title: Investigation into the effects of using two or four acupuncture needles with bidirectional rotation on experimentally-induced contact heat pain in healthy subjects.
abstract: OBJECTIVE
  There is growing evidence from experimental studies that the acupuncture dose or technique influences the speed of onset of hypoalgesia. The aim of this study was to investigate the effects of acupuncture using two or four needles on experimental contact thermal pain in healthy volunteers.
  
  
  METHODS
  Forty two participants were randomised into three groups: four-needle group (LI4, LI11, LI10, TE5), two-needle group (verum at LI4, LI11 and mock at LI10, TE5) and mock acupuncture group (LI4, LI11, LI10, TE5). Each participant rated pain intensity (visual analogue scale, VAS) to a series of noxious stimuli administered to the forearm 2°C above the heat pain threshold during needling and immediately after removal of the needles.
  
  
  RESULTS
  Experimentally-induced heat pain intensity (VAS) during and after the intervention was lower than pre-intervention but there were no statistically significant differences in this change between groups. There were no statistically significant differences between groups in the time taken for pain intensity to decrease by 33% from pre-intervention. However, a 33% decrease in pain intensity within 3 min of needle insertion was observed for 13 participants (92.9%) in the four-needle group compared with 66.7% of participants in the two-needle group and 57.1% in the mock acupuncture group. There was less variance in VAS in the four-needle group, suggesting more consistency in hypoalgesic response when using more needles.
  
  
  CONCLUSIONS
  There is tentative evidence that four needles may be superior to two needles in generating rapid onset hypoalgesia. The findings suggest that further investigation is warranted.
authors.affiliation: Research & Development, Research Office, Airedale NHS Foundation Trust, Keighley, UK Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK Leeds Pallium Research Group, Leeds, UK.
authors.forename: Carole A
authors.initials: CA
authors.lastname: Paley
authors.affiliation: Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK Leeds Pallium Research Group, Leeds, UK.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Johnson
mesh_terms: D015669:Acupuncture Points; D015670:Acupuncture Therapy; D000328:Adult; D005260:Female; D064368:Healthy Volunteers; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D017288:Pain Threshold; D012399:Rotation; D055815:Young Adult
keywords: ACUPUNCTURE; COMPLEMENTARY MEDICINE; PAIN MANAGEMENT; PAIN RESEARCH; PALLIATIVE CARE