by Dr. Colin Race

From joint pain to fertility and everywhere in between, acupuncture is a very effective treatment when used correctly and with the appropriate patients. Here in our clinic we regularly see the positive clinical results of acupuncture. Patients also often comment on how relaxed and rejuvenated they feel following each treatment, which is beneficial to the whole health of the patient.

There are difficulties in conducting research trials with acupuncture, as is the case with a number of types of complementary therapies. The primary difficulty is accounting for individuality in patients presenting with the same conditions—each may need a somewhat different approach to their treatment, which is not easily done in rigidly designed trials of many patients. Nevertheless, along with the vast quantity of observational evidence, there is a growing base of published scientific research. This research supports the integration of acupuncture into conventional medical practice. Here are just a few recent examples.

(Journal of Clinical Oncology–January 5, 2010)

• Acupuncture appears to be as effective as venlafaxine (Effexor), a standard drug therapy for relieving vasomotor symptoms in breast cancer patients. As an added bonus, acupuncture treatment also boosted libido, improved mental clarity, and did not have any adverse effects.
• Overall, the results of the study, published online December 28 in the Journal of Clinical Oncology, showed acupuncture to be a “safe, effective, and durable treatment for vasomotor symptoms secondary to long–term antiestrogen hormone therapy in breast cancer patients.”

(Climacteric–January 8, 2009)

• SAN ANTONIO (EGMN)—A course of acupuncture reduced hot flashes in women with a history of breast cancer by more than half while improving sleep and quality–of–life measures to a similar extent as hormone therapy in a Swedish randomized trial.
• Particularly noteworthy was the durability of acupuncture’s benefits. Nine months following conclusion of the 3–month course of acupuncture sessions, most patients continued to have a significant reduction in hot flashes and improved measures of well being, Dr. Jessica Frisk reported at the San Antonio Breast Cancer Symposium.
• She added that in her clinical practice, acupuncture has become her first–line treatment for hot flashes. Hormone therapy (HT) is more effective; indeed, it essentially eliminated hot flashes in the women randomized to the HT study arm. But Scandinavian breast cancer patients now reject HT as an option because of reports of an associated increased risk of breast cancer recurrence.
• “They want other things – and acupuncture is quite a safe treatment,” said Dr. Frisk, a general surgeon at Linköping (Sweden) University.

(British Medical Journal–February 7, 2008)

• For infertile women, giving acupuncture at the time of embryo transfer is associated with increased pregnancy and live birth rates, according to a study published online by the British Medical Journal.
• Led by Eric Manheimer of University of Maryland School of Medicine, Baltimore, the researchers searched the literature for trials of acupuncture in women undergoing in vitro fertilization. In all included studies, intervention patients underwent needle acupuncture within 1 day of embryo transfer. Control patients received sham acupuncture or no treatment. All studies provided data on clinical pregnancy, ongoing pregnancy, and/or live birth rates.
• The systematic review identified 7 studies including a total of 1,366 patients. All randomized patients were included in meta–analyses. For all 7 trials, the original investigators provided additional data on outcomes, eg, live births. Clinical heterogeneity was low.
• Performing acupuncture within a day of embryo transfer was associated with an improved clinical pregnancy rate: odds ratio (OR) 1.65, with a number needed to treat (NNT) of 10. There were also significant increases in ongoing pregnancy rate, OR 1.87, NNT 9; and live birth rate, OR 1.91, NNT 9.

Canadian Medical Association Journal – January 2007)

• Auricular acupuncture is a promising method for postoperative pain relief. Analysis showed that patients from the control group (n = 59) required more ibuprofen than patients from the auricular acupuncture group (n = 61): median (interquartile range) 600 (200–800) v. 200 (0–600) mg (p = 0.012).
• The majority of patients in both groups believed that they had received true acupuncture and wanted to repeat it in future. The authors conclude that auricular acupuncture reduced the requirement for ibuprofen after ambulatory knee surgery relative to an invasive needle control procedure.

(Arthritis and Rheumatism – November 2006)

• Adding acupuncture to routine care in patients with chronic pain from osteoarthritis of the hip or knee was safe and resulted in “a clinically relevant and persistent benefit” in a large study of such patients, Dr. Claudia Witt and her associates reported
• Of the total patients, 322 were randomized to acupuncture and 310 to the control group; 2,921 who refused randomization were treated with acupuncture. About 57% of the patients had osteoarthritis (OA) of the knee, nearly 15% had OA of the hip, and approximately 30% had both
• At 3 months, scores on the WOMAC had improved by a mean of 17.6 points from baseline among those in the randomized acupuncture group, compared with a mean of 0.9 in the control group, a significant difference. Almost 35% of those in the acupuncture group were responders (defined as at least a 50% reduction in WOMAC scores), compared with 6.5% of those in the control group.
• Improvements in the physical component of the quality–of–life score were also significantly greater at 3 months among those receiving acupuncture.
• In addition, the benefits of acupuncture appeared to persist through 6 months, although patients received no acupuncture after 3 months (Arthritis Rheum. 2006;54:3485–93).

(Obstetrics & Gynecology–July, 2005)

• Seventeen percent of American men and women suffer from overactive bladder syndrome, and about one half of these women also have incontinence. Social isolation, loss of productivity and lowered self–image are common consequences of this condition.
• Women who received 4 weekly bladder–specific acupuncture treatments had significant improvements in bladder capacity, urgency, frequency and quality of life scores as compared with women who received placebo acupuncture treatments.

(Obstetrics & Gynecology – Feb 22, 2010)

• Acupuncture resulted in significantly greater improvements in depression among pregnant women than two control treatments, a small, randomized trial showed.
• Nearly two–thirds (63%) of women who received depression–specific acupuncture responded to treatment, compared with 44.3% of controls who received another acupuncture protocol or massage (P‹0.05), according to Rachel Manber, PhD, of Stanford University, and colleagues.

(Obstetrics & Gynecology–2001, Journal of Pain Symptom Management–2000)

• Acupuncture is a therapy worthy of consideration and can be added to a treatment regimen at any time. It has now been studied in two randomized trials in pregnant women who had nausea and vomiting, and together the findings suggest that the therapy can be worth a try.

(Presented at the annual meeting of the American Society of Clinical Oncology on June 1, 2008)

It seems counterintuitive, but sticking needles into the hands, the legs, the ears, and the scalp at the hairline can provide significant relief of pain and dry mouth as well as improvement of function in patients after neck dissection for surgical treatment of cancer, reported investigators.

More than a third of patients who underwent acupuncture in a randomized controlled trial had significant improvements in pain and disability as measured by a validated composite scale, compared with fewer than 7% of controls who underwent customary care, reported Dr. David Pfister, chief of the head and neck medical oncology service and chief of the integrative medicine service at Memorial Sloan–Kettering Cancer Center in New York.

Pain and shoulder dysfunction are common following a comprehensive head and neck dissection, particularly when the procedure is not modified to spare nerve or muscle function, said Dr. Pfister at a press briefing on May 31.