No abstract

There are no curative treatments for cervical dystonia (CD), therefore conventional management is aimed at pain relief and muscle relaxation. Many patients with CD use complementary and integrative medicine interventions to manage symptoms, yet there are limited data on the use of acupuncture for CD. The aim of the current study was to determine the feasibility, safety, and efficacy of adjuvant acupuncture. A pilot open-label study was conducted on acupuncture treatments as add-on therapy to botulinum-toxin injection sessions (3 months apart) in 5 subjects with chronic idiopathic CD. Six 1-hour acupuncture sessions were administered every other week over the 3-month period between consecutive botulinum-toxin sessions. Data from exploratory efficacy endpoints-including a visual analogue scale for pain, the Clinician Global Impression of Change, the Patient Global Impression of Change, the Toronto Western Spasmodic Torticollis Rating Scale, and the Short Form-36) Health Survey-were collected. Five subjects completed the study with only 1 acupuncture session missed by 1 subject, thereby meeting the study's predetermined adherence goal. All participants reported improvement from acupuncture. Only minor adverse events were reported, with self-resolved discomfort in 1 subject and self-resolved minor bruising in 2 subjects. Acupuncture is feasible and safe as an adjunct treatment for chronic CD, and might be associated with subjective symptomatic benefits.

Overall, PROMIS computer adaptive tests were able to assess domains of QOL briefly. Although pretreatment acupuncture expectations highlighted subgroup differences in outcomes at baseline, linear-growth models demonstrated the positive effects of acupuncture over time on anxiety, depression, pain interference, and sleep disturbance.

Fibromyalgia is a difficult disorder both to diagnose and treat. To complicate this further, patients often present with several co-existing conditions, medical and/or psychological, that may involve a great deal of symptom overlap. Patients often are only moderately if at all responsive to traditional medications and physical therapy modalities. This often leaves patients feeling frustrated, confused, and misunderstood, leading to secondary psychological processes that impact both the pain experience itself and quality of life. Patients often seek CAM therapies as primary treatments regardless of the level of research evidence available. Helping them maintain a sense of hope and selectively directing them to coordinated evidence-based treatments is crucial to their continued healing. This panel will discuss the role of multiple complementary practices, as well as the research basis for each, in the treatment of fibromyalgia. Starting with the role of the integrative physician in evaluation and establishing a treatment protocol and examining the roles of traditional Chinese medicine, chiropractic, massage/energy techniques and health psychology in the long-term process of care. Issues around coordination of care, patient compliance with sometimes overwhelming lifestyle changes, mood shifts, maintaining hope, and continued provider communication around progress and plan changes will be addressed. These topics will also be applied and addressed within a case study format that will involve attendees' participation.