PAIN+ CPN

Doctor, I am taking opioids for my chronic pain condition, but I want to reduce my dose. Will electroacupuncture help me to reduce my opioid dose?

Electroacupuncture or sham electroacupuncture may help patients reduce their doses of opioid medication. Patients were able to reduce their dose of opioid medication and maintain the lower dose for 3 months. Reducing the dose in opioid medication did not affect patients’ level of pain.   

What is the evidence?

Researchers looked at patients with chronic musculoskeletal pain who were treated with electroacupuncture and compared them to patients treated with sham electroacupuncture and to patients who didn’t receive any specific treatment (a control group). They measured opioid dose before and after treatment, pain before and after treatment, and side effects related to opioid medication. They found that:

  • Patients in the electroacupuncture group and the sham group both had a significant reduction in their opioid medication dose. They were able to maintain that reduction for 3 months after treatment ended.
  • There was no change in pain scores from the beginning to the end of treatment in any of the three groups
  • Patients in the control group did not have a reduction in opioid dose
  • Patients in the electroacupuncture group had fewer opioid-related side effects than in the other two groups
  • Side effects of electroacupuncture included pain at the needle site, lethargy, and bruising

What kind of study was this?

This was a randomized controlled trial (RCT). In an RCT, patients are randomly assigned to receive the treatment under study or a comparator treatment.

Who participated in the study? This study included 108 people who had chronic musculoskeletal pain (in any part of their body) who had been taking opioid medications regularly for more than 2 months.

How was the study done?

This study had three groups:

  1. Electroacupuncture
  2. Sham acupuncture
  3. A control group that didn’t receive any specific treatment

Before they were randomized, all patients met with a pain specialist who explained the impact of chronic pain, possible problems with opioid medication, and each patient received an individual schedule for reducing their opioid medication.  Patients were allowed to take non-opioid pain medications for any pain relief.


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Electroacupuncture

vs

Sham electroacupuncture or usual care

Electroacupuncture is a form of acupuncture where a small electric current is passed between acupuncture needles. Electrical stimulation was done for 20 minutes.

Patients had 12 sessions of electroacupuncture over 10 weeks.

The electroacupuncture was provided by registered acupuncturists with at least 3 years of experience.


Sham acupuncture

In sham acupuncture, needles were shallowly inserted in sham points. The needles had a flashing light and beeping sound but had no electric current.

Usual care

After meeting with the pain specialist and receiving their individual dose reduction schedule, these patients were offered no further treatment.

After 10 weeks had passed, the patients in this group were offered electroacupuncture if they wanted it.

Why was this research done?

Many patients with chronic pain conditions are given opioid medication to reduce their pain. The long-term benefits of opioid medications for chronic pain are not clear, and opioid medications can be associated with serious side effects. This study looked at whether electroacupuncture could assist patients in reducing their opioid medication dose, whether it could do so better than sham acupuncture or no acupuncture, and whether electroacupuncture was safe to use.

This Evidence Summary is based on the following article:

Zheng Z, Gibson S, Helme RD, et al. Effects of Electroacupuncture on Opioid Consumption in Patients with Chronic Musculoskeletal Pain: A Multicenter Randomized Controlled Trial. Pain Med. 2018 Jun 8. pii: 5035035. doi: 10.1093/pm/pny113. PubMed

Published: Friday, December 21, 2018