Acupuncture Effective for Fibromyalgia
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."
Reference
Source 101
August
25, 2005
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