German researchers at the University Medical Center, Hamburg-Eppendorf, have found that acupuncture improves nerve regeneration in chemotherapy-induced peripheral neuropathy. The progress is measurable both in terms of subjective reporting by patients, and objective neurological findings.
In a cross-over study, 60 patients were randomly assigned to either an acupuncture group, or to a waiting list control group. Ten acupuncture sessions were given once per week. The groups were then reversed, for a further ten weeks of treatment to be given this time to the former waiting list group.
After 28 weeks, evaluation of both groups showed that sensory nerve amplitude and conduction velocity were both improved after acupuncture, compared with the control group. Acupuncture patients also reported improvements in symptoms such as burning pain, cramps, numbness, symptom frequency and unsteadiness of gait. Physical examination revealed that acupuncture patients had significant improvements in blind walking, heel-to-toe walking, ability to perceive vibration and neuropathy deficit scores, compared with the waiting list group.
(Acupuncture improves chemotherapy-induced neuropathy explored by neurophysiological & clinical outcomes – The randomized, controlled, cross-over ACUCIN trial. Phytomedicine, September 2022.)
American clinicians have found that a type of ear acupuncture termed battlefield acupuncture, reduces pain and opioid use in military veterans undergoing surgery. A total of 72 patients, mean age 64 and scheduled for major surgery under general anaesthesia, were randomly assigned to receive either ear acupuncture or sham acupuncture for postoperative pain. Surgery was typically abdominal, thoracic or for hip/knee replacements.
Median postoperative opioid consumption was significantly lower in the acupuncture group (18 units) compared to the sham group (39 units). Also lower in the acupuncture group, were subjective pain intensity, nausea and vomiting. Only one acupuncture group patient experienced nausea, compared with 13 in the sham group.
The researchers conclude that the diminished postoperative pain intensity, reduced postoperative opioid requirement, and the lower incidence of postoperative nausea and vomiting observed, demonstrate the potential advantages of this low-cost and low-risk therapy in this patient population. Further research is needed to test its effectiveness in individual surgical procedures.
(Battlefield Acupuncture Use for Perioperative Anesthesia in Veterans Affairs Surgical Patients: A Single-Center Randomized Controlled Trial. Journal of Integrative & Complementary Medicine, 10 August 2022.)
American researchers investigating whether acupuncture helps chemotherapy-induced neuropathy, have conducted a three-arm randomised trial at Memorial Sloan Kettering Cancer Center, New York. A group of 75 cancer patients were recruited. All had completed chemotherapy at least three months prior, and were experiencing moderate to severe neuropathy in the form of numbness, tingling or pain. Patients were randomly assigned to either real acupuncture, sham acupuncture or usual care. Acupuncture was given in the form of ten sessions over eight weeks, and biweekly for the first fortnight.
The real acupuncture group exhibited statistically significant improvements in quality of life, anxiety, insomnia and fatigue.
(Health-Related Quality of Life in Cancer Survivors with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Clinical Trial. Oncologist, November 2021.)
The latest NICE guideline on treatment of chronic pain, recommends acupuncture, exercise or psychological therapies, as non-pharmacological approaches to managing chronic primary pain. By contrast, paracetamol, non-steroidal anti-inflammatories and opioids, are not recommended.
The NICE committee which devised the guideline acknowledged that there is now a large evidence base for acupuncture’s short term effectiveness. They cited 27 studies showing it reduced pain and improved quality of life for up to three months.
(Chronic pain (primary & secondary) in over 16s: assessment of all chronic pain & management of chronic primary pain. NICE guideline [NG193], 7 April 2021.)
US military veterans who have acupuncture before surgery, report less pain and need far fewer opioids to manage their discomfort. In the randomized, controlled study presented at the 2020 annual meeting of the American Society of Anesthesiologists, the veterans were also more satisfied with their pain control.
“Six percent of patients given opioids after surgery become dependent on them, and veterans are twice as likely to die from accidental overdoses than civilians,” said Brinda Krish, D.O., lead author of the study and an anesthesiology resident at Detroit Medical Center. “Clearly it is crucial to have multiple options for treating pain, and acupuncture is an excellent alternative. It is safe, cost effective and it works.”
Researchers treated two groups of patients at the John D. Dingell VA Medical Center in Detroit. One group due for hip replacement were randomly assigned to either acupuncture or a control group before surgery. The other included patients undergoing a variety of procedures (including gallbladder removal, hernia repair, hysterectomy or prostate surgery); these were also randomly assigned to either acupuncture or a control group before surgery.
In the first group, patients who had not received acupuncture consumed nearly three times as much morphine in the first 24 hours after surgery, as those who had the treatment. Acupuncture patients reported less pain and 14% reported less anxiety.
In the second group, acupuncture patients consumed only half as many opioids as those in the control group. Only 3% reported nausea and vomiting after surgery, compared to 38% of the control group.
(American Society of Anesthesiologists 2020 Annual Meeting News.)