Study: Placebo or not, acupuncture helps pain

Posted: September 11, 2012

CHICAGO - Acupuncture gets a thumbs-up for helping relieve pain from chronic headaches, backaches and arthritis in a review of more than two dozen studies - the latest analysis of an often-studied therapy that has as many fans as critics.

Some believe its only powers are a psychological, placebo effect. But some doctors believe even if that's the explanation for acupuncture's effectiveness, there's no reason not to offer it if it makes people feel better.

The new analysis examined 29 studies involving almost 18,000 adults. The researchers concluded that the needle remedy worked better than usual pain treatment and slightly better than fake acupuncture. That kind of analysis is not the strongest type of research, but the authors took extra steps including examining raw data from the original studies.

The results "provide the most robust evidence to date that acupuncture is a reasonable referral option," wrote the authors, who include researchers with Memorial Sloan-Kettering Cancer Center in New York and several universities in England and Germany.

The new analysis was published online Monday in Archives of Internal Medicine. The federal government paid for most of the study.

Acupuncture's use has become more mainstream. The military has used it to help treat pain from war wounds, and California recently passed legislation that would include acupuncture among treatments recommended for coverage under provisions of the nation's new health care law. That law requires insurance plans to cover certain categories of benefits starting in 2014. Deciding specifics is being left up to the states.

Some private insurance plans already cover acupuncture; Medicare does not.

In traditional Chinese medicine, acupuncture involves inserting long, very thin needles just beneath the skin's surface at specific points on the body to control pain or stress. Several weekly sessions are usually involved, typically costing about $60 to $100 a session. Research on fake acupuncture sometimes also uses needles, but on different areas of the body.

Acupuncture skeptic Dr. Stephen Barrett said the study results are dubious. The retired psychiatrist, who runs the Quackwatch website on medical scams, says acupuncture studies often involve strict conditions that don't mirror the real world.

The new analysis combined results of patients with recurring headaches, arthritis or back, neck and shoulder pain. The studies had randomly assigned patients to acupuncture and either fake acupuncture or standard pain care like drugs or physical therapy.

The authors used a pain scale of 0 to 100: The patients' average baseline pain measured 60; it dropped to 30 on average in those who got acupuncture, 35 in those who got fake acupuncture, and 43 in the usual treatment group.

While the difference for real versus fake acupuncture was small, it suggests acupuncture could have more than a psychological effect, said lead author Andrew Vickers of Sloan-Kettering.

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