title: Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials.
abstract: BACKGROUND
  Acupuncture and moxibustion have widely been used to treat lateral elbow pain (LEP). A comprehensive systematic review of randomized controlled trials (RCTs) including both English and Chinese databases was conducted to assess the efficacy of acupuncture and moxibustion in the treatment of LEP.
  
  
  METHODS
  Revised STRICTA (2010) criteria were used to appraise the acupuncture procedures, the Cochrane risk of bias tool was used to assess the methodological quality of the studies. A total of 19 RCTs that compared acupuncture and/or moxibustion with sham acupuncture, another form of acupuncture, or conventional treatment were included.
  
  
  RESULTS
  All studies had at least one domain rated as high risk or uncertain risk of bias in the Cochrane risk of bias tool. Results from three RCTs of moderate quality showed that acupuncture was more effective than sham acupuncture. Results from 10 RCTs of mostly low quality showed that acupuncture or moxibustion was superior or equal to conventional treatment, such as local anesthetic injection, local steroid injection, non-steroidal anti- inflammatory drugs, or ultrasound. There were six low quality RCTs that compared acupuncture and moxibustion combined with manual acupuncture alone, and all showed that acupuncture and moxibustion combined was superior to manual acupuncture alone.
  
  
  CONCLUSIONS
  Moderate quality studies suggest that acupuncture is more effective than sham acupuncture. Interpretations of findings regarding acupuncture vs. conventional treatment, and acupuncture and moxibustion combined vs. manual acupuncture alone are limited by the methodological qualities of these studies. Future studies with improved methodological design are warranted to confirm the efficacy of acupuncture and moxibustion for LEP.
authors.forename: Marcus
authors.initials: M
authors.lastname: Gadau
authors.forename: Wing-Fai
authors.initials: WF
authors.lastname: Yeung
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.forename: Chris
authors.initials: C
authors.lastname: Zaslawski
authors.forename: Yuan-Sheng
authors.initials: YS
authors.lastname: Tan
authors.forename: Fu-Chun
authors.initials: FC
authors.lastname: Wang
authors.forename: Sergio
authors.initials: S
authors.lastname: Bangrazi
authors.forename: Ka-Fai
authors.initials: KF
authors.lastname: Chung
authors.forename: Zhao-Xiang
authors.initials: ZX
authors.lastname: Bian
authors.affiliation: School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, SAR, China. spzhang@hkbu.edu.hk.
authors.forename: Shi-Ping
authors.initials: SP
authors.lastname: Zhang
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods; D018771:Arthralgia / Q000628:therapy*; D006801:Humans; D009071:Moxibustion / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D000092464:Elbow Injuries
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