Acupuncture helps Chronic Pain in Urban Primary Care

Research from America.

Researchers in the US have found that weekly acupuncture is associated with improvements in pain and quality of life, when included in the usual care of chronic pain patients in urban health centres. In a trial, 226 patients selected from four health centres in the Bronx, New York, began receiving acupuncture. Osteoarthritis, back and neck pain were usually the reason for referral to the trial. Patients were frequently older (mean age 54), receiving disability payments, in poor or fair overall health, and with high baseline pain levels.

Following a mean of 9.7 acupuncture treatments on a weekly basis, there was a significant improvement in pain severity and physical wellbeing at 12 and 24 weeks, compared to baseline levels.

(Outcomes of acupuncture for chronic pain in urban primary care. Journal of the American Board of Family Medicine, Nov-Dec 2013.)

Acupuncture assists with Pain Relief after Heart Surgery

Acupuncture assists with pain relief after heart surgery: research from Germany.
A study undertaken in Germany has shown acupuncture offers significant benefits to patients who have undergone coronary bypass surgery. Impaired breathing and depressed lung function as a side-effect of opioid pain killers, are common complications of the sternotomy procedure, in which a longitudinal incision is made along the sternum or breastbone.

A total of 100 such patients at Heidelberg University Hospital were randomly allocated to one of three groups:
– group 1 received standard pain relief plus acupuncture at sub-optimal acupuncture points to act as a control;
– group 2 received standard pain relief plus acupuncture at optimal acupuncture points chosen according to traditional Chinese medicine as appropriate to the condition being treated;
– group 3 received standard pain relief alone.

Both acupuncture groups experienced statistically significant pain relief, but whereas group 1 experienced an 18% pain reduction, group 2 experienced a 71% reduction. In addition to recording subjective pain scores, the researchers also studied patients’ forced vital capacity, an objective measure of analgesia-related improvement in the ability to expand the rib cage. In group 1, this increased by a statistically insignificant 30ml, whereas in group 2, the increase was 306ml. The researchers conclude acupuncture provides clinically significant pain relief resulting in improved breathing. Due to the difference in results between groups 1 and 2, they also believe the choice of acupuncture points is of crucial importance, showing the technique to be much more effective than might be expected from placebo alone.

(Objectifying acupuncture effects by lung function and numeric rating scale in patients undergoing heart surgery. Evidence-Based Complementary & Alternative Medicine, 2013.)

US Military uses Acupuncture for Pain

Ear acupuncture for pain relief.

An American military research team has undertaken a feasibility study to assess the effectiveness and acceptability of acupuncture for pain control in injured personnel. Ear acupuncture was given to patients experiencing pain during evacuation by air from Germany to a base in Maryland, USA. Patients reported statistically significant reductions in pain following treatment: average pain scores fell from 4.07 prior to treatment, to 2.17 one hour after treatment, and 2.76 one hour after the flight.

(Moving Acupuncture to the Frontline of Military Medical Care: A Feasibility Study. Medical Acupuncture, February 2013.)

Acupuncture Treatment of Phantom Limb Pain

Clinicians have published a report of a patient with phantom limb pain, successfully treated with acupuncture within a Swansea GP practice. The 45-year-old man was suffering pain and sensation following amputation of his forearm above the elbow twelve weeks earlier. After seven weekly acupuncture sessions on his opposite arm, he experienced complete relief of the phantom limb pain and significant improvement of the phantom sensations. He remained free of pain at follow-up after 5 months.

The author, a GP within the practice, concludes that the patient derived considerable benefit from short sessions of acupuncture. This benefit was commented on when he attended a secondary care pain control clinic which was unaware that he was having acupuncture in primary care. The clinic letter noted a dramatic improvement in his symptoms.

(Acupuncture Treatment of Phantom Limb Pain and Phantom Limb Sensation in a Primary Care Setting. Acupuncture in Medicine, on-line 6 December 2012.)

Acupuncture is Effective for Chronic Pain

An international collaboration which included some of the UK’s leading acupuncture researchers, has provided definitive evidence that acupuncture is effective for chronic pain. The collaboration gathered individual patient data for nearly 18 000 patients who took part in 29 high-quality, randomised, controlled trials of acupuncture for four chronic pain conditions: back and neck pain, shoulder pain, headache and osteoarthritis.

For each of the four conditions, true acupuncture was superior to control, and significantly more effective than usual care alone. The researchers conclude that this study provides the most robust evidence to date that acupuncture is a reasonable referral option for patients with chronic pain. The significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture. They hope that their findings will inform policy-making aswell as encourage clinicians to recommend acupuncture as a safe and effective treatment.

(Acupuncture for Chronic Pain: Individual Patient Data Meta-Analysis. Archives of Internal Medicine, 10 September 2012.)