THURSDAY, Aug. 25 (HealthDay News) -- A brief
regimen of acupuncture appears to offer more than a
month of relief from some of the most debilitating
symptoms of moderate-to-severe fibromyalgia, a new
study suggests.
The findings are to be presented Thursday by Mayo
Clinic researchers at the 11th World Congress on
Pain, the meeting of the International Association
for the Study of Pain, in Sydney, Australia.
The scientists cautioned that while acupuncture
seems to alleviate some of the pain, chronic fatigue
and anxiety that many fibromyalgia patients
experience, the treatment should not be viewed as a
cure.
They further stressed that even with improved
energy levels and reduced stress, patients did not
demonstrate improvements in either short-term or
long-term physical functions after treatment.
Nonetheless, the Mayo team expressed hope that
further studies will demonstrate that a sustained
regimen of acupuncture treatments may offer
fibromyalgia patients a shot at significant
quality-of-life benefits over the long-term.
"We found that acupuncture helps with the
symptoms, and might be particularly attractive to
patients that might not be able to take a range of
medications because of side effects," said study
lead author Dr. David P. Martin, of the department
of anesthesiology at the Mayo Clinic's division of
pain medicine.
Fibromyalgia, which has no known cause, can
provoke pain, fatigue, stiffness, headaches,
numbness, tingling, sleep disturbances, sensitivity
to heat and cold, and cognitive and memory problems,
according to the National Institutes of Health.
The NIH estimates that between 3 percent and 6
percent of Americans suffer from the often-disabling
disorder. While 80 percent to 90 percent of all
victims are women, fibromyalgia can strike men,
women and children of any age or race.
Doctors typically treat the condition with a
combination of symptom-based approaches that offer
piecemeal pain management, such as stress and sleep
counseling, aerobic exercise, and the tricyclic
family of antidepressants.
But, antidepressants are only partially effective
and can sometimes provoke side effects, such as
excessive sleepiness, dry mouth, constipation and
weight gain, Martin said.
Seeking to expand treatment options, the Mayo
team tested the benefit of acupuncture on 50
fibromyalgia patients who were described as
"moderately debilitated."
The patients -- all of whom had failed to achieve
symptom relief with traditional treatments -- were
divided into two groups. The first group received
six sessions of acupuncture over a two- to
three-week period. The second group received six
sessions of simulated acupuncture in the same time
frame.
Both before and immediately after the acupuncture
and simulated sessions, all the patients completed
questionnaires regarding their specific symptoms,
their level of related pain, and the impact of
fibromyalgia on their daily routines. The surveys
were also offered one and seven months after
treatment.
Martin and his team found that symptoms --
particularly in terms of pain, fatigue and anxiety
-- improved significantly and in larger measure
among real acupuncture patients compared with the
simulated acupuncture patients. The most dramatic
symptom improvements were noted at one month after
acupuncture.
Yet physical function did not improve. And seven
months after acupuncture, pain, fatigue and anxiety
symptoms had all returned to pretreatment levels.
Martin suggested that offering acupuncture to
patients on an ongoing basis may provide more
sustained benefit. And, he added, he would recommend
acupuncture to fibromyalgia patients who are open to
the notion.
"We need further studies with a larger
population," he said. "But the kind of acupuncture
we offered was not incredibly unique. You could
probably get it at many locations across the
country. So I'd recommend patients discuss it with
their family physician, and get a referral because
people come to acupuncture through all different
courses of training."
Dr. Stuart L. Silverman, a professor of medicine
and rheumatology, and the medical director of the
Fibromyalgia Rehabilitation Program at
Cedars-Sinai/University of California, Los Angeles,
cautioned that the jury is still out on the
potential benefit of acupuncture for fibromyalgia.
"While it's certainly possible and encouraging
that in some hands acupuncture works, we have to
wait for further study," Silverman said. "Fibromyalgia
is a question of central pain -- not peripheral
pain. It's as if a person's pain fuse in the brain
is broken. They have a problem with the processing
of sensory information. They perceive almost any
sensation as being painful.
"So while we do know that acupuncture is helpful
for peripheral pain, for tennis elbow, for example,
it's much harder when we ask acupuncture to treat a
pain in the brain -- to treat brain modulation of
pain. I think it might be able to do it. But we
don't yet know," he added.
Understanding, identifying and treating
fibromyalgia can be challenging and confusing for
both patients and physicians. NIH researchers point
out, for example, that although fibromyalgia is a
rheumatic condition -- causing the onset of chronic
pain due to joint and soft tissue impairment -- it
is not actually a disease of the joints, and is
therefore not officially considered a form of
arthritis.
An official fibromyalgia diagnosis is typically
based solely on reported symptoms, medical exams and
the patient's history, since no current lab test or
X-ray can effectively screen for the disorder.
"These patients often have to leave their social
obligations early and are not able to meet all the
expectations of friends and family or be able to do
their fair share of the housework," said Martin.
"Yet when they go to the doctor, the doctor says
that everything's normal -- and it's very
frustrating for the patient. These people get pretty
desperate."
