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Acupuncture Today – November, 2012, Vol. 13, Issue 11

Research: Acupuncture Is Both Cost and Medically Effective

Two recent research reports find that acupuncture is an effective treatment for several types of chronic pain and has the added advantage of being less costly than standard medical care.

According to a story in the Sept. 10, 2012 edition of Medscape Medical News, a "meta-analysis" performed by lead author Andrew J. Vickers, DPhil, attending research methodologist, Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York found that "found that about 50% of patients who got acupuncture had improvement in pain compared with 30% who didn't get acupuncture and 42.5% who had sham acupuncture."

The report, Acupuncture for Chronic Pain Individual Patient Data Meta-analysis, originally appeared in the Archives of Internal Medicine.

The findings contradict a series of controversial reports in the last three years that have contended that "sham acupuncture" is as effective as real acupuncture.

However, the article notes that for other types of interventions for chronic pain "the placebo effect is typically about one third of the effect of the treatment, (but) 'in acupuncture, it looks like it's two thirds,' said Dr. Vickers. 'That's quite a large benefit and that's what the patient will actually experience in real clinical practice,' where the decision is not whether to have true or sham acupuncture but whether to get a referral for acupuncture or not."

The study itself was " a systematic review to identify randomized controlled trials (RCTs) of acupuncture for chronic pain in which allocation concealment was determined unambiguously to be adequate. Individual patient data meta-analyses were conducted using data from 29 of 31 eligible RCTs, with a total of 17 922 patients analyzed."

It concluded that "Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option." It reviewed the effects of acupuncture on four chronic pain conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain. In his interview Vickers said that acupuncture is also a cost-effective intervention. "Those studies have typically found that the health gain per dollar spent is well under the typical threshold."

Acupuncture Found Valuable in Treatment of Knee Pain

A British study, which focussed specifically on acupuncture's cost-effectiveness in treating chronic knee pain, concluded that one-third of patients with knee osteoarthritis and were candidates for total knee replacement surgery had achieved long-term symptom relief after two years. The study, published on Sept. 12, 2012, determined that the acupuncture treatments had saved at least 100,000 pounds (about $162,000) per year within the study group.

The report, "Group acupuncture for knee pain: evaluation of a cost-saving initiative in the health service," was published in the journal, Acupuncture in Medicine.

About 80% of patients with knee osteoarthritis who attended MSK CATS (musculoskeletal clinical assessment and treatment services) in 2008 and were considered candidates for TKR surgery were willing to try acupuncture first. Ninety patients were screened for acupuncture in this NHS service offering treatment in groups. Of these 90 patients, we know that at least 31 had not had TKR within the following 2 years."

Typical total knee replacement surgery in the UK costs about 5000 pounds (roughly $8100), the report stated.

It concluded: "Although TKR (Total Knee Replacement) is successful in the sense that revision rates are low, as many as 15% of patients experience severe knee pain 3–4 years later and 18% are dissatisfied with the results. Experts recommend that all conservative options should be offered before resorting to surgery.

"The evidence published on acupuncture in patients with knee osteoarthritis shows that it is safe and effective in reducing pain and improving function, thus qualifying it as an appropriate conservative treatment for this condition."

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