Acupuncture Therapy As an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update

Overview

Journal Pain Med

Specialties Critical Care
Neurology
Psychiatry

Date 2022 Apr 5

PMID 35380733

Authors

Arya Nielsen

Jeffery A Dusek

Lisa Taylor-Swanson

Heather Tick

Affiliations

Soon will be listed here.

Abstract

Background: A crisis in pain management persists, as does the epidemic of opioid overdose deaths, addiction, and diversion. Pain medicine is meeting these challenges by returning to its origins: the Bonica model of multidisciplinary pain care. The 2018 Academic Consortium White Paper detailed the historical context and magnitude of the pain crisis and the evidence base for nonpharmacologic strategies. More than 50% of chronic opioid use begins in the acute pain care setting. Acupuncture may be able to reduce this risk.

Objective: This article updates the evidence base for acupuncture therapy for acute pain with a review of systematic reviews and meta-analyses on postsurgical/perioperative pain with opioid sparing and acute nonsurgical/trauma pain, including acute pain in the emergency department.

Methods: To update reviews cited in the 2018 White Paper, electronic searches were conducted in PubMed, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials for "acupuncture" and "acupuncture therapy" and "acute pain," "surgery," "peri-operative," "trauma," "emergency department," "urgent care," "review(s) ," "systematic review," "meta-analysis," with additional manual review of titles, links, and reference lists.

Results: There are 22 systematic reviews, 17 with meta-analyses of acupuncture in acute pain settings, and a review for acute pain in the intensive care unit. There are additional studies of acupuncture in acute pain settings.

Conclusion: The majority of reviews found acupuncture therapy to be an efficacious strategy for acute pain, with potential to avoid or reduce opioid reliance. Future multicenter trials are needed to clarify the dosage and generalizability of acupuncture for acute pain in the emergency department. With an extremely low risk profile, acupuncture therapy is an important strategy in comprehensive acute pain care.

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References

Langevin H, Churchill D, FOX J, Badger G, Garra B, Krag M . Biomechanical response to acupuncture needling in humans. J Appl Physiol (1985). 2001; 91(6):2471-8. DOI: 10.1152/jappl.2001.91.6.2471. View

van Ravesteyn L, Lambregtse-van den Berg M, Hoogendijk W, Kamperman A . Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis. PLoS One. 2017; 12(3):e0173397. PMC: 5373816. DOI: 10.1371/journal.pone.0173397. View

Langevin H, Churchill D, Wu J, Badger G, Yandow J, Fox J . Evidence of connective tissue involvement in acupuncture. FASEB J. 2002; 16(8):872-4. DOI: 10.1096/fj.01-0925fje. View

Zhu J, Xu Q, Zou R, Wu W, Wang X, Wang Y . Distal acupoint stimulation versus peri-incisional stimulation for postoperative pain in open abdominal surgery: a systematic review and implications for clinical practice. BMC Complement Altern Med. 2019; 19(1):192. PMC: 6668193. DOI: 10.1186/s12906-019-2583-8. View

White A . A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004; 22(3):122-33. DOI: 10.1136/aim.22.3.122. View

Napadow V, Liu J, Li M, Kettner N, Ryan A, Kwong K . Somatosensory cortical plasticity in carpal tunnel syndrome treated by acupuncture. Hum Brain Mapp. 2006; 28(3):159-71. PMC: 6871379. DOI: 10.1002/hbm.20261. View

Crawford P, Moss D, Crawford A, Sharon D . Modified Battlefield Acupuncture Does Not Reduce Pain or Improve Quality of Life in Patients with Lower Extremity Surgery. Mil Med. 2018; 184(Suppl 1):545-549. DOI: 10.1093/milmed/usy277. View

Lee J, Choi T, Lee M, Lee H, Shin B, Lee H . Acupuncture for acute low back pain: a systematic review. Clin J Pain. 2012; 29(2):172-85. DOI: 10.1097/AJP.0b013e31824909f9. View

Jan A, Aldridge E, Rogers I, Visser E, Bulsara M, Niemtzow R . Review article: Does acupuncture have a role in providing analgesia in the emergency setting? A systematic review and meta-analysis. Emerg Med Australas. 2017; 29(5):490-498. DOI: 10.1111/1742-6723.12832. View

10.

. NIH Consensus Conference. Acupuncture. JAMA. 1998; 280(17):1518-24. View

11.

Kaynar M, Koyuncu F, Buldu I, Tekinarslan E, Tepeler A, Karatag T . Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic. Am J Emerg Med. 2015; 33(6):749-53. DOI: 10.1016/j.ajem.2015.02.033. View

12.

Zhao X, Du Y, Liu P, Wang S . Acupuncture for stroke: evidence of effectiveness, safety, and cost from systematic reviews. Top Stroke Rehabil. 2012; 19(3):226-33. DOI: 10.1310/tsr1903-226. View

13.

Ballantyne J . Opioids for the Treatment of Chronic Pain: Mistakes Made, Lessons Learned, and Future Directions. Anesth Analg. 2017; 125(5):1769-1778. DOI: 10.1213/ANE.0000000000002500. View

14.

Coq J, Barr A, Strata F, Russier M, Kietrys D, Merzenich M . Peripheral and central changes combine to induce motor behavioral deficits in a moderate repetition task. Exp Neurol. 2009; 220(2):234-45. PMC: 2783426. DOI: 10.1016/j.expneurol.2009.08.008. View

15.

Kim T, Lee M, Birch S, Alraek T . Plausible Mechanism of Sham Acupuncture Based on Biomarkers: A Systematic Review of Randomized Controlled Trials. Front Neurosci. 2022; 16:834112. PMC: 8850388. DOI: 10.3389/fnins.2022.834112. View

16.

Yin N, Yang H, Yao W, Xia Y, Ding G . Mast Cells and Nerve Signal Conduction in Acupuncture. Evid Based Complement Alternat Med. 2018; 2018:3524279. PMC: 5863328. DOI: 10.1155/2018/3524279. View

17.

Harris R, Zubieta J, Scott D, Napadow V, Gracely R, Clauw D . Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage. 2009; 47(3):1077-85. PMC: 2757074. DOI: 10.1016/j.neuroimage.2009.05.083. View

18.

Meerwijk E, Larson M, Schmidt E, Adams R, Bauer M, Ritter G . Nonpharmacological Treatment of Army Service Members with Chronic Pain Is Associated with Fewer Adverse Outcomes After Transition to the Veterans Health Administration. J Gen Intern Med. 2019; 35(3):775-783. PMC: 7080907. DOI: 10.1007/s11606-019-05450-4. View

19.

Yeh C, Chiang Y, Hoffman S, Liang Z, Klem M, Tam W . Efficacy of auricular therapy for pain management: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2014; 2014:934670. PMC: 4140110. DOI: 10.1155/2014/934670. View

20.

Orr S, Friedman B, Christie S, Minen M, Bamford C, Kelley N . Management of Adults With Acute Migraine in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies. Headache. 2016; 56(6):911-40. DOI: 10.1111/head.12835. View