Category: Pain

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.)

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.)

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.)

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.)

Authors of an American systematic review have found acupuncture to be effective for acute pain in the hospital emergency department setting. Meta-analyses were performed on data from 14 randomised controlled trials covering a total of 1210 patients. The trials compared acupuncture with sham, acupuncture with standard analgesia, and also examined acupuncture as an adjunct to standard care.

Acupuncture was more clinically effective than sham, and comparable with conventional drug therapy for acute pain. It was also associated with improved patient satisfaction, lower costs and fewer adverse effects. There was limited evidence suggesting superior results may be achieved when adding adjunctive acupuncture to standard analgesia.

(Does acupuncture have a role in providing analgesia in the emergency setting? A systematic review and meta-analysis. Emergency Medicine Australasia, 26 July 2017 epub ahead of print.)

The largest ever pragmatic, randomised trial looking at acupuncture undertaken in hospital emergency departments, has found it is a safe and effective alternative to conventional drugs for acute pain. A total of 1964 patients presenting at four Melbourne hospitals with back pain, migraine and ankle sprain, were randomised to receive acupuncture, acupuncture plus analgesics, or analgesics alone. All patients had to complain of pain rated a minimum of 4 on a 10-point verbal scale. Although neither drugs nor acupuncture offered clinically relevant pain reduction within an hour, patients found either treatment acceptable. The effectiveness of acupuncture was comparable with that of drugs.

(Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Medical Journal of Australia, 2017.)