Background: Acupuncture is still a controversial topic, as methodologic problems associated to its research impair scientific progress. Besides effective allocation of acupoints and double blinding, quantification of its effects is still a problem that has to be addressed. In particular, the effects of acupuncture need to be quantified more clearly for relieving pain and reducing inflammatory effects associated to Rheumatoid Arthritis (RA).We aim to study the effects of acupuncture resorting to an algometry device specifically designed to assess the pressure tolerated by RA patients.Methods/Design: A quasi-experimental nature design was developed. Fourteen RA patients with a Traditional Chinese Medicine (TCM) (Heidelberg Model) diagnosis of a so called pivotal or turning point syndrome, and meeting the criteria of the American College of Rheumatology, received three acupuncture treatments in one week with a standardized treatment.A newly developed pressure algometry device, designed to assess the tolerance in hand pain in RA, was tested. We compared the outcome of clinical acupuncture, as measured by Pressure Algometry (PA) and Visual Analogue Scale (VAS).
Results:The patients tolerated higher pressure on the hands (p=0.001) as well as improved VAS scores along with the treatment (p=0.005). All 14 patients displayed improvements in PA, while 11 improved their VAS scores. Out of the remaining, two patients had their VAS score unaltered and one (who also displayed the smallest improvement in PA) worsened slightly.
Discussion:The findings of this study suggest that acupuncture effects in hand pain relief can be measured by the PA device. This opens the door to quantify the differences between the tolerated hand pressure before and after the acupuncture treatment to one specific TCM syndrome designed as turning point in a future double blinded acupuncture study on pain in RA patients.Trial Registration Number: NCT02553005.Keywords: Acupuncture; Pain; Pressure algometry; Rheumatoid arthritis; Turning point syndrome Citation: Seca S, Miranda D, Patrício M, Correia R, Kirch S, et al. (2017) Although self reported pain intensity is important, it is a composition of the physiological and psychological features of the patient and their health problem that is further mediated by social aspects, which can make it difficult to interpret the responses [17].Physicians often assume that inflammation is the main determinant factor of RA pain intensity. However more than one in ten RA patients that are shown to be in remission by the Disease Activity Score 28 (DAS28) still report clinically significant pain levels. The fact is that pain persists despite the absence of signs of inflammation [2].The magnitude of symptoms may not necessarily correlate with the severity of the underlying disease and symptoms may persist even when disease exacerbations have apparently settled.Pain and tenderness associated with the disease are not only present in directly affected joints but also in adjacent, apparently normal, tissues. Thes...