Acupuncture

Acupuncture is a component of traditional Chinese medicine that has been used for the treatment of pain for thousands of years and is based on the premise that illness arises from the imbalance of energy flow (Qi) through the body (Dyson-Hudson et al. 2001). Needle acupuncture involves inserting fine needles into specific points to correct these imbalances (Dyson-Hudson et al. 2001; NIH Consensus Conference 1998; Pomeran 1998; Wong & Rapson 1999). Acupuncture has been shown to activate type II and type III muscle afferent nerves or A delta fibers, blocking the pain gate by stimulating large sensory neurons as well as releasing endogenous opioids, neurotransmitters and neurohormones (Dyson-Hudson et al. 2001; Pomeran 1998; Wong & Rapson 1999).

Discussion

Evidence from the studies above suggests acupuncture results in significant decrease in pain intensity over time compared to control (Estores et al. 2017). However, no group differences were found between acupuncture and sham treatment (Dyson-Hudson 2007) or Tager Psychophysical Integration (Dyson-Hudson 2001) or massage (Norrbrink & Lundeberg 2011). True acupoint was significantly more effective in reducing pain intensity compared to sham or no acupoint (Yeh et al. 2010). Electroacupunture was also shown to improve symmetric bilateral burning pain post intervention (Rapson et al. 2003).

Conclusion

There is level 1a evidence (from two RCTs: Dyson-Hudson et al. 2001, 2007) that in general acupuncture is no more effective than Trager therapy or sham acupuncture in reducing nociceptive musculoskeletal shoulder pain post SCI.

There is level 1b evidence (from one RCT: Yeh et al. 2010) that electroacupuncture reduces neuropathic pain of patients with SCI.

There is level 2 evidence (Norrbrink & Lundeberg 2011) that acupuncture is as effective as massage in reducing pain post SCI.