Since 2017, I have been invited to give presentations to the fellow students of the Anesthesiology Department of Medical School, University of Virginia for four times and to the members of the Charlottesville Virginia Chapter of the American Academy of Professional Coders once. It was my great honor to talk about the facts of acupuncture to them, the main stream medical fields in the USA.
The topic I used was the Pain and Acupuncture. Acupuncture’s effectiveness, safety, and cost-effectiveness were discussed. Today only its efficacy is to be talked about, based on the research.
1 Acupuncture is effective for low back pain.
1.1 Michael Haake, PhD, MD, et published an article with the title of German Acupuncture Trials (Gerac) For Chronic Low Back Pain (Randomized, Multicenter, Blinded, Parallel-Group Trial with 3 Groups) in the Journal of Archives of internal medicine in 2007. 1,162 patients in 340 outpatient practices were divided into three groups based on the treatments types: acupuncture, sham acupuncture or conventional non-acupuncture therapy such as drugs, physical therapy and exercise. Their ages were between 18-86 and the mean of medical history was 8 years. Sham acupuncture meant the needles were place on either side of the lateral part of the back and on the lower limbs, avoiding all known verum points or meridian. Their conclusion was that Low back pain improved after acupuncture treatment for at least 6 months. Effectiveness of acupuncture, either verum or sham, was almost twice that of conventional therapy.
1.2 Eric Manheimer, MS, et. published an article with the title of Meta-Analysis: Acupuncture for Low Back Pain in the journal of American College of Physicians in 2005. 33 Randomized, controlled trials through searches of MEDLINE, Cochrane Central, EMBASE, AMED, CINAHL, CISCOM, and GERA databases from 1976 through August 2004 were analyzed. Their conclusion was that “Acupuncture effectively relieves chronic low back pain and it is as effective as other active therapies.”
2. Acupuncture is effective for knee pain.
2.1 A White, et. published an article with the title of Acupuncture Treatment for Chronic Knee pain: A Systematic Review in the journal of Rheumatology in 2007. Thirteen randomized, controlled trials were included and 1,334 patients participated. They concluded that “acupuncture is significantly superior to sham acupuncture and to no additional intervention in improving pain and function in patients with chronic knee pain.”
2.2 C Witt, et. published an article with the title of Acupuncture in Patients with Osteoarthritis of the Knee: A randomized in the journal of Lancet in 2005. 300 patients with chronic osteoarthritis of the knee were randomly assigned to acupuncture (n=150), minimal acupuncture (superficial needling at non-acupuncture points; n=76), or a waiting list control (n=74). Acupuncture and minimal acupuncture were administered in 12 sessions over 8 weeks in 28 outpatient centers. Patients completed standard questionnaires at baseline and after 8 weeks, 26 weeks, and 52 weeks. They concluded that “after 8 weeks of treatment, pain and joint function are improved more with acupuncture than with minimal acupuncture or no acupuncture in patients with osteoarthritis of the knee. However, this benefit decreases over time.”
3. Acupuncture is effective for chronic pain.
3.1 Andrew J. Vickers, et published an article with the title of Acupuncture for Chronic Pain (Individual Patient Data Meta-analysis) at the journal of Archives of internal medicine in 2012. 17,922 patients in 29 eligible randomized and controlled trials were analyzed. They suffered with back and neck pain, osteoarthritis, chronic headache and shoulder pain. Their conclusions were “Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option” and “Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo.”
4. Acupuncture is effective for acute pain.
4.1 Arya Nielsen, et published an article with the title of Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update at the journal of Pain Medicine in 2022. More than 480 trials and 32,000 patients in 22 systematic reviews were analyzed. The conditions were postsurgical/perioperative pain with opioid sparing and acute nonsurgical/trauma pain, including acute pain in the emergency department such as acute LBP, acute neck pain, and acute ankle sprain; other musculoskeletal pain conditions, fractures, and nonpenetrating injuries; acute abdominal pain, appendicitis pain, renal colic, acute headache and migraine, acute dental pain, and acute pharyngitis. They made inclusions as 1. “The majority of reviews supports the feasibility and benefit of acupuncture therapy as an effective standalone or adjunct intervention in acute perioperative pain and acute pain in the ED or urgent care setting”. And 2. “The evidence supporting effectiveness, safety, reduced need for opioids and NSAIDs, and improved patient satisfaction is a compelling reason for acupuncture therapy to be covered for acute pain by public and private insurance.”
Acupuncture, originating in China has been used there over 2500 years, and throughout the world, particularly since the 1970s. According to the World Health Organization, acupuncture is used in 103 of 129 countries. More and more research, done in many centers or countries, attesting to the wide range of diseases and conditions that can be effectively treated with this approach have been published over the years. Though the ones I used this time are very little portion of all, it can give a clear glimpse of the whole picture of its efficacy.