Contradictory Study Results: Is Acupuncture Beneficial for FM, Or Not?

Wednesday, November 16, 2005
By: Elisabeth Deffner
Reprinted from FM Online

According to a recent Mayo Clinic study, acupuncture provides relief from moderate to severe fibromyalgia symptoms.

But a study out of the University of Washington found that patients receiving acupuncture treatments did not improve more than patients receiving sham treatments.
What’s a fibromyalgia patient to believe?
According to researchers, it’s a good idea for patients to pay attention to any and every study that releases information pertaining to fibromyalgia—even when some of those studies seem to contradict others.
“There have been more than several studies on the effects of acupuncture for fibromyalgia and other painful disorders; they have had varied results, some suggesting that it’s useful, some suggesting that it doesn’t have an effect,” admits Dr. David P. Martin, lead investigator on the Mayo Clinic study.
But, he adds, “Each study is designed somewhat differently. That is the source of confusion between one study and another. In fact, they are probably not all contradictory. There is a thread of truth that runs through all of them.”
Other researchers agree. There are so many variables, they explain, that it’s not surprising that different studies come up with seemingly contradictory results.
“There are lots of reasons that studies can get contradictory results,” says Karen Sherman, Ph.D., who worked on the University of Washington study. “The patient populations—even if of the same disease—can be different in terms of severity of disease or other characteristics that influence likelihood of getting better—say, whether they’re on disability or not. Not even all effective treatments will work for all groups of patients.”
“Because [FM is] a syndrome,” adds Martin, “there may be people acupuncture works for and people it doesn’t.”
In acupuncture studies, the placebo effect can be especially powerful, researchers note. In acupuncture studies, sham treatments involve needles that don’t actually pierce the skin, or that are not placed in the correct places.  “Just the expectation among patient and doctor that the patient will get better makes the patient get better,” Martin explains.
“When we’re dealing with pills, it’s easy to give a sugar pill. But with something like acupuncture, it’s very difficult to fool both the doctor and the patient.”
Further InvestigationIt would be comforting for everyone if we knew that study results were definitive—but it is evident that the general community needs to be as cautious in interpreting study results as the investigators are themselves.
“I tell my patients we live in a sound-bite era. Everybody wants a two-second conclusion on the news,” says Martin. “But the truth of the matter is it’s more complicated than that.”
So what’s a discerning patient to do? Here are some tips for interpreting study results, and determining how valuable the results are for you.

  • Talk about studies that interest you with your doctor, and ask for his or her interpretation. “Go to a doctor who’s had a chance to weigh the different studies and look at the differences, and has enough experience to look over time at the consensus of evidence, and also apply it specifically to their case,” says Martin.
  • Delve deeper into the studies. “Instead of just discounting studies because other studies contradict them, look at predictors—variants in practice and patients—how better to achieve success in FM patients,” says Dr. Michael McNett, medical director of the Fibromyalgia Treatment Centers of America.
  • If you have already undergone treatments that you feel are helping your FM symptoms, don’t discontinue them just because studies indicate that those treatments are not helpful. (If studies indicate the treatments may have dangerous side effects, though, check with your doctor before continuing.)

If you’re interested in acupuncture and feel it may help you, give it a try. “I think the bottom line is that fibromyalgia symptoms probably do respond to acupuncture, although I wouldn’t expect that acupuncture works for everyone, nor is acupuncture a cure for the syndrome,” says Martin.“What is perhaps most important is that there are relatively few to no side effects to acupuncture performed with modern disposable needles, in stark contrast to some medications which do have serious side effects.”