Acupuncture for pain

Introduction to research into acupuncture for pain relief

Acupuncture is widely associated with the treatment of pain, both acute and chronic.

I appreciate that my patients are not – for the most part – researchers, but I hope this information gives you some idea of the extent of formal research into acupuncture treatments and understanding acupuncture’s mechanisms for pain relief carried out by scientists worldwide.

To find out more and – if you’re interested, get a quick introduction to understanding research papers – I encourage you to visit Evidence A-Z on the website of my professional body, the British Acupuncture Council.

National Institute for Health and Care Excellence (NICE) guidelines on acupuncture for relief of chronic primary pain changed in January 2021, recognising acupuncture as superior in some instances to ‘usual care’ medications.   What does this mean? 

Pain management in this new guideline is focused on what’s known as chronic primary pain, i.e. there is no underlying condition that adequately accounts for the pain or its impact. It is often accompanied by significant emotional distress and functional disability.

Common conditions that would qualify are fibromyalgia, myofascial pain (i.e. in the muscles and surrounding connective tissue), chronic neck pain and chronic pelvic pain, as well as many others.

NICE recommends acupuncture (within a traditional Chinese or a western framework) as appropriate alongside exercise programs, psychological therapies and antidepressant drugs.

NICE considered a number of treatments in creating this guideline including opioids, anti-inflammatories, paracetamol, benzodiazepines and gabapentinoids. None of these were found to have evidence of benefit for chronic pain and there are possible harms associated with their use. Acupuncture was found to be superior to both sham and usual care for pain according to the 32 studies reviewed by NICE.

This new guideline is a significant development for both patients with chronic pain and acupuncture practitioners in the UK. BAcC accredited acupuncturists are particularly well qualified for treating the wide spectrum of symptoms seen in patients with chronic primary pain conditions due to their degree level training and wide scope of practice.

(Source: British Acupuncture Council on pain relief. January 2021)

What about acupuncture for acute pain or chronic pain with other causes? 

For acute pain, a systematic review of 13 trials carried out in 2016 found that acupuncture was more effective than both sham needling and injection with painkillers. (1)

For chronic pain, in the largest study of its kind to date, 454,920 patients were treated with acupuncture for headache, low back pain, and/or osteoarthritis in an open pragmatic trial. Effectiveness was rated as marked or moderate in 76% of cases by the 8,727 treating physicians. (2)

Another study, given in the journal Current Opinion in Anesthesiology and titled ‘Acupuncture for Chronic Pain: an Update and Critical Overview’, concluded that ‘mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches. Additional data are emerging that support the use of acupuncture as an adjunct or alternative to opioids, and in perioperative settings.’ (3)

For more on research into acupuncture for other conditions as well as for pain, please visit the British Acupuncture Council Evidence A-Z

References

  1. Xiang A, Cheng K, Xu P, & Liu S (nd). The immediate analgesic effect of acupuncture for pain: a systematic review and meta-analysis
  2. Weidenhammer W, Streng A, Linde K, Hoppe A, Melchart D. Acupuncture for chronic pain within the research program of 10 German Health Insurance Funds–basic results from an observational study. Complementary therapies in medicine. 2007;15(4):238-46
  3. Yin C, Buchheit TE, & Park JJ (2017). Acupuncture for chronic pain: an update and critical overview. Current Opinion in Anaesthesiology, 1. https://doi.org/10.1097/ACO.0000000000000501