Do further studies of acupuncture for pain make sense? An informal review

Authors


E-mail: les@pharmavision-consulting.co.uk

Abstract

Background

Therapeutic evidence of effectiveness for acupuncture is largely confined to pain, but is compromised by poor study quality, limited methodologies and selective reporting.

Objectives

To assess how the evidence of effectiveness for acupuncture for pain has developed over time, and to inform future research decisions.

Methods

PubMed was searched for meta-analyses and systematic reviews of acupuncture for pain. No time limits were imposed.

Results

Twenty-two meta-analyses and systematic reviews of acupuncture for pain were identified. There was one report of positive evidence for acupuncture vs. placebo from 1990–2004, and six from 2005–2012. An apparent clustering of positive evidence in recent years could be explained by the emergence of better trial methodologies, although a placebo effect still cannot be dismissed. Treatment effects appear to be small.

Conclusions

As recent studies show small effect sizes, acupuncture may have a specific but clinically unimportant effect; alternatively, the small benefits seen may have resulted from a residual placebo effect. A better understanding of the effect of acupuncture may be achieved through deeper analysis of existing studies, rather than the conduct of new randomised controlled trials.

Ancillary