Acupuncture helps to ease the severity of fibromyalgia symptoms, even in people who failed to respond to pharmacological treatment, a study suggests.
The study, “Acupuncture for Fibromyalgia: An Open-Label Pragmatic Study on Effects on Disease Severity, Neuropathic Pain Features, and Pain Catastrophizing,” was published in the journal Evidence-Based Complementary and Alternative Medicine.
Acupuncture, used in traditional Chinese medicine, involves the insertion of tiny needles at specific points in the body. Previous research has suggested that acupuncture can be beneficial for some people with fibromyalgia.
“However, there is no clarity on when to recommend a course of treatment with acupuncture, as it is unlikely to be adopted as a continuous treatment. In particular, it is not clear to which kind of patients (i.e., patients not treated with drug treatment and patients refractory to drug treatment) and in which phase of disease severity [it] should be proposed,” the researchers wrote.
Researchers tested the efficacy of acupuncture specifically in people with severe and unresponsive fibromyalgia.
Patients had a score of 39 or above on the Fibromyalgia Impact Questionnaire (FIQ-R) and a score of 5 or above on the Patient Health Questionnaire 15-item (PHQ15), despite treatment. Both questionnaires are measures of symptom severity, with higher scores reflecting worse symptoms.
All study participants had been on an optimal and stable drug therapy for at least three months, consisting of duloxetine (sold as Cymbalta and Irenka; 60 mg/day) and pregabalin (sold as Lyrica; 300 mg/day). However, their disease was unresponsive, meaning all had either failed to respond or were unable to tolerate the therapy.
Study participants were treated with half-hour sessions of full-body acupuncture, given once per week, for eight weeks.
Six of the 102 patients enrolled in the study stopped participating — four because they couldn’t get to the hospital every week, and two because they couldn’t tolerate the use of needles.
Data from the remaining 96 patients (85 women, 11 men, with an average age of 50.6) — who underwent clinical evaluations before and after the eight weeks of acupuncture treatment — were used for analyses.
Among these people, 32 (33.3%) were taking both duloxetine and pregabalin, 22 (22.9%) pregabalin only, 13 (13.5%) duloxetine only, and 29 (30.2%) neither medication.
Analyses showed the average FIQ-R scores were significantly lower following acupuncture treatment (60.79 versus 46.40), as were those of the PHQ15 (14.58 versus 10.47). There were also significant improvements in assessments of helplessness and pain catastrophizing.
An overall improvement (decrease) in FIQ-R scores was recorded in 82 of the 96 patients (85.4%) who completed the acupuncture treatment. In 39 (40.6%) of them, the change was greater than 30%, which is considered clinically significant.
In four (4.2%) participants, scores dropped below 39 for FIQ-R and 5 for PHQ15, the initial threshold levels used to define disease unresponsiveness. The remaining 14 (14.6%) participants had a worsening (increase) of their FIQ-R scores following acupuncture treatment.
“In this study, we demonstrated the short-term efficacy of an eight-week course of acupuncture, added to the ongoing drug therapy, in patients affected by severe [fibromyalgia],” the investigators wrote.
“Future research should be directed at revealing predictors of the response to acupuncture treatment,” they added.
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