EXETER, ENGLAND — Data emerging from a large German research initiative sponsored by that country's insurance companies continue to support the use of acupuncture in the treatment of chronic pain conditions.
Two reports from the Acupuncture in Routine Care (ARC) study, presented at a symposium on alternative and complementary therapies sponsored by the universities of Exeter and Plymouth, demonstrated statistically significant and clinically relevant benefits for acupuncture when used in addition to routine care for headache and neck pain.
A total of 15,056 patients with migraine or tension-type headache were enrolled in the ARC headache study and randomly allocated to receive up to 15 acupuncture treatments during a 3-month period along with conventional treatment with analgesics, or to a control group receiving conventional treatment but no acupuncture. Patients who did not agree to randomization received acupuncture and were monitored as a third group, said Susanne Jena, M.D., of the Institute for Social Medicine, Charité Medical Center, Berlin.
Three-quarters of the patients were female, and their mean age was 44 years. Of the 3,182 who agreed to randomization, 1,613 were in the acupuncture group and 1,569 were in the control group.
After 3 months of treatment, the frequency of headache days per month decreased from 8.4 days to 4.7 days in the two acupuncture groups, a significantly greater reduction than in the control group (8.1 days per month before treatment and 7.5 days per month post treatment).
The data also were analyzed according to headache type. Patients with migraine had an average of 7 days per month with headache before treatment and 4 days per month with headache after treatment including acupuncture; those with tension type headache decreased from an average of 10 days per month with headache to 5 days per month, she said.
The improvements persisted for the subsequent 3 months, she said.
Among the control group, 70% of patients required concomitant treatment with analgesics, compared with 50% of patients in the acupuncture groups.
The second report, from the ARC neck pain study, found similar results among 13,846 patients with chronic neck pain. In this cohort, 68% of whom were women with a mean age of 53 years, 1,753 were randomized to receive acupuncture, 1,698 served as controls, and 10,395 who had declined randomization also received acupuncture.
After 3 months of treatment, improvements on the neck pain disability score were more pronounced in the acupuncture groups than in the control group, said Claudia Becker-Witt, M.D., also with Charité. Scores fell from 56.4 to 39.6 in the acupuncture groups and from 54.5 to 51.2 in the control group, a statistically significant difference.
In both studies, the acupuncture groups also experienced significantly greater improvements in quality of life.
About 8% -9% of patients in both studies experienced side effects from acupuncture; they were not life threatening.
Analyses of cost-effectiveness and overall health benefits are being done, Dr. Becker-Witt said.