2020 Evidence-Based Complementary and Alternative Medicine

Acupuncture could be safe and effective for pain reduction, restoring shoulder function, and restoring flexion range of motion for frozen shoulder patients in the short term and midterm.

In this systematic review and a meta-analysis, acupuncture had shown to be a safe treatment with a significant effect in regard to reducing pain, improving shoulder function, and flexion ROM in the short term and midterm. However, due to the small number of included studies and methodological limitations in these studies, more large-scale high-quality RCTs are warranted in order to give a robust conclusion. Future studies should compare acupuncture to other treatments and sham acupuncture. Additionally, longer follow-up time is needed for investigating the effect of acupuncture in the mid- and long term, and the duration of future FS studies follow-up should be increased to one year.

The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis Ben-Arie E, Kao PY, Lee YC, Ho WC, Chou LW, Liu HP

2020 Pain Research and Management

Acupuncture appears to be superior to drug or blocking therapy or sham acupuncture therapy for lateral epicondylitis.

In conclusion, despite the limitations of the methodology, the results of this meta-analysis indicated that acupuncture therapy might be more effective than drugs and blocking therapy in improving the clinical efficacy rate and decreasing the VAS score. Well-designed RCTs with larger sample sizes and long-term follow-up on these topics are still needed to supply reliable evidence on the efficacy of acupuncture for treating lateral epicondylitis.

Effectiveness of Acupuncture for Lateral Epicondylitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Zhou Y, Guo Y, Zhou R, Wu P, Liang F, Yang Z

2019 Clinical Rehabilitation

For both symptom relief and function improvement, manual acupuncture is superior to ibuprofen for carpal tunnel syndrome.

Result of this systematic review has shown that acupuncture and related therapies appear to be effective in improving symptoms, function and pain in carpal tunnel syndrome.

However, validity of such conclusion is limited as majority of the included trials are at high risk of bias from lack of blinding.

Associated adverse events were minimal.

Acupuncture and related interventions for carpal tunnel syndrome: systematic review Wu IXY, Lam VCK, Ho RST, Cheung WKW, Sit RWS, Chou LW, Zhang Y, Leung TH, Chung VCH

2017 Physiotherapy

Acupuncture combined with physiotherapy or exercise was found to be more effective for frozen shoulder than physiotherapy or exercise alone in the short and long term.

Shoulder pain is a leading musculoskeletal pain complaint, and is responsible for high morbidity with marked impact on quality of life. Acupuncture is a modality commonly employed in the treatment of shoulder conditions; however, past systematic reviews investigating its effectiveness have been inconclusive, noting a paucity of good quality research. A new body of research has since been published, and is included within this review. The objective of this systematic review was therefore to investigate the current evidence base for the effectiveness of acupuncture in the treatment of shoulder pain.

Effectiveness of acupuncture in the treatment of shoulder pain: a systematic review of published randomised clinical trials A. Rubio M. Mansfield J. Lewis

2017 Pain Medicine

Our study provides evidence that acupuncture has a specific impact on frozen shoulder beyond the placebo effects that may not only be beneficial in reducing short-term pain perception, but may also have a positive long-term influence on the time course of recovery.

Primary adhesive capsulitis ("frozen shoulder") is a common disorder associated with pain and significant morbidity in humans worldwide. This first double-blinded (patient- and observer-blinded) study in patients with AC showed the efficiency of our special distal needling protocol by systematic combination of acupoints for immediate pain reduction. The study also confirmed the suitability of press tack needles and press tack placebos as an effective option for double-blind studies in acupuncture. The follow-up clinical observation with classical needle acupuncture confirmed that results obtained with the press tack placebos/press tack needles design can be transferred to classical needle acupuncture. Furthermore, conservative therapy that included acupuncture represented a superior effectiveness on the time course of recovery in AC patients compared with patients treated with conservative therapy alone in a standard clinical setting.

Immediate Pain Relief in Adhesive Capsulitis by Acupuncture—A Randomized Controlled Double-Blinded Study Schröder S, Meyer-Hamme G, Friedemann T, Kirch S, Hauck M, Plaetke R, Friedrichs S, Gulati A, Briem D

2016 Cochrane Database of Systematic Reviews

Acupuncture relieves neck pain better than sham acupuncture and those who received acupuncture report less pain and disability at short‐term follow‐up than those on a wait‐list.

For mechanical neck pain, we found that acupuncture is beneficial immediately following treatment and at short‐term follow‐up compared with sham treatments for pain intensity; at short‐term follow‐up compared with sham treatments for disability (NPQ); at short‐term follow‐up compared with inactive treatments for pain intensity; and at short‐term follow‐up compared with wait‐list control for pain intensity and neck disability improvement. Effects do not seem sustainable over the long term. Acupuncture treatments appear to be relatively safe.

Acupuncture for neck disorders Trinh K, Graham N, Irnich D, Cameron ID, Forget M.

2015 Journal of Acupuncture and Meridian Studies

Short-term acupuncture treatment is more effective than ibuprofen for mild to moderate carpal tunnel syndrome.

In our study, none of the patients treated with acupuncture developed complications, whereas five patients treated with ibuprofen had gastrointestinal side effects (we then used omeprazole); however, none of them withdrew from the study due to the adverse effects. Therefore, acupuncture is superior in safety as well.

The limitations of this study include the low number of treatment sessions in the group treated with acupuncture. If the number of treatment sessions were added, better therapeutic results may have been obtained.

Overall, it seems that acupuncture is a relatively uncomplicated and safe treatment option for patients with mild to moderate CTS and can improve symptoms and electrodiagnostic parameters.

Efficacies of Acupuncture and Anti-inflammatory Treatment for Carpal Tunnel Syndrome Hadianfard M, Bazrafshan E, Momeninejad H, Jahani N.

2014 BMC Complementary Medicine and Therapies

Moderate quality studies suggest that acupuncture is more effective than sham acupuncture for lateral elbow pain.

All studies had at least one domain rated as high risk or uncertain risk of bias in the Cochrane risk of bias tool. Results from three RCTs of moderate quality showed that acupuncture was more effective than sham acupuncture. Results from 10 RCTs of mostly low quality showed that acupuncture or moxibustion was superior or equal to conventional treatment, such as local anesthetic injection, local steroid injection, non-steroidal anti- inflammatory drugs, or ultrasound. There were six low quality RCTs that compared acupuncture and moxibustion combined with manual acupuncture alone, and all showed that acupuncture and moxibustion combined was superior to manual acupuncture alone.

Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials Gadau M, Yeung WF, Liu H, Zaslawski C, Tan YS, Wang FC, et al

2014 Journal of Acupuncture and Meridian Studies

Acupuncture can be considered as an alternative option for treatment of De Quervain's tenosynovitis.

Although injection has been considered the mainstay of management for tendinopathy, the exact mechanism of its therapeutic effect is unknown. Furthermore, a number of studies have provided strong evidence that corticosteroid injection is beneficial in the short term but may be worse than other conservative interventions in the intermediate and long terms.

According to this study, acupuncture improved not only pain intensity, but also disability status of the patients with De Quervain's tenosynovitis. Although we noted a higher improvement rate in patient's symptoms in the injection group, the difference between the two groups was small when the overall effects were evaluated over time and, therefore, the efficacy of acupuncture is likewise remarkable.

Efficacy of Acupuncture versus Local Methylprednisolone Acetate Injection in De Quervain's Tenosynovitis: A Randomized Controlled Trial Hadianfard M, Ashraf A, Fakheri M, Nasiri A

2010 The Journal of Pain

A meta-analysis of acupuncture versus steroid block therapy favored acupuncture in terms of responder rate.

Our systematic review and meta-analysis demonstrate that the evidence for acupuncture as a symptomatic therapy of carpal tunnel syndrome is encouraging but not convincing. The total number of included RCTs and their methodological quality were low. Further rigorous studies are required to establish whether acupuncture has therapeutic value for this indication.

Acupuncture for Carpal Tunnel Syndrome: A Systematic Review of Randomized Controlled Trials Lee, H., Shim, H., Shin, B., Jung, A., Lee, M., & Ernst, E.