Health institutions recognize the effectiveness of acupuncture for the treatment of pain: for a few days the therapy has been included in the National Guidelines System of the Istituto Superiore di Sanità. “An important recognition for our work”, he observes Carlo Maria Giovanardipresident of the Italian Federation of FISA Acupuncture Societies.
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The document was proposed by the scientific society and elaborated with the support of external consultants, including researchers from the Mario Negri Institute in Milan: “According to the law 24/2017 (Gelli law) on professional responsibility, we are called as a scientific company to prepare guidelines on matters of our competence “, explains Giovanardi. A self-financed commitment that required three years of work to evaluate the available studies, based on rigorous criteria such as the PICO model (English acronym for Population Intervention Comparison Outcome), which allows you to formulate targeted questions to evaluate the effectiveness of a therapy .
Needles against drugs for migraine and chronic low back pain
“In the case of acupuncture, verifying its effectiveness with respect to drugs”, explains Giovanardi. “Our evaluations show, with a moderate degree of certainty – the second best possible result based on the scale provided for the guidelines – that needles have an efficacy comparable to that of drugs, but more limited side effects.” In particular, the Guidelines concern the use of acupuncture to treat migraine and chronic low back pain: “These indications will be included in the general guidelines on the treatment of pain, with the aim of guiding doctors”, recalls Giovanardi “We have chosen to work out of two of the pathologies that create major problems at the health and social level, others will soon be added, such as dysmenorrhea or chemotherapy neuropathy in breast cancer patients “.
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Migraine: drug-like efficacy, fewer side effects
On migraine, in particular, there are many studies that show how acupuncture guarantees results comparable to those of drugs with significantly lower side effects. “The treatment with needles, especially if used in conjunction with drugs, allows to reduce the frequency and severity of attacks”, Giovanardi recalls. And a systematic review published in the journal Frontiers in Neurology confirms that acupuncture is slightly more effective and much safer than migraine prophylaxis drugs.
Good results also with regard to chronic low back pain, especially in combination with pharmacological and non-pharmacological treatment, “without forgetting – recalls Giovanardi – that acupuncture guarantees both physical and psychological benefits that go beyond the symptom for which the treatment”. One study shows that 75% of subjects treated with needles noted positive changes in physical symptoms, 67% in emotional and mental symptoms, and 40% in lifestyle.
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The dose and the points to be treated
Meanwhile, the research refines the methodologies, inserting the concept of dose: acupuncture treatments are by definition personalized, and there are different styles and different practices, in China for example the treatments are often daily. “There are hundreds of points that can be used, even if a good acupuncturist can work well by treating seventy / eighty of them adequately”, explains Giovanardi. “But in order to establish the efficacy of the therapy it is still necessary to define general parameters concerning the minimum number of points to be treated, the stimulation modality and the duration of the treatment”.
Now these treatments cannot be ignored
It is now a question of translating the Guidelines into clinical practice: “It will take time – observes Giovanardi – the guidelines of the European Society of Urology, for example, indicate the effectiveness of acupuncture to treat prostate pain syndrome, but how many are the specialists who recommend it? ” Then there are the difficulties represented by uneven regional regulations to be overcome, in the face of a post-graduate training course already regulated in the formal aspects by the State-Regions Agreement of February 7, 2013. “But now these treatments must be recommended in the cases provided for. , it will no longer be allowed to ignore them “, concludes the FISA president:” We have many solid confirmations on the efficacy of acupuncture and we are also beginning to know its mechanisms of action, now it is necessary to enhance its availability from within the public structures which currently number 133 , too few to meet the needs of patients “. So much so that the scientific society intends to start monitoring to assess the frequency of use of acupuncture for the prophylaxis of migraine and the treatment of chronic low back pain, before and after the publication of the Guidelines.