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A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
Published on: January 5, 2024
A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia
Nassim P Assefi1, Karen J Sherman, Clemma Jacobsen
1The Group Health Cooperative Center for Health Studies, and University of Washington, Seattle, Washington, USA.
Background:
Fibromyalgia is a common chronic pain condition for which patients frequently use acupuncture.
Objective:
To determine whether acupuncture relieves pain in fibromyalgia.
Design:
Randomized, sham-controlled trial in which participants, data collection staff, and data analysts were blinded to treatment group.
Setting:
Private acupuncture offices in the greater Seattle, Washington, metropolitan area.
Patients:
100 adults with fibromyalgia.
Intervention:
Twice-weekly treatment for 12 weeks with an acupuncture program that was specifically designed to treat fibromyalgia, or 1 of 3 sham acupuncture treatments: acupuncture for an unrelated condition, needle insertion at nonacupoint locations, or noninsertive simulated acupuncture.
Measurements:
The primary outcome was subjective pain as measured by a 10-cm visual analogue scale ranging from 0 (no pain) to 10 (worst pain ever). Measurements were obtained at baseline; 1, 4, 8, and 12 weeks of treatment; and 3 and 6 months after completion of treatment. Participant blinding and adverse effects were ascertained by self-report. The primary outcomes were evaluated by pooling the 3 sham-control groups and comparing them with the group that received acupuncture to treat fibromyalgia.
Results:
The mean subjective pain rating among patients who received acupuncture for fibromyalgia did not differ from that in the pooled sham acupuncture group (mean between-group difference, 0.5 cm [95% CI, -0.3 cm to 1.2 cm]). Participant blinding was adequate throughout the trial, and no serious adverse effects were noted.
Limitations:
A prescription of acupuncture at fixed points may differ from acupuncture administered in clinical settings, in which therapy is individualized and often combined with herbal supplementation and other adjunctive measures. A usual-care comparison group was not studied.
Conclusion:
Acupuncture was no better than sham acupuncture at relieving pain in fibromyalgia.
