Pain Task Force Updates White Paper on the Role of Acupuncture for Acute Pain

The majority of reviews indicate that acupuncture therapy may effectively reduce acute pain and has the potential to decrease reliance on opioids. These white paper findings, by the Academic Consortium Pain Task Force, were published in Pain Medicine.

This narrative review sought to update the information about nonpharmacologic strategies, particularly acupuncture, for the treatment of acute pain. Publication databases were searched through December 2020 for relevant systematic reviews with or without meta-analyses.

A total of 22 systematic reviews, 17 of which included meta-analyses, were included in this white paper update.

In the postoperative setting, systematic reviews and meta-analyses (SRMs) found that compared with sham treatment, acupuncture reduced the need for opioids by 21% at 8 hours, 23% at 24 hours, and 29% at 72 hours after surgery.

In addition, acupuncture was associated was decreased consumption of analgesic medications (standardized mean difference [SMD], 0.54; 95% CI, 0.30-0.77) and another SRM reported a 42% reduction of analgesic use at 2 hours. Coupled with reduced use of opioids or analgesics, studies reported fewer adverse events, such as dizziness and nausea.

Acupuncture in the acute traumatic and emergency department setting was found to be feasible and in 1 SRM, 71% of patients were either mostly or very satisfied with treatment. Acupuncture was associated with a pain reduction of 44.4% compared with 10.5% for sham treatment recipients. One SRM found that acupuncture was favored over no treatment; massage; thermal therapy with Chinese medicine; infrared radiation; or rest, ice, compression, and elevation but was not favored over dimethyl sulfoxide.

Seven SRMs evaluated acupuncture for migraine. Compared with sham or no treatment, acupuncture appeared to be more effective at preventing acute migraine.

For acute low back pain, 3 SRMs found significant benefits, including reduced pain and analgesic pain medication use.

A total of 3 studies evaluated the use of auricular therapy, termed battlefield acupuncture. This strategy was found to be feasible but had mixed results. One study found battlefield acupuncture to be effective and another ineffective.

In general, this review of SRMs supported the use of acupuncture to treat acute pain. Acupuncture was found to be feasible in various settings and to reduce analgesic medication use, including opioids. With less opioid use, studies generally reported a reduction in opioid-associated adverse events.

Reference

Nielsen A, Dusek J, Taylor-Swanson L, Tick H. Acupuncture therapy as an evidence-based nonpharmacologic strategy for comprehensive acute pain care: the academic consortium pain task force white paper update. Pain Med. 2022;pnac056. doi:10.1093/pm/pnac056