Landmark summary in Journal of Pain deems referral for acupuncture for chronic pain a reasonable option

World leading acupuncture scientists recently published in the official journal of the American Pain Society  (Journal of Pain; ; 2018, May; 19(5): 455-474) a landmark update on research that evaluates and summarizes all legitimate, randomized clinical trials for acupuncture treating chronic pain conditions, including neck and back pain, shoulder pain, chronic headache, or osteoarthritis.

Highlights of the meta-analysis:

1. Acupuncture has a clinically relevant effect on chronic pain that persists over time

2. The effect of acupuncture cannot be explained only by placebo effects

3. Factors in addition to the specific effects of needling are important contributors

4. Referral for acupuncture treatment is a reasonable option for chronic pain patients

Research trials were filtered for standard high-quality parameters and selected ones where acupuncture was compared to sham (fake) or no acupuncture control.  They evaluated 39 studies since the last 2008 update representing 20,827 patients.

On the mechanism side,The Society for Acupuncture Research for decades has summarized and supported research on both pragmatic and mechanism. And no, they do not focus on “chi”, but rather neuro-physiological mechanisms.

Mechanistic findings for Acupuncture: Advances over the last 3 decades in research has shed light into the possible mechanisms and physiology of acupuncture, including:

1. “It is thought that the immediate analgesic effects of acupuncture may be dependent on neural (nerve) innervation.”

2. “Acupuncture has also been shown to induce the release of endogenous opioids in various parts of the brain.”

3. “Local tissue effects including release of adenosine at the site of needle stimulation have also been observed as have increases in local blood flow.”

References:

Society for Acupuncture Research letter on progress in acupuncture research and mechanism: https://www.acupunctureresearch.org/assets/docs/CMS%20announcement.pdf

Landmark summary in Journal of Pain:  Acupuncture for chronic pain: update of an individual patient data meta-analysis.  J Pain. 2018 May; 19(5) 455-474. Vickers, AJ, et al.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927830/pdf/nihms935739.pdf