Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency

Harris, R. E.

Tian, X.

Williams, D. A.

Tian, T. X.

Cupps, T. R.

Petzke, F.

Groner, K. H.

Biswas, P.

Gracely, R. H.

Clauw, D. J.

2005

11(4)

663-671

RCT

CAM Control

Acu Versus > 1 Control

Acu Versus Acu

Acupuncture

Analgesia

Auricular Acupuncture

Fatigue

Fibromyalgia

Fixed Acupuncture Protocol

Penetrating Sham

Pain

RCT

Restricted Modalities, Acupuncture + Other

Sham Acupoint Control

Sham Control

Standard Needling Depth

TCM Acupuncture Style

Verum Acupoint Control

Nervous System Diseases

Objectives: The objective of this study was to investigate whether typical acupuncture methods such as needle placement, needle stimulation, and treatment frequency were important factors in fibromyalgia symptom improvement. Design/settings/subjects: A single-site, single-blind, randomized trial of 114 participants diagnosed with fibromyalgia for at least 1 year was performed. Intervention: Participants were randomized to one of four treatment groups: (1) T/S needles placed in traditional sites with manual needle stimulation (n = 29): (2) T/0 traditional needle location without stimulation (n = 30); (3) N/S needles inserted in nontraditional locations that were not thought to be acupuncture sites, with stimulation (n = 28); and (4) N/0 nontraditional needle location without stimulation (n = 2 7). All groups received treatment once weekly, followed by twice weekly, and finally three times weekly, for a total of 18 treatments. Each increase in frequency was separated by a 2-week washout period. Outcome measures: Pain was assessed by a numerical rating scale, fatigue by the Multi-dimensional Fatigue Inventory, and physical function by the Short Form-36. Results: Overall pain improvement was noted with 25%-35% of subjects having a clinically significant decrease in pain; however this was not dependent upon "correct" needle stimulation (t = 1.03; p = 0.307) or location (t = 0.76; p = 0.450). An overall dose effect of treatment was observed, with three sessions weekly providing more analgesia than sessions once weekly (t = 2.10; p = 0.039). Among treatment responders, improvements in pain, fatigue, and physical function were highly codependent (all p </= 0.002). Conclusions: Although needle insertion led to analgesia and improvement in other somatic symptoms, correct needle location and stimulation were not crucial

Nervous System Diseases

>1/WK

114

13 Weeks