Fibromyalgia Symptoms Respond to Acupuncture

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Fibromyalgia Symptoms Respond to Acupuncture

http://www.medpagetoday.com/Rheumatology/GeneralRheumatology/tb/3564

MedPage Today Action Points

a.. 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.

b.. Point out that this relatively small clinical trial

did not determine the long term duration of the acupuncture benefit. The

time course of improvement will have to be characterized in future studies.

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. "

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

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.