Acupuncture Effective for Fibromyalgia
Study finds short-term benefits, indicating need for extended treatment
By Alan Mozes
HealthDay Reporter THURSDAY, Aug. 25/05 (HealthDay News) -- A brief regimen of acupuncture appears to offer more than a month of relief from some of the most debilitating symptoms of moderate-to-severe fibromyalgia, a new study suggests.
The findings are to be presented Thursday by Mayo Clinic researchers at the 11th World Congress on Pain, the meeting of the International Association for the Study of Pain, in Sydney, Australia.
The scientists cautioned that while acupuncture seems to alleviate some of the pain, chronic fatigue and anxiety that many fibromyalgia patients experience, the treatment should not be viewed as a cure.
They further stressed that even with improved energy levels and reduced stress, patients did not demonstrate improvements in either short-term or long-term physical functions after treatment.
Nonetheless, the Mayo team expressed hope that further studies will demonstrate that a sustained regimen of acupuncture treatments may offer fibromyalgia patients a shot at significant quality-of-life benefits over the long-term.
"We found that acupuncture helps with the symptoms, and might be particularly attractive to patients that might not be able to take a range of medications because of side effects," said study lead author Dr. David P. Martin, of the department of anesthesiology at the Mayo Clinic's division of pain medicine.
Fibromyalgia, which has no known cause, can provoke pain, fatigue, stiffness, headaches, numbness, tingling, sleep disturbances, sensitivity to heat and cold, and cognitive and memory problems, according to the National Institutes of Health.
The NIH estimates that between 3 percent and 6 percent of Americans suffer from the often-disabling disorder. While 80 percent to 90 percent of all victims are women, fibromyalgia can strike men, women and children of any age or race.
Doctors typically treat the condition with a combination of symptom-based approaches that offer piecemeal pain management, such as stress and sleep counseling, aerobic exercise, and the tricyclic family of antidepressants.
But, antidepressants are only partially effective and can sometimes provoke side effects, such as excessive sleepiness, dry mouth, constipation and weight gain, Martin said.
Seeking to expand treatment options, the Mayo team tested the benefit of acupuncture on 50 fibromyalgia patients who were described as "moderately debilitated."
The patients -- all of whom had failed to achieve symptom relief with traditional treatments -- were divided into two groups. The first group received six sessions of acupuncture over a two- to three-week period. The second group received six sessions of simulated acupuncture in the same time frame.
Both before and immediately after the acupuncture and simulated sessions, all the patients completed questionnaires regarding their specific symptoms, their level of related pain, and the impact of fibromyalgia on their daily routines. The surveys were also offered one and seven months after treatment.
Martin and his team found that symptoms -- particularly in terms of pain, fatigue and anxiety -- improved significantly and in larger measure among real acupuncture patients compared with the simulated acupuncture patients. The most dramatic symptom improvements were noted at one month after acupuncture. Yet physical function did not improve. And seven months after acupuncture, pain, fatigue and anxiety symptoms had all returned to pretreatment levels. Martin suggested that offering acupuncture to patients on an ongoing basis may provide more sustained benefit. And, he added, he would recommend acupuncture to fibromyalgia patients who are open to the notion.
"We need further studies with a larger population," he said. "But the kind of acupuncture we offered was not incredibly unique. You could probably get it at many locations across the country. So I'd recommend patients discuss it with their family physician, and get a referral because people come to acupuncture through all different courses of training."
Dr. Stuart L. Silverman, a professor of medicine and rheumatology, and the medical director of the Fibromyalgia Rehabilitation Program at Cedars-Sinai/University of California, Los Angeles, cautioned that the jury is still out on the potential benefit of acupuncture for fibromyalgia.
"While it's certainly possible and encouraging that in some hands acupuncture works, we have to wait for further study," Silverman said. "Fibromyalgia is a question of central pain -- not peripheral pain. It's as if a person's pain fuse in the brain is broken. They have a problem with the processing of sensory information. They perceive almost any sensation as being painful.
"So while we do know that acupuncture is helpful for peripheral pain, for tennis elbow, for example, it's much harder when we ask acupuncture to treat a pain in the brain -- to treat brain modulation of pain. I think it might be able to do it. But we don't yet know," he added.
Understanding, identifying and treating fibromyalgia can be challenging and confusing for both patients and physicians. NIH researchers point out, for example, that although fibromyalgia is a rheumatic condition -- causing the onset of chronic pain due to joint and soft tissue impairment -- it is not actually a disease of the joints, and is therefore not officially considered a form of arthritis.
An official fibromyalgia diagnosis is typically based solely on reported symptoms, medical exams and the patient's history, since no current lab test or X-ray can effectively screen for the disorder.
"These patients often have to leave their social obligations early and are not able to meet all the expectations of friends and family or be able to do their fair share of the housework," said Martin. "Yet when they go to the doctor, the doctor says that everything's normal -- and it's very frustrating for the patient. These people get pretty desperate."
SOURCES: David P. Martin, M.D, Ph.D., department of anesthesiology, division of pain medicine, Mayo Clinic, Rochester, Minn.; Stuart L. Silverman, M.D., professor of medicine and rheumatology and medical director of Fibromyalgia Rehabilitation Program at Cedars-Sinai/University of California, Los Angeles; Aug. 25, 2005, presentation, 11th World Congress on Pain, the meeting of the International Association for the Study of Pain, Sydney, Australia
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