What alternative health practitioners might not tell you

ebm-first.com

Home

Acupuncture

Research and efficacy

This page is under revision and will be updated with 2010-2011 links shortly.

Related links

Acupuncture

Acupuncture risks

Traditional Chinese Medicine (TCM)

Chinese bile farm bears

Acupuncture: What Does the Most Reliable Evidence Tell Us?

"In an attempt to find the most reliable type of evidence, this article provides an overview of Cochrane reviews of acupuncture….. It is concluded that Cochrane reviews of acupuncture do not suggest that this treatment is effective for a wide range of conditions." Ernst E., Journal of Pain and Symptom Management (11th September 2008) NOTE: The Cochrane Collaboration is a worldwide network of independent scientists dedicated to systematically summarising the totality of the evidence related to specific medical subjects in a rigorous and transparently impartial fashion.

COCHRANE SYSTEMATIC REVIEWS:

Acupuncture for assisted conception (Cochrane Review 2008)

"There is no evidence of benefit on pregnancy outcomes when acupuncture is performed around the time of oocyte retrieval." Cheong YC, Hung Yu, Ng E, Ledger WL. Acupuncture and assisted conception. Report in Focus on Alternative and Complementary Therapies [FACT] (March 2009)

Acupuncture for restless legs syndrome (Cochrane Review)

"There is insufficient evidence to support the use of acupuncture for the symptomatic treatment of restless legs syndrome." Cui Y, Wang Y, Liu Z, (8th October 2008)

Acupuncture for epilepsy (Cochrane Review)

"Patients with epilepsy are currently treated with antiepileptic drugs, but a significant number of people continue to have seizures and many experience adverse effects to the drugs. As a result there is increasing interest in alternative therapies and acupuncture is one of those. Eleven studies were included, however acupuncture has not yet been proven to be effective and safe for treating people with epilepsy." Cheuk DKL, Wong V (16th July 2008)

Acupuncture for stroke rehabilitation (Cochrane Review)

Concludes that there is no clear evidence of the effects of acupuncture on stroke rehabilitation. (5th April 2006)

Acupuncture for treatment of irritable bowel syndrome (Cochrane Review)

Concludes that there is no evidence to support the use of acupuncture for the treatment of irritable bowel syndrome (IBS). (17th August 2006)

Auricular acupuncture for cocaine dependence (Cochrane Review)

Concludes that there is currently no evidence that auricular acupuncture is effective for the treatment of cocaine dependence. (January 2006)

Acupuncture and related interventions for smoking cessation (Cochrane Review)

Concludes that there is no consistent evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation, but methodological problems mean that no firm conclusions can be drawn. (24th October 2005)

Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis (Cochrane Review)

Concludes that although the results of the study on electroacupuncture show that electroacupuncture may be beneficial to reduce symptomatic knee pain in patients with RA 24 hours and 4 months post treatment, the reviewers concluded that the poor quality of the trial, including the small sample size preclude its recommendation. The reviewers further conclude that acupuncture has no effect on ESR, CRP, pain, patient's global assessment, number of swollen joints, number of tender joints, general health, disease activity and reduction of analgesics. (22nd August 2005)

Acupuncture for schizophrenia (Cochrane Review)

Concludes that there is insufficient evidence to recommend the use of acupuncture for people with schizophrenia. (5th July 2005)

Acupuncture for acute stroke (Cochrane Review)

Concludes that acupuncture appeared to be safe but without clear evidence of benefit. (1st December 2004)

Acupuncture and dry-needling for low back pain (Cochrane Review)

Conlcudes that the data do not allow firm conclusions about the effectiveness of acupuncture for acute low-back pain. (30th October 2004)

Acupuncture for depression (Cochrane Review)

Concludes that there is insufficient evidence to determine the efficacy of acupuncture compared to medication, or to wait list control or sham acupuncture, in the management of depression. (17th march 2004)

Acupuncture for Bell's palsy (Cochrane Review)

Concludes that more evidence is needed to show whether acupuncture is beneficial for Bell's palsy. (24th October 2003)

Acupuncture for induction of labour (Cochrane Review)

Concludes that there is insufficient evidence describing the efficacy of acupuncture to induce labour. (10th October 2003)

Acupuncture for chronic asthma (Cochrane Review)

Concludes that there is not enough evidence to make recommendations about the value of acupuncture in asthma treatment. (11th March 2003)

SYSTEMATIC REVIEWS:

Acupuncture for treating hot flushes in men with prostate cancer: a systematic review

CONCLUSION: The evidence is not convincing to suggest acupuncture is an effective treatment for hot flush in patients with PC. Further research is required to investigate whether acupuncture has hot-flush-specific effects. Lee MS, Kim KH, Shin BC, Choi SM, Ernst E. Support Care Cancer. (18th February 2009)

Acupuncture for treating erectile dysfunction: a systematic review

CONCLUSION: The evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED. Further research is required to investigate whether there are specific benefits of acupuncture for men with ED. Lee MS, Shin BC, Ernst E, BJU Int. (23rd February 2009)

Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups

"We found a small analgesic effect of acupuncture that seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear." Madsen MV, Gotzsche PC, Hrobjartsson A. BMJ (27th January 2009) [Quoted from the full text of the review]

Acupuncture for Alzheimer's disease: a systematic review

CONCLUSION: Even though the number of studies is small, the existing evidence does not demonstrate the effectiveness of acupuncture for AD. Int J Clin Pract. (2009)

A systematic review and meta-analysis of acupuncture in in vitro fertilisation

CONCLUSION: Currently available literature does not provide sufficient evidence that adjuvant acupuncture improves IVF clinical pregnancy rate. El-Toukhy T Sunkara SK Khairy M Dyer R Khalaf Y Coomarasamy A. BJOG. 2008 Sep;115(10):1203-13

Auricular acupuncture for insomnia: a systematic review

"Conclusion: We conclude that, because of the paucity and of the poor quality of the data, the evidence for the effectiveness of AA for the symptomatic treatment of insomnia is limited. Further, rigorously designed trials are warranted to confirm these results." Lee MS, Shin BC, Suen LK, Park TY, Ernst E, Int. J. Clin. Pract. (25th August 2008)

A systematic review of the clinical effectiveness of acupuncture for allergic rhinitis

Conclusion: There is currently insufficient evidence to support or refute the use of acupuncture in patients with AR. A large well conducted RCT, which overcomes identified methodological problems in the existing RCTs, would be required to resolve this questions. Complementary and Alternative Medicine (22nd April 2008)

Acupuncture for rheumatoid arthritis: a systematic review

"In conclusion, penetrating or non-penetrating sham-controlled RCTs failed to show specific effects of acupuncture for pain control in patients with RA. More rigorous research seems to be warranted." M. S. Lee, B. C. Shin, and E. Ernst, (Rheumatology 2008 — 47:1747-1753) [pdf]

Systematic review of clinical trials of acupuncture-related therapies for primary dysmenorrhea

CONCLUSIONS: Because of low methodologic quality and small sample size, there is no convincing evidence for acupuncture in the treatment of primary dysmenorrhea. There is an urgent need for randomized, blinded, placebo-controlled trials to assess the effects of acupuncture. Yang H, Liu CZ, Chen X, Ma LX, Xie JP, Guo NN, Ma ZB, Zheng YY, Zhu J, Liu JP. Acta Obstet Gynecol Scand. (2008)

A systematic review of randomized controlled trials of acupuncture in the treatment of depression

Concludes that despite the findings that the odds ratios of existing literature suggest a role for acupuncture in the treatment of depression, the evidence thus far is inconclusive. Leo RJ, Ligot JS Jr, Journal of Affective Disorders (January 2007)

Acupuncture for fibromyalgia — a systematic review of randomized clinical trials

Conclusion: The notion that acupuncture is an effective symptomatic treatment for fibromyalgia is not supported by the results from rigorous clinical trials. On the basis of this evidence, acupuncture cannot be recommended for fibromyalgia. Mayhew E, Ernst E. Rheumatology (December 2006)

Systematic review of systematic reviews of acupuncture published 1996-2005

Concludes that systematic reviews of acupuncture have overstated effectiveness by including studies likely to be biased. They provide no robust evidence that acupuncture works for any indication. Clinical Medicine (July-August 2006)

Acupuncture for the relief of cancer-related pain — a systematic review

Conclusions: "The notion that acupuncture may be an effective analgesic adjunctive method for cancer patients is not supported by the data currently available from the majority of rigorous clinical trials. Because of its widespread acceptance, appropriately powered RCTs are needed." European Journal of Pain (August 2005)

Acupuncture analgesia during surgery: a systematic review

"In conclusion, this review does not support the use of acupuncture as an adjunct to standard anaesthetic procedures during surgery." Pain (April 2005)

Efficacy of acupuncture for cocaine dependence: a systematic review and meta-analysis

This systematic review and meta-analysis did not support the use of acupuncture for the treatment of cocaine dependence. Harm Reduction Journal (March 2005)

Acupuncture: Evidence from Systematic Reviews and Meta-analyses

"This systematic review confirms the findings from other reviews which indicate consistent support for the effectiveness of acupuncture in the treatment of postoperative nausea/vomiting, and dental pain. For other indicators the robustness of the effect of acupuncture is debatable and its clinical value questionable for conditions such as idiopathic headaches, chronic pain, smoking and fibromyalgia, however some reviews indicated promising results." Alberta Heritage Foundation for Medical Research (March 2002) [pdf]

Efficacy of acupuncture as a treatment for tinnitus: a systematic review

Concludes that acupuncture has not been demonstrated to be efficacious as a treatment for tinnitus on the evidence of rigorous randomized controlled trials. Archives of Otolaryngology — Head and Neck Surgery (April 2000)

A systematic review of randomized controlled trials of acupuncture for neck pain

Concludes that the hypothesis that acupuncture is efficacious in the treatment of neck pain is not based on the available evidence from sound clinical trials. Rheumatology (Oxford) (February 1999)

OTHER PAPERS:

Auricular acupuncture as an adjunct to opiate detoxification treatment: effects on withdrawal symptoms

"Auricular acupuncture had no effect upon withdrawal severity or craving when provided as an adjunct to a standard methadone detoxification treatment. The results are consistent with the findings of other studies that failed to find any effect of acupuncture in the treatment of drug dependence. The failure to find any clinical gains from the adjunctive use of auricular acupuncture during detoxification from opiates raises concerns about the widespread acceptance of this intervention." Bearn J, Swami A, Stewart D, Atnas C, Giotto L, Gossop M., J Subst Abuse Treat. (April 2009)

Acupuncture for menopausal hot flushes

"There were no significant effects for changes in hot flush interference, sleep, mood, health-related QoL, or psychological well-being." Avis NE, Legault C, Coeytaux RR et al. A randomized, controlled pilot study of acupuncture treatment for menopausal hot flashes. Menopause 2008. Report in Focus on Alternative and Complementary Therapies [FACT] (December 2008)

Acupuncture for pain and mobility in osteoarthritis of the knee

"Both study and control groups showed significant improvement with respect to time effects in terms of 6-min walking distance, pain VAS, pain domain and mobility domain scores determined by the osteoarthritis of the knee outcome measurement, after adjusting for co-variables. However, improvements measured in the study group did not differ significantly from those in the control group." Maa SH, Sun MF, Wu CC. The effectiveness of acupuncture on pain and mobility in patients with osteoarthritis of the knee: a pilot study. J Nurs Res 2008. Report in Focus on Alternative and Complementary Therapies [FACT] (December 2008)

Acupuncture and dry needling in the management of myofascial trigger point pain

Needling was not found to be significantly superior to placebo. Tough EA, White AR, Cummings TM et al. Acupuncture and dry needling in the management of myofascial trigger point pain: A systematic review and meta-analysis of randomised controlled trials. Eur J Pain 2008. Report in Focus on Alternative and Complementary Therapies [FACT] (September 2008)

Acupuncture for treatment of persistent arm pain due to repetitive use: a randomized controlled clinical trial

Results: Arm pain scores improved in both groups during the treatment period, but improvements were significantly greater in the sham group than in the true acupuncture group. This difference disappeared by 1 month after treatment ended. The true acupuncture group experienced more side effects, predominantly mild pain at time of treatments. Clinical Journal of Pain (March-April 2008)

Severe knee osteoarthritis: a randomized controlled trial of acupuncture, physiotherapy (supervised exercise) and standard management for patients awaiting knee replacement

Conclusions: We have demonstrated that patients with severe knee osteoarthritis can achieve a short-term reduction in OKS when treated with acupuncture. However, we failed to demonstrate any other clinically or statically significant effects between the groups. Both interventions can be delivered effectively in an out-patient group setting at a district general hospital. Further study is needed to evaluate the combined effects of these treatments. Rheumatology (29th June 2007)

Meta-analysis: Acupuncture for Osteoarthritis of the Knee

"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." Implications: "The use of different types of comparisons (sham acupuncture vs. interventions in which the participant knew whether they were receiving acupuncture) explains the variability in the conclusions of published trials about the effectiveness of acupuncture for treating knee osteo-arthritis. Placebo or expectation effects probably account for the observed benefits." Annals of Internal Medicine (19th June 2007)

Acupuncture for Chronic Pain in Japan: A Review

"Many reports of chronic pain treatment by acupuncture and moxibustion are listed in Japanese databases. From the data, we conclude that there is limited evidence that acupuncture is more effective than no treatment, and inconclusive evidence that trigger point acupuncture is more effective than placebo, sham acupuncture or standard care." Evidence-based Complementary and Alternative Medicine (9th January 2007)

Stop Hypertension With the Acupuncture Research Program (SHARP)

The results of this randomised, controlled clinical trial demonstrated that acupuncture provided no greater benefit than invasive sham acupuncture in reducing systolic or diastolic BP (blood pressure). Hypertension (November 2006)

Acupuncture and Knee Osteoarthritis

A three-armed randomized trial. Conclusions: "Compared with physiotherapy and as-needed anti-inflammatory drugs, addition of either TCA (traditional Chinese acupuncture) or sham acupuncture led to greater improvement in WOMAC score at 26 weeks. No statistically significant difference was observed between TCA and sham acupuncture, suggesting that the observed differences could be due to placebo effects, differences in intensity of provider contact, or a physiologic effect of needling regardless of whether it is done according to TCA principles." Annals of Internal Medicine (July 2006)

Acupuncture treatment for irritable bowel syndrome

Concludes that acupuncture in IBS (irritable bowel syndrome) is primarily a placebo response. Gut (May 2006)

Acupuncture in migraine prophylaxis: a randomized sham-controlled trial

The findings showed that semi-standardized acupuncture showed no difference from sham acupuncture in preventing migraine attacks. Cephalalgia (May 2006)

Acupuncture — a critical analysis

Concludes that "acupuncture remains steeped in controversy. Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response". E. Ernst, Journal of Internal Medicine (February 2006)

Acupuncture for subacute stroke rehabilitation: a sham-controlled, subject-and-assessor-blind, randomized trial

This trial found no difference between acupuncture and sham acupuncture in the ability of stroke patients to perform daily activities of living or in their health-related quality of life. The study involved 116 patients who received 12 treatment sessions during a 2-week period. Archives of Internal Medicine (September 2005)

A Randomized Clinical Trial of Acupuncture Compared with Sham Acupuncture in Fibromyalgia

Concludes that acupuncture was no better than sham acupuncture at relieving pain in fibromyalgia. Annals of Internal Medicine (5th July 2005)

Acupuncture for Patients With Migraine

A randomized controlled trial. Concludes that acupuncture was no more effective than sham acupuncture in reducing migraine headaches although both interventions were more effective than a waiting list control. Journal of the American Medical Association (4th May 2005)

Is acupuncture analgesia an expectancy effect?: preliminary evidence based on participants' perceived assignments in two placebo-controlled trials

"Patients' beliefs regarding the receipt of acupuncture bore a stronger relationship to pain than any specific action possessed by acupuncture." Eval Health Prof. (2005)

Acupuncture for Treatment of Chronic Neck Pain

Acupuncture delivered in 8 sessions over 4 weeks decreased pain but did not perform any better than placebo from a clinical perspective. Annals of Internal Medicine (21st December 2004)

Efficacy of acupressure and acustimulation bands for the prevention of motion sickness

Neither band nor placebo prevented the development of motion sickness, regardless of whether the bands were used correctly or incorrectly. Aviat Space Environ Med. (March 2004)

Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: A randomised placebo-controlled patient and observer blind trial

This study found no evidence that acupuncture is effective against postoperative nausea and vomiting. A subgroup analysis found that vomiting was significantly reduced among the acupuncture patients, but the authors noted that this finding might be due to studying multiple outcomes. Anaesthesia (February 2004)

Auricular acupuncture in the tratment of cocaine/crack abuse: a review of the efficacy, the use of the National Acupuncture Detoxification Association protocol, and the selection of sham points

This review could not confirm that acupuncture was an effective treatment for cocaine abuse. Journal of Alternative and Complementary Medicine (December 2004)

Acustimulation of the neiguan point during gastroscopy: Its effects on nausea and retching

A double-blind, controlled study of 327 patients at a Turkish hospital found no evidence that electroacupuncture could prevent nausea and retching during gastroscopy, a procedure in which a flexible instrument is passed through the mouth into the stomach. Turkish Journal of Gastroenterology (2004)

A prospective, randomized pilot trial of acupuncture of the kidney-bladder distinct meridian for lower urinary tract symptoms

Concludes the acupuncture to the kidney-bladder distinct meridian neither relieves lower urinary tract symptoms nor impacts PSA. Journal of Urology (March 2003)

Effectiveness of acupuncture in the treatment of pain from osteoarthritis of the knee

Concludes that there is currently insufficient evidence to recommend acupuncture as a treatment for pain from osteoarthritis of the knee. Aten Primaria (December 2002)

Acupuncture treatment of chronic low-back pain — a randomized, blinded, placebo-controlled trial with 9-month follow-up

This trial demonstrated a placebo effect of traditional acupuncture in chronic LBP (low back pain). Pain (March 2002)

Acupuncture for Asthma — Fact or Fiction?

"Further well-done trials are needed. Until then, we remain skeptical and cannot recommend acupuncture for the treatment of asthma." CHEST (2002)

Acupuncture Outcomes, Expectations, Patient-Provider Relationship, and the Placebo Effect: Implications for Health Promotion

Concludes that perceived acupuncture outcomes seem not to be related to placebo effects and patient expectations, but rather to client-practitioner relationship factors. American Journal of Public Health (2002)

Short-term acupuncture therapy is of no benefit in patients with moderate persistent asthma

Concludes that in patients with moderate persistent asthma, a short course of acupuncture treatment resulted in no change in lung functions, bronchial hyperactivity, or patient symptoms. CHEST (May 2002)

Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain

Concludes that Traditional Chinese Medical acupuncture was relatively ineffective. Archives of Internal Medicine (April 2001)

Acupuncture trials and quality

"Acupuncture is commonly believed to be effective for the treatment of chronic pain, despite growing evidence from systematic reviews that it is not." Bandolier (October 2000)

Is acupuncture effective for the treatment of chronic pain? A systematic review

Concludes that there is limited evidence that acupuncture is more effective than no treatment for chronic pain; and inconclusive evidence that acupuncture is more effective than placebo,sham acupuncture or standard care. Pain (June 2000)

Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain

Concludes that there is no convincing evidence for the analgesic efficacy of acupuncture for back or neck pain. Pain (May 2000)

Laser acupuncture for adolescent smokers — a randomized double blind controlled trial

Concludes that there was no significant difference in the rates of smoking cessation in the treatment and control groups. American Journal of Chinese Medicine (2000)

A meta-analysis of acupuncture techniques for smoking cessation

Concludes that acupuncture was not superior to sham acupuncture for smoking cessation; no particular aspect of acupuncture technique was associated with a positive effect. TC Online (Winter 1999)

Acupressure-acupuncture antiemetic prophylaxis in children undergoing tonsillectomy

Concludes that perioperative acupressure and acupuncture did not diminish emesis in children following tonsillectomy. Anesthesiology (May 1999)

The effect of traditional Chinese acupuncture on severe tinnitus. A double-blind, placebo-controlled clinical study with an open therapeutic surveillance

No statistically significant differences were found between the acupuncture group and the placebo group. English abstract of a Danish article (January 1999)

Acupuncture in the treatment of asthma: a critical review

"The data presently in the literature do not provide sufficient support for a useful role for acupuncture in asthma management." Allergol Immunopathology (Nov-Dec 1998)

Effect of traditional Chinese acupuncture on severe tinnitus: a double-blind, placebo-controlled, clinical investigation with open therapeutic control

No statistically significant differences were found between the acupuncture group and the placebo group. British Journal of Audiology (June 1998)

Does the Choice of Placebo Determine the Results of Clinical Studies on Acupuncture?

Concludes "Studies using EPM (energetic placebo model) as placebo failed more frequently to show any differences between real acupuncture and placebo treatment than those using MPM (metameric placebo model) as placebo. On the other hand, sham acupuncture appears almost as active as 'real' acupuncture". Sanchez Aranjo M., Forsch Komplementarmed. (1998)