Electroacupuncture for the relief of suboptimally managed pain in ankylosing spondylitis: A single-arm pilot study

Patients with ankylosing spondylitis (AS), who suffer from inflammatory back pain, spend about two times more on healthcare than the general population. However, current treatments are unsatisfactory. The aim of this single-armed pilot study was to assess the feasibility of using electroacupuncture (EA) to manage AS pain that is not adequately controlled by analgesics. We hypothesized that, after 6 weeks of treatment, at least 10% of the subjects would experience a 30% reduction in their pain severity numerical rating scale (NRS) score when compared to baseline.

Twenty AS subjects who were experiencing moderate to severe pain despite usual care were recruited between March 2016 and August 2017 in Hong Kong, with two patients ultimately dropping out. Semi-standardized EA was performed on the 20 subjects twice a week for 6-10 weeks. Outcome measures were mainly examined at baseline and at weeks 6, 10 and 18. These measures included: pain severity NRS, medication use, Bath ankylosing spondylitis functional index, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis global index, short-form 36, Bath ankylosing spondylitis metrology index, chest expansion, swollen and painful joint count, C-reactive protein and erythrocyte sedimentation rate.

A one-sided exact binomial test showed that at least 10% of the subjects achieved a 30% pain reduction at week 6 (p = 0.002).

AS pain was decreased after 6 weeks of EA treatment. However, a randomized controlled trial with an adequate sample size is needed to confirm this finding.

NCT02697968 (ClinicalTrials.gov).