|
Clinical Question:
Is acupuncture effective in decreasing symptoms in patients with
fibromyalgia?
Bottom Line:
A standardized acupuncture protocol was no better than sham acupuncture in
relieving pain or improving other symptoms in patients with significant
fibromyalgia symptoms. Patients in all groups reported slightly better
scores. Acupuncture is just one aspect of traditional Chinese medicine,
however, and this fairly artificial study does not help us understand if
this approach is effective.
Reference:
Assefi NP, Sherman KJ, Jacobsen C, Goldberg J, Smith WR, Buchwald D. A
randomized clinical trial of acupuncture compared with sham acupuncture in
fibromyalgia. Ann Intern Med 2005; 143:10-19.
Study Design:
Randomized controlled trial (double-blinded)
Funding:
Government
Setting:
Outpatient (any)
Synopsis:
The researchers recruited by advertisement 100 people with a diagnosis of
fibromyalgia, who had a global pain score of 4 or more (average = 7) on a
visual analog scale of 0 (no pain) to 10 (worst pain ever), and who agreed
to maintain current treatment during the study. Using concealed allocation,
the patients were randomized to receive either traditional Chinese Medicine
acupuncture according to a standardized (ie, not individualized) protocol (n
= 25) or 1 of 3 sham acupuncture treatments (n = 25 patients each)
administered by 8 practitioners. The participants were treated twice weekly
for 12 weeks with acupuncture only. The study, in its attempt to maintain
consistency of the acupuncture treatment, resulted in artificial treatment,
since acupuncture is just one aspect of traditional Chinese medicine and the
clinician usually adjusts treatment to the specific patients. Using
intention-to-treat analysis, no differences were found in any outcome; pain
intensity and fatigue intensity improved similarly in all 4 groups, as did
sleep quality and overall well-being. Scores of general health status, as
measured by the Short Form 36-item Health Survey, did not change in any of
the 4 groups. |