Acupuncture has been used for centuries to treat pain and is fast becoming more acceptable in the West to manage chronic pain. Acupuncture also remains controversial in allopathic medicine, primarily because its mechanism of action is yet unknown. A systematic review published in the Journal of the American Medical Association has found conclusively that treatment with acupuncture is more effective for chronic pain than either sham acupuncture or treatment as usual involving no acupuncture.
To suss out acupuncture’s effect on chronic pain, the authors scoured the medical literature from 1996 to 2008 and found 31 studies conducted in the United States, United Kingdom, Germany, Spain, and Sweden for their primary analysis. Of these, 29 studies contained data on individual patients. Eleven of the 31 trials were sham-controlled, 10 had no acupuncture control, and 10 randomized participants into 3 arms:  acupuncture, sham-acupuncture, or treatment as usual (no acupuncture). All told, 14,597 patients participated in studies without an acupuncture control, and 5,230 patients participated in studies in which the control was sham acupuncture.
The authors then conducted several analyses, first according to the comparison group (no acupuncture control or sham acupuncture) and then by pain condition (nonspecific musculoskeletal pain, osteoarthritis, chronic headache, or shoulder pain). They found that acupuncture reduced pain at greater rates than any control in all comparisons (P<0.001): Response rates were 30% for no acupuncture, 42.5% for sham acupuncture, and 50% for acupuncture.
The authors note that one of the limitations of the studies under review is that sham acupuncture is an unstable control as sham techniques vary greatly and many involve penetration of the skin. It is still unknown if a puncturing sham is a genuinely inactive placebo. Future studies may need to focus on providing a sham acupuncture that is truly inactive because the unknown mechanism of sham acupuncture may skew comparisons with genuine acupuncture.*
Vickers AJ, Linde K. Acupuncture for chronic pain. JAMA. 2014;311(9):955-956.


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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.