persistent, clinically relevant benefits for primary care patients with chronic
headache, particularly migraine and that expansion of NHS acupuncture
services should be considered.
Knee pain
Patellofemoral pain syndrome is the leading cause of chronic knee pain in
young adults and may affect up to 15% of young men in the US military
service.^83 The results of a controlled trial, which included a total of 75
patients with patellofemoral pain, led the authors to conclude that acupunc-
ture may be beneficial as a treatment for the condition.^84 A systematic
review of high-quality RCTs also suggested that acupuncture can reduce
pain and disability in people with chronic knee pain.^85 Despite this evidence
the role of acupuncture in the management of chronic knee pain is still
unclear.
Neck pain
There is some evidence that acupuncture may be effective when it is used for
neck pain,86,87although a systematic review of 14 RCTs of this application
concluded that existing data were insufficient to make a firm judgement.^88
Pelvic girdle pain
A randomised, single-blind trial at a hospital, and at 27 maternity care
centres in Gothenburg from 2000 to 2002, showed that acupuncture and
stabilising exercises were both efficient complements to standard treat-
ment for the management of pelvic girdle pain during pregnancy, with
acupuncture being superior.^89
Pain after surgery
A randomised trial of auricular acupuncture given for pain relief after
arthroscopic knee surgery performed under general anaesthesia found that
acupuncture reduced the need for ibuprofen after surgery more than an inva-
sive needle control procedure.^90 Interestingly, most patients in both groups
believed that they had received true acupuncture and wanted to repeat it in
future.
Drug dependence
In a randomised, sham-controlled open trial with one active and two control
arms the use of acupuncture in cocaine dependence was investigated.^91 The
primary outcome was cocaine use assessed by three times weekly urine
analysis. A total of 52 patients completed the study. Patients who completed
a course of auricular acupuncture appeared to be more likely to abstain
from using cocaine than either of the other two control groups. Another
study showed that acupuncture could be of use in cocaine abusers stabilised
on buprenorphine as a substitute.^92 To combat the severe drug problem, the
Chinese government has adopted the methadone maintenance treatment
144 | Traditional medicine