Wrist-ankle acupuncture has a positive effect on chronic pain: a systematic review and meta-analysis

An increasing number of practitioners are using acupuncture methods such as wrist-ankle acupuncture (WAA) to treat pain. We aimed systematically to evaluate the effects of WAA on cancer pain, primary pain, chronic musculoskeletal pain and pathological neuralgia pain. Nine electronic databases were searched for randomized controlled trials (RCTs) on WAA from inception of the data base to July 31, 2022. RCTs within the inclusion and exclusion criteria were included in the study. Outcomes included pain score, clinical efficacy (overall efficiency), and occurrence of adverse events. The risk of bias was evaluated using the Cochrane Collaboration criteria and meta-analysis was performed using RevMan 5.4.1 software to determine the effect of WAA intervention and statistical significance was set a P < 0.05. A total of 19 RCTs were included in the meta-analysis including 1,380 participants, consisting of 673 who had received WAA alone or in combination with other treatments (WAA group, WG) and 707 who did not receive WAA (control group, CG). Subgroup analyses were performed according to different chronic pain types and occurrence of adverse events of WAA versus oral or non-oral drug therapy. The WG had better analgesic effects on various types of chronic pain than CG (P < 0.00001) and clinical efficacy (P < 0.00001). Additionally, WAA was shown to be safer than oral medication (P = 0.09). Therefore, WAA has good analgesic efficacy for several types of common chronic pain alone and in combination with other therapies, and it is safer than oral medication. However, more high-quality randomized controlled trials are needed in the future to support this evidence. Graphical abstract: http://links.lww.com/AHM/A48