National Institute of Health and Acupuncture Studies
The report from a Consensus Development Conference on Acupuncture held at the National Institutes of Health (NIH) in 1997 stated that acupuncture is being “widely” practiced—by thousands of physicians, dentists, acupuncturists, and other practitioners—for relief or prevention of pain and for various other health conditions. Congress affirms the validity and promise of acupuncture as concluded by the 197 National Institutes of Health Consensus Conference: 1. “The data in support of acupuncture as strong as those for many accepted Western medical therapies.” 2 “One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions.” (Acupuncture. NIH Consensus Statement 1997 Nov 3-5; 15(5):1-34. http://consensus.nih.gov/1997/1997acupuncture107html.htm)
According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, an estimated 3.1 million U.S. adults and 150,000 children had used acupuncture in the previous year. Between the 2002 and 2007 NHIS, acupuncture use among adults increased by approximately 1 million people (Acupuncture: An Introduction, http://nccam.nih.gov/health/acupuncture/introduction.htm)
Research from the Acupuncture Trialists’s Collaboration conducted an analysis of 29 randomized clinical trails on acupuncture for treating pain and confirmed the total effects of acupuncture, as experienced by patients in clinical practice, are clinically relevant and that acupuncture is more than just placebo and a reasonable referral option for patients with chronic pain.
(Vickers, AJ, Gronin AM, Machino AC et al. Acupuncture for chronic pain: individual patient date meta-analysis, Archives of Internal Medicine. Arch Intern Med. 2012;172(19):1444-1453 http://archinte.jamanetwork.com/article.aspx?articleid=1357513).
The Dana Farber Cancer Institute at Harvard University has developed evidence-based “actionable” acupuncture protocols for specific cancer pain conditions and related symptoms in order to provide more clinically relevant solutions for clinicians and cancer patients with pain. These conditions include postoperative cancer pain, postoperative nausea and vomiting, postsurgical gastroparesis syndrome, opioid-induced constipation, opioid-induced pruritus, chemotherapy induced neuropathy, aromatase inhibitor-associated joint pain and neck dissection-related pain and dysfunction.
(Acupuncture May Be Helpful for Chronic Pain: A Meta-Analysis http://nccam.nih.gov/research/results/spotlight/091012)
The National Cancer Institute PDQ statement in the overview about the acupuncture it confirms:
- As part of traditional Chinese medicine, acupuncture has been practiced in China and other Asian countries for thousands of years.
- Acupuncture is defined as the application of stimulation such as needling, moxibustion, cupping, and acupressure on specific sites of the body known as acupuncture points.
- Acupuncture has been practiced in the United States for about 200 years. The U.S. Food and Drug Administration approved the acupuncture needle as a medical device in 1996.
- Acupuncture is used to treat a wide range of illnesses and ailments, including hot flashes, xerostomia, and neuropathy. Cancer patients use it for fatigue, pain management, and control of nausea and vomiting (N/V).
- Laboratory and animal studies to explore the mechanisms of acupuncture for cancer treatment have focused mainly on the role of acupuncture in the activation of immune functions, such as increasing blood cell count and enhancing lymphocyte and natural killer cell activity.
- The aim of most acupuncture clinical observation and clinical trials in cancer patients has been to evaluate the effects of acupuncture on symptom management.
- The most convincing research data on the effects of acupuncture in cancer patients have emerged from studies of the management of chemotherapy -induced N/V
Use of Acupuncture for Pain
According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, 1.4 percent of respondents (an estimated 3.1 million Americans) said they had used acupuncture in the past year. A special analysis of acupuncture data from an earlier NHIS found that pain or musculoskeletal complaints accounted for 7 of the top 10 conditions for which people use acupuncture. Back pain was the most common, followed by joint pain, neck pain, severe headache/migraine, and recurring pain.
Acupuncture has been studied for a wide range of pain conditions, such as postoperative dental pain, carpal tunnel syndrome, fibromyalgia, headache, low-back pain, menstrual cramps, myofascial pain, osteoarthritis, and tennis elbow.
Overall, it can be very difficult to compare acupuncture research results from study to study and to draw conclusions from the cumulative body of evidence. This is because studies may use different acupuncture techniques (e.g., electrical vs. manual), controls (comparison groups), and outcome measures.
One particularly complex factor in acupuncture research is choosing the controls for a clinical trial. The choice depends in part on whether the researchers want to study a particular aspect of acupuncture (e.g., effects on the brain) or to determine whether acupuncture is useful compared with other forms of care. Examples of control groups include study participants who receive no acupuncture, simulated acupuncture (procedures that mimic acupuncture, sometimes also referred to as “placebo” or “sham”), or other treatments (in addition to or in place of acupuncture or simulated acupuncture).
An emerging theme in acupuncture research is the role of the placebo. For example, a 2009 systematic review of research on the pain-relieving effects of acupuncture compared with placebo (simulated) or no acupuncture was inconclusive. The reviewers found a small difference between acupuncture and placebo and a moderate difference between placebo and no acupuncture; the effect of placebo acupuncture varied considerably, and the effect of acupuncture appeared unrelated to the specific kind of placebo procedure used. All of the study participants received standard care, typically consisting of analgesic drugs and physical therapy.
The following sections summarize research on acupuncture for a variety of pain conditions, including those reported by NHIS respondents who had used acupuncture. In general, acupuncture appears to be a promising alternative for some of these pain conditions; however, further research is needed.