Acupuncture offers some pain relief but at a level below clinical significance, according to a report published online Jan. 28 in BMJ.
Matias Vested Madsen, of the Nordic Cochrane Centre in Copenhagen, Denmark, and colleagues conducted a review of 13 trials comprising 3,025 patients who underwent acupuncture, placebo (sham) acupuncture, or no acupuncture in randomized trials to establish the pain relief effects of the therapy on pain caused by a range of conditions including knee osteoarthritis, migraine and low back pain.
Acupuncture resulted in a 4 mm reduction in pain levels on a 100 mm visual analogue scale, well below the 10 mm difference that is described as minimal or little change, and therefore of no clinical significance, the investigators found. There was a wide variation in results for placebo acupuncture, from a 24 mm change in some large trials to a clinically irrelevant 5 mm change in others, the researchers report.
"We suggest that future trials on acupuncture for pain focus on two strategies. Firstly, researchers could try to reduce bias by ensuring blinding when possible," the authors write. "Secondly, researchers could try to separate the effects involved: the physiological effect of needling at acupuncture sites or at other sites and the psychological effect of the treatment ritual or of the patient-provider interaction more broadly."