Acupuncture for Pain in Chronic Pancreatitis

Abstract

The study presents proof-of-concept for the analgesic effect of acupuncture in pancreatic pain. Although the effect was short lasting, the framework may be used to conceptualize future trials of acupuncture in visceral pain.

Central and Peripheral Mechanism of Acupuncture Analgesia on Visceral Pain: A Systematic Review

“…There were seven studies with human subjects. Two studies included irritable bowel syndrome (IBS) patients [15, 16], and one study involved primary dysmenorrhea [17] and another study involved chronic pancreatitis patients [18]. Further, a study by Kotani et al [19] investigated postoperative visceral pain in patients who underwent upper or lower abdominal surgeries [18], and two studies involved healthy participants [20, 21] (Table 2).…”

“…In human studies, improvements in the pain behavioral outcomes have been consistently observed after acupuncture treatment. Acupuncture treatment showed significantly greater analgesic effects based on subjective pain ratings than sham acupuncture [16, 18, 19], and the maximum tolerable rectal sensation and distention pressure in IBS patients were significantly increased by acu-TENS compared to sham TENS [20] (Tables 2 and 5).…”

“…(3) Brain and Brain Stem . Functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) were used to measure neuronal activity in IBS patients [15] and healthy participants [18, 21]. The fMRI results showed significant increases in the brain activity in the thalamus and insula in the EA group compared to in the sham EA group [15], and there were no significant differences observed in the EEG data between the groups [18, 21] (Tables 2 and 5, Figure 3).…”

“…There were three randomized parallel-group trials [15, 19, 20] and two randomized cross-over trials [18, 21] included in our review. One study reported results from two different groups (acupuncture and acu-TENS), and within each group, the assignment of the different interventions to the patients was randomized [17].…”

Towards a neurobiological understanding of pain in chronic pancreatitis: mechanisms and implications for treatment

“…Hence, spinal cord stimulation, transcranial magnetic stimulation, and acupuncture have all been proven effective in proof-of-concept studies, but rigorous evaluation in properly designed clinical trials have not yet been conducted. 29 , 43 , 44 Neurolytic procedure such as endoscopic guided plexus blocks was previously widely used for pain in CP but is now considered obsolete due to poor long-term outcomes and risk of side effects such as postural hypotension and diarrhea. 78 Thoracoscopic splanchnicectomy has been described as an alternative and minimally invasive therapy for pancreatic pain.…”