Sunday, 27 July 2014

Is acupuncture useful for MS-related symptoms?

How can we test whether or not acupuncture works for MS-related symptoms? #MSBlog #MSResearch

"The findings of the following systematic review on acupuncture treatment in MS are clearly disappointing, and unsurprising. They find that the body of published literature on the effectiveness of acupuncture for MS-related symptoms is poor. They authors recommend further studies with more rigorous designs. The latter statement is easier written/said than done. How do you do rigorous acupuncture studies? It is very difficult if not impossible to blind acupuncture studies, or to use a placebo. Some suggest using sham acupuncture; i.e. using acupuncture needles incorrectly positioned. The problem with sham acupuncture is that it may work (see Moffet abstract below). The interesting thing is that many MSers who have tried acupuncture report it helps their symptoms, in particular pain. Should we ignore their response? At our hospital MSers can have acupuncture via our pain clinic. The question that I can't answer is whether or not it is effective and in particular cost-effective. The latter question is increasingly being asked about all the services we provide. If we can't show that a treatment is cost-effective then we shouldn't be offering it."

"I would be interested to know how many of you have had acupuncture for an MS-related symptom and whether or not it helped you?"




Epub: Karpatkin et al. Acupuncture and multiple sclerosis: a review of the evidence. Evid Based Complement Alternat Med. 2014;2014:972935.

Background: Use of acupuncture to treat MS is fairly common, but little literature exists which studies its effectiveness. 

Objective: The purpose of this paper is to review the literature on the use of acupuncture to treat MS. 

Methods & Results: A literature search resulted in 12 peer-reviewed articles on the subject that examined the use of acupuncture to treat MS related quality of life (QoL), fatigue, spasticity, and pain. The majority of the studies were poorly designed-without control, randomization, or blinding. Description of the subjects, interventions, and outcome measures as well as statistical analysis was often lacking or minimal. 

Conclusions: Although many of the studies suggested that acupuncture was successful in improving MS related symptoms, lack of statistical rigor and poor study design make it difficult to draw any conclusions about the true effectiveness of this intervention in the MS population. Further studies with more rigorous designs and analysis are needed before accurate claims can be made as to the effectiveness of acupuncture in this population.



Moffet HH. Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials. J Altern Complement Med. 2009 Mar;15(3):213-6.


OBJECTIVE: This study sought to determine whether sham acupuncture is as efficacious as true acupuncture, as defined by traditional acupuncture theories.

METHODS: A systematic review was conducted of clinical trials that used sham acupuncture controls with needle insertion at wrong points (points not indicated for the condition) or non-points (locations that are not known acupuncture points). This study used a convenience sample of 229 articles resulting from a PubMed search using the keyword "acupuncture" and limited to "clinical trials" published in English in 2005 or 2006. Studies were categorized by use of wrong points versus non-points and the use of normal insertion and stimulation versus superficial insertion or minimal stimulation.

RESULTS: Thirty-eight acupuncture trials were identified. Most studies (22/38 = 58%) found no statistically significant difference in outcomes, and most of these (13/22 = 59%) found that sham acupuncture may be as efficacious as true acupuncture, especially when superficial needling was applied to non-points.

CONCLUSIONS: The findings cast doubt on the validity of traditional acupuncture theories about point locations and indications. Scientific rationales for acupuncture trials are needed to define valid controls, and the theoretical basis for traditional acupuncture practice needs to be re-evaluated.

3 comments:

  1. A believer will always be a Believer.

    A Non Believer will always be a Non Believer.

    The real test is "does it work for you"???

    If you are concerned about what other people think you are already a failure, as you do not
    know what other people think - only what you think they think.

    Remain open minded - the babble of monkeys is only important to the monkeys !!!

    Have a Great Day

    ReplyDelete
  2. I'm thinking of trying acupuncture for my MS related pain. Painful aching back and calf muscles when I stand. I have been trying to get an appointment with the NHS pain management clinic in my area. However I was informed by two GP's there is at least a 12 month waiting list. I am in pain now so this is no use to me.
    I have been researching treatments offered at private pain management clinics and acupuncture is a treatment sometimes offered. Not specifically for MS mentioned though.

    ReplyDelete
    Replies
    1. I use acupuncture for neurological sensory pain and fatigue, it works to some extent but it is not a miracle cure all. I've no idea if it would work for aching back and calf muscles. I pay privately and my acupuncturist is very good (based in London) but you might also be able to get a referral to the Royal London Hospital for Integrated Medicine, who have both pain and acupuncture clinics. Though not so helpful unless you live in London. Possibly, also a physiotherapist may be able to help with this. You have my sympathy, pain is a horrible debilitating thing to have.

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