Research: LEE, Department of Anaest

Listed in Issue 55

Abstract

LEE, Department of Anaesthesia, National University Hospital, Singapore. analeetl@nus.edu.sg reviewed the literature (35 references) to assess whether acupuncture is an effective treatment for chronic pain.<br>

Background

Acupuncture has been widely used to treat a variety of pain conditions; however, convincing scientific evidence for its efficacy is lacking. Earlier randomized controlled trials attempted to follow a double-blind, placebo-controlled model. This approach has encountered many problems including the virtual impossibility of blinding the acupuncturist and the uncertainties inherent in choosing control acupuncture points. The authors based their review upon the result of previous reviews, meta-analyses and consensus conferences. The search was conducted with MEDLINE from 1966, EMBASE from 1980 and Cochrane library 1999, volume 1. Only randomized trials of acupuncture involving needling for subjects with chronic pain published in English were included.

Methodology

Results

Basic scientific research has demonstrated convincingly that within the context of acute pain, acupuncture's effects are related to the release of a variety of natural opioids. Acupuncture has been shown to be effective for postoperative dental pain. There are reasonable studies showing relief of pain with acupuncture upon diverse pain conditions including menstrual cramps, tennis elbow, low back pain and fibromyalgia. This suggest that acupuncture may have a more general effect upon pain. There are also studies, however, which provide equivocal results due to design, sample size and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, including placebo and sham acupuncture groups

Conclusion

Most of the studies were of poor methodological quality; therefore there is a need for further high quality randomized controlled trials. Future studies should also have larger sample sizes, use a valid acupuncture treatment, and have both a short-term and long-term follow-up.

References

Lee TL. Acupuncture and chronic pain management. Annals of the Academy of Medicine, Singapore 29(1): 17-21. Jan 2000.

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