A study found that electroacupuncture was superior to both auricular acupuncture and standard care for skeletal muscle pain management in cancer survivors.
Electroacupuncture reduced pain by 1.9 points on the 0-10 scale of the Brief Pain Inventory (BPI), compared to standard care. Auricular acupuncture, which was developed by the US military, reduced pain by 1.6 points compared to standard care, and was associated with more adverse effects (AE). Standard care consisted of analgesics, physical therapy, and steroid injections.
“The magnitude of effect of electroacupuncture was clinically important and durable,” the authors wrote. “This finding is consistent with evidence from other large acupuncture trials for chronic pain in the general population. Electroacupuncture has been shown to influence endogenous opioid release, which provides a mechanistic basis for chronic pain management.”
“The present trial includes a large and diverse group of cancer survivors and provides evidence that electroacupuncture provides additional benefits beyond usual care, including not only reduction in pain severity, but also improvements in physical function and quality of life and reductions in analgesic use.”
The PEACE Study enrolled patients with a history of cancer who had experienced musculoskeletal pain for at least three months and at least 15 of the preceding 30 days, with a worst pain intensity within the past week of ≥ 4 (moderate or greater) on the BPI.
Patients were randomised 2:2:1 to receive either electroacupuncture, auricular acupuncture (which were both delivered by licensed, experienced practitioners) or standard care.
In electroacupuncture procedure, needles were placed at four sites near the location of pain and four additional sites elsewhere on the body to address comorbid symptoms. The treatments consisted of 10 weekly 30-minute sessions.
The auricular acupuncture, also known as ‘battlefield acupuncture’ had a standardised procedure where a single needle was inserted into the cingulate gyrus of one ear. The patient then walked for one minute, and if pain remained ≥ 1 on the BPI, another needle was inserted into the other ear. The process was repeated for the four remaining ear acupuncture points.
Mean baseline BPI scores ranged from 5.0 to 5.6. At week 12, mean BPI score had declined by 0.48 in the standard care group, 2.39 in the electroacupuncture group (P < 0.001), and 2.03 in the auricular acupuncture group (P < 0.001). The 0.36 difference between the two acupuncture groups exceeded the prespecified noninferiority margin of 0.657 for auricular versus electroacupuncture.
Source: MedPage Today
Journal information: Mao JJ, et al “Effectiveness of electroacupuncture or auricular acupuncture vs usual care for chronic musculoskeletal pain among cancer survivors: the PEACE randomized clinical trial” JAMA Oncol 2021; DOI: 10.1001/jamaoncol.2021.0310.
