Efficacy of acupuncture in fibromyalgia syndrome—a systematic review with a meta-analysis of controlled clinical trials

Langhorst, Jost; Klose, Petra; Musial, Frauke; Irnich, Dominik; Haüser, Winfried

doi:10.1093/rheumatology/kep439

Cited by 100 publications

(71 citation statements)

References 33 publications

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“…Systematic Reviews and Meta-Analyses on MA Versus EA In addition to examining individual clinical trials, we explored the literature to assess whether systematic reviews and meta-analyses might shed light on the relative effectiveness of MA and EA (search strategy included in Table 3). [70][71][72][73][74][75][76] Of the 188 identified reviews, 89 met our initial inclusion criteria. Of these 89 reviews, 15 did not pool data in a meta-analysis, so that no quantitative comparison was conducted, and only 7 of the remaining reviews presented pooled data that included a quantitative comparison of outcome for MA and EA.…”

Section: Clinical Trials Comparing Ma and Eamentioning

confidence: 99%

“…The other 6 reviews made comparisons of the two stimulation procedures in an indirect manner, using different data in separate analyses to compare the effects of MA versus controls against EA versus controls. These indirect comparisons, which make comparability more limited, included acupuncture for smoking cessation, 71 chemotherapyinduced leukopenia, 72 depression, 77 obesity, 74 schizophrenia, 75 and fibromyalgia 76 (Table 3). Across these 6 reviews, the findings are inconclusive as to whether EA or MA was associated with better outcomes.…”

Section: Clinical Trials Comparing Ma and Eamentioning

confidence: 99%

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Manual and Electrical Needle Stimulation in Acupuncture Research: Pitfalls and Challenges of Heterogeneity

Langevin

Schnyer

MacPherson

et al. 2015

The Journal of Alternative and Complementary Medicine

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In the field of acupuncture research there is an implicit yet unexplored assumption that the evidence on manual and electrical stimulation techniques, derived from basic science studies, clinical trials, systematic reviews, and meta-analyses, is generally interchangeable. Such interchangeability would justify a bidirectional approach to acupuncture research, where basic science studies and clinical trials each inform the other. This article examines the validity of this fundamental assumption by critically reviewing the literature and comparing manual to electrical acupuncture in basic science studies, clinical trials, and meta-analyses. The evidence from this study does not support the assumption that these techniques are interchangeable. This article also identifies endemic methodologic limitations that have impaired progress in the field. For example, basic science studies have not matched the frequency and duration of manual needle stimulation to the frequency and duration of electrical stimulation. Further, most clinical trials purporting to compare the two types of stimulation have instead tested electroacupuncture as an adjunct to manual acupuncture. The current findings reveal fundamental gaps in the understanding of the mechanisms and relative effectiveness of manual versus electrical acupuncture. Finally, future research directions are suggested to better differentiate electrical from manual simulation, and implications for clinical practice are discussed.

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Section: Clinical Trials Comparing Ma and Eamentioning

confidence: 99%

Section: Clinical Trials Comparing Ma and Eamentioning

confidence: 99%

Manual and Electrical Needle Stimulation in Acupuncture Research: Pitfalls and Challenges of Heterogeneity

Langevin

Schnyer

MacPherson

et al. 2015

The Journal of Alternative and Complementary Medicine

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“…Langhorst et al (2010) observaram que a acupuntura é capaz de influenciar na percepção da dor através da modulação de mecanismos fisiológicos como, por exemplo, a liberação de endorfinas.…”

Section: Tratamento Não Farmacológicounclassified

“…Em casos de dores graves e brandas o mesmo sucesso não pôde ser comprovado (LANGHORST et al, 2010). Uma desvantagem da acupuntura é que só foram demonstrados efeitos sobre a dor, já em relação aos demais sintomas da FM, existem poucas evidências disponíveis (TERRY et al, 2012).…”

Section: Tratamento Não Farmacológicounclassified

Fibromialgia: diagnóstico, fisiopatologia e tratamentos

et al. 2015

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RESUMOA fibromialgia (FM) é uma condição crônica, caracterizada pela presença de dor generalizada e outros sintomas como fadiga, distúrbios do sono e alterações cognitivas. Apesar de intensamente estudada, a fisiopatologia da FM ainda não foi totalmente esclarecida, o que prejudica seriamente a elaboração de condutas terapêuticas realmente eficazes. Dessa forma, a incidência da FM está crescendo e os gastos públicos e privados decorrentes desse fenômeno, também estão aumentando. Sem tratamento, os pacientes continuam a sofrer com a sintomatologia e se tornam cada vez mais desmotivados perante o seu quadro clínico. O objetivo deste estudo foi reunir e sintetizar parte da informação disponível sobre a FM, principalmente no que se refere aos critérios de diagnóstico, fisiopatologia, tratamentos farmacológicos e tratamentos não farmacológicos disponíveis. Para tanto, bancos de dados nacionais (Scielo e Bireme) e internacionais (Pubmed, Biomed, Medlinx e Pedro) foram consultados. Os dados deste estudo sugerem que a FM é uma condição clínica com etiologia multifatorial, que somente pode ser diagnosticada pelo exame clínico e que ainda não possui cura. Contudo, uma série de tratamentos encontra-se disponíveis, tanto farmacológicos como

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“…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. In order to specify indications for which acupuncture should be used and to optimize treatment, it is crucial to understand how the effect of acupuncture is mediated.…”

Section: Introductionmentioning

confidence: 99%

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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Efficacy of acupuncture in fibromyalgia syndrome—a systematic review with a meta-analysis of controlled clinical trials

Abstract: A small analgesic effect of acupuncture was present, which, however, was not clearly distinguishable from bias. Thus, acupuncture cannot be recommended for the management of FMS.

Cited by 100 publications

References 33 publications

Manual and Electrical Needle Stimulation in Acupuncture Research: Pitfalls and Challenges of Heterogeneity

Manual and Electrical Needle Stimulation in Acupuncture Research: Pitfalls and Challenges of Heterogeneity

Fibromialgia: diagnóstico, fisiopatologia e tratamentos

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

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