Category: Pain

Whatever the pain, acupuncture is a gentle and safe treatment approach. It has been shown to be more effective than control for all pain conditions covered in a large review . It is not a placebo treatment for chronic pain. Its effects persist over time, showing only a 15% reduction one year after treatment.

The latest 2021 NICE guideline on treatment of chronic pain, recommends acupuncture, exercise or psychological therapies. By contrast, paracetamol, non-steroidal anti-inflammatories and opioids, are not recommended.

Acupuncture may also help with any consequences of your pain such as disturbed sleep, depression or loss of appetite.

Pain is our body’s alarm signal, so its cause should always be investigated. It can vary in nature from the dull ache of an arthritic hip, to the almost intolerable electric shocks of trigeminal neuralgia. Tolerance varies between individuals, but is lower if we are tired, stressed or without other distractions. Some forms are responsive to simple painkillers, whilst others demand stronger, prescription-only drugs, the side-effects of which can be troublesome.

Below you will find a wide range of research into acupuncture for pain. The trials vary in quality, but systematic reviews and randomised controlled trials are generally considered to provide the highest quality evidence. If you would like to read more about evidence quality, I would refer you to the British Acupuncture Council’s description of the evidence pyramid.

The studies cover chronic pain from a variety of causes, plus pain relief in hospital A&E, ICU and post-operative settings. There is also peripheral neuropathy, trigeminal neuralgia, phantom limb pain, studies with military veterans, and a look at how acupuncture could be part of the solution to dependence on opioid drugs. Pain from shingles, multiple sclerosis and cancer are covered, as is dental pain. Note that some specific types of pain eg neck or back pain, come under their own headings elsewhere.

Please feel free to call me to discuss your situation.

Acupuncture for trigeminal neuralgia appears to have better analgesic potential than the drug carbamazepine, according to Korean authors of a systematic review. They examined data from 30 randomised controlled trials covering nearly 2300 patients. Compared with the drug, acupuncture was associated with improved pain scores, better response rates, lower frequency of attacks and fewer adverse effects.

The authors note that all but one of the trials had a risk of bias, and call for additional independent studies in a variety of countries.

(Acupuncture for the treatment of trigeminal neuralgia: A systematic review & meta-analysis. Complementary Therapies in Clinical Practice, August 2023.)

Acupuncture helps acute pain is the assessment of collaborators from four American medical and nursing schools. They concluded that the majority of reviews found acupuncture to be efficacious for acute pain, with potential to avoid or reduce opioid reliance. The research updates the evidence base for acupuncture for acute pain, with a review of systematic reviews and meta-analyses on postsurgical/perioperative pain with opioid sparing, and acute nonsurgical/trauma pain. The latter included pain in the emergency department.

In the US, there has been mounting pressure for pain medicine to shift away from an overreliance on opioids and overutilized procedures and surgeries, toward more comprehensive pain care that includes evidence-based non-pharmacological strategies. The researchers say that the evidence base for acupuncture is extensive. Acupuncture is supported or recommended as part of pain care by the US Agency for Healthcare Research and Quality, the US Food & Drug Administration, the US Department of Health and Human Services, and the largest hospital accreditation organization in the US, The Joint Commission. Further, the American Academy of Family Physicians endorsed the American College of Physicians Guidelines recommending acupuncture as a first option for acute, subacute, and chronic lower back pain.

A total of 22 systematic reviews, including 17 with meta-analyses of acupuncture in acute pain settings and a review for pain in the intensive care unit, were included in this study. In the emergency department setting, studies reported high acceptability of acupuncture by patients. Acupuncture produced a decrease in pain comparable to that produced by drugs, with the additional benefit of a reduction in anxiety.

The effectiveness of acupuncture coupled with a very low rate of adverse events, is reflected in the authors’ summary. “The evidence supporting effectiveness, safety, reduced need for opioids and NSAIDs, and improved patient satisfaction is a compelling reason for acupuncture therapy to be covered for acute pain by public and private insurance. Policy barriers preventing licensed acupuncturists from being Medicare-billing providers need to be addressed. Health care practitioners and administrators need training in the evidence base for acupuncture therapy, and they need to advocate for policy initiatives that remedy systemic reimbursement barriers to evidence-based comprehensive pain care strategies.”

(Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update. Pain Medicine, September 2022.)

Acupuncture helps chemo-induced neuropathy ie peripheral neuropathy caused as a side-effect of chemotherapy, according to researchers from the Christie NHS Foundation Trust and the University of Manchester. In a pragmatic trial, 108 cancer patients receiving chemotherapy and experiencing neuropathy, were randomised to have ten weeks of either acupuncture plus usual care, or usual care alone. Acupuncture comprised a weekly 40 minute session, whilst usual care was medication with gabapentin, pregabalin and/or amitriptyline.

At week 10, 68% of cases in the acupuncture group were classified as successfully treated, compared with 33% in the control group. Beneficial outcomes seen in the acupuncture group included clinicians’ grading of neuropathy, cancer-related quality of life and patients’ subjective pain scores. The team concludes that the data from this study has corroborated results from a previous evaluation and other smaller studies, confirming that this cohort of participants benefited from the acupuncture they received. The results also suggest that acupuncture can impact the complex symptom burden associated with this condition, not just the pain. However, sustainability of any improvements in symptoms requires longer follow-up.

(A randomised pragmatic clinical trial of ACUpuncture plus standard care versus standard care alone FOr Chemotherapy Induced peripheral Neuropathy ACUFOCIN). European Journal of Oncology Nursing, October 2022.)

Acupuncture helps “chemo neuropathy” symptoms ie peripheral neuropathy associated with chemotherapy treatment of cancer, according to researchers at the Faculty of Medicine, Technion-Israel Institute of Technology. A group of 168 participants were enrolled in a pragmatic trial, and treated in accordance with their preferences for either acupuncture and complementary & integrative medicine, or standard care alone as a control. Patients in the intervention arm were randomised to receive either twice-weekly acupuncture for six weeks, or acupuncture plus manual movement or mind-body therapy.

From baseline to six week assessment, the intervention groups improved significantly compared with the control group for criteria including overall chemotherapy-related quality of life, emotional wellbeing, hand numbness/tingling & discomfort, and physical functioning.

The researchers conclude that acupuncture, with or without complementary & integrative medical modalities, can relieve chemo neuropathy symptoms during oncology treatment. This is most pronounced for hand numbness, tingling, pain, discomfort, and for physical functioning.

(Impact of acupuncture & integrative therapies on chemotherapy-induced peripheral neuropathy: A multicentered, randomized controlled trial. Cancer, 12 August 2022.)