Acupuncture boosts effectiveness of standard medical care for chronic pain, depression

In a report published in the National Institute for Health Research (NIHR) Journals Library, the researchers showed that there is significant evidence to demonstrate that acupuncture provides more than a placebo effect.

Professor of Acupuncture Research, Hugh MacPherson, working with a team of scientists from the UK and US, brought together the results of 29 high quality clinical trials focused on patients treated with acupuncture and standard medical care.

In the majority of these trials, patients with chronic pain treated with acupuncture and standard medical care were tested against those who were provided with standard medical care alone, such as anti-inflammatory drugs and physiotherapy. The trials involved approximately 18,000 patients diagnosed with chronic pain of the neck, lower back, head, and knee.

The report shows that the addition of acupuncture compared to standard medical care alone significantly reduced the number of headaches and migraine attacks and reduced the severity of neck and lower back pain. It also showed that acupuncture reduced the pain and disability of osteoarthritis, which led to patients being less reliant on anti-inflammatory tablets to control pain.

The study also concluded that acupuncture is cost effective, with the value for money being rated as less than the threshold of £20,000 cost per quality of life year -- a metric for cost-effectiveness used by the National Institute for Health and Care Excellence (NICE).

Professor MacPherson, from the University of York's Department of Health Sciences, said: "There has been an increase in practitioners using acupuncture as an intervention. Approximately four million acupuncture treatments are provided a year in the UK, but the evidence to show how clinically effective this form of treatment is has been limited.

"There has been a question mark for many years over whether policy and decision makers should or should not provide wider access to acupuncture. Our aim was to bring together data from high quality clinical trials and provide a robust evidence base that will help reduce this uncertainty and support commissioners and health professionals in making informed decisions backed up with research."

The team also conducted a new clinical trial for depression, where acupuncture or counselling was provided and compared to the effectiveness of medication, such as antidepressants.

In a study of 755 patients with depression in the North of England, researchers showed that both acupuncture and counselling significantly reduced the severity of depressions and that these benefits were largely sustained for up to 12 months after treatment.

Professor MacPherson said: "The front-line treatment for depression in primary care usually involves antidepressants; however, they do not work well for more than half of patients.

"In the largest study of its kind, we have now provided a solid evidence base to show that not only can acupuncture and counselling bring patients out of an episode of depression, but it can keep the condition at bay for up to a year on average."

The benefits of acupuncture are partially associated with placebo effects, which has contributed to the uncertainty around acupuncture's clinical effectiveness. Professor MacPherson states, however, that this new research provides definitive evidence that when acupuncture is used to treat chronic pain, the reductions in pain are substantially more than those measured from sham (placebo) acupuncture.

Used only in clinical trials for research purposes, sham acupuncture involves inserting needles at the 'wrong' locations, or using non-inserted needles (fake needles) at the correct locations. That 'true' acupuncture has significantly more effect in reducing pain than sham acupuncture, provides evidence that acupuncture is not simply a placebo effect.

Professor MacPherson added: "Our new data provides a significant step forward in treating chronic pain and managing depression, because patients and health professionals can now make decisions on acupuncture with more confidence. Not only is it more cost effective, but it reduces pain levels and improves mood levels, which could reduce over reliance on drugs that can sometimes result in unwanted side effects."