Auricular point acupressure shows promise for chronic back pain

By Lucy Piper, Senior medwireNews Reporter

Auricular point acupressure (APA) may have potential for the treatment of chronic low back pain (CLBP), findings from a feasibility study show.

The results showed an average 70% reduction in pain intensity after 4 weeks of APA treatment, with this improvement maintained at 1-month follow up.

"This is greater than most studies in the acupuncture literature, which usually show 30% improvement," notes the team led by Chao Hsing Yeh (University of Pittsburgh, Pennsylvania, USA).

APA is based on traditional Chinese medicine and uses acupoints on specific areas of the inner and outer ear to treat disease. It involves small objects, such as botanical plant seeds or metal pellets approximately 2 mm in size, being taped to the patient's ear by a therapist, to which pressure is then applied by the patient at home.

In their study of 19 patients with CLBP, the researchers randomly assigned 10 to a true APA group and nine to a sham APA group (seeds taped to acupoints not designated for CLBP).

After 4 weeks of treatment, patients receiving true APA experienced a 70% reduction in worst pain intensity and a 75% reduction in overall pain severity, as measured on the Brief Pain Inventory Short Form. The corresponding reductions for patients receiving sham APA were just 18% and 29%, reflecting a significant difference. The difference remained significant at the 1-month follow up.

In terms of functioning, results on the Roland-Morris Disability Questionnaire showed a 42% reduction in symptoms after 4 weeks of treatment and at 1 month follow up for patients in the true APA group, compared with just 7% and 21%, respectively, for those in the sham group.

The findings were similar for the Oswestry Low Back Pain Disability Index, with 4-week treatment and 1-month follow-up reductions of 28% for the true APA group versus 23% and 14%, respectively, for the sham group.

The researchers note in Evidence-Based Complementary and Alternative Medicine that the retention rate for the study was 90% and none of the participants found it difficult to apply APA at home. Overall, 90% of patients receiving true APA reported feeling better or much better and 100% were satisfied with their care.

"APA has promising potential as an adjunct therapy for CLBP," say Yeh et al.

They add: "APA, without using needles, offers a less invasive alternative to acupuncture and can be self-administered. Studies are still needed to investigate the stimulation 'intensity' parameter or APA for treatment effects."

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