFC,
  title={Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta‐analyses},
  author={Ann Hopton and Hugh MacPherson},
  journal={Pain Practice},
  year={2010},
  volume={10}
}
Objectives:  There is controversy as to whether or not acupuncture is more effective than placebo. To help clarify this debate, we synthesized the evidence gathered from systematic reviews on the pooled data of high‐quality randomized controlled trials comparing acupuncture to sham acupuncture for chronic pain. 
A New Method for Sham‐Controlled Acupuncture in Experimental Visceral Pain – a Randomized, Single‐Blinded Study
TLDR
This study aimed to validate a new method for blinded sham acupuncture in experimental rectal pain by establishing models for assessment of acupunctures effect against visceral pain.
The response‐time relationship and covariate effects of acupuncture for chronic pain: A systematic review and model‐based longitudinal meta‐analysis
Critical clinical questions regarding how soon and how long the analgesic effect will be achieved by acupuncture, as well as who will be responsive to acupuncture, need further address. The aim of
Does acupuncture activate endogenous analgesia in chronic whiplash‐associated disorders? A randomized crossover trial
TLDR
Examination of whether acupuncture results in activation of endogenous analgesia and relief in symptoms in patients with chronic WAD to find out if treatments influence the process of central sensitization.
Acupuncture for Low Back Pain: An Overview of Systematic Reviews
TLDR
Systematic reviews of variable quality showed that acupuncture, either used in isolation or as an adjunct to conventional therapy, provides short-term improvements in pain and function for chronic LBP.
Complementary and Alternative Medicine for Chronic Musculoskeletal Pain.
A review of randomized clinical trial studies suggests that acupuncture and spinal manipulation may be effective for the treatment of chronic musculoskeletal pain.
Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial
Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain,
Acupuncture for the Relief of Chronic Pain: A Synthesis of Systematic Reviews
TLDR
It is suggested that an enriched enrolment with randomised withdrawal design may overcome some of these methodological shortcomings of RCTs and improve the quality of evidence so that healthcare providers and commissioners can make informed choices on the interventions which can legitimately be provided to patients living with chronic pain.
Do further studies of acupuncture for pain make sense? An informal review
TLDR
As recent studies show small effect sizes, acupuncture may have a specific but clinically unimportant effect; alternatively, the small benefits seen may have resulted from a residual placebo effect.
The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A Meta-Analysis.
TLDR
This meta-analysis demonstrates that acupuncture can improve short and long-term physical function, but it appears to provide only short-term pain relief in patients with chronic knee pain due to osteoarthritis.
Is acupuncture no more than a placebo? Extensive discussion required about possible bias.
TLDR
The present review aimed to suggest techniques to design high-quality studies, minimize the placebo effect and optimize acupuncture administration in acupuncture studies.
...
...

References

SHOWING 1-10 OF 52 REFERENCES
Acupuncture and Osteoarthritis of the Knee: A Review of Randomized, Controlled Trials
TLDR
Review of English-language articles describing randomized, controlled trials of the effects of needle or electroacupuncture on knee osteoarthritis provides evidence that acupuncture is an effective treatment for pain and physical dysfunction associated with osteo arthritis.
Acupuncture – a critical analysis
  • E. Ernst
  • Medicine
    Journal of internal medicine
  • 2006
TLDR
Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response, and acupuncture remains steeped in controversy.
Acupuncture for the Management of Chronic Headache: A Systematic Review
TLDR
Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate.
Acupuncture treatment for chronic knee pain: a systematic review.
TLDR
Systematic review and meta-analysis of randomized controlled trials of adequate acupuncture found acupuncture that meets criteria for adequate treatment is significantly superior to sham acupuncture and to no additional intervention in improving pain and function in patients with chronic knee pain.
Effectiveness of Acupuncture for Low Back Pain: A Systematic Review
TLDR
There is moderate evidence that acupuncture is more effective than no treatment, and strong evidence of no significant difference between acupuncture and sham acupuncture, for short-term pain relief, but the effectiveness of acupuncture compared with other forms of conventional therapies still requires further investigation.
Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis.
TLDR
Sham-controlled RCTs suggest specific effects of acupuncture for pain control in patients with peripheral joint OA, and considering its favourable safety profile acupuncture seems an option worthy of consideration particularly for knee OA.
Effectiveness of acupuncture for migraine: critical literature review.
TLDR
Findings agreed with previous literature reviews that the majority of studies of acupuncture for migraine research are of poor quality, with conflicting results, and large, high quality randomized controlled trials ofupuncture for migraine are needed.
Clinical trials of acupuncture: consensus recommendations for optimal treatment, sham controls and blinding.
TLDR
This consensus document considers issues with the aim of improving the design of efficacy trials of acupuncture in order that they are more likely to be conclusive and more meaningfully interpreted.
Meta-analysis: Acupuncture for Osteoarthritis of the Knee
TLDR
This meta-analysis of 9 trials showed that sham-controlled trials identified no clinically meaningful short-term benefits in pain or function with acupuncture for knee osteo-arthritis, although trials that did not use a sham control identified some benefits.
Meta-Analysis: Acupuncture for Low Back Pain
TLDR
Evidence is found that acupuncture is more effective than sham or no treatment for patients with chronic low back pain, and the hypothesis that treatment effect size is correlated with study quality, treatment factors, and patient factors is addressed.
...
...