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Deutsche Zeitschrift für Akupunktur

, Volume 55, Issue 4, pp 24–25 | Cite as

Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis

  • A. J. Vickers
  • A. M. Cronin
  • A. C. Maschino
  • G. Lewith
  • H. MacPherson
  • N. E. Foster
  • K. J. Sherman
  • C. M. Witt
  • K. Linde
  • Holger Cramer
  • Acupuncture Trialists’ Collaboration
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Abstract

Background

Although acupuncture is widely used for chronic pain, there remains considerable controversy as to its value. We aimed to determine the effect size of acupuncture for 4 chronic pain conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain.

Methods

We conducted a systematic review to identify randomized controlled trials (RCTs) of acupuncture for chronic pain in which allocation concealment was determined unambiguously to be adequate. Individual patient data meta-analyses were conducted using data from 29 of 31 eligible RCTs, with a total of 17 922 patients analyzed.

Results

In the primary analysis, including all eligible RCTs, acupuncture was superior to both sham and no-acupuncture control for each pain condition (P <.001 for all comparisons). After exclusion of an outlying set of RCTs that strongly favored acupuncture, the effect sizes were similar across pain conditions. Patients receiving acupuncture had less pain, with scores that were 0.23 (95% CI, 0.13–0.33), 0.16 (95% CI, 0.07–0.25), and 0.15 (95% CI, 0.07–0.24) SDs lower than sham controls for back and neck pain, osteoarthritis, and chronic headache, respectively; the effect sizes in comparison to no-acupuncture controls were 0.55 (95% CI, 0.51–0.58), 0.57 (95% CI, 0.50–0.64), and 0.42 (95% CI, 0.37–0.46) SDs. These results were robust to a variety of sensitivity analyses, including those related to publication bias.

Conclusions

Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture.

Literatur

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    Burke A, Upchurch DM, Dye C, Chyu L. Acupuncture use in the United States: findings from the National Health Interview Survey. J Altern Complement Med. 2006;12:639–48.CrossRefPubMedGoogle Scholar
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    Cummings M. Modellvorhaben Akupunktur — a summary of the ART, ARC and GERAC trials. Acupunct Med. 2009;27:26–30.CrossRefPubMedGoogle Scholar
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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2012

Authors and Affiliations

  • A. J. Vickers
    • 1
  • A. M. Cronin
    • 2
  • A. C. Maschino
    • 1
  • G. Lewith
    • 3
  • H. MacPherson
    • 4
  • N. E. Foster
    • 5
  • K. J. Sherman
    • 6
  • C. M. Witt
    • 7
  • K. Linde
    • 8
  • Holger Cramer
    • 9
  • Acupuncture Trialists’ Collaboration
  1. 1.Memorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Dana-Farber Cancer InstituteBostonUSA
  3. 3.Complementary and Integrated Medicine Research UnitSouthampton Medical SchoolSouthamptonEngland
  4. 4.Complementary Medicine Research GroupUniversity of YorkYorkEngland
  5. 5.Arthritis Research UK Primary Care CentreKeele University, Newcastle-under-LymeStaffordshireEngland
  6. 6.Group Health Research InstituteSeattleUSA
  7. 7.Epidemiology and Health EconomicsUniversity Medical Center Charité and Institute for Social MedicineBerlinDeutschland
  8. 8.Institute of General Practice, Technische Universität MünchenMünchenDeutschland
  9. 9.Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen-Mitte, Knappschafts-KrankenhausUniversität Duisburg-Essen, Alfried Krupp von Bohlen und Halbach-Stiftungsprofessur für NaturheilkundeEssenDeutschland

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