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Acupuncture for chronic pain (needle therapy)

Preregistered, allocation-concealed RCTs pooled at the patient level show small-to-moderate standardized pain improvements versus sham and larger standardized gaps versus no-acupuncture controls for common musculoskeletal and headache conditions; effect sizes vary by control type and baseline pain severity.

What this protocol is

Acupuncture here means skin-penetrating needle techniques evaluated in randomised trials for chronic musculoskeletal pain, osteoarthritis, headache, or shoulder pain—the evidence base curated below mirrors the Acupuncture Trialists’ Collaboration individual patient data (IPD) programme.

Variation within one hub

Electro-acupuncture vs manual, session frequency, course length, and sham design (penetrating vs non-penetrating placebo needles, positioning) are dose and comparator variation, not separate protocol slugs—read each linked row for the control arm that drives interpretability.

Evidence anchors (PubMed)

  • IPD meta-analysis update: Vickers et al. 2018 (J Pain; PMID 29198932; vickers-2018-acupuncture-chronic-pain-ipd-ma) — 39 trials, 20,827 patients; acupuncture superior to both sham and no acupuncture for each pain condition (P < 0.001), with standardized mean differences ~0.2 vs sham and ~0.5 vs non-acupuncture controls in abstract summary; ~15% attenuation of effect at 1 year.
  • Responder distribution: Foster et al. 2021 (Acupunct Med; PMID 32571096; foster-2021-acupuncture-responders-skew-ipd-ma) — skewness contrasts across 20,827 patients; very small right-skew differences favouring acupuncture vs controls, sensitivity-dependent significance.
  • Moderators: Witt et al. 2019 (Clin J Pain; PMID 30908336; witt-2019-acupuncture-moderators-baseline-pain-ipd-ma) — among five patient-level covariates, higher baseline pain severity showed the clearest signal for greater absolute benefit from acupuncture.

Distinct protocols (do not merge)

  • Mindfulness meditation (meditation-practice) — attention-training curricula without needle somatosensory stimulation as the primary intervention.
  • Tai chi & Qigong (tai-chi-qigong) — whole-body movement prescriptions; separate trial literature even when both appear in traditional East Asian medicine contexts.
  • Progressive muscle relaxation (progressive-muscle-relaxation) — tense–release somatic cycles.

Safety / clinical hygiene

Use licensed providers; discuss bleeding risk, anticoagulation, pregnancy, pacemakers (if electro-acupuncture), and infection control with clinicians—this wiki summarises trial efficacy literature, not sterile technique standards.

Tertiary map

Consumer encyclopedia pages on acupuncture may overstate mechanism certainty—effect sizes and comparator types stay PubMed-first on the linked rows above.

Evidence