Pain Task Force Updates White Paper on Role of Acupuncture in Acute Pain

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The majority of reviews indicate that acupuncture therapy can effectively reduce acute pain and has the potential to reduce opioid addiction. The findings of this white paper, written by the Academic Consortium Pain Task Force, have been published in pain medication.

This narrative review aimed to update information on non-pharmacological strategies, particularly acupuncture, for the treatment of acute pain. Publication databases were searched up to December 2020 for relevant systematic reviews with or without meta-analyses.

A total of 22 systematic reviews, 17 of which included meta-analyses, were included in this white paper update.


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In the postoperative setting, systematic reviews and meta-analyses (SRMs) have found that, compared to sham treatment, acupuncture reduced the need for opioids by 21% at 8 hours, 23% at 24 hours, and 29% at 72 hours after surgery.

In addition, acupuncture was associated with a decrease in analgesic consumption (standardized mean difference [SMD], 0.54; 95% CI, 0.30-0.77) and another SRM reported a 42% reduction in analgesic use at 2 hours. Associated with reduced use of opioids or painkillers, the studies reported fewer adverse events, such as dizziness and nausea.

Acupuncture in acute trauma and emergency departments was found to be feasible and in 1 SRM, 71% of patients were either mostly or very satisfied with the treatment. Acupuncture was associated with a pain reduction of 44.4% compared to 10.5% for sham treatment recipients. One SRM found that acupuncture was preferred over no treatment; massage; thermal therapy with Chinese medicine; infrared radiation; or rest, ice, compression, and elevation, but was not preferred over dimethyl sulfoxide.

Seven SRMs evaluated acupuncture for migraine. Compared to sham treatment or no treatment, acupuncture appears to be more effective in preventing acute migraine.

For acute low back pain, 3 SRMs found significant benefits, including pain reduction and the use of analgesics.

A total of 3 studies evaluated the use of auricular therapy, called battlefield acupuncture. This strategy proved feasible but had mixed results. One study found battlefield acupuncture to be effective and another to be ineffective.

In general, this review of MRS supports the use of acupuncture to treat acute pain. Acupuncture has been shown to be feasible in a variety of settings and reduces the use of analgesic medications, including opioids. With lower opioid consumption, studies generally reported a reduction in opioid-associated adverse events.

Reference

Nielsen A, Dusek J, Taylor-Swanson L, Tick H. Acupuncture therapy as an evidence-based, non-pharmacological strategy for the comprehensive treatment of acute pain: an update to the University Consortium Pain Task Force White Paper. Medical Pain. 2022; pnac056. doi:10.1093/pm/pnac056

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