HealthDay News — Acupuncture is an effective treatment for chronic pain conditions — including back and neck pain, osteoarthritis and chronic headache — with acupuncture pain relief superior to both no-acupuncture controls and sham-acupuncture groups, results of a systematic review and meta-analysis indicate.

“Our results from individual patient data meta-analyses of nearly 18,000 randomized patients in high-quality randomized controlled trials provide the most robust evidence to date that acupuncture is a reasonable referral option for patients with chronic pain,” Andrew J. Vickers, DPhil, of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues reported in Archives of Internal Medicine.

The metaanalysis involved individual data from 29 high-quality, randomized controlled trials and encompassed 17,922 patients. The researchers sought to determine the efficacy of acupuncture on four chronic pain conditions: back and neck pain, osteoarthritis, chronic headache and shoulder pain.

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Acupuncture was superior to both sham and no-acupuncture controls for each pain condition, they found, and the size of the effect in each pain condition was about the same. Overall, patients who were treated with acupuncture experienced less pain, with scores that were 0.23, 0.16, and 0.15 standard deviations lower than sham controls for back and neck pain, osteoarthritis and chronic headache, respectively.

Compared with no-acupuncture controls, the effect sizes were 0.55, 0.57 and 0.42 standard deviations for back and neck pain, osteoarthritis and chronic headache, respectively.

“Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option,” the researchers wrote. “Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo.”

In an accompanying editorial, Andrew L. Avins, MD, MPH, of the Kaiser-Permanente Northern California Division of Research, in Oakland, called the relationship between traditional and complimentary/alternative medicine (CAM) “ambiguous,” and emphasized the importance of understanding the mechanism of action behind the findings.

“At the end of the day, our patients seek our help to feel better and lead longer and more enjoyable lives,” Alvins  wrote. “Perhaps a more productive strategy at this point would be to provide whatever benefits we can for our patients, while we continue to explore more carefully all mechanisms of healing.”


  1. Vickers AJ et al. Arch Intern Med. 2012;doi:10.1001/archinternmed.2012.3654.
  2. Avins A. Arch Intern Med. 2012;doi:10.1001/archinternmed.2012.4198