Early-Phase Intervention With Traditional Japanese Acupuncture and Moxibustion for Fibromyalgia: A Case Report

Fibromyalgia (FM) is a common chronic pain with no established treatment. Acupuncture is an expected treatment for FM though a diagnosis of FM tends to be delayed, and the advantage is still unclear in early-phase intervention with acupuncture treatment for FM. A 51-year-old woman with panic disorder presented with a four-month history of whole-body pain and was diagnosed with FM. She was unable to do housework or control her pain with medication. And she took 10 mg of paroxetine, a selective serotonin reuptake inhibitor (SSRI), to treat her depressive mood or panic disorder. A traditional Japanese acupuncture and moxibustion treatment, Hokushin-kai, was started. According to the Oriental medical diagnosis, she was categorized with "hyperactivity of liver yang," "dampness encumbering spleen," and "kidney yin deficiency" patterns. The treatment was administered once a week, and only one or two sterilized disposable needles were inserted into each acupoint (such as BL19, LR8, or KI3) for 10 minutes and with no manipulations. At the first presentation, the numerical rating scale (NRS) value was 6. After six weeks, her whole-body pain level remained around NRS 0-2 for 4-5 days after each treatment session. She was then able to resume housework after 12 weeks. Since ancient times, acupuncturists have recognized how acupuncture becomes less effective over time, especially for chronic pain. Moreover, the concept of a treatment-sensitive period for chronic pain prevention has recently been proposed. Further research, including early-phase interventions for acupuncture treatment, is required to evaluate the clinical effects of various treatments on FM.