when compared with placebo.74,75A pilot study for an RCT of acupuncture
in low back pain concluded that the results were ‘promising’ and worthy of
further research.^76
A study was conducted as part of a major acupuncture research initia-
tive by health insurance companies in Germany: 2807 patients with chronic
back pain who attended over 1000 study centres were randomised to receive
either acupuncture or no acupuncture in addition to whatever conventional
care they chose to have. After 3 months of treatment, patients who received
the acupuncture showed significantly greater improvements in back function
and quality-of-life scores.^77
A short course of traditional acupuncture for persistent non-specific low
back pain in primary care has been shown to provide a modest health
benefit for minor extra cost to the UK NHS compared with usual care.^78
Acupuncture care for low back pain appeared to be cost-effective in the
longer term.
Dental pain
Most of the studies included in a systematic review of 16 trials of dental
pain suggested that acupuncture does have a greater effect than placebo.^79
Headache and migraine
Four hundred and one patients with chronic headache were recruited from
general medical practices in England and Wales and were randomly assigned
to receive either standard care or acupuncture (12 treatments over 3
months). At 12 months after the onset of treatment headache scores in the
acupuncture group fell by 34% (compared with 16% in the control group),
with 22 fewer days of headache per year. They took 15% less medication,
made 25% fewer doctor visits and took 15% fewer days off work. The
greatest improvements were found in patients with migraine.^80
A study investigated the effectiveness of acupuncture compared with
minimal acupuncture and no acupuncture in patients with tension-type
headache.^81 The end-point was the difference in numbers of days with
headache between 4 weeks before randomisation and 9–12 weeks after
randomisation, as recorded by participants in headache diaries. The
acupuncture intervention investigated in this trial was more effective than
no treatment, but not significantly more effective than minimal acupuncture
for the treatment of tension-type headache.
Vickers et al. determined the effects of a policy of ‘use acupuncture’ on
headache, health status, days off sick and use of resources in patients with
chronic headache compared with a policy of ‘avoid acupuncture’.^82
Headache score at 12 months, the primary end-point, was lower in the
acupuncture group (16.2, standard deviation [SD] 13.7, n161, 34%
reduction from baseline) than in controls (22.3, SD 17.0, n140, 16%
reduction from baseline). It was concluded that acupuncture leads to
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