Table 1.
Systematic reviews of clinical trials of acupuncture & acupressure in pain
| Author Year | Indication | Controls | Studies | features | Results | Conclusion |
| 1 / 2 / 3 | ||||||
| / 4 / 5 | ||||||
| Chronic | ||||||
| pain | ||||||
| Ezzo 2000 | chronic | sham, | 51 RCT | y / y / y / | Positive results in 21 studies, negative in 3, | Limited evidence that acupuncture is |
| [9] | pain | placebo, no | y / n | and neutral in 27. Better studies more often | more effective than no treatment, | |
| treatment, | negative or neutral | inconclusive evidence regarding | ||||
| standard | placebo, sham and standard care | |||||
| ter Riet | chronic | sham, | 51 CCT | y / y / y / | Trials small and of low quality. 24 with | The efficacy of acupuncture in the |
| 90/89 | pain | other, no | y / n | positive and 27 with negative results. Better | treatment of chronic pain remains | |
| [10,11] | treatment | studies more often negative | doubtful | |||
| Patel 89 [12] | chronic | sham, no | 14 RCT | n / y / n | Overall patients receiving acupuncture were | Available evidence positive but |
| pain | treatment, | / y / y | 18% (p < 0.01) more likely to experience | definitive conclusions difficult due to | ||
| standard | improvement | various potential sources of bias | ||||
| Smith 2000 | back & | sham, | 13 RCT | y / y / y / | 5 studies positive, 8 studies negative; better | No convincing evidence for the |
| [13] | neck pain | other, no | y / n | studies reported more often negative results | analgetic efficacy of acupuncture for | |
| treatment | back and neck pain | |||||
| White 99 | neck pain | sham, | 14 RCT | y / y / y / | 7 studies positive, 7 negative. Of the 8 better | No convincing evidence for the |
| [14] | other, no | y / n | studies 5 negative, 3 positive | effectiveness of acupuncture for neck | ||
| treatment | pain | |||||
| van Tulder | low back | sham, | 11 RCT | y / y / y / | Conclusions of primary authors positive in 8 | Authors would not recommend acu- |
| 99 [15,16] | pain | other, no | y / n | studies, by reviewers for 2 studies. | puncture as regular treatment for low | |
| treatment | Methodological quality judged as low | back pain. High quality trials needed | ||||
| Ernst 98 [17] | back pain | sham, | 12 RCT | y / y / y / | OR for improvement compared with all | Acupuncture superior to various |
| other, no | y / y | control interventions 2.30 (95%CI 1.28–4.13), | control interventions although | |||
| treatment | with sham 1.37 (0.84–2.25). Majority of | insufficient evidence whether | ||||
| studies good quality | superior to sham | |||||
| Longworth | sciatica | unclear | 1 RCT, 6 | p / p / n | Most studies of poor quality; a large number | There may be a role for acupuncture |
| 97 [18] | CCT, 31 | / y / n | of patients seem to have benefited | treatment of lumbar disk protrusions | ||
| uncontrolled | and sciatica | |||||
| studies | ||||||
| ter Riet 89 | neck and | unclear | 16 RCT, 6 | y / p / y | Study design was generally poor. Results | Due to the low methodological quality |
| [19] | back pain | CCT | / n / n | only discussed for a few better quality | no definitive conclusions can be | |
| studies | drawn | |||||
| Headache | ||||||
| McCrory | tension- | sham, | 6 RCT | y / y / y / | 3 of 4 sham-controlled trials positive (best | Insufficient evidence to draw |
| 2000* [20] | type | physio- | y / n | negative), physiotherapy better in 1 of 2 trials | conclusions on the efficacy. Further | |
| headache | therapy | rigorous trials needed | ||||
| Melchart 99 | idiopathic | sham, | 22 RCT | y / y / y / | Majority of 14 sham controlled trials with at | Existing evidence suggests that |
| [21] | headaches | other, no | y / y | least a trend in favour of acupuncture. Trials | acupuncture has a role in headache | |
| treatment | vs. other treatments contradictory | treatment. However, quality and | ||||
| amount of evidence not fully | ||||||
| convincing | ||||||
| Goslin 99 | migraine | sham, | 6 RCT | y / y / y / | 2 of 3 placebo-controlled trials positive, | Insufficient data on acupuncture to |
| [22] | other, no | y / n | similar effects as drug treatment in 2 trials | draw conclusions on its efficacy | ||
| treatment | ||||||
| Vernon 99** | tension- | sham, | 8 RCT | y / y / y / | 2 of 4 sham-controlled trials positive, results | Too few trials and contradictory |
| [23] | type and | other, no | y / n | vs. physiotherapy contradictory | findings precluding definitive | |
| cervicogeni | treatment | conclusions | ||||
| c | ||||||
| ter Riet 89 | tension | sham, other | 7 RCT, 1 | y / p / y | Small study size and methodological | No definitive conclusions on the |
| [24] | type | treatment | CCT | / n / n | problems make the available trials | effectiveness of acupuncture for |
| headache | uninterpretable | headache can be drawn | ||||
| ter Riet 89 | facial pain | sham | 2 RCT | y / p / y | Methodological quality poor | No definitive conclusions possible |
| [25] | / y / n | |||||
| Pain | ||||||
| various | ||||||
| Ernst 98 [26] | acute | sham, | 11 RCT, 5 | y / p / y | The majority of trials imply that acupuncture | Acupuncture can alleviate dental pain |
| dental pain | other, no | CCT | / y / n | is effective in dental analgesia | but additional research necessary | |
| treatment | ||||||
| Ernst 99 [27] | temporoma | other and | 3 RCT | y / y / n | 3 comparisons with standard treatments and | Available data suggest beneficial |
| n-dibular | no | / y / n | 2 with no treatment with favorable effects of | effects; more rigorous, sham- | ||
| joint | treatment | acupuncture | controlled trials needed | |||
| dysfunction |
*Disease focused review on a variety of interventions including acupunture and acupressure; **Disease focused review on a variety of complementary medicine interventions including acupunture and acupressure Features: 1 = comprehensive search, 2 = explicit inclusion criteria, 3 = formal quality assessment, 4 = summary of results for each included study, 5 = meta-analysis; y = yes, p = partly, n = no, - = not applicable, ? = unclear RCT = randomized controlled trials, CCT = non-randomized controlled trials, CS = cohort studies; OR = odds ratio, RR = rate ratio