Auricular Point Acupressure Research Articles

Evidence Based Alternative Medicines in Pain Management.

Evidence Based Alternative Medicines in Pain Management.

The Anti-Inflammatory Actions of Auricular Point Acupressure for Chronic Low Back Pain.

Background. Auricular point acupressure (APA) is a promising treatment for pain management. Few studies have investigated the physiological mechanisms of APA analgesics. Method. In this pilot randomized clinical trial (RCT), a 4-week APA treatment was used to manage chronic low back pain (CLBP). Sixty-one participants were randomized into a real APA group (n = 32) or a sham APA group (n = 29). Blood samples, pain intensity, and physical function were collected at baseline and after 4 weeks of treatment. Results. Subjects in the real APA group reported a 56% reduction of pain intensity and a 26% improvement in physical function. Serum blood samples showed (1) a decrease in IL-1β, IL-2, IL-6, and calcitonin gene-related peptide [CGRP] and (2) an increase in IL-4. In contrast, subjects in the sham APA group (1) reported a 9% reduction in pain and a 2% improvement in physical function and (2) exhibited minimal changes of inflammatory cytokines and neuropeptides. Statistically significant differences in IL-4 and CGRP expression between the real and sham APA groups were verified. Conclusion. These findings suggest that APA treatment affects pain intensity through modulation of the immune system, as reflected by APA-induced changes in serum inflammatory cytokine and neuropeptide levels.

Auricular Point Acupressure as an Adjunct Analgesic Treatment for Cancer Patients: A Feasibility Study

This study aimed (1) to examine the feasibility of an auricular point acupressure (APA) research protocol in terms of recruitment and for the assessment and management of pain and (2) to examine the potential APA analgesic effects for cancer patients. This study was a repeated-measures one-group design. Participants were recruited from the cancer center follow-up clinic affiliated with a large university hospital in the northeastern United States. Participants included 50 patients aged 55-87 years with a diagnosis of cancer. Participants received 7 days of APA treatment for their pain. After appropriate acupoints were identified, vaccaria seeds were carefully taped onto each selected auricular point on each ear. The study recruitment and retention rates were 92% and 91%, respectively. Importantly, the study found preliminary evidence for the analgesic effects of APA for cancer pain management. For example, by the end of the 7-day study, APA reduced pain intensity more than 55% for “worst pain” and about 57% for “average pain” and “pain intensity.” Moreover, the use of pain medication was reduced during the APA treatment (e.g., 78% of patients [n = 39] took less pain medication than before the treatment). APA appears to be highly acceptable to patients with cancer-related pain. However, without a placebo control, we cannot draw conclusive evidence for the analgesic effect of APA for cancer patients. A sham group must be added to future studies to differentiate the true effects of APA from the possible psychological effects of the APA treatment.

Auricular point acupressure for chronic pain: a feasibility study of a 4-week treatment protocol.

This 1-group, 4-week observational study aimed to (1) assess the feasibility of recruiting, retention, and completion of a 4-week auricular point acupressure (APA) treatment protocol for chronic pain in adult patients and (2) assess the effects of APA in pain reduction (pain severity and pain interference) among these patients. The participants received a 4-week APA treatment protocol in weekly cycles. Each weekly cycle included 5 days with APA seeds taped onto the ear and 2 days without. Each participant was called every day to monitor adherence to the treatment protocol (the actual times the participant pressed the seeds each day and the duration of applied pressure), to answer analgesic use, and to answer the pain intensity questionnaire. Thirty participants were initially enrolled in this study, but 5 did not continue. The retention rate was 83% (n = 25). Approximately 60% of the participants (n = 15) adhered to the 4-week APA and completed all data assessments. At baseline assessment, only 40% of all participants (n = 12 of 30) were confident that APA would reduce and eliminate pain; nonetheless, all participants reported fewer episodes of pain occurrences and pain intensity with the APA treatment. For the participants who completed the 4-week APA protocol (n = 15), 96% (n = 14) decreased analgesic medication intake and 88% (n = 13) felt "much better" after the APA treatment. Participants reported an average reduction of 63% in the worst pain intensity at day 7. By the end of the 4-week APA protocol, an even greater reduction in pain intensity was reported (66%, n = 10, at day 28). The participants who did not complete the treatment protocol reported an average pain reduction of 29%, which fluctuated to 22% before they dropped out. Auricular point acupressure is feasible for patients with chronic pain. The preliminary findings of this feasibility study show a reduction in pain intensity and improvement in physical function, which demonstrate the potential for APA as a treatment option for patients with chronic pain.

Function of Auricular Point Acupressure in Inducing Changes in Inflammatory Cytokines During Chronic Low-Back Pain: A Pilot Study

Background: Auricular therapy is a promising treatment for pain. However, the physiologic mechanisms of analgesic effects are not well-understood, which limits the scientific credibility of auricular therapy for pain management. Objectives: This prospective, randomized clinical trial (RCT) was conducted to determine whether or not the levels of pro- and anti-inflammatory cytokines change in response to auricular point acupressure (APA) for chronic low-back pain (CLBP). Methods: Blood samples (10 mL) were collected in a vacutainer, based on standard phlebotomy procedures. Blood was drawn at the following timepoints: before APA treatment to measure the baseline; 30 minutes after the first APA treatment; weekly for 4 weeks; and within 1 month of a follow-up visit (a total of seven timepoints) for each subject). Results: Participants with CLBP reported a mean 70% reduction of pain intensity at the completion of the 4-week APA regimen. The participants also had changes in serum pro- and anti-inflammatory cytokines. In particular, interleukin (IL)-1β, IL-4, and IL-10 were decreased. IL-2, IL-6, and tumor necrosis factor (TNF)-α were increased. In contrast, the participants who were in the sham APA group, with a 29% pain reduction, had a different profile. In particular, I-L2, IL-4, and TNF-α were decreased. IL-1β, IL-6, and IL-10 were increased. IL-1β, IL-2, IL-6, and IL-10 levels were associated with the worst pain intensity score, suggesting that these cytokines had an important role in mediating the APA effect on CLBP. Conclusions: The changes in cytokine levels in response to APA treatment suggested that APA could influence the level of circulating cytokines in patients with CLBP.

Application Of Auricular Therapy For Cancer-Related Pain In Nursing Care

Regardless of the advances in cancer treatment, cancer-related pain is still one of the most challenging symptoms that patients face. In the United States, cancer patients have turned to a wide variety of complementary and alternative medicine (CAM) therapies as an adjunct to conventional cancer treatments. This paper introduces Auricular Point Acupressure (APA), an innovative acupuncture technique that (1) features the use of seed patches instead of needles and (2) treats only the acupoints located on the surface of the ear. The technique not only offers a less invasive alternative to acupuncture, but also can be self-managed—the patient is instructed to press the points on which the patches have been placed at regular intervals and as needed to decrease pain. As a non-invasive, semi-self-managed, non-pharmacological technique for pain relief, APA has minimal side effects and, therefore, may be particularly acceptable to cancer patients. This paper describes the historical development of auricular therapy, auricular therapy treatments, a proposed biological mechanism underlying the analgesic effects of APA, and the implications of APA on nursing practice for cancer-related pain management.

Auricular point acupressure to manage chronic low back pain in older adults: a randomized controlled pilot study.

This prospective, randomized clinical trial (RCT) pilot study was designed to (1) assess the feasibility and tolerability of an easily administered, auricular point acupressure (APA) intervention and (2) provide an initial assessment of effect size as compared to a sham treatment. Thirty-seven subjects were randomized to receive either the real or sham APA treatment. All participants were treated once a week for 4 weeks. Self-report measures were obtained at baseline, weekly during treatment, at end-of-intervention (EOI), and at a 1-month follow-up. A dropout rate of 26% in the real APA group and 50% in the sham group was observed. The reduction in worst pain from baseline to EOI was 41% for the real and 5% for the sham group with a Cohen's effect size of 1.22 (P < 0.00). Disability scores on the Roland Morris Disability Questionnaire (RMDQ) decreased in the real group by 29% and were unchanged in the sham group (+3%) (P < 0.00). Given the high dropout rate, results must be interpreted with caution; nevertheless, our results suggest that APA may provide an inexpensive and effective complementary approach for the management of back pain in older adults, and further study is warranted.

A Randomized Clinical Trial of Auricular Point Acupressure for Chronic Low Back Pain: A Feasibility Study

Objectives. This prospective, randomized clinical trial (RCT) was designed to investigate the feasibility and effects of a 4-week auricular point acupressure (APA) for chronic low back pain (CLBP). Methods. Participants were randomized to either true APA (true acupoints with taped seeds on the designated ear points for CLBP) or sham APA (sham acupoints with taped seeds but on different locations than those designated for CLBP). The duration of treatment was four weeks. Participants were assessed before treatment, weekly during treatment, and 1 month following treatment. Results. Participants in the true APA group who completed the 4-week APA treatment had a 70% reduction in worst pain intensity, a 75% reduction in overall pain intensity, and a 42% improvement in disability due to back pain from baseline assessment. The reductions of worst pain and overall pain intensity in the true APA group were statistically greater than participants in the sham group (P < 0.01) at the completion of a 4-week APA and 1 month followup. Discussion. The preliminary findings of this feasibility study showed a reduction in pain intensity and improvement in physical function suggesting that APA may be a promising treatment for patients with CLBP.

Longitudinal analgesic effect of auricular point acupressure as an adjunct treatment for patients with pain

Longitudinal analgesic effect of auricular point acupressure as an adjunct treatment for patients with pain

Reduction in Nausea and Vomiting in Children Undergoing Cancer Chemotherapy by Either Appropriate or Sham Auricular Acupuncture Points with Standard Care

Over 40% of children with cancer have reported that chemotherapy-induced nausea and vomiting (CINV) are the two most distressing side-effects of treatment even when antiemetic drugs have been used. The purpose of this article is to report the findings from a feasibility and pilot study using auricular point acupressure point for CINV in a small group of children in Taiwan. This was a crossover randomized design study. CINV symptoms were assessed on 10 patients just prior to and for 7 days following each of three rounds of chemotherapy drugs (CTX). They received standard care (SC) and were not entered into a test treatment group until they completed the baseline assessment, which was conducted during their first round of chemotherapy after entering the study. Just prior to receiving the second round of CTX, patients were randomized into one of two treatment conditions: auricular acupressure intervention, in addition to standard care (AAP) or auricular acupressure using sham auricular points (SAP) in addition to standard care. For the third round of CTX, they were switched to the other treatment group. The enrollment rate for this study was 77% of the children invited to participate and of those, 88% provided completed data sets for all three treatment conditions. Patients in the AAP group reported significantly lower occurrence and severity of nausea and vomiting than patients in the SC group (p<0.05). There were no significant differences of nausea and vomiting for patients between the AAP and SAP groups. All of the patients took antiemetic medication on the day they received CTX, and 80% of patients reported that the antiemetics did not help to treat CINV. These preliminary findings did show evidence that AAP is acceptable to the children and their parents to prevent/treat CINV. However, there were no statistically significant differences between the AAP and SAP groups in the prevention/treatment of CINV. There were clinical trend differences between the groups, which may due to the small sample size. In a larger study, it would be important to determine whether the effects of the AAP and SAP treatment are independent of any psychologic effects, such as the researcher's increased presence in both treatment groups.

Auricular point acupressure for chronic low back pain: a feasibility study for 1-week treatment.

Objectives. The objective of this one-group, repeated-measures design was to explore the acceptance of auricular point acupressure (APA) to reduce chronic low back pain (CLBP) and estimate minimum clinically important differences (MCIDs) for pain intensity change. Methods. Subjects received 7-day APA treatment. After appropriate acupoints were identified, vaccaria seeds were carefully taped onto each selected auricular point for 7-day. The Brief Pain Inventory Short Form (BPI) was used to collect outcome data. Results. A total of 74 subjects participated in the study. Ten subjects dropped out and the retention rate was 87%. Subjects reported a 46% reduction in BPI worst pain, and over 50% reduction in BPI average pain, overall pain severity and pain interference by the end of study, and 62.5% subjects also reported less pain medication use. The MCIDs for the subscale of BPI ranged from .70 to 1.86 points. The percentage improvement of MCIDs from baseline was between 14.5–24.9%. Discussion. APA appears to be highly acceptable to patients with CLBP. A sham group is needed in order to differentiate the true effects of APA from the possible psychological effects of more frequent visits by the auricular therapist and patients' expectation of the APA treatment.