Negative Findings (3) – Acupuncture No Better Than Placebo for Pain

Our third ‘negative findings’ report concerns the possible benefits of acupuncture in the treatment of pain.  A recent ‘review of reviews’, published in the journal Pain, examined the data from publications about acupuncture in the treatment of pain.   The researchers found 57 systematic reviews that met their criteria; 4 of them were “of excellent methodological quality”’.  Positive reports of effectiveness were found in reviews including neck pain.  Otherwise, the findings showed that both needle placement acupuncture and 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.

The researchers also examined the case studies of 95 acupuncture patients with severe adverse effects.  There were 38 cases of infection, 42 cases of trauma (pneumothorax was the most common), and 13 events of other types.  Five patients died following treatment.       

In the same issue of the journal Pain there’s another article describing a study comparing traditional or simulated acupuncture for the treatment of symptoms associated with radiotherapy for pelvic cancer.  The simulated acupuncture involved blunt telescopic placebo needles pressed against the skin.  Those getting genuine or simulated acupuncture felt much less nauseous than those given standard care.   

If sham acupuncture is as good as ‘regular’ acupuncture and better than standard care, wouldn’t it make sense to substitute it for needle punctures that can result in rare but severe adverse effects?  Maybe more attention should be paid to the ways in which sham acupuncture can work – can it be the patient’s belief, the therapist’s convincing style, or a sort of hypnotic communication between therapist and patient?   

Based on the results of this review of reviews, I’d probably substitute cognitive-behavioral therapy for acupuncture in my pain therapy program . . .