Chronic Epicondylitis: Effects of Real and Sham Acupuncture Treatment: A Randomised ControlledPatient- and Examiner-Blinded Long-Term Trial

Abstract

Objective: The clinical long-term effectiveness of real and sham acupuncture treatment on differentiated pain measurement was evaluated in chronic lateral epicondylitis, an example of a tendomyotic disorder. Methods: Randomised, examiner- and patient-blinded controlled clinical study. Outcome measurement: pain at rest, pain on movement, pain on exertion, frequency and duration of pain. Real acupuncture (n = 23) was tested versus invasive sham acupuncture (n = 22). Ten treatments were given (2 treatments/week). Patients were examined at baseline (E1) as well as 2 weeks (E2), 2 months (E3) and 1 year (E4) after the end of treatment. In the treatment with real acupuncture, acupuncture points were selected and mechanically stimulated while in the sham group non-acupuncture points were selected. Results: There was no significant difference between the groups at baseline for any outcome parameter. Two weeks, 2 months and 1 year after the end of treatment there were significant reductions in all pain variables compared to baseline. At the first follow-up, significant group differences were registered for pain on motion and pain on exertion in favour to the real acupuncture group. These differences in pain intensity between the groups were no longer significant at the 2 months and 12 months follow-ups. Conclusion: The results suggest that, in the treatment of chronic epicondylitis, the selection of so-called real acupuncture points gives better results than invasive sham acupuncture at early follow-up. This additional effect can be interpreted as a specific effect of real acupuncture.

A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia

“…48 53-55 Three studies compared acupuncture with placebo. 48 53 55 The remaining paper compared acupuncture with US. 54 Physical interventions for lateral epicondylalgia differences in the applied interventions and timing of outcome assessment, no pooling of studies was possible.…”

“…Similarly, the disabilities of the arm, shoulder, and hand questionnaire (DASH) was significantly different in favour of acupuncture over placebo at two weeks (SMD 0.77; 95% CI 0.14 to 1.40), but not so by two months (SMD 0. 48 There appears to be some evidence to support the efficacy of acupuncture over a placebo as a treatment for LE in short term outcomes. However, this benefit appears to be short lived-that is, two to eight weeks.…”

Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials

“…One hundred ninety-six full-text articles were retrieved for further assessment. Two studies were duplicated publications [15,16]. Finally, 19 studies (14 Chinese, four English, one Italian) met the inclusion criteria and were included in this review.…”

“…Of the 19 studies, 14 were published in Chinese and were conducted in China; four were published in English, three of which were conducted in Germany [15-17] and one was conducted in Canada [18]. The remaining study was conducted in Italy and published in Italian [19].…”

Acupuncture point localization varies among acupuncturists

“…Prominent examples are the German acupuncture trials GERAC and ART [6]. On the other hand, the AP-specific mode of action is recognized and supported by several studies; examples are PC 6 for controlling postanesthetic vomiting and nausea [7], or a acupuncture regimen involving LI 4 and LI 10 for the treatment of lateral epicondylitis [8,9]. Furthermore, brain imaging studies revealed that activation of certain brain areas is specifically associated with stimulation at APs [10][11][12].…”