At the top level the evidence was consistently significantly positive and acupuncture was recommended by the original review author(s). At the next level the evidence is again consistently positive but thought to be insufficient for firm conclusions – typically because of the number, size or quality of the trials.
The highest evidence is for:
- allergic rhinitis
- back pain (chronic)
- headache (tension type, chronic) and migraine
- knee osteoarthritis
- nausea and vomiting (either post-operative or due to chemotherapy)
- post-operative pain
Two of these (low back pain and knee osteoarthritis) are very common chronic ailments where NICE has in recent years ruled against acupuncture. Two of them (tension headache and migraine) are also very common ailments but where NICE recommended acupuncture, so their decisions are strangely inconsistent.
The potential positive list of 34 conditions is too long to set out here: please go to the source http://www.acupuncture.org.au/OURSERVICES/Publications/AcupunctureEvidenceProject.aspx . It includes more of the chronic musculoskeletal pains (neck, elbow, heel, shoulder), some of the common internal illnesses (asthma, IBS), the most prevalent psychological conditions and symptoms (anxiety, depression, insomnia), some cancer symptoms (pain, fatigue) and both primary and secondary stroke treatment. The favourable evidence for stroke may surprise people outside of the profession but this is the most common inpatient indication for acupuncture in Chinese hospitals.
In the ‘unclear’ group of 71 we have many conditions that may get promoted in the future. This is because, as more evidence accumulates, it tends to solidify the positive trends into statistical significance. Over the period 2005 to 2016, 24 of the 122 conditions reviewed here have improved their grading while only two have got worse. Here are some of the commoner conditions in the ‘unclear’ group: carpal tunnel syndrome, chronic fatigue, dysmenorrhoea, fibromyalgia, menopausal syndrome, tinnitus, urinary incontinence.
To give a balanced view we should also mention the five conditions found to have no evidence of effect (which is not the same as having evidence of no effect: they could yet be redeemed). These relate particularly to substance misuse (alcohol, cocaine, tobacco); also epilepsy and pregnancy nausea. This last is perhaps surprising as acupuncture has been used frequently for this, and also the evidence on acupuncture for nausea from other causes is very solid (see above). Bear in mind though that these results reflect only what research has been done to date; they are not necessarily a good indication of how you would get on with acupuncture in normal practice. Normal practice can be quite different from research trials, where the treatment may be quite regimented. Also the people who participate in trials are often not representative of patients more generally. Look for recommendations from people you know and trust – but at the end of the day it’s only your own personal experience that counts.
If you like your research in cartoon form then take a look at this Youtube video from Montreal acupuncturist Olivier Roy: 50 good reasons to have acupuncture https://www.youtube.com/watch?v=f4IdCCFVGiI. It’s based directly on the AACMA review.