Abstract
To date, there is considerable evidence of the effectiveness of acupuncture in fibromyalgia syndrome (FM). However, it is not known in which body areas acupuncture is more effective. The objective of this study was to assess the improvements of pain induced by acupuncture in single body areas in patients with FM. In this open-label pragmatic study, FM patients in a state of high disease severity were consecutively enrolled and treated with a course of 8 weekly sessions of manual acupuncture. Patients were assessed with the Self-Administered Pain Scale (SAPS) of the Fibromyalgia Assessment Status at baseline and at the end of eight acupuncture sessions. Acupuncture sessions were all conducted with the same acupuncture formula (LV3, SP6, ST36, LI4, CV6, CV12, Ex-HN-3, and GV20) in each session and in each patient. Ninety-six FM patients completed the course of treatment. All the 16 body areas assessed by SAPS showed improvement in pain. A statistically significant improvement was achieved in 12 of the 16 body areas investigated, with the best results in abdomen and forearms (p = 0.001), while the worst results were registered for neck (p = 0.058), chest (p = 0.059), left buttock (p = 0.065), and right thigh (p = 0.052). The treatment has also shown significant effectiveness in improving fatigue and sleep quality (p < 0.0001). Acupuncture has a beneficial effect on pain in all body areas in FM patients with high disease severity, with the greatest effects in the abdominal region and in the forearms, allowing a personalization of the treatment.
Highlights
Acupuncture, a therapeutic technique that goes back thousands of years, is still an effective treatment strategy for chronic musculoskeletal pain [1]
At present, randomized controlled trials (RCTS) have demonstrated the effect of acupuncture in the treatment of fibromyalgia syndrome (FM) [4,5,6,7]. e latest EUropean League Against Rheumatism (EULAR) guidelines for the management of FM have suggested a “weak for” recommendation regarding the use of acupuncture [8]. e main advantages of acupuncture are the excellent tolerability and the almost absence of adverse events when compared to the standard drug therapy of FM [4]
A recent meta-analysis of RCTs documented the benefits of acupuncture on pain and quality of life in FM, demonstrating the superiority of verum acupuncture over sham acupuncture, and concluding that it may be a recommended treatment in FM patients [9]
Summary
Acupuncture, a therapeutic technique that goes back thousands of years, is still an effective treatment strategy for chronic musculoskeletal pain [1]. At present, randomized controlled trials (RCTS) have demonstrated the effect of acupuncture in the treatment of FM [4,5,6,7]. A recent meta-analysis of RCTs documented the benefits of acupuncture on pain and quality of life in FM, demonstrating the superiority of verum acupuncture over sham acupuncture, and concluding that it may be a recommended treatment in FM patients [9]. In evaluating the effectiveness of acupuncture in FM, the majority of studies have focused mainly on generic patient-reported outcomes (e.g., numerical rating scale [NRS] of pain) [4], or disease-specific instruments (e.g., Fibromyalgia Impact Questionnaire [FIQ]) [5, 10]. Other authors have documented improvements in serum biomarkers [6, 11]
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