Acupuncture analgesia: II. Clinical considerations.
BACKGROUND
Acupuncture and related percutaneous neuromodulation therapies can be used to treat patients with both acute and chronic pain. In this review, we critically examined peer-reviewed clinical studies evaluating the analgesic properties of acupuncture modalities.


METHODS
Using Ovid and published medical databases, we examined prospective, randomized, sham-controlled clinical investigations involving the use of acupuncture and related forms of acustimulation for the management of pain. Case reports, case series, and cohort studies were not included in this analysis.


RESULTS
Peer-reviewed literature suggests that acupuncture and other forms of acustimulation are effective in the short-term management of low back pain, neck pain, and osteoarthritis involving the knee. However, the literature also suggests that short-term treatment with acupuncture does not result in long-term benefits. Data regarding the efficacy of acupuncture for dental pain, colonoscopy pain, and intraoperative analgesia are inconclusive. Studies describing the use of acupuncture during labor suggest that it may be useful during the early stages, but not throughout the entire course of labor. Finally, the effects of acupuncture on postoperative pain are inconclusive and are dependent on the timing of the intervention and the patient's level of consciousness.


CONCLUSIONS
Current data regarding the clinical efficacy of acupuncture and related techniques suggest that the benefits are short-lasting. There remains a need for well designed, sham-controlled clinical trials to evaluate the effect of these modalities on clinically relevant outcome measures such as resumption of daily normal activities when used in the management of acute and chronic pain syndromes.
Wang
Shu-Ming
SM
Center for Advancement of Perioperative Health, Department of Anesthesiology, Yale School of Medicine, 333 Cedar St., New Haven, CT 06510, USA. shu-ming.wang@yale.edu
Kain
Zeev N
ZN
White
Paul F
PF
D015667:Acupuncture Analgesia / Q000295:instrumentation / Q000379:methods*; D000818:Animals; D006801:Humans; D010146:Pain / Q000503:physiopathology / Q000517:prevention & control; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic / Q000379:methods*