The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain Journal Article


Authors: MacPherson, H.; Vertosick, E. A.; Foster, N. E.; Lewith, G.; Linde, K.; Sherman, K. J.; Witt, C. M.; Vickers, A. J.; On behalf of the Acupuncture Trialists’ Collaboration
Article Title: The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain
Abstract: There is uncertainty regarding how long the effects of acupuncture treatment persist after a course of treatment. We aimed to determine the trajectory of pain scores over time after acupuncture, using a large individual patient data set from high-quality randomized trials of acupuncture for chronic pain. The available individual patient data set included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck, and shoulder), osteoarthritis of the knee, and headache/migraine. We used meta-analytic techniques to determine the trajectory of posttreatment pain scores. Data on longer term follow-up were available for 20 trials, including 6376 patients. In trials comparing acupuncture to no acupuncture control (wait-list, usual care, etc), effect sizes diminished by a nonsignificant 0.011 SD per 3 months (95% confidence interval: -0.014 to 0.037, P = 0.4) after treatment ended. The central estimate suggests that approximately 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. For trials comparing acupuncture to sham, we observed a reduction in effect size of 0.025 SD per 3 months (95% confidence interval: 0.000-0.050, P = 0.050), suggesting approximately a 50% diminution at 12 months. The effects of a course of acupuncture treatment for patients with chronic pain do not seem to decrease importantly over 12 months. Patients can generally be reassured that treatment effects persist. Studies of the cost-effectiveness of acupuncture should take our findings into account when considering the time horizon of acupuncture effects. Further research should measure longer term outcomes of acupuncture.
Keywords: animal; animals; acupuncture; chronic pain; meta analysis; acupuncture therapy; procedures; humans; human
Journal Title: Pain
Volume: 158
Issue: 5
ISSN: 0304-3959
Publisher: Elsevier Science BV  
Date Published: 2017-05-01
Start Page: 784
End Page: 793
Language: English
DOI: 10.1097/j.pain.0000000000000747
PUBMED: 27764035
PROVIDER: scopus
PMCID: PMC5393924
DOI/URL:
Notes: Article -- Export Date: 2 August 2017 -- Source: Scopus
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  1. Andrew J Vickers
    883 Vickers
  2. Emily Vertosick
    136 Vertosick