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 helps pain after prostate surgery, according to a German research team at University Hospital Hamburg-Eppendorf, Hamburg. Their randomised controlled trial set out to evaluate the effectiveness of adding acupuncture to standard postoperative pain management for 126 patients undergoing open radical prostatectomy.

Patients were divided into three groups: standard analgesia; acupuncture plus standard analgesia; sham acupuncture plus standard analgesia. The acupuncture group reported significantly less postoperative pain than the other two groups. No significant differences were observed between groups on analgesic use and health status at discharge. The team concludes that incorporating acupuncture into postoperative pain management can improve patient postoperative outcomes.

(A randomized controlled study on acupuncture for peri-operative pain after open radical prostatectomy. British Journal of Urology International/BJU Int, 5 February 2024.)

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.)

American clinicians have found that a type of ear acupuncture termed battlefield acupuncture, reduces pain and opioid use in military veterans undergoing surgery. A total of 72 patients, mean age 64 and scheduled for major surgery under general anaesthesia, were randomly assigned to receive either ear acupuncture or sham acupuncture for postoperative pain. Surgery was typically abdominal, thoracic or for hip/knee replacements.

Median postoperative opioid consumption was significantly lower in the acupuncture group (18 units) compared to the sham group (39 units). Also lower in the acupuncture group, were subjective pain intensity, nausea and vomiting. Only one acupuncture group patient experienced nausea, compared with 13 in the sham group.

The researchers conclude that  the diminished postoperative pain intensity, reduced postoperative opioid requirement, and the lower incidence of postoperative nausea and vomiting observed, demonstrate the potential advantages of this low-cost and low-risk therapy in this patient population. Further research is needed to test its effectiveness in individual surgical procedures.

(Battlefield Acupuncture Use for Perioperative Anesthesia in Veterans Affairs Surgical Patients: A Single-Center Randomized Controlled Trial. Journal of Integrative & Complementary Medicine, 10 August 2022.)