Acupuncture for Fibromyalgia: Does it Work?

What the Evidence Shows

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Acupuncture is getting increased attention as a treatment for fibromyalgia. Because the condition is hard to treat, people are often willing to turn to complementary and alternative (CAM) treatments to find relief. One study (Deare) states that 20% of people diagnosed with fibromyalgia try acupuncture within the first two years.

Several features of acupuncture make it desirable for those of us with this condition:

  • It has a low side-effect risk,
  • It doesn't interact negatively with other treatments,
  • If it doesn't work, you can simply stop — there's no weaning-off process,
  • And we can find a lot of anecdotal evidence about its effectiveness.

Of course, anecdotal evidence doesn't equate to scientific proof, leaving you with the question, "Does it really work?" A growing body of research suggests that it does. However, there are still problems with the way the way CAM treatments — and especially acupuncture — are studied.

Acupuncture Studies: The Problems

Medical studies rely on placebos to test treatments against. A placebo needs to be something that doesn't have a treatment effect. If the study's looking at a treatment that comes in a pill, for example, it's easy to simply give the control group a sugar pill.

With acupuncture, though, this raises real difficulties. Participants will obviously know whether someone is inserting needles into their skin.

Since traditional acupuncture is based on a system of meridians (energy centers around the body), researchers have used sham acupuncture that involves placing needles in areas outside the meridian system.

Some researchers and acupuncture practitioners argue that sham acupuncture is not truly a placebo—that because we don't know by what mechanism acupuncture works, we can't definitively say that sham acupuncture doesn't have a similar effect to actual acupuncture.

Thus, they suggest that when sham acupuncture and traditional acupuncture produce similar results in trials, it's because they're both having an effect on the body.

Another problem is that studies of CAM therapies often don't have the same level of scientific rigor as other kinds of medical trials, which leaves us not knowing how much stock to put in their results.

Acupuncture Studies for Fibromyalgia

Researchers have looked into several types of acupuncture and acupuncture-like treatments in recent years. These include:

  • Traditional acupuncture,
  • Acupuncture with moxibustion (burning a substance called moxa near the skin, also called warm needling),
  • Acupuncture with cupping (a traditional Chinese treatment that involves suction),
  • Dry needling (inserting acupuncture needles or empty syringes into painful areas of muscles),
  • Vibration of acupuncture points,
  • Electroacupuncture, which involves electronic stimulation of acupoints (without needles).

You can find studies showing positive results with most of these techniques as well as those saying there's no improvement in fibromyalgia symptoms.

Reviews of literature published in 2013 (Cao H, Deare) and 2014 (Yang) came to the following conclusions:

  • Acupuncture and similar treatments appear to be effective fibromyalgia treatments compared with medications.
  • Acupuncture combined with drugs and exercise may improve pain thresholds in the short-term.
  • Evidence that acupuncture improves pain and stiffness in fibromyalgia is of low to moderate quality.
  • Electroacupuncture may be superior to traditional acupuncture for pain and stiffness, well-being, sleep, and fatigue.
  • Acupuncture appears safe for people with fibromyalgia.
  • Acupuncture did not appear to reduce pain more effectively than sham acupuncture.
  • Further studies with better designs and larger sample sizes are needed.

A review of acupuncture for rheumatic diseases in general (Amezaga Urruela) came to similar conclusions.

Individual studies have suggested that acupuncture may have the following benefits for people with fibromyalgia:

  • Immediate pain reduction,
  • Improved overall well-being,
  • Reduced pain sensitivity,
  • Global improvement of symptoms.

Is Acupuncture Right for You?

The decision to try acupuncture is, as with any treatment, best made by you and your doctor while looking at the overall picture of your symptoms and other treatments. Remember that what works for one of us may not work for all, so your experience with acupuncture may be different from what you've heard/read from others with fibromyalgia.

Be sure to check with your insurance company to see if acupuncture treatments are covered.

Learn More:

Source:

Ablin J, et al. Evidence-based complementary and alternative medicine: eCAM. 2013;2013:485272. Treatment of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines and with special emphasis on complementary and alternative therapies.

Amezaga Urrela M, Suarez-Almazor ME. Current rheumatology reports. 2012 Dec;14(6):589-97. Acupuncture in the treatment of rheumatic diseases.

Bastos JL, et al. Journal of acupuncture and meridian studies. 2013 Jun;6(3):163-8. Effective acupuncture at tender points for the management of fibromyalgia syndrome: a case series.

Birch S. The 3rd JSAM international symposium on evidence-based acupuncture. June 2012. Sham acupuncture is not a placebo treatment — implications and problems in research.

Cao HJ, et al. Trials. 2014 Jul 10;15:280. Using a partially randomized patient preference study designed to evaluate therapeutic effect of acupuncture and cupping therapy for fibromyalgia: study protocol for partially randomized controlled trials.

Cao H, et al. Evidence-based complementary and alternative medicine: eCAM. 2013;2013:362831. Acupoint stimulation for fibromyalgia: a systematic review of randomized controlled trials.

Casanueva B, et al. Rheumatology international. 2014 Jun;34(6):861-6. Short-term improvement following dry needle stimulation of tender points in fibromyalgia.

Deare JC, et al. The and Cochrane database of systemic reviews. 2013 May 31;5:CD007070. Acupuncture for treating fibromyalgia.

Hadianfard MJ, Hosseinzadeh Parizi M. Iranian Red Crescent medical journal. 2012 Oct;14(10):631-40. Randomized clinical trial fibromyalgia treatment with acupuncture compared with fluoxetine

Harte SE, et al. Medical acupuncture. 2013 Apr;25(2):154-160. Pressure pain sensitivity and insular combined glutamate and glutamine (glx) are associated with subsequent clinical response to sham but not traditional acupuncture in patients who have chronic pain.

Iannuccelli C, et al. Clinical and experimental rheumatology. 2012 Nov-Dec;30(6 Suppl 74):112-6. Complementary treatment in fibromyalgia: combination of somatic and abdominal acupuncture.

Kondo T, Kawamoto M. Biopsychosocial medicine. 2014 Jan 24;8(1):7. Acupuncture and moxibustion for stress-related disorders.

Saad M, de Medeiros R. Current pain and headache reports. 2013 Aug;17(8):354. Complementary therapies for fibromyalgia syndrome — a rational approach.

Stepping Stone Acupuncture & Wellness. "The current problem with acupuncture research." Posted January 20, 2011. All rights reserved. Accessed April 2015.

Stival RS, et al. Revista brasileira de reumatologia. 2014 Nov-Dec;54(6):431-6. Acupuncture in fibromyalgia: a randomized, controlled study addressing the pain response. [Article in Portuguese; abstract referenced.]

Weber A, et al. Journal of alternative and complementary medicine. 2015 Feb;21(2):77-82. Effects of music in combination with vibration and acupuncture points on the treatment of fibromyalgia.

Yang B, et al. Journal of traditional Chinese medicine. 2014 Aug;34(4):381-91. Efficacy of acupuncture on fibromyalgia syndrome: a meta-analysis.

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