Acupuncture found lacking for fibromyalgia

NEW YORK (Reuters Health) - Acupuncture may provide some temporary pain relief for people with fibromyalgia, but does not help with fatigue, sleep problems, or physical function, according to a new research review. However, the results are too inconsistent to recommend acupuncture as a treatment fibromyalgia, the reviewers conclude.

Fibromyalgia, a debilitating pain syndrome that affects an estimated 2 to 4 percent of the population, is characterized by chronic pain, fatigue and difficulty sleeping. It's a somewhat mysterious condition with no clear-cut cause.

Winfried Hauser of the Klinikum Saarbrucken in Germany and colleagues reviewed seven randomized controlled trials of acupuncture that included a total of 385 people with fibromyalgia. The study subjects were mostly white middle-aged women.

All of the studies used traditional Chinese acupuncture, where fine needles are inserted into specific points in the skin. In addition, two of the studies used electroacupuncture, where the practitioner fits the needles with clips that are attached to a small device that delivers a continuous electrical impulse to stimulate the acupuncture point. Three of the studies used control groups with various kinds of sham or simulated acupuncture, and one compared simulated acupuncture to no treatment.

While the investigators found "strong evidence" that acupuncture relieves fibromyalgia pain, they caution that the results were too inconsistent to recommend it for the management of the condition.

They came to this conclusion mainly because, in one of the seven studies, sham and simulated acupuncture yielded better results than real acupuncture treatment. Furthermore, the authors found that acupuncture-related pain relief only occurred right after treatment, and did not last until the next follow-up.

"Choosing appropriate control conditions in clinical acupuncture trials on chronic pain syndromes is a particularly difficult problem," Hauser noted in an email to Reuters Health.

"Acupuncture is an effective treatment for several painful conditions, and most acupuncture therapists achieve good results for treatment. However, in most studies on acupuncture and pain, there is no difference between acupuncture and the control condition (often sham or minimal acupuncture)," the investigator added.

Despite this lack of strong evidence for acupuncture in treating fibromyalgia, the authors acknowledge that the treatment is still popular among patients.

They therefore recommend that further studies be undertaken, including larger, multi-center studies; studies involving comparisons with traditional medical treatments; and different forms and intensities of stimulation (i.e., manual vs. electric stimulation).

SOURCE: Rheumatology, January 25, 2010.