Abstract
Although acupuncture is gaining popularity for the treatment of nonspecific pain, the immediate analgesic effect of acupuncture has never been reviewed. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on disease-related pain to critically evaluate the immediate effect of acupuncture for pain relief. The PubMed and Cochrane Central Register of Controlled Trials databases as well as three Chinese databases including the China National Knowledge Infrastructure (CNKI), Wanfang, and VIP platforms were searched through November 2016. The outcome was the extent of pain relief from baseline within 30 min of the first acupuncture treatment. We evaluated all RCTs comparing acupuncture with other interventions for disease-related pain. Real acupuncture showed statistically significantly greater pain relief effect compared to sham acupuncture (SMD, −0.56; 95% confidence interval [CI], −1.00 to −0.12; 9 RCTs) and analgesic injection (SMD, −1.33; 95% CI, −1.94 to −0.72; 3 RCTs). No serious adverse events were documented. Acupuncture was associated with a greater immediate pain relief effect compared to sham acupuncture and analgesic injections. Further RCTs with stricter design and methodologies are warranted to evaluate the immediate pain relief effect of acupuncture for more disease-related pain.
Highlights
Pain is a major health problem with serious social and economic consequences
The initial electronic database search identified 2586 potential studies of interest. After screening these citations by their titles and abstracts, we considered 102 potentially eligible articles for inclusion and retrieved the corresponding full articles
For the duration of pain, the results showed that real acupuncture was statistically significantly more effective than sham acupuncture for chronic pain (SMD, −0.54; 95% confidence intervals (CIs), −0.88 to −0.21; 6 randomized controlled trials (RCTs); I2 = 50%); the pooled result was not statistically significant for acute pain (SMD, −0.48; 95% CI, −1.76 to 0.80; 3 RCTs; I2 = 95%)
Summary
Pain is a major health problem with serious social and economic consequences. The annual cost of pain management in the USA in 2010 was $560–635 billion, which was a conservative estimate because it excluded the cost of management of pain affecting institutionalized individuals [1]. A majority of people suffering pain in the USA and Europe have reported inadequate pain control, and one-third worry about addiction to pain medications [2, 3]. Pain conditions appear to have a greater negative impact on the factors affecting the quality of life, such as work performance, sleep, and mood, compared with other health problems [4, 5]. Given the increasing life expectancy and the aging population, appropriate management of pain and reduction of disability are likely to assume greater importance
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