2021 Evidence-Based Complementary and Alternative Medicine

Moderate-quality evidence revealed an association between acupressure and greater pain relief compared with physical therapy.

The systematic review and meta-analysis included 23 RCTs with 2400 participants with low back pain. Consistent with previous systematic reviews, moderate-quality evidence revealed an association between acupressure and greater pain relief compared with physical therapy.

Although rated as very-low to low, poor quality evidence suggested that acupressure, with or without combinative acupuncture therapy, contributed to a greater amelioration of pain and functional disability from low back pain compared with usual care, tuina massage, or acupuncture.

Trial sequential analysis results revealed that adequate studies supported the significance of the clinical response rate of acupressure, with or without combinative acupuncture therapy, compared to other treatments.

Clinical Efficacy and Safety of Acupressure on Low Back Pain: A Systematic Review and Meta-Analysis Tao Li , Xiaohui Li ,Fan Huang , Qiang Tian , Z. Y. Fan , and S. Wu

2020 Evidence-Based Complementary and Alternative Medicine

Acupuncture could significantly relieve pain and increase cure rate for acute ankle sprain, even producing improved results when combined with other therapies.

The researchers executed parallel-group randomized controlled trials without any language or publication date restraints. Participants suffering from acute ankle sprains were included irrespective of their demographic details, or the diagnostic criteria used to confirm their condition. Experimental interventions consisted of acupuncture alone or a combination of acupuncture and traditional therapies, while the control interventions were either no treatment, placebo, or traditional therapies only. The Kofoed ankle score was the main outcome, with secondary outcomes covering a range of parameters from pain scale to cure rate. Several databases were searched to find potentially eligible studies up to the date of September 10, 2020, with trial registry platforms and the reference lists of the eligible studies also being verified for any ongoing or unpublished studies.

The study analysed seventeen eligible studies to study the effect of acupuncture on acute ankle sprains. No significant difference was found between the Kofoed ankle scores of the acupuncture and Rest, Ice, Compression, Elevation (RICE) groups. However, acupuncture did show a significant impact on pain relief and an increased cure rate compared to the RICE group. The combination of acupuncture and RICE also resulted in a significant increase in pain relief and cure rate compared to just the RICE method. Acupuncture, when combined with massage, brought about a significant reduction in pain compared to just massage, while the combination with traditional Chinese medicine outperformed Chinese medicine alone in pain relief, duration of pain, and cure rate. There were almost no adverse reactions reported, with one mild drug-related allergic reaction which healed without any treatment.

Efficacy and Safety of Acupuncture Therapy for Patients with Acute Ankle Sprain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Liu AF, Gong SW, Chen JX, Zhai JB

2018 Acupuncture in Medicine

Acupuncture showed a more favourable effect in the treatment of lumbar disc herniation than lumbar traction, ibuprofen, diclofenac sodium and meloxicam.

Thirty RCTs involving 3503 participants were included in the study. Meta-analysis showed that acupuncture had a higher total effective rate than lumbar traction, ibuprofen, diclofenac sodium and meloxicam. Acupuncture was also better than lumbar traction and diclofenac sodium in terms of visual analogue scale (VAS) scores, and better than lumbar traction with respect to Japanese Orthopaedic Association (JOA) scores.

In addition, the total effective rate in five individual trials was greater for acupuncture than for mannitol plus dexamethasone and mecobalamin, ibuprofen plus fugui gutong capsule, loxoprofen, mannitol plus dexamethasone and huoxue zhitong decoction, respectively. Additionally, two individual trials showed a superior effect of acupuncture in VAS scores comparedwith ibuprofen or mannitol plus dexamethasone, respectively.

Acupuncture for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis Tang S, Mo Z, Zhang R

2018 Revista Latino-Americana de Enfermagem

Cupping therapy has demonstrated notable effects in reducing chronic back pain in adults.

The systematic review and meta-analysis involved two independent researchers who examined national and international databases. They also explored the reference lists of additional systematic reviews. The quality of the studies was evaluated using the Jadad scale, a globally recognized tool assessing the methodological quality of clinical trials.

Extracting 16 studies for qualitative review and 10 for quantitative analysis, the research found positive impacts of cupping therapy on chronic back pain in adults. It was noted that there isn't a standardized protocol for treatment with this therapy. The study mainly evaluated outcomes based on factors such as pain intensity, physical incapacity, the quality of life, and the nociceptive threshold before the application of mechanical stimulus. A noteworthy reduction in pain intensity was seen through the use of cupping therapy.

Cupping therapy and chronic back pain: systematic review and meta-analysis Moura, C. C., Chaves, É., Cardoso, A., Nogueira, D. A., Corrêa, H. P., & Chianca, T.

2017 Acupuncture in Medicine

Acupuncture may be effective at relieving chronic knee pain 12 weeks after acupuncture administration.

Nineteen trials were included in this systematic review. Of these, data from 17 studies were available for analysis. Regarding the effectiveness of acupuncture alone or combined with other treatment, the results of the meta-analysis showed that acupuncture was associated with significantly reduced CKP at 12 weeks on WOMAC pain subscale and VAS. As for safety, no difference was found between the acupuncture and control groups.

Updated systematic review and meta-analysis of acupuncture for chronic knee pain Zhang Q, Yue J, Golianu B, Sun Z, Lu Y.

2016 Complementary Medicine Research

Acupuncture therapy is more effective than NSAID in improving clinical efficacy rates and pain scores for treatment of chrondomalacia patellae.

To our knowledge, this is the first meta-analysis of acupuncture therapy in the treatment of CMP. Seven RCT involving 707 patients with CMP were selected for this meta-analysis. Based on the findings of the present systematic review, acupuncture therapy can further improve the clinical effect and pain scores when compared with NSAID controls. However, the potential beneficial effect of acupuncture is possibly overstated owing to the low general methodological quality of the included RCT. Conclusions regarding the safety of acupuncture therapy cannot be drawn since the eligible trials provide no evidence on this aspect.

Acupuncture Versus Non-Steroidal Anti-Inflammatory Drugs for Treatment of Chondromalacia Patellae: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Lv Z.-T.a · Li Z.-Q.b · Zhou X.c · Ma W.-W.d · Zhang J.-M.a · Chen A.-M

2016 Journal of Orthopaedic & Sports Physical Therapy

Acupuncture, specifically needle-based and electroacupuncture, can potentially provide therapeutic benefits for carpal tunnel syndrome, Achilles tendinopathy, and shoulder injuries.

Methodology: The researchers executed a systematic review on multiple databases such as MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials covering a period from 1990 to 2015. Their search was focused on identifying responsive randomized controlled trials, cohort studies, and case-control studies which focused on the effectiveness and safety of acupuncture therapies for musculoskeletal disorders. The Scottish Intercollegiate Guidelines Network criteria was used to evaluate the eligible studies. Furthermore, best-evidence synthesis was performed to sum up results from studies with low bias risk. A sensitivity analysis was also performed to comprehend the potential impact of excluding studies with high bias risk.

Results: The comprehensive review identified 5180 articles, from which 15 were selected for final analysis (10 had a low risk of bias and 5 with a high risk of bias). Among other findings, the results showed that traditional needle acupuncture may outperform oral steroids and vitamin B1/B6 supplements for carpal tunnel syndrome and exercises for Achilles tendinopathy. Moreover, electroacupuncture might be superior than placebo for shoulder injuries. The extent of benefits offered by dry needling for plantar fasciitis remained equivocal. Traditional needle acupuncture didn't show significant advantage over placebo for upper extremity pain, or no intervention for patellofemoral pain, and findings for shoulder pain were inconclusive.

Effectiveness of Acupuncture Therapies to Manage Musculoskeletal Disorders of the Extremities: A Systematic Review Cox, J., Varatharajan, S., Côté, P., & Optima Collaboration

2015 Evidence-Based Complementary and Alternative Medicine

Acupuncture may be effective in treating the pain associated with sciatica.

A total of 12 studies (involving 1842 participants) were included. Results showed that acupuncture was more effective than conventional Western medicine (CWM) in outcomes effectiveness, pain intensity, and pain threshold. Subgroup and sensitivity analysis found that the results did not change in different treatment method and drug categories substantially. The reported adverse effects were acceptable.

The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis Ji M, Wang X, Chen M, Shen Y, Zhang X, Yang J

2015 Evidence-Based Complementary and Alternative Medicine

The use of acupuncture may be more effective than drugs and may enhance the effect of drugs for patients with sciatica.

The results of this systematic review suggest that the use of acupuncture may more effectively relieve leg pain/lumbago and improve global assessment of sciatica when compared with NSAID (ibuprofen, meloxicam, and diclofenac) treatment. Moreover, adjuvant acupuncture may enhance the effect of medications in leg pain/lumbago relief. To patients, acupuncture points appear more effective than nonacupoints. Acupuncture is relatively safe and is rarely associated with serious adverse events in patients with sciatica. However, this meta-analysis was lacking in relevant and rigorous RCTs. Because the evidence was limited, higher quality and more rigorously designed clinical trials with larger sample sizes will be needed to further confirm our findings.

Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis Zongshi Qin, Xiaoxu Liu, Jiani Wu, Yanbing Zhai, Zhishun Liu,

2015 Evidence-Based Complementary and Alternative Medicine

Acupuncture, either used in isolation or as an adjunct to conventional therapy, provides short-term improvements in pain and function for chronic low back pain.

Sixteen systematic reviews were appraised. Overall, the methodological quality was low and external validity weak. For acute LBP, evidence that acupuncture has a more favorable effect than sham acupuncture in relieving pain was inconsistent; it had a similar effect on improving function. For chronic LBP, evidence consistently demonstrated that acupuncture provides short-term clinically relevant benefits for pain relief and functional improvement compared with no treatment or acupuncture plus another conventional intervention.

Acupuncture for Low Back Pain: An Overview of Systematic Reviews Liu L, Skinner M, McDonough S, Mabire L, Baxter GD.

2014 BMC Complementary Medicine and Therapies

The use of acupuncture for osteoarthritis is associated with significant reductions in pain intensity, improvement in functional mobility and quality of life.

In this systematic review, we found acupuncture administered to adults with osteoarthritis to be associated with a statistically significant reduction in pain intensity, improved functional mobility and improved health-related quality of life. Reductions in pain were greater in trials with longer intervention periods. Though under-reported and inconsistently described, major adverse events with acupuncture were not reported. Subgroup analyses suggest that acupuncture is most effective for reducing osteoarthritic pain when administered for more than four weeks. Outcome assessment for the majority of trials occurred immediately following the intervention period and thus the durability of treatment effects are unknown.

Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. Manyanga, T., Froese, M., Zarychanski, R. et al.

2013 BMC Complementary Medicine and Therapies

Acupuncture has shown potential in alleviating symptoms and improving overall quality of life for patients suffering from ankle sprains.

To evaluate the effectiveness of acupuncture in treating ankle sprains, the researchers performed a systematic review, sourcing data from 15 databases and two trial registries up until February 2012. Only randomized controlled trials of acupuncture that involved patients with ankle sprains and reported improvements of symptoms, particularly pain, were included. Different aspects such as the type of acupuncture, the grade of sprain, and the type of control were considered. The risk of bias and sample size were assessed using a Cochrane risk of bias tool, and sensitivity analyses were performed regarding these factors and reported outcomes.

In relation to the results, they incorporated 17 trials with a total of 1820 participants. It was found that overall quality of the trials was lacking, with only three properly describing their randomization methods, and just one detailing a method for obscuring allocation. More participants who received acupuncture reported a global improvement of symptoms compared to those who did not undergo acupuncture. Additionally, acupuncture as an auxiliary treatment also enhanced global symptoms compared to other treatments alone, without significant changes in results. The advantages of acupuncture remained notable even after limiting the analysis to the two trials with the lowest risk of bias. Acupuncture proved to be more efficient than other control methods in reducing pain, enabling return to normal activities, and enhancing quality of life. However, these analyses relied on a small range of studies. Acupuncture did not seem to be connected with any detrimental events.

Acupuncture for ankle sprain: systematic review and meta-analysis Park J, Hahn S, Park JY, Park HJ, Lee H

2012 Acupuncture in Medicine

There is evidence supporting the effectiveness of acupuncture for plantar heel pain comparable to that available for conventionally used interventions, such as stretching, night splints or dexamethasone.

Five randomised controlled trials and three non-randomised comparative studies were included. High quality studies report significant benefits. In one, acupuncture was associated with significant improvement in pain and function when combined with standard treatment (including non-steroidal anti-inflammatory drugs). In another, acupuncture point PC7 improved pain and pressure pain threshold significantly more than LI4. Other papers were of lower quality but suggest benefits from other acupuncture approaches.

The Effectiveness of Acupuncture for Plantar Heel Pain: A Systematic Review Clark RJ, Tighe M