Efficacy of auricular therapy for pain management: a systematic review and meta-analysis.

Chao Hsing Yeh,Lung-Chang Chien,Samuel L Hoffman,Mary Lou Klem,Yi Chien Chiang,Lorna Kwai-Ping Suen,Zhan Liang,Wilson W S Tam

doi:10.1155/2014/934670

Abstract

Objective. The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group. Methods. Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score. Results. Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [−2.36, −0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included). Conclusion. Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain.

Highlights

Pain is a highly prevalent and costly health problem in the United States
Among the 13 trials, auricular therapy was found to be a significant method of pain relief when compared to the sham or control group (SMD = −1.59, 95% confidence intervals (CI) [−2.36, −0.82], P = 0.001)
Heterogeneity was reduced (χ2 = 51.23, I2 = 80%, P < 0.01) and the standardized mean differences (SMD) decreased to 0.69

Summary

Introduction

Pain is a highly prevalent and costly health problem in the United States. Back pain, in particular, affects at least 84% of individuals at some point during their lives [1, 2], and pain recurs in up to 80% of cases within 1 year [2]. In the United States, back pain is the second most common cause of disability [3], the second leading cause of lost workplace productivity (after the common cold) [4], and the third most common reason for visiting a health provider [5]. These effects place an enormous burden on U.S. society and health care systems, as reflected by an estimated cost ranging from $84.1 billion (direct cost of health care) to $624.8 billion (indirect cost including loss of productivity) per year [6,7,8]. Pain in its various manifestations is responsible for work absences, which create an enormous economic burden on individuals, families, communities, industry, and government [1, 9]

Methods

Results

Discussion

Conclusion