Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis

Cronin, Angel M.; Maschino, Alexandra C.; Lewith, George; MacPherson, Hugh; Foster, Nadine E; Sherman, Karen J.; Witt, Claudia M.; Linde, Klaus; Cramer, Holger

doi:10.1016/j.dza.2012.11.010

Cited by 236 publications

(314 citation statements)

References 49 publications

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“…However, a quarter of these studies found significant threshold changes also after sham acupuncture, while only one of the included articles reported changes of sensory thresholds after an inert control procedure. These facts go in line with the previously drawn conclusion that there are effects specific to acupuncture, but that sham acupuncture may cause physiological reactions exceeding pure placebo effects [6,108,109]. It can be assumed that this in part explains the clinical effects of sham acupuncture interventions observed in acupuncture randomized controlled trials.…”

Section: Results Interpretationsupporting

confidence: 75%

“…3). Thus, these findings provide a physiological basis for the growing body of evidence for the effectiveness of acupuncture in locomotor conditions associated with tenderness [111][112][113].…”

Section: Results Interpretationmentioning

confidence: 99%

“…There is substantial evidence for acupuncture being effective in the treatment of acute [3][4][5] and chronic pain [6]. However, for several other pain conditions such as neuropathic pain [7] or fibromyalgia [8], evidence remains inconclusive.…”

Section: Introductionmentioning

confidence: 98%

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Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

Baeumler¹,

Fleckenstein²,

Takayama

et al. 2015

Deutsche Zeitschrift für Akupunktur

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Background: The effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system. Methods: Pubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed. Results: Out of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short-and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception.

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Section: Results Interpretationsupporting

confidence: 75%

Section: Results Interpretationmentioning

confidence: 99%

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Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

Baeumler¹,

Fleckenstein²,

Takayama

et al. 2015

Deutsche Zeitschrift für Akupunktur

View full text Add to dashboard Cite

show abstract

“…However, a recent individual meta-analysis based on data from 29 randomized clinical trials with a total of 17,922 patients reported clear differences between real acupuncture and sham procedures for several chronic pain conditions. 69 This is a strong argument for incorporating sham procedures as a possible control condition in future studies. Such studies should also consider online pain ratings, which are delivered after each painful stimulus during the fMRI session, instead of retrospective pain ratings.…”

Section: Discussionmentioning

confidence: 99%

Acupuncture-Related Modulation of Pain-Associated Brain Networks During Electrical Pain Stimulation: A Functional Magnetic Resonance Imaging Study

Theysohn

Choi

Gizewski

et al. 2014

The Journal of Alternative and Complementary Medicine

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Objective: Findings of existing functional MRI (fMRI) studies on the neural mechanisms that mediate effects of acupuncture analgesia are inconsistent. This study analyzes the effects of manual acupuncture on pain ratings and brain activation in response to experimental, electrical pain stimuli. Design: Fourteen healthy volunteers were examined by using a 1.5-T MRI scanner. The intensity of pain stimuli was adjusted to individual pain ratings on a numeric rating scale. Baseline fMRI was performed during electrical pain stimulation in a blocked design. For the second session, manual acupuncture with repeated stimulation was performed on contralateral acupoints-large intestine 4, liver 3, and stomach 36-before imaging. After imaging, subjective pain ratings and ratings of the de qi sensation were assessed. Results: Compared with baseline, volunteers showed modulated brain activity under pain conditions in the cingulate gyrus, insula, primary somatosensory cortex, and prefrontal areas after the acupuncture session. In accordance with the literature, anterior insular and prefrontal activity seemed to be correlated with acupuncture treatment. Conclusion: This study supports the existence of analgesic acupuncture effects that outlast the needling period. Pain-associated brain areas were modulated in direct response to a preceding acupuncture treatment.

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“…26,27 Acupuncture also has been indicated as having a positive therapeutic effect on other mTBI-related symptoms such as headaches, neck pain, and nausea. [28][29][30][31] Because of the prevalent nature of mTBI injuries, there is need for additional treatment protocols to be available for injuries sustained by adults in nonathletic situations. The purpose of this case report is to describe the management of an adult patient with mTBI injury through the use of manual cervical chiropractic manipulation, soft tissue therapy, and acupuncture.…”

Section: Introductionmentioning

confidence: 99%

Management of Mild Traumatic Brain Injury Symptoms in a 31-Year-Old Woman Using Cervical Manipulation and Acupuncture: A Case Report

Gergen¹

2015

Journal of Chiropractic Medicine

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Objective: The objective was to describe chiropractic and acupuncture care of a patient with acute mild traumatic brain injury (mTBI) symptoms. Clinical Features: A 31-year-old woman had acute neck pain, headache, dizziness, nausea, tinnitus, difficulty concentrating, and fatigue following a fall. She was diagnosed at an urgent care facility with mTBI immediately following the fall. Pharmaceutical intervention had been ineffective for her symptoms. Intervention and Outcome: The patient was treated with chiropractic adjustments characterized as high velocity, low amplitude thrusts directed to the cervical spine and local acupuncture points in the cervical and cranial regions. The patient received care for a total of 8 visits over 2.5 weeks with resolution of concussive symptoms. Conclusion: This patient with mTBI responded favorably to a conservative treatment protocol with the combination of chiropractic and acupuncture care.

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Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis

Abstract: Background-Although acupuncture is widely used for chronic pain, there remains considerable controversy as to its value. We aimed to determine the effect size of acupuncture for four chronic pain conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain.

Cited by 236 publications

References 49 publications

Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

Effects of Acupuncture on Sensory Perception: A Systematic Review and Meta-Analysis

Acupuncture-Related Modulation of Pain-Associated Brain Networks During Electrical Pain Stimulation: A Functional Magnetic Resonance Imaging Study

Management of Mild Traumatic Brain Injury Symptoms in a 31-Year-Old Woman Using Cervical Manipulation and Acupuncture: A Case Report

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