Acupuncture Therapy in a Group Setting for Chronic Pain

Kligler, Benjamin; Nielsen, Arya; Kohrherr, Corinne; Schmid, Tracy; Waltermaurer, Eve; Perez, Elidania; Merrell, Woodson

doi:10.1093/pm/pnx134

Cited by 34 publications

(45 citation statements)

References 61 publications

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“…A recent pilot trial which provided group acupuncture in a more optimal setting found a larger proportion of patients experiencing a clinically significant reduction in pain and depression. 46…”

Section: Discussionmentioning

confidence: 99%

“…51 Reporting followed Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). 52 In addition to acupuncture needling, the manual also provided for the incorporation of therapies often used with acupuncture including palpation, 53,54 Tui na (a traditional Chinese manual therapy), 55,56 Gua sha (unidirectional press stroking of a lubricated area of skin with a smooth, round-edged instrument), 46,57,58 and extended auricular treatment with ear seeds (Semen Vaccaria). [59][60][61][62] Participants were also given general lifestyle recommendations in terms of diet, the importance of moving, and external hot and cold exposure.…”

Section: Interventionsmentioning

confidence: 99%

“…In group acupuncture, patients are treated simultaneously, in a staggered fashion, situated near and in view of one another. Studies demonstrate that group acupuncture is acceptable to patients, 38,[41][42][43][44][45][46] and early studies show it to be effective for pain. 46 However, to date, no studies have compared the effectiveness of group versus individual acupuncture for chronic pain.…”

Section: Introductionmentioning

confidence: 99%

“…Studies demonstrate that group acupuncture is acceptable to patients, 38,[41][42][43][44][45][46] and early studies show it to be effective for pain. 46 However, to date, no studies have compared the effectiveness of group versus individual acupuncture for chronic pain. 47,48 The "Acupuncture Approaches to Decrease Disparities in Outcomes of Pain Treatment Two Arm Comparative Effectiveness Trial" (AADDOPT-2) sought to answer this question in an underserved and ethnically diverse patient population.…”

Section: Introductionmentioning

confidence: 99%

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Individual vs. Group Delivery of Acupuncture Therapy for Chronic Musculoskeletal Pain in Urban Primary Care—a Randomized Trial

et al. 2020

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Background Acupuncture has been shown to be effective for the treatment of chronic musculoskeletal back, neck, and osteoarthritis pain. However, access to acupuncture treatment has been limited in medically underserved and low-income populations. Objective Acupuncture therapy delivered in groups could reduce cost and expand access. We compared the effectiveness of group versus individual acupuncture for pain and function among ethnically diverse, low-income primary care patients with chronic musculoskeletal pain. Design This was a randomized comparative effectiveness non-inferiority trial in 6 Bronx primary care community health centers. Participants with chronic (> 3 months) back, neck, or osteoarthritis pain were randomly assigned to individual or group acupuncture therapy for 12 weeks. Participants Seven hundred seventy-nine participants were randomized. Mean age was 54.8 years. 35.3% of participants identified as black and 56.9% identified as Latino. Seventy-six percent were Medicaid insured, 60% reported poor/fair health, and 37% were unable to work due to disability. Interventions Participants received weekly acupuncture treatment in either group or individual setting for 12 weeks. Main Measures Primary outcome was pain interference on the Brief Pain Inventory at 12 weeks; secondary outcomes were pain severity (BPI), physical and mental well-being (PROMIS-10), and opiate use. Outcome measures were collected at baseline, 12 and 24 weeks. Key Results 37.5% of individual arm and 30.3% in group had > 30% improvement in pain interference (d = 7.2%, 95% CI − 0.6%, 15.1%). Non-inferiority of group acupuncture was not demonstrated for the primary outcome assuming a margin of 10%. In the responder analysis of physical well-being, 63.1% of individual participants and 59.5% of group had clinically important improvement at 12 weeks (d = 3.6%, 95% CI − 4.2%, 11.4%). Conclusions Both individual and group acupuncture therapy delivered in primary care settings reduced chronic pain and improved physical function at 12 weeks; non-inferiority of group was not shown. Trial Registration Clinicaltrials.gov # NCT02456727

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Section: Discussionmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Individual vs. Group Delivery of Acupuncture Therapy for Chronic Musculoskeletal Pain in Urban Primary Care—a Randomized Trial

et al. 2020

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“…Definitions according to WHO, FDA or EMA differ by nuance [35,[47][48][49]. In the literature, these terms are sometimes used synonymously (e.g., [50,51]). The exact definitions of reputable institutions are listed in the supplemental material (see additional file 2).…”

Section: Discussionmentioning

confidence: 99%

Comparing physicians’ and patients’ reporting on adverse reactions in randomized trials on acupuncture—a secondary data analysis

Schwaneberg

Witt

Roll

et al. 2019

BMC Complement Altern Med

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Background: We aimed to compare patients' and physicians' safety reporting using data from large acupuncture trials (44,818 patients) and to determine associations between patient characteristics and reporting of adverse reactions. Methods: Six pragmatic randomized trials with an additional non-randomized study arm that included those patients who refused randomization were evaluated. Patients received acupuncture treatment for osteoarthritis of the hip or knee, chronic neck pain, chronic low back pain, chronic headache, dysmenorrhea, or allergic rhinitis or asthma. Safety outcomes were evaluated by questionnaires from both the physicians and the patients. To determine level of agreement between physicians and patients on the prevalence of adverse reactions, Cohen's kappa was used. With multilevel models associations between patient characteristics and reporting of adverse reactions were assessed. Results: Patients reported on average three times more adverse reactions than the study physicians: for bleeding/ haematoma, 6.7% of patients (n = 2458) vs. 0.6% of physicians (n = 255) and for pain, 1.7% of patients (n = 636) vs. 0.5% of physicians (n = 207). We found only minor agreements between patients and physicians (maximum Cohen's kappa: 0.50, 95% confidence interval [0.49;0.51] for depressive mood). Being a female and participation in the randomization were associated with higher odds of reporting an adverse reaction. Conclusions: In our study, patients' and physicians' reports on adverse reactions of acupuncture differed substantially, possibly due to differences in patients' and physicians' questionnaires and definitions. For the assessment of safety, we strongly support the inclusion of patients' and physicians' reports while ensuring standardization of data collection and definitions.

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The cumulative analgesic effect of repeated electroacupuncture is modulated by Adora3 in the SCDH of mice with neuropathic pain

Kiani,

Li,

Guo

et al. 2024

Anim Models and Exp Med

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BackgroundExisting remedial approaches for relieving neuropathic pain (NPP) are challenging and open the way for alternative therapeutic measures such as electroacupuncture (EA). The mechanism underlying the antinociceptive effects of repeated EA sessions, particularly concerning the regulation of the Adora3 receptor and its associated enzymes, has remained elusive.MethodsThis study used a mouse model of spared nerve injury (SNI) to explore the cumulative analgesic effects of repeated EA at ST36 (Zusanli) and its impact on Adora3 regulation in the spinal cord dorsal horn (SCDH). Forty‐eight male mice underwent SNI surgery for induction of neuropathic pain and were randomly assigned to the SNI, SNI + 2EA, SNI + 4EA, and SNI + 7EA groups. Spinal cord (L4–L6) was sampled for immunofluorescence, adenosine (ADO) detection and for molecular investigations following repeated EA treatment.ResultsFollowing spared nerve injury (SNI), there was a significant decrease in mechanical withdrawal thresholds (PWTs) and thermal nociceptive withdrawal latency (TWL) in the ipsilateral hind paw on the third day post‐surgery, while the contralateral hind paw PWTs showed no significant changes. On subsequent EA treatments, the SNI + EA groups led to a significant increase in pain thresholds (p < 0.05). Repeated EA sessions in SNI mice upregulated Adenosine A3 (Adora3) and cluster of differentiation‐73 (CD73) expression while downregulating adenosine deaminase (ADA) and enhancing neuronal instigation in the SCDH. Colocalization analysis of Neun‐treated cells revealed increased Adora3 expression, particularly in the SNI + 7EA group.ConclusionsIn conclusion, cumulative electroacupuncture treatment reduced neuropathic pain by regulating Adora3 and CD73 expression, inhibiting ADA and most likely increasing neuronal activation in the SCDH. This study offers a promising therapeutic option for managing neuropathic pain, paving the way for further research.

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Acupuncture Therapy in a Group Setting for Chronic Pain

Cited by 34 publications

References 61 publications

Individual vs. Group Delivery of Acupuncture Therapy for Chronic Musculoskeletal Pain in Urban Primary Care—a Randomized Trial

Individual vs. Group Delivery of Acupuncture Therapy for Chronic Musculoskeletal Pain in Urban Primary Care—a Randomized Trial

Comparing physicians’ and patients’ reporting on adverse reactions in randomized trials on acupuncture—a secondary data analysis

The cumulative analgesic effect of repeated electroacupuncture is modulated by Adora3 in the SCDH of mice with neuropathic pain

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