Everyone is likely to experience some form of pain at some stage of their life. This could be acute pain due to injury of the neck, shoulder or back; sports injuries such as tennis elbow or frozen shoulders; or monthly pre-menstrual pain. Typical chronic pain conditions include osteoarthritis; rheumatoid arthritis; low back, shoulder & neck pain; headache & migraine; cancer pain; fibromyalgia; neuropathic pain (e.g. sciatica, trigeminal neuralgia, post shingles neuralgia); chronic overuse conditions (e.g. tendonitis); & chronic visceral pain (e.g. irritable bowel syndrome, interstitial cystitis, endometriosis). For instance, back pain can affect anyone at any age & most people will suffer from it at some point in their lives. It is the UK's leading cause of disability & one of the main reasons for work-related sickness absence.
In recent years high-quality clinical trials investigating acupuncture have been conducted, particularly for chronic pain conditions. Therefore, there is evidence available, & the systematic reviews can draw firm conclusions. A systematic review of high-quality trials, involving over 20,000 adults with osteoarthritis, chronic headache or musculoskeletal pain (back, neck or shoulder) concluded:
Acupuncture was more effective than control for all pain conditions (pragmatic trials)
Acupuncture is not a placebo for treatment of chronic pain
The effects persisted over time (15% reduction at one year)
Acupuncture is currently included in the following NICE guidelines:
Acupuncture may help relieve chronic pain by:
stimulating nerves located in muscles & other tissues, which leads to release of endorphins & other neurohumoral factors & changes the processing of pain in the brain & spinal cord
modulating the limbic-paralimbic-neocortical network
reducing inflammation, by promoting release of vascular & immunomodulatory factors
improving muscle stiffness & joint mobility by increasing local microcirculation, which aids dispersal of swelling.