[Paracelsus] Improvement in Fibromyalgia Symptoms With Acupuncture: Results of a Randomized Controlled Trial. Mayo Clinic Proceedings 2006; 81(6):749-757. (fwd)

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Subject: [Paracelsus] Improvement in Fibromyalgia Symptoms With Acupuncture:

Results of a Randomized Controlled Trial. Mayo Clinic Proceedings 2006;

81(6):749-757.

Acupuncture was found to significantly improve

symptoms of fibromyalgia; symptomatic improvement

was not restricted to pain relief and was most

significant for fatigue and anxiety.

DP, Sletten CD, BA, Berger IH.

Improvement in fibromyalgia symptoms with

acupuncture: results of a randomized controlled

trial. Mayo Clin Proc 2006 Jun;81(6):749-757.

PMID: 16770975

http://www.mayoclinicproceedings.com/Abstract.asp?AID=2482 & Abst=Abstract & UID=

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Abstract

Mayo Clin Proc. 2006;81:749-757 © 2006 Mayo

Foundation for Medical Education and Research

ORIGINAL ARTICLE

Improvement in Fibromyalgia Symptoms With

Acupuncture: Results of a Randomized Controlled

Trial

DAVID P. MARTIN, MD, PHD; CHRISTOPHER D. SLETTEN

, PHD; BRENT A. WILLIAMS, MS; INES H. BERGER , MD

Address reprint requests and correspondence to

P. , MD, PhD, Department of

Anesthesiology, Mayo Clinic College of Medicine,

200 First St SW, Rochester, MN 55905 (e-mail:

martin.david@...).

OBJECTIVE: To test the hypothesis that

acupuncture improves symptoms of fibromyalgia.

PATIENTS AND METHODS: We conducted a prospective,

partially blinded, controlled, randomized

clinical trial of patients receiving true

acupuncture compared with a control group of

patients who received simulated acupuncture. All

patients met American College of Rheumatology

criteria for fibromyalgia and had tried

conservative symptomatic treatments other than

acupuncture. We measured symptoms with the

Fibromyalgia Impact Questionnaire (FIQ) and the

Multidimensional Pain Inventory at baseline,

immediately after treatment, and at 1 month and 7

months after treatment. The trial was conducted

from May 28, 2002, to August 18, 2003.

RESULTS: Fifty patients participated in the

study: 25 in the acupuncture group and 25 in the

control group. Total fibromyalgia symptoms, as

measured by the FIQ, were significantly improved

in the acupuncture group compared with the

control group during the study period (P=.01).

The largest difference in mean FIQ total scores

was observed at 1 month (42.2 vs 34.8 in the

control and acupuncture groups, respectively;

P=.007). Fatigue and anxiety were the most

significantly improved symptoms during the

followup period. However, activity and physical

function levels did not change. Acupuncture was

well tolerated, with minimal adverse effects.

CONCLUSION: This study paradigm allows for

controlled and blinded clinical trials of

acupuncture. We found that acupuncture

significantly improved symptoms of fibromyalgia.

Symptomatic improvement was not restricted to

pain relief and was most significant for fatigue

and anxiety.

Mayo Clin Proc. 2006;81(6):749-757

FIQ=Fibromyalgia Impact Questionnaire; MPI=Multidimensional Pain Inventory

Full text | PDF

+

Fibromyalgia Symptoms Respond to Acupuncture

By Judith Groch, MedPage Today Senior Writer

Reviewed by Zalman S. Agus, MD; Emeritus

Professor at the University of Pennsylvania

School of Medicine.

June 16, 2006

Also covered by: CNN

MedPage Today Action Points

* Explain to interested patients that this study

found that acupuncture eased pain, fatigue, and

anxiety, at least for a few months, for those

with fibromyalgia.

* Point out that this relatively small clinical

did not determine the long term duration of the

acupuncture benefit. The time course of

improvement will have to be characterized in

future studies.

Review

ROCHESTER, Minn., June 16 - Acupuncture not only

offered pain relief for fibromyalgia patients,

but it significantly improved fatigue and anxiety

symptoms, Mayo Clinic researchers reported.

This prospective, partially blinded, controlled,

randomized trial included 50 fibromyalgia

patients who had met American College of

Rheumatology criteria for the disorder and had

tried conservative treatments, including dietary

and herbal supplements, , M.D.,

Ph.D., and colleagues, here wrote in the June

issue of the Mayo Clinic Proceedings.

Although not progressive or degenerative,

fibromyalgia can severely affect quality of life.

The disorder is possibly an alteration in pain

threshold or sensory processing at the spinal

cord level or higher cortical levels and has no

known cure. Fibromyalgia affects 2% of the

general population: 3.4% women and 0.5% men.

Symptoms of patients in the Mayo study were

measured with the Fibromyalgia Impact

Questionnaire (FIQ) and the Multidimensional Pain

Inventory (MPI) at baseline, immediately after

treatment, and at one and seven months after

treatment.

Twenty-five patients were treated with true

acupuncture, while 25 were given simulated

acupuncture and served as a control group.

Treatments, performed at one facility by two

acupuncturists, were given at six sessions over

two to three weeks.

Total fibromyalgia symptoms, as measured by the

FIQ, were significantly improved in the

acupuncture group compared with the control group

during the study period (P=.01), the researchers

reported.

However, the largest difference in mean FIQ total

scores (7.4) occurred at one month (42.2 in the

control group versus 34.8 in the acupuncture

group (P=.007). At this point, pain severity, as

measured by the MPI, had also decreased

significantly: -34.2 ±11.4 vs 41.6 ±9.1 (P=.03).

Of all the symptoms, the greatest improvement

occurred for fatigue and anxiety, the researchers

reported. At one month, fatigue scored 5.6 ±2.7

for the acupuncture patients vs 7.7 ±2.1 for the

controls (P=.001), while anxiety measured 2.6

±2.3 vs 5.1 ±2.6 (P=.003).

On the other hand, general activity and physical

function levels did not change, the investigators

said. They explained that they had not set

activity changes as a goal for the patients nor

did they encourage behavior change. Nevertheless,

on the basis of similar findings in other

studies, " symptom reduction may be necessary, but

not sufficient, for functional rehabilitation, "

Dr. and colleagues wrote.

Maximum benefits occurred at one month, with a

fall off at seven months. Unfortunately, the

design of the clinical trial did not permit a

more precise determination of acupuncture's

duration, a factor that should be addressed in

future studies, Dr. said.

The treatments were well tolerated by the

patients, and most reported enjoying the

experience. Many patients in both groups reported

feeling tired and/or relaxed immediately after

treatment, while mild bruising and soreness were

more common in the acupuncture patients, the

researchers reported.

Among the study's limitations, the researchers

noted, is the fact that the patients were mostly

women; also, participants were mainly white,

because of the local population from which the

Minnesota study was drawn.

The study showed that acupuncture reduced the FIQ

score by seven points. The magnitude of this

clinical benefit for acupuncture, they said, is

similar to that reported with pharmacological

intervention, such as tricyclic antidepressants

(seven points), Prozac (fluoxetine) (eight

points), and Ultram (tramadol) and acetaminophen

(six points).

" Therefore the effect of acupuncture is both

clinically and statistically significant, " they

said, and " may have a role in the symptomatic

treatment of patients with fibromyalgia. "

Primary source: Mayo Clinic Proceedings

Source reference:

P. , et al " Improvement in

Fibromyalgia Symptoms With Acupuncture: Results

of a Randomized Controlled Trial " Mayo Clinic

Proceedings 2006;81 (6):749-757.

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© 2004-6 MedPage Today, LLC. .

http://www.medpagetoday.com/Rheumatology/GeneralRheumatology/tb2/3564?pfc=101 & sp\

c=222

also:

Staud R, Price DD. Mechanisms of acupuncture

analgesia for clinical and experimental pain.

Expert Rev Neurother 2006 May;6(5):661-667.

PMID: 16734514

Singh BB, Wu WS, Hwang SH, Khorsan R,

Der-Martirosian C, Vinjamury SP, Wang CN, Lin SY.

Effectiveness of acupuncture in the treatment of

fibromyalgia. Altern Ther Health Med 2006

Mar-Apr;12(2):34-41.

PMID: 16541995

Li CD, Fu XY, Jiang ZY, Yang XG, Huang SQ, Wang

QF, Liu J, Chen Y. [Clinical study on combination

of acupuncture, cupping and medicine for

treatment of fibromyalgia syndrome] Zhongguo Zhen

Jiu 2006 Jan;26(1):8-10. [Chinese]

PMID: 16491748

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