Acupuncture for chronic fatigue syndrome?

A recent meta-analysis on the effects of acupuncture for Chronic Fatigue Syndrome (CFS) featured recently in the peer reviewed journal Biomed Central.  The study looks at 31 clinical trials, and concludes that a combination of acupuncture and moxibustion* treatments may have a ‘better effect than other treatments’.

Research on acupuncture for chronic fatigue syndrome

The study uses this definition for Chronic Fatigue Syndrome: ‘Unexplained fatigue that lasts for at least six months and is accompanied by four or more of the following symptoms: unrefreshing sleep, lengthy malaise after exertion, impairment of concentration or short-term memory, sore throat, tender lymph nodes, multi-joint and muscle pain and headaches.’

The researchers identified and chose 31 randomised-controlled trials (RCTs – the gold standard of evidence based medicine) to analyse in the study.  The study only looks at high quality research on acupuncture for Chronic Fatigue Syndrome.  It focuses on RCTs, either published or unpublished.  The study only considers improvements of 30% or more to be relevant.  Researchers independently assessed the trials using the Cochrane Collaborations tool, the most well-respected research analysis method for clinical trials.

2255 participants aged 18-78 had taken part in the clinical trials.  Their treatment duration ranged from 10-90 days.  The trials compared a combination of acupuncture and moxibustion with just acupuncture or moxibustion, Chinese herbal medicine, Western medicine, and placebo.

The most effective treatment

The study showed that acupuncture for Chronic Fatigue Syndrome, combined with moxibustion, was the most effective treatment.  Acupuncture or moxibustion alone came second, then Chinese Herbal medicine, Western medicine, and lastly placebo.

Although the mechanisms of acupuncture for Chronic Fatigue Syndrome are still unclear, researchers saw changes in the immune system’s functioning after treatment.  The changes suggest that acupuncture for Chronic Fatigue Syndrome regulates the immune system, calms inflammatory responses and boosts anti-inflammatory responses.

Stronger evidence needed

However, the authors also concluded, ‘higher quality studies are needed to confirm our findings’.  The researchers applied the Cochrane Risk of Bias tool to the data.  This showed possible signs of bias in some of the studies.  This is the most complete and up-to-date meta-analysis so far.  But stronger evidence is needed to validate its findings.

The full text of the meta-analysis on the effects of acupuncture for Chronic Fatigue Syndrome can be found here

 My approach

I always ground my practice in the most up-to-date research available.  Therefore, I do follow some of the treatment protocol shown in this study.  I would likely use many of the acupoints used in the trials that the research covers.

I consider that acupuncture for Chronic Fatigue Syndrome is not a strong or broad enough approach to treatment if used alone.  Since CFS is such a pervasive and long term condition, I also look at dietary and lifestyle patterns and recommend changes where necessary.  I always tailor a course of treatment to the individual and their condition.

From a Chinese Medicine point of view, the underlying issues in the system can differ from person to person.  Kidney-Yin deficiency and Spleen-Qi deficiency are common causes.  But they are not the only pathologies relating to CFS.  I would not limit my practice to a ‘one size fits all’ approach, as we are all so different.  I would therefore consider adding herbal medicine if and when necessary, as it can work very well alongside acupuncture.

If you would like to discuss this with me, please get in touch.

*Moxibustion is a form of heat therapy in which dried plant materials called “moxa” are burned on or very near the surface of the skin. The intention is to warm and invigorate the flow of Qi in the body and dispel certain pathogenic influences.