title: Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency.
abstract: OBJECTIVE
  The objective of this study was to investigate whether typical acupuncture methods such as needle placement, needle stimulation, and treatment frequency were important factors in fibromyalgia symptom improvement. DESIGN/SETTINGS/SUBJECTS: A single-site, single-blind, randomized trial of 114 participants diagnosed with fibromyalgia for at least 1 year was performed.
  
  
  METHODS
  Participants were randomized to one of four treatment groups: (1) T/S needles placed in traditional sites with manual needle stimulation (n = 29): (2) T/0 traditional needle location without stimulation (n = 30); (3) N/S needles inserted in nontraditional locations that were not thought to be acupuncture sites, with stimulation (n = 28); and (4) N/0 nontraditional needle location without stimulation (n = 2 7). All groups received treatment once weekly, followed by twice weekly, and finally three times weekly, for a total of 18 treatments. Each increase in frequency was separated by a 2-week washout period.
  
  
  METHODS
  Pain was assessed by a numerical rating scale, fatigue by the Multi-dimensional Fatigue Inventory, and physical function by the Short Form-36.
  
  
  RESULTS
  Overall pain improvement was noted with 25%-35% of subjects having a clinically significant decrease in pain; however this was not dependent upon "correct" needle stimulation (t = 1.03; p = 0.307) or location (t = 0.76; p = 0.450). An overall dose effect of treatment was observed, with three sessions weekly providing more analgesia than sessions once weekly (t = 2.10; p = 0.039). Among treatment responders, improvements in pain, fatigue, and physical function were highly codependent (all p < or = 0.002).
  
  
  CONCLUSIONS
  Although needle insertion led to analgesia and improvement in other somatic symptoms, correct needle location and stimulation were not crucial.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, MI 48106, USA. reharris@med.umich.edu
authors.forename: Richard E
authors.initials: RE
authors.lastname: Harris
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Tian
authors.forename: David A
authors.initials: DA
authors.lastname: Williams
authors.forename: Thomas X
authors.initials: TX
authors.lastname: Tian
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Cupps
authors.forename: Frank
authors.initials: F
authors.lastname: Petzke
authors.forename: Kimberly H
authors.initials: KH
authors.lastname: Groner
authors.forename: Pinaki
authors.initials: P
authors.lastname: Biswas
authors.forename: Richard H
authors.initials: RH
authors.lastname: Gracely
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Clauw
mesh_terms: D015667:Acupuncture Analgesia / Q000379:methods*; D015669:Acupuncture Points; D000328:Adult; D003863:Depression / Q000628:therapy; D005260:Female; D005356:Fibromyalgia / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply; D009325:Nausea / Q000628:therapy; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome