In spite of multiple medical treatments available,
neuropathic pain continues to pose great therapeutic
challenges. While acupuncture has been gaining
popularity for the treatment of multiple pain
disorders, little is known about its effects on
neuropathic pain.
To critically assess the evidence for acupuncture in
the treatment of peripheral neuropathy researchers
systematically searched the Medline, AMED, Cochrane,
Scopus, CINAHL and clintrials.gov databases from
inception to May 2013. Parallel and cross-over RCTs
which assessed acupuncture’s efficacy for any type
of neuropathy, including mononeuropathy were
reviewed.
Trials were included if at least 1 group received
acupuncture and 1 group - sham acupuncture or other
control treatment.
All included RCTs needed a SASQI-CAM quality score
of >9.
Individual patient data meta-analyses were conducted
using 6 eligible RCTs, with a total of 680 patients
analyzed.
15 publications met the inclusion criteria. The
selected RCTs included acupuncture intervention for
neuropathy caused by diabetes, bell’s palsy, carpal
tunnel syndrome, HIV and idiopathic conditions.
No studies on chemotherapy or other toxin-induced
neuropathy met the inclusion criteria.
Acupuncture regimens and primary outcome measures
differed among studies and various methodological
issues were identified. Still, the majority of RCTs
reviewed showed clear benefit for acupuncture over
control in the treatment of diabetic neuropathy,
Bell’s palsy and carpal tunnel syndrome.
Acupuncture is probably effective in the treatment
of HIV-related neuropathy and there is insufficient
evidence for its benefits in idiopathic neuropathy.
Meta-analyses of all diabetic neuropathy and bell’s
palsy data using a summary estimate random effects
model showed combined Odds Ratio (OR) of 4.23
(95[percnt] CI 2.3-7.8), p<0.001 favoring
acupuncture over control for pain outcomes.
The majority of trials demonstrate a positive effect
of acupuncture over control condition in the
treatment of neuropathy. Further more rigorously
designed studies are needed to better characterize
this effect.
For more information
Neurology
Effects of Acupuncture on Neuropathic Pain: A
Systematic Review and Meta-analysis (P3.306)
Neural Regeneration Research
Molecular mechanisms underlying the effects of
acupuncture on neuropathic pain.
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