No Evidence That Acupuncture Reduces Arm Pain

Researchers from Harvard Medical School got a surprise this year. They studied the use of acupuncture for the treatment of arm pain from repetitive strain injuries (RSI). The expected result was that the patients treated with acupuncture would have better outcomes than those treated with sham (placebo) acupuncture.

The actual results showed that the sham acupuncture treatment reduced arm pain in patients more effectively than for those patients in the actual acupuncture group. The patients in both groups had forearm and/or hand pain for three months or more from repetitive use.

Each group received eight treatments over a four-week period of time. The sham group had what looked like a real acupuncture needle. But in reality, it had a blunt (not sharp) tip. The tip of the needle touched the skin but wasn't inserted into the skin. The true acupuncture group had skin penetration with real needles. The patients did not know if they were getting true acupuncture or sham acupuncture treatments.

The authors offer some thoughts on the results. First, they pointed out that the groups were no different in terms of symptoms, sex, or level of education at the start of the study.

Both groups got better with treatment. The sham group improved more in pain intensity and severity. Arm function and grip strength were not better with one treatment over the other. An equal number of patients in both groups reported pain as a side effect of treatment.

It's not clear why the sham group had better results than the true acupuncture group. Discomfort from the needles in the true acupuncture group may have made a difference. And the sham needles may have delivered an acupressure effect.

Acupuncture experts suggested that the treatment wasn't long enough. Other studies have shown that true acupuncture takes longer than four weeks to be most effective. And after one month, the two groups were equal in terms of pain, symptoms, and function. More study is needed to find out when to use acupuncture and for how long.

Rose H. Goldman, MD, MPH, et al. Acupuncture for Treatment of Persistent Arm Pain Due to Repetitive Use. In The Clinical Journal of Pain. March/April 2008. Vol. 24. No. 3. Pp. 211-218.

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