Neil Bernardi-Wright, L.Ac., FABORM
Alana Ramey-Bernardi, L.Ac. 
 Acupuncture and Traditional Chinese Medicine

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Current Research
Recent articles on the efficacy of Acupuncture 

e peruse periodicals published by major western medical associations for articles and studies on acupuncture and highlight them here.  After we first come across a study we place a summary at the top of the page, and periodically move it lower, grouped with similar studies.

"A Sham Controlled Trial of Acupuncture as an Adjunct in Migraine Prophylaxis" published in Acupuncture in Medicine (a publication of the British Medical Association), November 2013. This study evaluated acupuncture treatment of migraine sufferers who hadn't responded sufficiently to medication.  The treatment portion of the study lasted four weeks, the frequency of headaches decreased and was statistically significant after four months when the study ended.

Additional Research:

Male and Female Fertility:
Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection” published in Fertility and Sterility, May 2006. A relatively large study (225 women) that evaluated acupuncture done immediately after the embryo transfer of the in vitro fertilization (IVF) process and again 3 days later. Implantation rates with acupuncture were twice as high, and more importantly so was the ongoing pregnancy rate.

 “Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systematic review and meta-analysis” published in the British Medical Journal , March 2008. This is a review of seven trials with a total of 1366 women. A meta-analysis takes data from a group of similar studies and makes an effort to evaluate them as one. From the conclusion: “acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilization”.

“A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia”, published in Fertility and Sterility April 24, 2009. Oligasthenozoospermia refers to men with a high percentage of poorly swimming sperm (poor motility). The men in the study who received acupuncture had significant improvements in the percentage of sufficiently motile sperm.

“Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility”, published in Fertility and Sterility July 2005. Forty men with at least one of three problems with their sperm were included in this study. Interestingly, they were only treated for 5 weeks, even though it takes approximately 70 days for sperm to mature. One has to wonder if the improvement would not have been more pronounced if the patients had been treated for the full sperm cultivation period. From the conclusion: “The treatment of idiopathic male infertility could benefit from employing acupuncture”.

Non fertility womens health:

“Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care”, published in the American Journal of Obstetrics, February 1, 2008. Dysmenorrhea is pain associated with the menstrual period. This trial included 649 women treated with either “usual care” or acupuncture plus “usual care”. From the conclusion: “…acupuncture in patients with dysmenorrhea was associated with improvements in pain and quality of life as compared to treatment with usual care alone and was cost effective within usual thresholds”.

 “Acupuncture versus Venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial”. Published in Journal of Clinical Oncology, Vol 28, No 4, February 1, 2010. A common therapy for breast cancer is the use of antiestrogen drugs such as Tamoxifen, a primary side effect of which are vasomotor symptoms, hot flashes being the most common. The drug Venlafaxine, marketed under the name Effexor, is often prescribed to help deal with these vasomotor symptoms but comes with its own list of adverse effects. This study compared venlafaxine with acupuncture for the treatment of vasomotor symptoms in women undergoing antiestrogen therapy for breast cancer. It found that while acupuncture and venlafaxine were related with comparable improvements in vasomotor symptoms during the treatment phase of the trial, hot flashes returned for the venlafaxine group within two weeks of stopping the drug. Hot flashes in the acupuncture group “remained at low levels” after treatment stopped. The venlafaxine group reported “18 incidences of adverse effects” versus none for the acupuncture group. Further, “Acupuncture had the additional benefit of increased sex drive in some women, and most reported an improvement in their energy, clarity of thought, and sense of well-being.” An improved sense of well being is a common “side effect” of acupuncture, regardless of the symptom being treated. From the conclusion: “Acupuncture appears to be equivalent to drug therapy in these patients. It is a safe, effective and durable treatment for vasomotor symptoms secondary to long term antiestrogen hormone use in patients with breast cancer”.

Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early stage breast cancer”. Published in Journal of Clinical Oncology online ahead of print January 25, 2010. Aromatase inhibitors (Arimidex, Aromasin, Femara) are anti-estrogenic drugs commonly used in the treatment of breast cancer in post-menopausal women. Joint stiffness and pain is a commonly reported side effect of this class of drugs. This study compared what the authors termed “true acupuncture”, using commonly accepted points and protocols with “sham acupuncture”, using shallow needle insertions at non-traditional points. From an acupuncturists perspective the idea of sham acupuncture doesn’t really work; if your body notices the needle insertion, it’s no longer inert and will influence the body in some way. None the less, the study did find that patients treated with “true acupuncture had significant improvement of joint pain and stiffness, which was not seen with sham acupuncture. Acupuncture is an effective and well-tolerated strategy for managing this common treatment-related side effect.”



“Cost effectiveness of acupuncture treatment in patients with headache”, published in Cephalalgia April 1, 2008. This large study (3182 patients), found acupuncture to be “a cost effective treatment in patients with primary headache”. 

"Acupuncture in patients with headache
”, published in Cephalalgia September 1, 2008. A very large trial- 15,056 patients- comparing “usual” care with and without the addition of acupuncture. Of note is that treatment improvements were still in place at a six month follow-up. From the abstract: “Acupuncture plus routine care in patients with headache was associated with marked clinical improvements compared with routine care alone”.

“Acupuncture for tension-type headache”, published by Cochrane Database Systems Review, January 1, 2009. Eleven trials with a total of 2317 patients were assessed. From the conclusion: “acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches”.

“Acupuncture for migraine prophylaxis”, published by Cochrane Database Systems Review” January 1, 2009. Twenty two trials with a total of 4419 patients were assessed. From the conclusion: “…acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse side effects”.

“Acupuncture for the management of chronic headache: a systematic review”, published in Anesthesia & Analgesia December 2008. Thirty one studies were reviewed. From the conclusion: “Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate”.


Musculoskeletal Pain:

"The effectiveness of acupuncture for plantar heel pain: a systematic review",
published in Acupuncture in Medicine (a British Medical Association journal), October 2012.  Plantar heel pain (PHP), also known as plantar fascitis, is pain on the sole of the foot, usually close to the heel and typically worse in the morning.  The authors describe it as a "complex phenomena"; it can be quite severe making standing, walking and other activities difficult.  Conventional treatment options are limited to night splints, physical therapy, anti-inflammatory drugs and steroid injections.  Success rates for any of these not very good.  This article is a review of 8 studies the authors felt were well done, reporting that "high quality studies report significant benefits" both using acupuncture as a stand alone treatment or with anti-inflammatory drugs.  "There is evidence supporting the effectiveness of acupuncture for PHP.  This is comparable to the evidence available for conventinally used interventions...Therefore acupuncture should be considered in recommendations for the management of patients with PHP". 

“Single point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial”, published in Rheumatology June 2008. This study looked at physiotherapy in the treatment of shoulder pain, with and without acupuncture. They found that including acupuncture with physiotherapy improves shoulder function and alleviates pain significantly more than physiotherapy alone, and that the reduction in the use of pain medication was greater in the acupuncture group.

“Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial”, published in Journal of Clinical Oncology, online ahead of print, April 20, 2010.  All the patients in this study had cancer and had undergone neck surgery.  One group was randomly assigned to receive acupuncture weekly, the other group received “usual care (eg, physical therapy, analgesia, and/or anti-inflammatory drugs…)”.  Neck pain and function was assessed, as well as xerostomia (dry mouth) as a secondary concern.  From the conclusion: “Significant reductions in pain, dysfunction, and xerostomia were observed in patients receiving acupuncture versus usual care.”

“Acupuncture therapy for chronic lower back pain: a systematic review” published in Annals of the Royal College of Surgeons June 7, 2010.  Four “relevant, randomized, controlled trials” of acupuncture treatment for chronic low back pain were “critically appraised”.  In the British national healthcare system, recent guidelines suggest acupuncture treatment as an option for this condition.  The goal of this study was to determine if this guideline is “justified”.  Their finding was that it is justified.  “These trials suggest acupuncture can be superior to usual care in treating chronic low back pain”.

“Randomized clinical trial of acupuncture for myofascial pain of the jaw muscles”  published in Journal of Orofacial Pain, September 1, 2009, volume 23 number 4, p. 353-359.  Twenty eight patients diagnosed with “chronic myofascial pain of the jaw muscles” were randomized to receive real or sham acupuncture.  Participants in the real acupuncture group were treated at a point known as Large Intestine 4 (Hegu) on the hand near the base of the thumb.  It is one of the most versatile, effective and commonly used acupuncture points, often used for facial symptoms amongst other things.   For patients receiving real acupuncture, reductions in jaw pain, jaw/face tightness, and neck pain were found as well as an increase in pain tolerance of the masseter muscle.  Of interest is that “Subjects were not able to determine whether they received real or sham acupuncture”- most studies using a sham acupuncture control do not test for this, and from an acupuncturists perspective the idea of a “sham” treatment doesn’t really work.  Note also that the point used was nowhere near the area of pain.  From the conclusion: “A single acupuncture session using one acupoint at Hegu large intestine 4 significantly reduced most myofascial pain endpoints when compared to sham acupuncture.”


Other health concerns:

“Acupuncture improves exercise tolerance of patients with heart failure: a placebo controlled pilot study” published in Heart June 15, 2010.  17 patients with congestive heart failure a chronic, debilitating disease were included in this small study.  Significant improvements were seen in the 6 minute walking distance (“remarkably increased”) and post exercise recovery, as well as the “general health” score and the “body pain” score of the quality of life questionnaire patients filled out.  Attempts at measuring how patients feel after a particular medical intervention is something often neglected in clinical studies, where purely objective methods of evaluation are usually used.  In this study, not only did the patients have objective improvements in their health, they also simply felt better and had less pain.  “Conclusion: acupuncture may become an additional therapeutic strategy to improve the exercise tolerance of patients with CHF, potentially by improving skeletal muscle function.”

"Acpuncture for Hot Flashes in Patients with Prostate Cancer" published in Urology, 1 November 2010.  A common treatment for prostate cancer is hormone therapy, bringing with it the common side effect of hot flashes.  This was a small pilot study of 22 patients.  By the end of the trial, 55% had at least a 50% reduction in their hot flash score.  Other research (see below) has found acupuncture to be effective in treating hot flashes in menopausal women; this is the first study we're aware of involving prostate cancer patients. 

“Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial”, published in Annals of Allergy, Asthma, and Immunology”, November 1, 2008. A total of 5,237 patients were included in this study which concluded that adding acupuncture to “routine care” “leads to clinically relevant and persistent benefits”.

"Acupuncture in Patients With Seasonal Allergic Rhinitis: A Randomized Trial", published in Annals of Internal Medicine, 19 February 2013.  This study, of a total of 422 patients, compared three groups: acupuncture plus Zyrtec, sham acupuncture plus Zyrtec, and Zyrtec alone.  From the conclusion: "Acupuncture lead to statistically significant improvements" compared with the other two groups.









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