March 07, 2016
February 21, 2016—Palm Springs, California—In a small study, auricular acupuncture proved to be a highly effective adjunctive therapy for neuropathic pain.
This conclusion, based on a single-center study of 18 patients age 11 – 78 years, was presented at the 32nd Annual Meeting of the American Academy of Pain Medicine, from February 18 – 21.
Juliane Lee, MD, of the Medical College of Wisconsin, Milwaukee, explained that neuropathic pain syndromes account for much disability and lost work and school days. Acupuncture has been shown to be effective for neuropathic pain (National Institutes of Health Consensus Development Conference on Acupuncture, November 3 – 5, 1997; Wang SM et al, Anesth Analg 106:2, 2008)
Auricular acupuncture is based on a homunculus on the surface of the ear. Dr. Robertson and colleagues offer auricular acupuncture in their multidisciplinary pediatric pain clinic, where adults are welcome for acupuncture only.
From 2009 to 2015, Dr. Lee’s team in Arkansas provided adjunctive auricular acupuncture to 18 pediatric and adult patients whose neuropathic pain was not adequately controlled by conventional measures. They failed to achieve satisfactory relief with anticonvulsants, antidepressants, alpha agonists, narcotics, other adjunctive analgesics, and physical and psychological counseling. The investigators analyzed the outcomes.
Dr. Lee said, “Identifying patient groups that exhibit the most striking response to acupuncture may help guide referring providers to select appropriate patients early.”
She added ”Since exposure and access to medical acupuncture are so limited in Arkansas, we wanted to determine which patients would most benefit from our acupuncture services. Our pain population was largely patients suffering from headaches, neuropathic pain, abdominal pain, and musculoskeletal pain.”
Eighteen patients with pain caused by complex regional pain syndrome I or II, phantom limb, trigeminal or post-herpetic neuralgia, or post-chemotherapy or peripheral neuropathy were treated.
Sixteen were treated with auricular semipermanent acupuncture needles, and two with acupressure beads. Needles and beads were retained for 3 days. Pain scores were collected immediately before and after treatment.
Average pain scores (from 0 – 10) were initially 6 ± 2.3 and 0.66 ± 0.99 post treatment in these seven pediatric and 11 adult patients treated with auricular acupuncture for neuropathic pain. Average pain reduction was 4.83 ± 2.18 (P < .05). A total of 88.8% (16/18) experienced at least a 30% reduction; and 61.1% (11/18), complete resolution of neuropathic pain.
Treatment failed two patients, who experienced <30% reduction in pain score.
Dr. Lee said, “The dramatic results were highly promising, and paralleled the pain reduction observed with adjunctive auricular acupuncture for other common, painful disorders.”
She added, “We demonstrated that a safe, minor procedure profoundly and rapidly reduced pain in a small patient population in which pain was severe, often debilitating, and for which other treatment options were suboptimal.”
Dr. Lee asserted, “Neuropathic pain represents a tremendous clinical challenge, and auricular acupuncture is a safe and effective treatment modality for alleviating neuropathic pain with minimal time, labor, and cost. Up to 60% of patients experienced complete resolution of their otherwise recalcitrant pain.”
When asked about clinical directions her team’s research could support, Dr. Lee answered, “We hope these results will raise awareness and interest in auricular acupuncture as a highly effective adjunct to standard therapies, and that patients and pain practitioners will consider including auricular acupuncture when initiating other therapies, or when other modalities have failed to provide adequate pain relief.”
As far as future research directions, Dr. Lee said, “We would like to conduct a larger scale, prospective, double blind, randomized, and controlled study of auricular acupuncture. Such a trial could allow us to better identify subpopulations of patients who can benefit from auricular acupuncture.”
Though the mechanism of action of acupuncture remains elusive, the technique offers statistically significant and often profound benefits, with minimal side effects. The ease of application and utility of acupuncture for neuropathic pain are encouraging, as the technique offers safe, rapid, and profound pain relief.
Auricular acupuncture is a well tolerated by adults and even children, and acupressure is effective for needle-phobic patients.
“For at least some of our patients,” Dr. Lee concluded, “we were able to provide auricular acupuncture as an adjunct to help expedite recovery, improve functioning and quality of life, and resume normal life.”