Acupuncture for Chronic Pain in US Medicaid Scheme

Acupuncture for chronic pain. Research commissioned by the US State of Vermont shows that acupuncture is effective for chronic pain and offers a wide array of other benefits, for patients on low incomes and treated under the government-funded Medicaid scheme. Previous studies have shown that this population is hampered in its access to non-pharmacological treatments, by lack of health insurance. In a pragmatic randomised trial, Medicaid patients with chronic pain were offered up to 12 acupuncture sessions over a 60 day period. This resulted in 156 patients (111 women & 45 men) receiving an average 8.2 treatments.

– There were significant improvements in pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep and social isolation.
– 57% of patients using non-opioid analgesics reported reductions in use.
– 32% of patients using opioid analgesics reported reductions in use.
– 74% of employed patients reported improved capacity to work.
– 96% of patients would recommend acupuncture to others with chronic pain.

(Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial. Global Advances in Health & Medicine, April 2018.)

Acupuncture Effective for Pain Relief in A&E Department

Acupuncture for pain relief in A&E Department. A systematic review by Australian authors has shown the effectiveness of ear acupuncture delivered for the purpose of pain relief in a hospital emergency department setting. The treatment was helpful when given either on its own, or as an adjunct to other pain relief measures. Six randomised trials and two observational studies, involving a total of 458 patients, were included in the analysis, which suggested that ear acupuncture can provide clinically meaningful analgesia for acute pain conditions in the emergency department. The treatment was also assessed to have other potential benefits, such as low risk and cost, reasonable application time, improved patient satisfaction, and non-interference with other necessary procedures.

The authors conclude that while study numbers were limited, ear acupuncture significantly reduces pain scores and has potential benefits for use in the emergency department. Further studies will define acupuncture’s role and if it reduces use of analgesic medications.

(Does Ear Acupuncture Have a Role for Pain Relief in the Emergency Setting? A Systematic Review & Meta-Analysis. Medical Acupuncture, October 2017.)

Acupuncture for Trigeminal Neuralgia

Research from Brazil quoted on Acupuncture in Exeter: acupuncture for trigeminal neuralgia. Researchers in the Medical School of the University of Sao Paulo, looking at the use of acupuncture for trigeminal neuralgia, have found that it can reduce levels of pain and medication use. In the longitudinal case-control study, they compared 30 healthy subjects with 60 patients diagnosed with idiopathic trigeminal neuralgia. The latter group were randomly assigned to receive either true acupuncture, sham acupuncture or treatment with the drug carbamazepine. The true acupuncture group received ten weekly sessions. The sham group received the same, except that they were only needled superficially at all acupuncture points.

Mean pain intensity decreased only in the true acupuncture group, while patients in the sham group required an increase in medication. Both acupuncture groups exhibited a reduction in secondary myofascial pain and mandibular limitation, but only the true acupuncture group maintained these improvements at six month follow-up. The authors conclude that true acupuncture benefits both the primary and secondary causes of idiopathic trigeminal neuralgia pain.

(Acupuncture treatment for idiopathic trigeminal neuralgia: A longitudinal case-control double blinded study. Chinese Journal of Integrative Medicine, November 2017.)

Acupuncture for Dental Pain is more Effective than Analgesics

Acupuncture for dental pain
Indian researchers studying the effectiveness of acupuncture for dental pain, have found it offers better pain relief than analgesics for inflamed dental pulp. A total of 157 patients aged 18 to 49, were randomly allocated to receive either real acupuncture plus placebo drug, sham acupuncture plus placebo drug, or sham acupuncture plus ibuprofen. All participants had been diagnosed with symptomatic irreversible pulpitis at the SRM Dental College, Tamil Nadu, and were in moderate to severe pain.

Patients treated with real acupuncture reported faster, more sustained pain relief compared with the other treatment arms. The authors conclude that acupuncture is a safer and more effective alternative to analgesics for management of pain in patients with symptomatic irreversible pulpitis.

(Comparison of Acupuncture with Ibuprofen for Pain Management in Patients with Symptomatic Irreversible Pulpitis: A Randomized Double-Blind Clinical Trial. Journal of Acupuncture & Meridian Studies, December 2017.)

Acupuncture could help America’s Opioid Epidemic

Acupuncture could help America's opioid epidemic.
In 2017, the US National Association of Attorneys General wrote to health insurers, asking them to review their policies and promote treatments such as acupuncture, physical therapy and massage, as alternatives to opioid painkillers. Opioid overdose is killing 91 Americans every day, and more than half of these deaths involve prescription drugs. Shortly afterwards, American acupuncture organisations published their joint paper showing how acupuncture could contribute to solving this crisis.

Numerous US federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. The authors recommend it as a powerful option which can be used as a first-line, drug-free method for pain relief and management. It can safely and cost-effectively be incorporated into diverse medical settings, resulting in significantly decreased healthcare expenditure, by both treating pain and avoiding opioid addiction. The US Military & Veterans Administration has already used acupuncture to successfully decrease the volume of opioids prescribed.

(Acupuncture’s Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management – White Paper 2017. Journal of Integrated Medicine, November 2017.)