2016-02-17

(Reuters Health) – Individualized acupuncture treatments were tied to greater pain relief for people with fibromyalgia, according to results from a small trial in Spain that compared the approach to sham acupuncture.

Researchers found the benefits of tailored acupuncture seemed to persist even a year after treatment. But an expert not involved in the research thinks the evidence for acupuncture is still limited.

Although all participants in the study had a fibromyalgia diagnosis, for those who got the real, rather than sham, treatments, the study team tailored acupuncture points based on Traditional Chinese Medicine diagnosis of underlying issues, such as “Liver Qi stagnation” or “Yin deficiency.”

“Doing so, it improves the results with the technique, as we demonstrate in our article where the result of the use of individualized acupuncture is far higher that standard acupuncture for these patients,” lead author Dr. Jorge Vas of the Pain Treatment Unit at Dona Mercedes Primary Health Center in Seville told Reuters Health by email.

“In . . . our pain clinic, we give individualized acupuncture not only for fibromyalgia patients but also for any patient with different pathologies, and we can see the difference in the result with patients in which standard acupuncture is practiced,” he said.

The study included 164 adults with fibromyalgia, a chronic widespread pain disorder affecting up to 5 percent of people. Patients had all been referred to Vas’ clinic from three primary care centers in southern Spain.

The researchers divided participants into two groups, with members of both receiving weekly 20-minute acupuncture sessions over nine weeks. One group received real, personalized acupuncture and the other got fake treatments from a therapist mimicking the actions of acupuncture without using needles.

Patients didn’t know which group they were in, and they continued to take any fibromyalgia medications they had already been prescribed.

All the patients were interviewed, completed questionnaires and were physically examined before the study began, after 10 weeks, six months and one year later.

Both groups experienced some pain relief at the 10-week point, but the reduction in pain intensity was significantly larger, at 41 percent, in the real acupuncture group compared with 27 percent in the sham acupuncture group.

By one year, those in the acupuncture group still reported a 19 percent reduction in pain intensity compared to their scores at the start of the study, while the sham group reported only a 6 percent reduction.

Comparing real acupuncture treatments to imitated acupuncture can be difficult as even the sham treatment group does attend a treatment session and gets personal attention from an acupuncturist, which past research suggests may have some effect of its own.

“It is also surprising that the control group treated with sham acupuncture, which was stimulation of acupuncture points with a little tube without puncture, worked for pain relief after the sessions even up to 10 weeks after finished treatment,” Vas said.

Drug treatments for fibromyalgia have had mixed results and they often carry side effects and may not be effective, Vas said. And the evidence for psychological techniques is also limited, he said.

The value of the current study’s findings may also be limited, however, according to Dr. Marco Matucci Cerinic, professor of rheumatology at the University of Florence, who was not part of the research.

The acupuncturists certainly knew whether they were delivering actual or sham treatment, and patients could also have been aware, which limits the results, he said.

The methodology of the study was questionable and may not add anything to the fibromyalgia literature, Cerinic told Reuters Health by email.

SOURCE: http://bit.ly/1KqEkaS Acupuncture in Medicine, online February 15, 2016.

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