Acupuncture Research

Acupuncture research is regularly published in journals worldwideA significant amount of research is based on randomised controlled trials. This means that a patient group has been divided randomly into two or more arms. One arm was given the treatment being tested, and the other was given a supposedly inactive placebo; the latter constitutes the “control”. This trial design was originally developed to test new drugs. The placebo tablet can be a pill made from something inactive and unrecognisable to patients.

However, for more complex interventions like acupuncture or surgery, controls which are both inert and credible to patients, are harder to devise. Sometimes in trials, acupuncture appears only a little more effective than the sham placebo procedure used as a control. (The latter may be where for example, patients unbeknown to them, have “irrelevant” acupuncture points needled.)

These results are mirrored in placebo-controlled trials of surgery. In a systematic review (1) published in the respected British Medical Journal:

74% of surgery trials found improvements in patients in the placebo arm;
51% of surgery trials found no difference between surgery and placebo.

In acupuncture trials, one explanation is likely to be that the sham procedures used by researchers are not actually inert. Thus when you compare real with sham treatment, the effects of the two are closer than they would otherwise be, so it is easy to simplistically conclude that acupuncture is not significantly better than sham. Another contributing factor is that the acupuncture given in trials can be sub-optimal, and not what a professional acupuncturist would actually do in clinical practice.

A more useful trial would compare one therapy against another, for effectiveness, safety and cost-effectiveness, because that would answer the question in the average GP’s mind when they are wondering how to help a patient with back pain say. “Should it be physiotherapy, acupuncture or exercise therapy?” No controls are then needed, and therapists in these trials can treat as they actually practise, rather than following a protocol devised by researchers. Otherwise we are trialling acupuncture say, not as it is actually practised.

With this in mind, I hope you will feel more informed when you see the research below, and indeed any medical research in the news. If you would like to read more about the quality of research evidence and how different designs of study relate to each other, I would refer you to the British Acupuncture Council’s description of the evidence pyramid. In addition, Evidence Based Acupuncture attempts to summarise the current state of knowledge, using the language of modern science.

Acupuncture research has provided several useful spin-offs for modern western medicine. These include advances in neuroimaging, an improved understanding of chronic pain, better clinical trial designs, and the TENS machine (2).

(1) Use of placebo controls in the evaluation of surgery: systematic review. British Medical Journal, 21 May 2014.
(2) Unanticipated Insights into Biomedicine from the Study of Acupuncture. Journal of Alternative & Complementary Medicine, 2016.

Acupuncture Facilitates Lifestyle & Behaviour Change

Acupuncture in Exeter: acupuncture facilitates lifestyle & behaviour change. A review undertaken by researchers at the University of Southampton, shows the full extent to which acupuncturists facilitate lifestyle and behaviour change as a routine part of traditional acupuncture practice. Seventy-nine articles exploring the topic, were included in the study. Key elements promoting behaviour change included individualised advice based on symptoms, holistic explanations for patients’ conditions, the therapeutic relationship, and patient involvement.

(Lifestyle & Health Behavior Change in Traditional Acupuncture Practice: A Systematic Critical Interpretive Synthesis. Journal of Alternative & Complementary Medicine, March 2021.)

Acupuncture and Radiotherapy

A clinical trial in London has shown the feasibility and usefulness of providing acupuncture within a busy NHS radiotherapy unit. A total of 101 cancer patients were randomised to receive either standard care in the unit, or standard care plus acupuncture. The latter was given to assist with common symptoms such as fatigue, nausea, vomiting, hot flushes, mood and sleep problems. Patients were given between three and eight acupuncture treatments, one week apart.

Patients reported qualitatively that they valued the positive impact acupuncture had, with improvements in fatigue, nausea, vomiting, pain, insomnia and shortness of breath being noted. Quantitatively, only improvements in fatigue were identified.

(A feasibility trial of acupuncture in cancer patients undergoing radiotherapy treatment. Complementary Therapies in Clinical Practice, May 2021.)

How Acupuncture Treats Hypertension

Acupuncture in Exeter for back pain and sciatica. Research in China has tried to ascertain the mechanisms behind how acupuncture treats hypertension. Patients with high blood pressure were examined by functional magnetic resonance imaging (MRI), and certain acupuncture point prescriptions were found to activate areas in the brain connected with blood pressure regulation. One combination of acupuncture points was associated with  positive immediate and long-term effects on blood pressure, particularly systolic blood pressure. 

(Acupuncture at LR3 and KI3 shows a control effect on essential hypertension and targeted action on cerebral regions related to blood pressure reactivagulation: a resting state functional magnetic resonance imaging study. Acupuncture in Medicine, February 2021.)

Acupressure benefits Dialysis Patients

Acupressure benefits dialysis patients. Acupressure can reduce thirst and improve quality of life in patients receiving dialysis treatment, according to a study undertaken in Turkey. Sixty patients were randomly assigned to either an acupressure or control group. In the acupressure group, treatment was applied to five acupuncture points during the first half of each dialysis session, for three days per week over a six week period. Acupressure was found to increase saliva secretion, decrease thirst severity, and improve quality of life.

(The Effect of Acupressure Applied to Individuals Receiving Hemodialysis Treatment on Severity of Thirst & Quality of Life. Alternative Therapies in Health & Medicine, May 2021.)