Abstract
OBJECTIVE: To critically assess the evidence for acupuncture in the treatment of peripheral neuropathy. BACKGROUND: 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. METHODS: We 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. RESULTS: 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. CONCLUSIONS: 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.
Disclosure: Dr. Dimitrova has nothing to disclose. Dr. Murchison has received research support from the National Institute for Neurological Disorders and Stroke. Dr. Oken has received personal compensation for activities with Dr. Willmar Schwabe Pharmaceuticals as a speaker.
Tuesday, April 21 2015, 2:00 pm-6:30 pm
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