In the Clinic

On Cancer: Clinical Trials Analysis Finds Acupuncture Effective for Treating Chronic Pain

By Andrea Peirce, BA, Writer/Editor  |  Tuesday, September 11, 2012
Acupuncture needles are inserted into specific locations (acupoints) on the body. Acupuncture needles are inserted into specific locations (acupoints) on the body.

Although acupuncture has long been used to treat chronic pain, its effectiveness remains a controversial topic among physicians and scientists. This is largely because no biological mechanism has been identified to explain how the insertion and stimulation of specialized needles at specific points on the body generates lasting effects, such as decreased pain many months after a treatment.

Now, in an extensive analysis of data from nearly 18,000 individuals involved in 29 high-quality clinical trials, Memorial Sloan Kettering health outcomes researcher Andrew Vickers and colleagues have determined that acupuncture is an effective treatment for chronic back and neck pain, osteoarthritis, shoulder pain, and headaches.

Clinical Trial and Patient Data Examined

The review article, published in the September 10 issue of the Archives of Internal Medicine, was based on an evaluation of clinical trials conducted in the United States, Germany, Spain, and Sweden. The analysis included data from only the highest-quality trials: those that determined at random whether a patient would receive acupuncture.

In the studies, patients were randomly assigned to actual acupuncture, sham acupuncture (in which needles are inserted superficially or at nontraditional sites), or standard care without acupuncture. After selecting the trials, Dr. Vickers and colleagues requested the original patient data from the study investigators to use in their analysis.

“There have been many clinical trials of acupuncture for chronic pain,” Dr. Vickers says, “but the quality of these studies has been questionable. In our study, we only used data from trials that were very carefully designed to avoid bias. And by obtaining the original data, we could make sure that the statistical analyses were as accurate as possible.”

Implications for Patients and Doctors

An estimated three million Americans have acupuncture treatments each year, in most cases to address conditions causing chronic pain. Dr. Vickers explains that several factors likely contribute to the benefits that patients report.

“People receiving acupuncture for pain experience a benefit beyond that gained from the correct insertion of needles,” he says. “There is probably some benefit to needle insertion regardless of whether it is at a correct acupuncture point. And of course there is often an effect related to believing that the treatment will be helpful.”  

According to the Archives study, acupuncture does result in a pain relief benefit over sham acupuncture for chronic back and neck pain, osteoarthritis, shoulder pain, and headache — and its effectiveness over standard treatment without acupuncture is much greater.

“This has major implications for clinical practice,” Dr. Vickers says. “Our findings provide the most-robust evidence to date that doctors are justified in making referrals to acupuncture for their patients with chronic pain. I hope that our findings help inform future clinical and policy decisions for acupuncture.”

The research was supported in part by the National Center for Complementary and Alternative Medicine of the National Institutes of Health under award number AT004189I, and by the Samueli Institute.

Comments

I have suffered from back and leg pains since 2001, after an airplane accident. I was recommended after seeing several doctors to an Acupuncturest. Since my visits with Dr. Rong-Bao Lu, M.D. The pains are ever felt. I am very greatful for doctors like Dr. Lu and it is refreshing to know that hospitals like yourselves are venturing out of the box for better non invasive treatments that do and can help patient with chronic pains.

looking for phlebotomy jobs or lab assistant.i have 15,years exp...
SAM Resume.doc

If you are interested in working with us, please explore our careers website: http://careers.mskcc.org.

I have chronic osteo arthritis discomfort in most joints.
Can you suggest how to find a skilled well trained acupuncturist here in Manhattan?
Thank you,
C. Brody

Thank you for your comment! If you would like to make an appointment with one of our acupuncturists, please call our Integrative Medicine Service at 646-888-0800.

Is the acupuncture for MSK patients covered by insurance?

Thanks for your comment! Please contact your insurance company for the specifics on your particular policy.

Accupuncture is a joke. A person is better off using electrical stimulation, or
a heat producing product. or a heating pad, or ice! I am 82 years of age,
take my word for it! Sloan Kettering is great, treated me for Non-Hodgkins Lymphoma in 1975, and 1981, and I am feeling great, and looking towards the future!

I know someone in Boston who received no benefit from acupuncture for acute chronic back pain due to a herniated disk. Perhaps he needs a more skilled practicioner---can you recommend where he might get such a referral in the Boston area?

Thanks for your comment! Barrie Cassileth, Chief of our Integrative Medicine Service, suggests that your friend contact an acupuncturist at the Dana Farber Cancer Institute in Boston. Your friend is also welcome to make an appointment with one of our acupuncturists in New York City.

Starting with a provocative statement and finishing with nonsense worthy of Lewis Carroll, the headline in the September 11 Calgary Herald read; Acupuncture helps relieve headache, back pain, whether placebo effect or not: study.

According to the article, “The new analysis was published online Monday in Archives of Internal Medicine. The federal government’s National Center for Complementary and Alternative Medicine paid for most of the study, along with a small grant from the Samueli Institute, a non-profit group that supports research on alternative healing.” Researchers with Memorial Sloan-Kettering Cancer Center in New York and several universities in England and Germany wrote that the results ‘provide the most robust evidence to date that acupuncture is a reasonable referral option,’ .

Archives of Internal Medicine, researchers led by Andrew Vickers, an epidemiologist and biostatistician at Memorial Sloan Kettering Cancer Center, report that stated that; “The effects of acupuncture are statistically significant and different from those of sham or placebo treatments,” says Vickers. “So we conclude that the effects aren’t due merely to the placebo effect.”

Dr. Vickers may be an epidemiologist and biostatistician, but clearly, needs to go back and take an introductory course on statistics. This is a first year statistics students error, misinterpreting statistical significance as meaning practical importance.

For more: http://askepticrtn.com/?p=1592

Please furnish a name os a physician in the Palm Springs area who is qualified to administer acupuncture shots for chronic back pain. by "Palm Springs area mean Palm Springs, Rancho Mirage, Palm Desert, Indian Wells, La Quinta or any other area within a radius of 5o miles of Palm Springs.

Many thanks for you reply.
Lewis Kent

Thanks for your comment! Our Integrative Medicine Service has suggested that you contact:

Petra Beatrice Moncrief, Licensed Acupuncturist, Garden of Wellness Acupuncture, 1276 N. Palm Canyon Drive, Suite 208 Palm Springs, CA 92262
Phone: 760-325-7776; or Michael F. Boyer MS, DiplAc, DiplCH, LAc, Palm Springs Acupuncture Center, 2145 Tahquitz Canyon Way, Ste 5 Palm Springs, CA 92262, Phone: (760) 327-2217.

I have had chronic migraine and daily atypical face pain ever since I experienced a premature menopause associated with the chemotherapy I received for non-hodgkin's lymphoma. I tried acupuncture but received no benefit. Maybe the acupuncturist was not very skilled. Is there any organization that certifies acupuncturists? How do I find a good one?

As an aside - thank you MSKCC. You provided the chemotherapy that saved my life.

Our Integrative Medicine Service is happy to provide you with recommendations if you can tell us the area in which you live. Thanks!

Oh Thanks!. I live in Lafayette, Louisiana.

Our Integrative Medicine Service suggests John P. Hebert, L.Ac., at 708 Jefferson Boulevard in Lafayette, Louisiana. His phone number is 337-593-9796. Thanks!

I'm 79 and, with two forms of stenosis and serious scoliosis I have continuous back pain. Also have 2 discs fused from a fall many years ago. Is there a competent acupuncturest here in N.W. New Jersey? I live in Morris County. MSK is absolutely the best. My colorectal cancer surgery was a great success in 2008 and I'm still doing great. Thanks for any further advice.

Thanks for your comment! You can call our Integrative Medicine Service to make an appointment with one of our acupuncturists at 646-888-0800. If you would prefer someone closer to home, you could also contact Dr. Yi Chan at 711 Pleasant Valley Way in West Orange, New Jersey at 973-325-0704.

I live in Dallas, Ga. Within 20 minutes of Marietta Ga. I have Chronic back pain, and the worst pain is From abdominal and pelvic adhesions. Can accupuncture help with adhesions? Please give me the name of a good accupuncturist near me , please. Adhesions cause me constant non stop jerking pain as my internal organs and stuck together. Thanks, Dianne

Thanks for your comment! Our Integrative Medicine Service has suggested that you contact Isabella Middleton, Licensed Acupuncturist, 4343 Shallowford Road, Suite B7, Marietta, GA 30062. Her telephone number is 770-846-7600.

That is a really long drive for me with the pain I have . Is there anyone closer to the square in Marietta or toward Dallas, Hiram Ga. I am sorry to seem ungrateful. But I won't be able to go that far. It hurts really bad when I ride in a car, because of the sitting. I also need someone who accepts medicare. Thank you very much for your time.
Dianne

Our Integrative Medicine Service suggests that you try contacting the following acupuncturists who appear to be located close to you. You will have to ask about their areas of specialty and the insurance coverage that they provide: Hyeryun E. Chung at 303 Scenic Highway in Lawrenceville, GA 30045. The telephone number is 770-875-9555 and the fax number is 770-962-5335. Dr. G. Toms Chiro at 144 Fox Drive in Dallas, GA 30157. The telephone number is 770-875-9555 and the fax number is 770-962-5335. Laura P. Strickland at 1229 Johnson Ferry Road, Suite 100B, in Marietta, GA 30068. The telephone number is 404-242-1356.

Do you have any suggestion for acupuncture in Toronto? Thanks!

Thanks for your comment! Our Integrative Medicine Service suggests Doris Mertins at 416-368-4858 and info@downtowncore.ca. The website is www.downtowncore.ca.

Does Medicare cover acupuncture ?

We spoke with Dr. Cassileth, who says that Medicare does not typically cover acupuncture, but it depends on your carrier. Memorial Sloan-Kettering offers Community Acupuncture sessions at an inexpensive rate. Please call 646-888-0800 for more information.

Too bad the author of this article didn't bother to check the numbers published in the study. The effects are barely larger than the placebo effect. Why even bother if it does so little?

Thank you for your comment. We asked Dr. Vickers about your concern and he noted that, in fact, the differences between acupuncture and placebo are similar to some other routinely accepted interventions for chronic pain, such as non-steroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis.

Can you recommend an acupuncturist on Long Island. I am a patient at Memorial and have Multiple Myeloma. However my pain is in my knees and has nothing to do with my disease but is caused by osteoarthritis. I live in Setauket. Stony Brook and Port Jefferson would also be convenient towns for me.

Laura, our Integrative Medicine Service keeps a registry of cancer-trained acupuncturists by location. You can call 646-888-0845 to find someone in your area. Thank you for your comment.

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