PubMed · 10368541
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1999. Acupuncture.. https://pubmed.ncbi.nlm.nih.gov/10368541/
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BACKGROUND: Because the value of popular forms of alternative care for chronic back pain remains uncertain, we compared the effectiveness of acupuncture, therapeutic massage, and self-care education for persistent back pain. METHODS: We randomized 262 patients aged 20 to 70 years who had persistent back pain to receive Traditional Chinese Medical acupuncture (n = 94), therapeutic massage (n = 78), or self-care educational materials (n = 90). Up to 10 massage or acupuncture visits were permitted over 10 weeks. Symptoms (0-10 scale) and dysfunction (0-23 scale) were assessed by telephone interviewers masked to treatment group. Follow-up was available for 95% of patients after 4, 10, and 52 weeks, and none withdrew for adverse effects. RESULTS: Treatment groups were compared after adjustment for prerandomization covariates using an intent-to-treat analysis. At 10 weeks, massage was superior to self-care on the symptom scale (3.41 vs 4.71, respectively; P =.01) and the disability scale (5.88 vs 8.92, respectively; P<.001). Massage was also superior to acupuncture on the disability scale (5.89 vs 8.25, respectively; P =.01). After 1 year, massage was not better than self-care but was better than acupuncture (symptom scale: 3.08 vs 4.74, respectively; P =.002; dysfunction scale: 6.29 vs 8.21, respectively; P =.05). The massage group used the least medications (P<.05) and had the lowest costs of subsequent care. CONCLUSIONS: Therapeutic massage was effective for persistent low back pain, apparently providing long-lasting benefits. Traditional Chinese Medical acupuncture was relatively ineffective. Massage might be an effective alternative to conventional medical care for persistent back pain.
PURPOSE: The objective of this review was to determine the incidence of adverse events associated with acupuncture. SUBJECTS AND METHODS: A search for prospective surveys of the safety of acupuncture was conducted using computerized databases (Medline, Embase, the Cochrane Library, and CISCOM), inquiries to acupuncture organizations, and our own files. Data on sample, size, types of patients duration of study, types of acupuncture, definition of adverse events, method of evaluation, and findings were extracted systematically from the retrieved reports. RESULTS: Nine surveys were located and included in the review. Their results were not uniform. The most common adverse events were needle pain (1% to 45%) from treatments, tiredness (2% to 41%), and bleeding (0.03% to 38%). Feelings of faintness and syncope were uncommon, with an incidence of 0% to 0.3%. Feelings of relaxation were reported by as many as 86% of patients. Pneumothorax was rare, occurring only twice in nearly a quarter of a million treatments. CONCLUSIONS: Although the incidence of minor adverse events associated with acupuncture may be considerable, serious adverse events are rare. Those responsible for establishing competence in acupuncture should consider how to reduce these risks.
Patients with rheumatic disease are turning to complementary and alternative therapies in growing numbers. Many of these therapies have a long history of apparent safety and efficacy but have not been adequately tested in controlled trials. To aid physicians in guiding patients' decisions, the most frequently used products and practices are reviewed.