Acupuncture For Pain No Better Than Placebo And Not Without Harm

[Guest guest]

Acupuncture For Pain No Better Than Placebo And Not Without Harm

http://www.medicalnewstoday.com/articles/220037.php

Although acupuncture is commonly used for pain control, doubts about its

effectiveness and safety remain. Investigators from the Universities of Exeter &

Plymouth (Exeter, UK) and the Korea Institute of Oriental Medicine (Daejeon,

South Korea) critically evaluated systematic reviews of acupuncture as a

treatment of pain in order to explore this question. Reporting in the April 2011

issue of PAIN®, they conclude that numerous systematic reviews have generated

little truly convincing evidence that acupuncture is effective in reducing pain,

and serious adverse effects continue to be reported.

" Many systematic reviews of acupuncture for pain management are available, yet

they only support few indications, and contradictions abound, " commented lead

investigator Professor Edzard Ernst, MD, PhD, Laing Chair in Complementary

Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, UK.

" Acupuncture remains associated with serious adverse effects. One might argue

that, in view of the popularity of acupuncture, the number of serious adverse

effects is minute. We would counter, however, that even one avoidable adverse

event is one too many. The key to making progress would be to train all

acupuncturists to a high level of competency. "

Researchers carefully identified and critically examined systematic reviews of

acupuncture studies for pain relief and case reviews reporting adverse effects.

Reviews were defined as systematic if they included an explicit Methods section

describing the search strategy and inclusion/exclusion criteria. Systematic

reviews had to focus on the effectiveness of any type of acupuncture for pain.

Of the 266 articles found, 56 were categorized as acceptable systematic reviews.

The authors observe that recent results from high-quality randomized controlled

trials have shown that various forms of acupuncture, including so-called " sham

acupuncture, " during which no needles actually penetrate the skin, are equally

effective for chronic low back pain, and more effective than standard care. In

these and other studies, the effects were attributed to such factors as

therapist conviction, patient enthusiasm or the acupuncturist's communication

style.

If even sham acupuncture is as good as or better than standard care, then what

is the harm? The answer lies in the adverse effect case studies. These studies

were grouped into three categories: Infection (38 cases), trauma (42 cases) and

other adverse effects (13 cases). Many of these adverse side effects are not

intrinsic to acupuncture, but rather result from malpractice of acupuncturists.

The most frequently reported complications included pneumothorax, (penetration

of the thorax) and bacterial and viral infections. Five patients died after

their treatment.

In an accompanying commentary, Harriet Hall, MD, states her position forcefully:

" Importantly, when a treatment is truly effective, studies tend to produce more

convincing results as time passes and the weight of evidence accumulates. When a

treatment is extensively studied for decades and the evidence continues to be

inconsistent, it becomes more and more likely that the treatment is not truly

effective. This appears to be the case for acupuncture. In fact, taken as a

whole, the published (and scientifically rigorous) evidence leads to the

conclusion that acupuncture is no more effective than placebo. "

The article is " Acupuncture: Does it alleviate pain and are there serious risks?

A review of reviews " by E. Ernst, Myeong Soo Lee and Tae-Young Choi (DOI:

10.1016/j.pain.2010.11.004). The accompanying commentary is " Acupuncture's

claims punctured: Not proven effective for pain, not harmless " by Harriet Hall,

MD (DOI: 10.1016/j.pain.2011.01.039). Both appear in PAIN®, Volume 152, Issue 4

(April 2011) published by Elsevier.

y

[Guest guest]

People die after having sex, too, but that doesn't stop the choo-choo train. ;-)

Acupuncture just seems so innocent. ;-)

If you're going to get acupuncture, do so from an accredited, trained and

licensed acupuncturist.

>

> Acupuncture For Pain No Better Than Placebo And Not Without Harm

>

> http://www.medicalnewstoday.com/articles/220037.php

>

> Although acupuncture is commonly used for pain control, doubts about its

effectiveness and safety remain. Investigators from the Universities of Exeter &

Plymouth (Exeter, UK) and the Korea Institute of Oriental Medicine (Daejeon,

South Korea) critically evaluated systematic reviews of acupuncture as a

treatment of pain in order to explore this question. Reporting in the April 2011

issue of PAIN®, they conclude that numerous systematic reviews have generated

little truly convincing evidence that acupuncture is effective in reducing pain,

and serious adverse effects continue to be reported.

>

> " Many systematic reviews of acupuncture for pain management are available, yet

they only support few indications, and contradictions abound, " commented lead

investigator Professor Edzard Ernst, MD, PhD, Laing Chair in Complementary

Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, UK.

" Acupuncture remains associated with serious adverse effects. One might argue

that, in view of the popularity of acupuncture, the number of serious adverse

effects is minute. We would counter, however, that even one avoidable adverse

event is one too many. The key to making progress would be to train all

acupuncturists to a high level of competency. "

>

> Researchers carefully identified and critically examined systematic reviews of

acupuncture studies for pain relief and case reviews reporting adverse effects.

Reviews were defined as systematic if they included an explicit Methods section

describing the search strategy and inclusion/exclusion criteria. Systematic

reviews had to focus on the effectiveness of any type of acupuncture for pain.

Of the 266 articles found, 56 were categorized as acceptable systematic reviews.

>

> The authors observe that recent results from high-quality randomized

controlled trials have shown that various forms of acupuncture, including

so-called " sham acupuncture, " during which no needles actually penetrate the

skin, are equally effective for chronic low back pain, and more effective than

standard care. In these and other studies, the effects were attributed to such

factors as therapist conviction, patient enthusiasm or the acupuncturist's

communication style.

>

> If even sham acupuncture is as good as or better than standard care, then what

is the harm? The answer lies in the adverse effect case studies. These studies

were grouped into three categories: Infection (38 cases), trauma (42 cases) and

other adverse effects (13 cases). Many of these adverse side effects are not

intrinsic to acupuncture, but rather result from malpractice of acupuncturists.

The most frequently reported complications included pneumothorax, (penetration

of the thorax) and bacterial and viral infections. Five patients died after

their treatment.

>

> In an accompanying commentary, Harriet Hall, MD, states her position

forcefully: " Importantly, when a treatment is truly effective, studies tend to

produce more convincing results as time passes and the weight of evidence

accumulates. When a treatment is extensively studied for decades and the

evidence continues to be inconsistent, it becomes more and more likely that the

treatment is not truly effective. This appears to be the case for acupuncture.

In fact, taken as a whole, the published (and scientifically rigorous) evidence

leads to the conclusion that acupuncture is no more effective than placebo. "

>

> The article is " Acupuncture: Does it alleviate pain and are there serious

risks? A review of reviews " by E. Ernst, Myeong Soo Lee and Tae-Young Choi (DOI:

10.1016/j.pain.2010.11.004). The accompanying commentary is " Acupuncture's

claims punctured: Not proven effective for pain, not harmless " by Harriet Hall,

MD (DOI: 10.1016/j.pain.2011.01.039). Both appear in PAIN®, Volume 152, Issue 4

(April 2011) published by Elsevier.

> y

>

[Guest guest]

I thought acupuncture might help my pain. All it did was make me sick

to my stomach.

[Guest guest]

It didn't help me either.

Geri