Yet another study confirms that acupuncture works better than conventional treatments alone for pain relief. On September 24th, the Archives of Internal Medicine published the results of the longest and most extensive study of acupuncture to treat back pain, a German collaboration sponsored by health insurance companies and involving more than 1,200 patients.
The sixth-month study broke participants into three experimental groups -- one that received genuine acupuncture treatments, one that received false acupuncture therapy, and a control group that participated in more conventional options, including physical therapy, massage, and exercise. Patients met regularly with their doctors, and their responses to treatments were measured on pain scales using traditional methods. Half of all patients receiving authentic acupuncture reported significant pain relief, while only twenty-seven percent of those utilizing conventional treatments did. Intriguingly, forty-four percent of those in the fake acupuncture group also reported significant relief, though it did not reduce their need for pain medications.
The mixed results took study authors by surprise. Although those who received the phony acupuncture regimen reported relief comparable to those getting the real thing, the former group was twice as likely to use pain killers. They were also nearly half as likely as those utilizing physical therapy, massage, and/or exercise regimens to take the medications.
No one is quite sure why approximately the same percentage of patients receiving the sham regimen reported pain relief as those receiving the authentic treatments. The benefits of acupuncture could be attributed to how the body transmits or processes pain signals. The therapy, whether genuine or false, could also induce a "super placebo" affect, triggering a very real reaction within the brain and altering the way the body perceives and responds to pain. So relatively little is understood about the pain response that these questions are, as of yet, unanswered.
Whatever the reasons, it seems to work, and the even better news is that acupuncture is becoming more accessible. In 2002, 2.1 million Americans used acupuncture, according to the Centers for Disease Control and Prevention. Even regions with a reputation for conservative views are seeing quality acupuncture and Chinese medical centers cropping up across their states -- particularly in cities like Dallas, Houston, and Austin. Unconventional methods of treatment could be of vital importance to states like Texas, where twenty-five percent of the population is currently going without health insurance; such residents may just need more options.
The German study, though the biggest and most rigorous, is not the first large-scale attempt by the Western medical (or "allopathic") community to test acupuncture's efficacy. In 2004, a study by the National Institutes of Health proved that acupuncture relieved pain and improved function related to osteoarthritis of the knee. Osteoarthritis, a condition affecting twenty million Americans, is one of the most frequent causes of disability among adults. Any therapy options, then, that prove to be effective are of vital importance.
"For the first time, a clinical trial with sufficient rigor, size, and duration has shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee," said Stephen E. Straus, M.D., Director of the National Center for Complimentary and Alternative Medicine.
Published in the Annals of Internal Medicine in 2004, the study was the largest randomized, controlled phase III clinical trial of acupuncture up until that point. Led by Dr. Brian M. Berman, M.D., Director of the Center for Integrative Medicine at the University of Maryland School of Medicine, 570 subjects aged fifty or over with osteoarthritis of the knee were divided into three groups similar to the German study -- one that received genuine acupuncture, one that got sham treatments, and a control group (for this study, a group that completed a self-help course recommended by the Arthritis Foundation). None of the patients had ever tried acupuncture or knee surgery, no one was using steroids or other injections for their condition, and all reported significant pain in the knee within one month prior to the study's inception.
Patients' pain and knee function were then assessed using standard methods, and their progress recorded at four, eight, fourteen, and twenty-six weeks. At eight weeks, the group receiving genuine acupuncture showed significant increase in function. At week fourteen, they reported a significant decrease in pain, as compared with the other two groups. Overall, the authentic acupuncture patients showed a forty percent decrease in pain and an increase in function by the same margin.
"These results...indicate that acupuncture can serve as an effective addition to a standard regimen of care and improve quality of life for knee osteoarthritis sufferers. The NCCAM has been building a portfolio of basic and clinical research that is now revealing the power and promise of applying stringent research methods to ancient practices like acupuncture," said Strauss. One of the biggest barriers to validating many complementary methods has been lack of funding and organization for large-scale, controlled studies. The NIH project, then, was a pivotal event in acupuncture's continuing quest to prove its legitimacy to the Western sciences.
With such old methods becoming new again, and with new methods changing everyday, it may be wise to integrate treatments that have, essentially, already gone through a trial-and-error form of testing for thousands of years. We may not always understand why a method works but, hey, if it provides pain relief to thousands -- possibly millions -- with no adverse side effects, who cares? So open your minds, pain sufferers, and expose that skin. Tiny little needles just may become your best friends.
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