Researchers with the Acupuncture Trialists' Collaboration have concluded that acupuncture is effective for the treatment of chronic pain, that the effects of acupuncture persist over time, and that the benefits of acupuncture cannot be explained away solely by the placebo effect.

The Journal of Pain research updated a previous analysis published by the same group of authors in 2012, when patient data from randomized controlled trials published through November 2008 were used. The new analysis included eligible trials published between December 2008 and December 2015.

Chronic pain is a significant condition that affects millions of Americans. While family physicians play an important role for many of these patients, survey results indicate that many physicians consider the training they received in pain management inadequate and may not feel comfortable in their ability to care for patients with chronic pain effectively.

One therapy that has received considerable attention for the treatment of chronic pain is acupuncture, found effective for a number of chronic pain conditions. Nonpharmacologic treatments like acupuncture may provide benefits to some patients, especially given the effects of the ongoing opioid epidemic on pain management, said Jennifer Frost, M.D., medical director for the American Academy of Family Physicians' Health of the Public and Science Division.

Patients were considered eligible for the trial if they met the following criteria:

They experienced one of four chronic pain conditions (nonspecific back or neck pain, shoulder pain, chronic headache or osteoarthritis).

The duration of pain lasted at least four weeks for musculoskeletal disorders.

Chinese and Western methods usedMore than half of the trials used acupuncture based on traditional Chinese techniques. The rest used Western techniques or a combination of the two. In nine trials, acupuncture points were selected according to a fixed needle formula (that is, the same points were used on all study participants). The remaining trials selected points according to a flexible formula.

In 80 percent of the trials, patients underwent between six and 15 acupuncture sessions. Most patients received acupuncture one to two times per week. In slightly more than half of the trials, the typical acupuncture session lasted less than 30 minutes.

"The results confirm and strengthen previous key findings that acupuncture has a clinically relevant effect compared with no acupuncture control," the authors wrote.

The authors added that "the effects of acupuncture are not completely explicable in terms of placebo effects," but cautioned that "factors other than the specific effects of needling at correct acupuncture point locations" contribute to the benefits derived from receiving acupuncture.

They suggested that acupuncture would be "a reasonable option" to consider in patients with chronic pain, and called for additional research to determine the best way of incorporating acupuncture into the care of these patients.

Source: American Academy of Family Physicians: aafp.org