Manual Acupuncture for Myofascial Pain Syndrome: A Systematic Review and Meta-Analysis

Wang, Rong; Li, Xiuxia; Zhou, Shenghu; Zhang, Xiaogang; Yang, Kehu; Liu, Xusheng

doi:10.1136/acupmed-2016-011176

Cited by 35 publications

(21 citation statements)

References 39 publications

(34 reference statements)

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“…A substantial body of evidence demonstrates that acupuncture is effective for chronic pain. 15 – 35 Consequently, a number of health policy and practice-oriented guidelines have been issued that support the use of acupuncture for chronic pain. For example, the American College of Physicians Clinical Practice Guideline recommends acupuncture for acute, subacute, and chronic low back pain (cLBP).…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial

Davis¹,

Badger²,

Valentine

et al. 2018

Glob Adv Health Med

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IntroductionIn response to the opioid crisis, the 2016 Vermont legislature commissioned a study to assess acupuncture for patients with chronic pain in the Vermont Medicaid population.ObjectiveTo assess the feasibility, acceptability, and effectiveness of acupuncture provided by licensed acupuncturists for Vermont Medicaid patients with chronic pain.MethodsA total of 156 Medicaid patients with chronic pain were offered up to 12 acupuncture treatments within a 60-day period at the offices of 28 Vermont licensed acupuncturists. PROMIS® questionnaires were administered prior to and at the end of the treatment period to assess changes in pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep disturbance, and social isolation. Questionnaires also captured patients’ overall impressions of treatments as well as self-reported changes in medication use and work function.ResultsOne hundred eleven women (71%) and 45 men (29%) with a wide range of pain complaints received a mean of 8.2 treatments during the intervention period. Measurements captured prior to and at the end of the treatment period showed significant improvements in group mean pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep disturbance, and social isolation as assessed by Patient-Reported Outcomes Measurement Information System (PROMIS) measures (paired t tests, P < .01). Fifty-seven percent of patients using analgesic (nonopioid) medication reported reductions in use. Thirty-two percent of patients using opioid medication reported reductions in use of opioid medication following the intervention. Seventy-four percent of employed patients reported improved capacity to work. Ninety-six percent of patients said that they would recommend acupuncture to others with chronic pain, and 91% reported qualitative improvements, including physical (31%), functional/behavioral (29%), and psycho-emotional (24%) improvements.ConclusionsOur findings demonstrate that acupuncture treatment for chronic pain is feasible and well received by patients in the Vermont Medicaid population. Receiving care from Licensed Acupuncturists was associated with significant improvements in physical, functional, psycho-emotional, and occupational outcomes compared with before receiving acupuncture treatments.

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Section: Introductionmentioning

confidence: 99%

Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial

Davis¹,

Badger²,

Valentine

et al. 2018

Glob Adv Health Med

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“…In three of the five patients, the pain relief was immediate, and in all patients the vocal fold motion normalized. The authors equated the observed pain relief from LEMG to dry needling in the treatment of myofascial pain syndrome (MPS) . Dry needling at trigger points is thought to work through a hyperstimulatory analgesic effect.…”

Section: Discussionmentioning

confidence: 99%

“…The authors equated the observed pain relief from LEMG to dry needling in the treatment of myofascial pain syndrome (MPS). [7][8][9] Dry needling at trigger points is thought to work through a hyperstimulatory analgesic effect. Jung et al 6 suggested that pain can limit the range of vocal fold motion due to guarding, with hypomobility exacerbating the dysphonia.…”

Section: Primary Odynophoniamentioning

confidence: 99%

Primary odynophonia: When pain is out of proportion to dysphonia

et al. 2019

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Objectives/Hypothesis Odynophonia is generally regarded as a symptom of a voice disorder. However, a subset of patients with odynophonia have debilitating pain out of proportion to the relatively mild degree of dysphonia and are not responsive to voice therapy. The goals of this study were to 1) describe the symptomatology of this subset of patients and differentiate it from typical odynophonia, 2) propose alternate models to explain this phenomenon of primary odynophonia, and 3) present a new treatment paradigm based on the proposed models. Study Design Case series. Methods Inclusion criteria were complaint of persistent pain associated with voicing, normal vocal fold mobility, complete glottic closure, and limited or lack of response of pain to voice therapy. Presenting symptoms, voice evaluation, and treatment outcomes were reviewed. Results Eleven patients fit the inclusion criteria. The degree of pain did not follow the trajectory of vocal improvement with therapy. The pain was stagnant or worsened with voice exercises. The most dramatic improvement came about in one patient who received false vocal fold Botox injections, and another who received thyrohyoid lidocaine/triamcinolone injection. We propose that these patients had developed primary odynophonia, in which the pain had become self‐sustaining and no longer responded to correction of hyperfunctional vocal behavior. The mechanism of pain persistence may involve superior laryngeal neuralgia, cartilaginous or ligamentous inflammation, and/or central sensitization. Conclusions A minority of patients have primary odynophonia distinct from typical odynophonia. Direct treatment of pain may be advisable prior to or in conjunction with voice therapy. Level of Evidence 4 Laryngoscope, 130:E183–E189, 2020

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“…In 2017, Espejo-Antúnez et al published a SR that evaluated the clinical efficacy of dry needling to alleviate pain associated with myofascial trigger points (15 RCTs [106]) and found a possible short-term benefit following dry needling. In 2017, SRs have found tentative evidence that acupuncture alone or combined with other therapies improved outcomes associated with myofascial pain syndrome (10 RCTs [108]; 33 RCTs [107]), although substantial heterogeneity and a high risk of bias, including inadequate sample sizes in the primary RCTs, undermined confidence in the findings.…”

Section: Myofascial Pain Syndrome and Myofascial Trigger Pointsmentioning

confidence: 99%

Acupuncture for the Relief of Chronic Pain: A Synthesis of Systematic Reviews

Paley

Johnson

2019

Medicina

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Background and Objectives: It is estimated that 28 million people in the UK live with chronic pain. A biopsychosocial approach to chronic pain is recommended which combines pharmacological interventions with behavioural and non-pharmacological treatments. Acupuncture represents one of a number of non-pharmacological interventions for pain. In the current climate of difficult commissioning decisions and constantly changing national guidance, the quest for strong supporting evidence has never been more important. Although hundreds of systematic reviews (SRs) and meta-analyses have been conducted, most have been inconclusive, and this has created uncertainty in clinical policy and practice. There is a need to bring all the evidence together for different pain conditions. The aim of this review is to synthesise SRs of RCTs evaluating the clinical efficacy of acupuncture to alleviate chronic pain and to consider the quality and adequacy of the evidence, including RCT design. Materials and Methods: Electronic databases were searched for English language SRs and meta-analyses on acupuncture for chronic pain. The SRs were scrutinised for methodology, risk of bias and judgement of efficacy. Results: A total of 177 reviews of acupuncture from 1989 to 2019 met our eligibility criteria. The majority of SRs found that RCTs of acupuncture had methodological shortcomings, including inadequate statistical power with a high risk of bias. Heterogeneity between RCTs was such that meta-analysis was often inappropriate. Conclusions: The large quantity of RCTs on acupuncture for chronic pain contained within systematic reviews provide evidence that is conflicting and inconclusive, due in part to recurring methodological shortcomings of RCTs. We suggest that an enriched enrolment with randomised withdrawal design may overcome some of these methodological shortcomings. It is essential that the quality of evidence is improved so that healthcare providers and commissioners can make informed choices on the interventions which can legitimately be provided to patients living with chronic pain.

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Manual Acupuncture for Myofascial Pain Syndrome: A Systematic Review and Meta-Analysis

Cited by 35 publications

References 39 publications

Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial

Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial

Primary odynophonia: When pain is out of proportion to dysphonia

Acupuncture for the Relief of Chronic Pain: A Synthesis of Systematic Reviews

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