Acupuncture and moxibustion for lateral elbow pain (tennis elbow)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012509/

Acupuncture  and moxibustion have widely been used to treat lateral elbow pain  (LEP). A comprehensive systematic review of randomized controlled trials  (RCTs) including both English and Chinese databases was conducted to  assess the efficacy of acupuncture and moxibustion in the treatment of  LEP.

Revised  STRICTA (2010) criteria were used to appraise the acupuncture  procedures, the Cochrane risk of bias tool was used to assess the  methodological quality of the studies. A total of 19 RCTs that compared  acupuncture and/or moxibustion with sham acupuncture, another form of  acupuncture, or conventional treatment were included.

All  studies had at least one domain rated as high risk or uncertain risk of  bias in the Cochrane risk of bias tool. Results from three RCTs of  moderate quality showed that acupuncture was more effective than sham  acupuncture. Results from 10 RCTs of mostly low quality showed that  acupuncture or moxibustion was superior or equal to conventional  treatment, such as local anesthetic injection, local steroid injection,  non-steroidal anti- inflammatory drugs, or ultrasound. There were six  low quality RCTs that compared acupuncture and moxibustion combined with  manual acupuncture alone, and all showed that acupuncture and  moxibustion combined was superior to manual acupuncture alone.

Moderate  quality studies suggest that acupuncture is more effective than sham  acupuncture. Interpretations of findings regarding acupuncture vs.  conventional treatment, and acupuncture and moxibustion combined vs.  manual acupuncture alone are limited by the methodological qualities of  these studies. Future studies with improved methodological design are  warranted to confirm the efficacy of acupuncture and moxibustion for  LEP.