Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency.
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.
Harris
Richard E
RE
Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, MI 48106, USA. reharris@med.umich.edu
Tian
Xiaoming
X
Williams
David A
DA
Tian
Thomas X
TX
Cupps
Thomas R
TR
Petzke
Frank
F
Groner
Kimberly H
KH
Biswas
Pinaki
P
Gracely
Richard H
RH
Clauw
Daniel J
DJ
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