Conditions

Conditions

We aim to provide support and reduce the symptoms associated with common conditions.

Pain is associated with many common conditions including Headaches, Migraines, Neck Pain, Back Pain, Muscle Pain, Arthritis, Muscle Problems and Sports Injuries.

Acupuncture may relieve (both sensory and affective) inflammatory pain. This occurs through activation of a variety of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms. (Zhang et al 2014 – Mechanisms of acupuncture in persistent pain).

Stress, Anxiety, Depression, Mood swings, Sleep Problems / Insomnia, Weight Management and Weight Loss.

We provide support for Fertility, IVF Support, Pregnancy and Womens Health. [Find out more]

Migraine prophylaxis

[Positive effect]

For migraine prophylaxis, acupuncture was rated as ‘effective’ in the Australian DVA review (2010) and ‘evidence of positive effect’ in the USVA Evidence map of acupuncture {2014} (5, 6). Since March 2013 a narrative review of high quality randomised controlled trials and two systematic reviews including a Cochrane systematic review update, have confirmed that acupuncture is superior to sham acupuncture and seems to be at least as effective as conventional preventative medication in reducing migraine frequency (40-42). Moreover, acupuncture is described as ‘safe, long-lasting and cost effective’ (40). Subgroup analysis in the Cochrane systematic review found that 16 or more treatment sessions showed a larger effect size (Z=4.06) than 12 treatments or fewer (Z=2.32). Evidence levels in these three reviews was moderate to high quality.

Headache

(chronic tension-type and chronic episodic) [Positive effect]

Chronic tension-type headaches and chronic episodic headaches were not reviewed in the Australian DVA review (2010) and rated as ‘evidence of positive effect’ in the USVA Evidence map of acupuncture (2014) (5, 6). The most recent Cochrane systematic review update confirmed that acupuncture is effective for frequent episodic and chronic tension-type headaches with moderate to low quality evidence (43). A brief review of systematic reviews and meta-analyses described acupuncture as having a ‘potentially important role as part of a treatment plan for migraine, tension-type headache, and several different types of chronic headache disorders’ (44). Studies in Germany and the UK found acupuncture for chronic headaches to be cost-effective (44).

Low back pain

[Chronic – positive effect; acute – potential positive effect]

For low back pain, acupuncture was rated as ‘effective (possibly}’ in the Australian DVA review (2010} and ‘unclear’ in the USVA Evidence map of acupuncture (2014) (5, 6). The main reason given for the ‘unclear’ rating in the USVA Evidence map was that ‘sham acupuncture controlled trials tended towards statistically nonsignificant results’ and a Cochrane systematic review in 2005 which drew no firm conclusions on the effectiveness of acupuncture for acute low back pain (6). The problems associated with the interpretation of the effects of sham acupuncture have already been discussed. When reviews separate the evidence on chronic low back pain from acute low back pain, as was done in the recent review by the US Agency for Healthcare Research and Quality, it was found that there is moderate quality evidence for the effectiveness of acupuncture in chronic low back pain for both pain intensity and function, but only low quality evidence for pain intensity and function in acute low back pain (45).

In a systematic review of 32 randomised controlled trials for acupuncture treatment of chronic non-specific low back pain, acupuncture was superior (both statistically and clinically significant) to sham acupuncture in pain reduction and improved function immediately after treatment (46). Acupuncture was equivalent but not superior to usual care in pain and function, but acupuncture plus usual care was superior to usual care alone (46). The reviewers rated the evidence level of their review as Level of Evidence I (46). A systematic review of 11 randomised controlled trials on acute low back pain, acupuncture was superior to NSAIDS for improving symptoms (small effect), and superior to sham for pain but not function (47). A narrative review of non-invasive and alternative treatments for chronic low back pain rated the evidence for the effectiveness of acupuncture as high and for acupressure as moderate (48).

A review of 16 systematic reviews found that acupuncture alone, or when added to usual care, provided short-term improvement in pain and function for chronic low back pain (medium to large clinical effects) and hence ‘should be advocated in routine clinical practice’ (49). For acute low back pain, the reviewers could not make firm conclusions about the effectiveness of acupuncture due the inclusion of only two systematic reviews (49). Two studies found that acupuncture is likely to be cost-effective for low back pain or chronic non-specific low back pain,respectively (50, 51).

Knee osteoarthritis pain

[Positive effect]

Knee osteoarthritis pain was not reviewed in the Australian DVA review (2010) and rated as ‘evidence of potential positive effect’ in the USVA Evidence map of acupuncture (2014) (5, 6). In a network meta-analysis comparing 22 interventions in 152 studies, acupuncture was found to be equal to balneotherapy and superior to sham acupuncture, muscle-strengthening exercise, Tai Chi, weight loss, standard care and aerobic exercise (in ranked order) (52). Acupuncture was also superior to standard care and muscle-strengthening exercises in a sub-analysis of moderate to high quality studies (52). In a systematic review of 12 randomised controlled trials, acupuncture was found to significantly reduce pain intensity, to improve functional mobility and quality of life (53). Subgroup analysis showed greater reduction in pain intensity when treatment lasted for more than four weeks (53). The reviewers concluded that ‘current evidence supports the use of acupuncture as an alternative for traditional analgesics in patients with osteoarthritis’ (53).

Allergic rhinitis

(seasonal and perennial/persistent) [Positive effect]

For allergic rhinitis, acupuncture was rated as ‘effective’ in the Australian DVA review (2010) and ‘unclear’ in the USVA Evidence map of acupuncture (2014) (5, 6). A systematic review of 13 randomised controlled trials concluded that ‘acupuncture could be a safe and valid treatment option for allergic rhinitis’ (moderate quality evidence) (54). Another systematic review (which included two large multi-centre randomised controlled trials, three comparisons of acupuncture versus medication and one cost-effectiveness study) concluded that there is high quality evidence of the efficacy and effectiveness of acupuncture and that it appears to be safe and cost-effective (15). Clinical practice guidelines for allergic rhinitis published by the Otolaryngology Head Neck Surgery Foundation in 2015 included acupuncture as Option five: ‘Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with AR who are interested in nonpharmacological therapy’ (Aggregate evidence quality – Grade B) (37).

Chemotherapy-induced nausea and vomiting

[Positive effect]

For chemotherapy-induced nausea and vomiting, acupuncture was rated as ‘effective’ in the Australian DVA review (2010) and was not reviewed separately to ‘cancer adverse effects’ in the USVA Evidence map of acupuncture (2014) (5, 6). In 2013, a systematic review of seven acupuncture and six acupressure RCTs found that acupuncture reduced the frequency of acute vomiting and the dose of rescue medication but did not reduce acute nausea severity or frequency compared to control. Acupressure showed a decrease in frequency of nausea but not acute vomiting or delayed symptoms. All studies used state-of-the-art combination anti-emetics in addition to acupuncture/acupressure. The reviewers rated the quality of evidence in the acupuncture studies as low to moderate while the acupressure studies were moderate to high quality. There was insufficient evidence to draw firm conclusions due to underpowered studies (21). However, an updated systematic review by Garcia et al in 2014 (using 18 new RCTs) found that acupuncture is an appropriate referral option for chemotherapy-induced nausea and vomiting (55). On this basis, CINV has been rated as positive rather than potential positive in this review.

Post-operative nausea and vomiting

[Positive effect]

For post-operative nausea and vomiting (PONV), acupuncture was rated as ‘insufficient evidence’ in the Australian DVA review {2010} and ‘potential positive effect’ in the USVA Evidence map of acupuncture (2014) (5, 6). In a systematic review and meta-analysis of 30 RCTs on acupuncture and acupressure in 2013, both acupuncture and acupressure reduced the number of cases of early nausea and vomiting (up to 24 hours post-surgery) (56). In 2015, a Cochrane update of 59 RCTs on PC6 stimulation found that PC6 stimulation was superior to sham, and equivalent to modern anti-emetics (16).

Post-operative pain

[Positive effect]

For post-operative pain, acupuncture was not reviewed in the Australian DVA review (2010) and rated as ‘unclear’ in the USVA Evidence map of acupuncture {2014} (5, 6). A systematic review and meta-analysis of 13 RCTs in 2016, found that acupuncture, electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS) improved pain on day one after surgery and reduced opioid use (17). Subgroup analysis showed that acupuncture and TEAS were superior to EA (17). A systematic review specifically on acute pain after back surgery reviewed five RCTs (three of which were high quality) and found encouraging but limited evidence for the efficacy of acupuncture (57). A systematic review on complementary therapies for pain after knee surgery included three RCTs on acupuncture and one on acupressure (58). The review found that acupressure reduced pain, and while acupuncture did not reduce pain it did reduce ibuprofen use (58). An RCT on acupuncture for pain after total knee arthroplasty found that acupuncture was superior to sham in post-operative fentanyl use, time to first request for fentanyl and pain intensity (59).

Stress and Anxiety

[Potential Positive effect]

Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine showed that Acupuncture has potential use in anxiety (79). Results from an integrative review titled “Effects from acupuncture in treating anxiety” show that the effects from acupuncture for treating anxiety have been shown to be significant as compared to conventional treatments (80). A systematic review from 2015 titled “Effects of acupressure on anxiety: a systematic review and meta-analysis” showed the Acupressure is effective in reducing anxiety (201).

References

McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition)

5. Biotext. Alternative therapies and Department of Veterans’ Affairs Gold and White Card arrangements. In: Australian Government Department of Veterans’ Affairs, editor: Australian Government Department of Veterans’ Affairs; 2010.

6. Hempel S, Taylor SL, Solloway MR, Miake-Lye IM, Beroes JM, Shanman R, et al. VA Evidence-based Synthesis Program Reports. Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs; 2014.

15. Taw MB, Reddy WD, Omole FS, Seidman MD. Acupuncture and allergic rhinitis. Curr Opin Otolaryngol Head Neck Surg. 2015 Jun;23(3):216-20.

16. Lee A, Chan SK, Fan LT. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2015(11):Cd003281.

17. Wu MS, Chen KH, Chen IF, Huang SK, Tzeng PC, Yeh ML, et al. The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis. PLOS ONE. 2016;11(3):e0150367.

21. McKeon C, Smith, C.A., Hardy, J. & Chang, E. Acupunctrue and acupressure for chemotherapy-induced nausea and vomiting : a systematic review. Australian Journal of Acupuncture and Chinese Medicine. 2013;8(1):2-17.

37. Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015 Feb;152(1 Suppl):S1-43.

40. Da Silva AN. Acupuncture for migraine prevention. Headache. 2015 Mar;55(3):470-3.

41. Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016(6):Cd001218.

42. Yang Y, Que Q, Ye X, Zheng G. Verum versus sham manual acupuncture for migraine: a systematic review of randomised controlled trials. Acupunct Med. 2016 Apr;34(2):76-83.

43. Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;4:Cd007587.

44. Coeytaux RR, Befus D. Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache. 2016 Jul;56(7):1238-40.

45. Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. AHRQ Comparative Effectiveness Reviews. Noninvasive Treatments for Low Back Pain. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016.

46. Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2124-38.

47. Lee JH, Choi TY, Lee MS, Lee H, Shin BC, Lee H. Acupuncture for acute low back pain: a systematic review. Clin J Pain. 2013 Feb;29(2):172-85.

48. Wellington J. Noninvasive and alternative management of chronic low back pain (efficacy and outcomes). Neuromodulation. 2014 Oct;17 Suppl 2:24-30.

49. Liu L, Skinner M, McDonough S, Mabire L, Baxter GD. Acupuncture for low back pain: an overview of systematic reviews. Evid Based Complement Alternat Med. 2015;2015:328196.

50. Andronis L, Kinghorn P, Qiao S, Whitehurst DG, Durrell S, McLeod H. Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review. Appl Health Econ Health Policy. 2016 Aug 22.

51. Taylor P, Pezzullo L, Grant SJ, Bensoussan A. Cost-effectiveness

52. Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis Cartilage. 2013 Sep;21(9):1290-8.

53. Manyanga T, Froese M, Zarychanski R, Abou-Setta A, Friesen C, Tennenhouse M, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014;14:312.

54. Feng S, Han M, Fan Y, Yang G, Liao Z, Liao W, et al. Acupuncture for the treatment of allergic

55. Garcia MK, McQuade J, Lee R, Haddad R, Spano M, Cohen L. Acupuncture for symptom management in cancer care: an update. Curr Oncol Rep. 2014 Dec;16(12):418.

56. Cheong KB, Zhang JP, Huang Y, Zhang ZJ. The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting–a systematic review and meta-analysis. PLOS ONE. 2013;8(12):e82474.

57. Cho YH, Kim CK, Heo KH, Lee MS, Ha IH, Son DW, et al. Acupuncture for acute postoperative pain after back surgery: a systematic review and meta-analysis of randomized controlled trials. Pain Pract. 2015 Mar;15(3):279-91.

58. Barlow T, Downham C, Barlow D. The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review. Complement Ther Med. 2013 Oct;21(5):529-34.

59. Chen CC, Yang CC, Hu CC, Shih HN, Chang YH, Hsieh PH. Acupuncture for pain relief after total knee arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2015 Jan-Feb;40(1):31-6.

79. Bazzan AJ, Zabrecky G, Monti DA, Newberg AB. Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine. Expert Rev Neurother. 2014 Apr;14(4):411- 23.

80. Goyata SL, Avelino CC, Santos SV, Souza Junior DI, Gurgel MD, Terra FS. Effects from acupuncture in treating anxiety: integrative review. Rev Bras Enferm. 2016 Jun;69(3):602-9.

201. Au DW, Tsang HW, Ling PP, Leung CH, Ip PK, Cheung WM. Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupunct Med. 2015 Oct;33(5):353-9.