Self-administered acupressure may be efficacious for reducing pain and fatigue in patients with chronic low back pain (cLBP), according to results from a small study published in Pain Medicine.

Acupressure, a traditional Chinese medicine, involves the application of physical pressure on specific acupoint body sites.

In this study, individuals with cLBP (ie, nonspecific LBP lasting ≥3 months) living in and around the Southeastern Michigan region were recruited using community outreach advertisements, including newspaper bulletins and posted flyers. Participants self-reported cLBP or it was identified using medical records. Participants (n=67; average age, 50.1 years; age range, 21-86) had to satisfy the following criteria to be enrolled: a score ≥4 on a 0 to 10 Pain Bothersome Scale; a score ≥3 out of 10 on a fatigue severity scale; patients had to be ambulatory with or without an assistive device; and participants had to be on stable therapy for the 2 months preceding study enrollment.

Participants were randomly assigned to receive relaxing acupressure (n=22), stimulating acupressure (n=22), or usual care (n=23). During the 6-week treatment period, individuals in the usual care group continued their usual treatment for back pain and fatigue. Participants in the acupressure groups were asked to self-administer acupressure to each acupoint (3 minutes per point) using a wooden acupressure aid, a pencil tip eraser, or their fingertip. Relaxing and stimulating acupressure acupoints was chosen by 4 acupressure practitioners.

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Fatigue was assessed with the Brief Fatigue Inventory, pain with the Brief Pain Inventory, sleep with the Pittsburgh Sleep Quality Index, and disability with the Roland Morris Scale at baseline and at a 6-week follow-up.

In this cohort, participants reported moderate levels of fatigue and pain. Reductions from baseline to 6 weeks were greater for pain in participants who self-administered relaxing and stimulating acupressure vs those who underwent usual care (35%; P =.0156 and 36%; P =.0198, respectively), and for fatigue in patients in the stimulating acupressure vs usual care group (26% reduction; P =.033). Sleep quality and disability were comparable between groups at 6 weeks.

On average, 85% of participants in the acupressure groups were adherent to therapy throughout the study period (relaxing acupressure, 91%; stimulating acupressure, 78%).

Adverse events that were reported by participants self-administering acupressure were mild, resolved rapidly, and were associated with the application of high pressure.

Study limitations include the small sample size, the sole enrollment of English-language-speaking individuals with cLBP, the assessment of sleep quality through self-reports, and the lack of blinding.

“[T]his study provides some evidence to suggest that stimulating acupressure improved fatigue compared with usual care, which is important given the effects of fatigue on back pain and daily function,” concluded the study authors.

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Reference

Murphy SL, Harris RE, Keshavarzi NR, Zick SM. Self-administered acupressure for chronic low back pain: A randomized controlled pilot trial [published online June 25, 2019]. Pain Med. doi:10.1093/pm/pnz138