DOI
https://doi.org/10.18849/ve.v9i1.681Abstract
PICO Question
In dogs with chronic pain, is acupuncture alone, compared to a placebo, more efficacious in alleviating pain and pain-related dysfunction?
Clinical bottom line
Category of research
Treatment.
Number and type of study designs reviewed
Four randomised, placebo-controlled clinical trials were critically appraised.
Strength of evidence
Weak.
Outcomes reported
A single study evaluating the efficacy of gold bead implantation, a form of permanent acupuncture, on pain associated with canine hip dysplasia (CHD) endorsed acupuncture’s superior pain alleviation and locomotion improvement through owner and veterinarian subjective outcome evaluation.
Three studies concluded that, overall, acupuncture was not efficacious regarding pain reduction or dysfunction improvement compared with placebo treatment.
Conclusion
Based on the limited current evidence, acupuncture could have analgesic effects as perceived by owners, but acupuncture, as a sole analgesic, is unlikely to be effective in alleviating pain and pain-related dysfunction in canine chronic pain associated with musculoskeletal causes. Evidence is lacking on chronic pain due to neurological and oncological causes. Further studies need to focus on researching various acupuncture modalities’ effects on chronic pain with musculoskeletal, neuropathic and oncological causes when utilised as a component of multimodal therapy. Currently, for canine patients with chronic pain, there is insufficient evidence for a veterinarian to recommend that a client utilise acupuncture as the sole method for pain management.
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Baker-Meuten, A., Wendland, T., Shamir, S.K., Hess, A.M. & Duerr, F.M. (2020). Evaluation of acupuncture for the treatment of pain associated with naturally-occurring osteoarthritis in dogs: a prospective, randomized, placebo-controlled, blinded clinical trial. BMC Veterinary Research. 16(1). DOI: https://doi.org/10.1186/s12917-020-02567-1
Bolliger, C., DeCamp, C.E., Stajich, M., Flo, G.L., Martinez, S.A., Bennett, R.L. & Bebchuk, T. (2002). Gait analysis of dogs with hip dysplasia treated with gold bead implantation acupuncture. Veterinary and Comparative Orthopaedics Traumatology. 15(02), 116–122. DOI: https://doi.org/1055/s-0038-1632724
Briggs, J.P. & Shurtleff, D. (2017). Acupuncture and Sham Acupuncture for Pain Relief—Reply. Journal of the American Veterinary Medical Association. 318(15), 1503–1503. DOI: https://doi.org/10.1001/jama.2017.13398
Brown, D.C., Boston, R.C. & Farrar, J.T. (2013). Comparison of Force Plate Gait Analysis and Owner Assessment of Pain Using the Canine Brief Pain Inventory in Dogs with Osteoarthritis. Journal of Veterinary Internal Medicine. 27(1), 22–30. DOI: https://doi.org/10.1111/jvim.12004
Cantwell, S.L. (2010). Traditional Chinese Veterinary Medicine: The Mechanism and Management of Acupuncture for Chronic Pain. Topics in Companion Animal Medicine. 25(1), 53–58. DOI: https://doi.org/10.1053/j.tcam.2009.10.006
Chang, K.M., Chen, K.S., Wang, H.C., Lai, C.H., Hsieh, Y.T., King, H.H. & Lee, W.M. (2013). Combination of Acupuncture and Aquapuncture Using Vitamin B Complex for Treatment of Chronic Degenerative Changes of Hip Joints and Anal Relaxation in a Dog. The Thai Journal of Veterinary Medicine. 42(3), 387–390. DOI: https://doi.org/10.56808/2985-1130.2413
Conzemius, M.G. & Evans, R.B. (2012). Caregiver placebo effect for dogs with lameness from osteoarthritis. Journal of the American Veterinary Medical Association. 241(10), 1314–1319. DOI: https://doi.org/10.2460/javma.241.10.1314
Gruen, M.E., Dorman, D.C. & Lascelles, B.D.X. (2017). Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease-associated pain. The Veterinary Record. 180(19), 473. DOI: https://doi.org/10.1136/vr.104168
Hielm-Björkman, A., Raekallio, M., Kuusela, E., Saarto, E., Markkola, A. & Tulamo, R.M. (2001). Double-blind evaluation of implants of gold wire at acupuncture points in the dog as a treatment for osteoarthritis induced by hip dysplasia. Veterinary Record. 149(15), 452–456. DOI: https://doi.org/10.1136/vr.149.15.452
Jæger, G.T., Larsen, S., Søli, N. & Moe, L. (2006). Double-blind, placebo-controlled trial of the pain-relieving effects of the implantation of gold beads into dogs with hip dysplasia. Veterinary Record. 158(21), 722–726. DOI: https://doi.org/10.1136/vr.158.21.722
Jæger, G.T., Stigen, Ø., Devor, M. & Moe, L. (2012). Gold Bead Implantation in Acupoints for Coxofemoral Arthrosis in Dogs: Method Description and Adverse Effects. Animals. 2(3), 426–436. DOI: https://doi.org/10.3390/ani2030426
Kapatkin, A.S., Tomasic, M., Beech, J., Meadows, C., Boston, R.C., Mayhew, P.D., Powers, M.Y. & Smith, G.K. (2006). Effects of electrostimulated acupuncture on ground reaction forces and pain scores in dogs with chronic elbow joint arthritis. Journal of the American Veterinary Medical Association. 228(9), 1350–1354. DOI: https://doi.org/10.2460/javma.228.9.1350
Kong, J., Kaptchuk, T.J., Polich, G., Kirsch, I., Vangel, M., Zyloney, C., Rosen, B. & Gollub, R. (2009). Expectancy and treatment interactions: a dissociation between acupuncture analgesia and expectancy evoked placebo analgesia. NeuroImage. 45(3), 940–949. DOI: https://doi.org/10.1016/j.neuroimage.2008.12.025
Lascelles, B.D.X., Brown, D.C., Conzemius, M.G., Gill, M., Oshinsky, M.L. & Sharkey, M. (2019). Measurement of chronic pain in companion animals: Discussions from the Pain in Animals Workshop (PAW) 2017. The Veterinary Journal. 250, 71–78. DOI: https://doi.org/10.1016/j.tvjl.2019.07.001
Pannucci, C.J. & Wilkins, E.G. (2010). Identifying and Avoiding Bias in Research. Plastic and Reconstructive Surgery. 126(2), 619–625. DOI: https://doi.org/10.1097/PRS.0b013e3181de24bc
Roynard, P., Frank, L., Xie, H. & Fowler, M. (2018). Acupuncture for Small Animal Neurologic Disorders. Veterinary Clinics of North America: Small Animal Practice. 48(1), 201–219. DOI: https://doi.org/10.1016/j.cvsm.2017.08.003
Scognamillo-Szabó, M.V.R., de Sousa, N.R., Carvalho, L.T. & Carvalho, F.S.R. (2010). Acupuncture and gold bead implant for hip dysplasia in German Shepherd. Acta Scientiae Veterinariae. 38(4), 443–448.
Tavel, M.E. (2014). The Placebo Effect: the Good, the Bad, and the Ugly. The American Journal of Medicine. 127(6), 484–488. DOI: https://doi.org/10.1016/j.amjmed.2014.02.002
Teixeira, L.R., Luna, S.P., Matsubara, L.M., Cápua, M.L., Santos, B.P., Mesquita, L.R., Faria, L.G., Agostinho, F.S. & Hielm-Björkman, A. (2016). Owner assessment of chronic pain intensity and results of gait analysis of dogs with hip dysplasia treated with acupuncture. Journal of the American Veterinary Medical Association. 249(9), 1031–1039. DOI: https://doi.org/10.2460/javma.249.9.1031
Trumble, T.N., Billinghurst, R.C. & McIlwraith, C.W. (2004). Correlation of prostaglandin E2 concentrations in synovial fluid with ground reaction forces and clinical variables for pain or inflammation in dogs with osteoarthritis induced by transection of the cranial cruciate ligament. American Journal of Veterinary Research. 65(9), 1269–1275. DOI: https://doi.org/10.2460/ajvr.2004.65.1269
Veit, N. (2013). Acupuncture as palliative pain therapy for OCD in canine shoulder joint. Zeitschrift für Ganzheitliche Tiermedizin. 27(2), 46–48. DOI: https://doi.org/10.1055/s-0032-1328406
Walton, M.B., Cowderoy, E., Lascelles, D. & Innes, J.F. (2013). Evaluation of Construct and Criterion Validity for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) Clinical Metrology Instrument and Comparison to Two Other Instruments. PLOS ONE. 8(3), e58125. DOI: https://doi.org/10.1371/journal.pone.0058125
Wang, Y., Zhao, J. & Hao, D. (2017). Is sham acupuncture a real placebo: Skeptical for sham acupuncture. World Journal of Acupuncture. 27(2), 1–5. DOI: https://doi.org/10.1016/S1003-5257(17)30110-1
Zeng, D., Yan, X., Deng, H., Li, J., Xiao, J., Yuan, J., Huang, J., Xu, N., Fu, W. & Liu, J. (2022). Placebo response varies between different types of sham acupuncture: A randomized double-blind trial in neck pain patients. European Journal of Pain. 26(5), 1006–1020. DOI: https://doi.org/10.1002/ejp.1924
License
Copyright (c) 2024 Jianjian Gong, Mary Frances Thompson
This work is licensed under a Creative Commons Attribution 4.0 International License.
Veterinary Evidence uses the Creative Commons copyright Creative Commons Attribution 4.0 International License. That means users are free to copy and redistribute the material in any medium or format. Remix, transform, and build upon the material for any purpose, even commercially - with the appropriate citation.
