Acupuncture Successful Alternative to Pain Drugs in Emergency Department

The results from a new clinical trial suggest that acupuncture administered in the emergency department may be a safe and effective alternative to pain drugs.

The authors discovered that acupuncture provided long-term pain relief for patients visiting the emergency department that was comparable to the effects of prescription drugs, according to a study published by the Medical Journal of Australia.

While the study showed a benefit from alternative pain management, the authors indicated this is a critical issue since neither therapy provided immediate relief.

Pain is the most common reason for visiting the emergency department; however, many patients may not always receive adequate treatment.

"While acupuncture is widely used by practitioners in community settings for treating pain, it is rarely used in hospital emergency departments," said lead investigator Marc Cohen, PhD. "Emergency nurses and doctors need a variety of pain-relieving options when treating patients, given the concerns around opioids such as morphine, which carry the risk of addiction when used long-term.”

Prescribing opioids was once the standard treatment, but many patients have become addicted to these drugs, prompting calls for tighter prescribing regulations. Many physicians may only prescribe the drugs for patients with serious conditions.

"Our study has shown acupuncture is a viable alternative, and would be especially beneficial for patients who are unable to take standard pain-relieving drugs because of other medical conditions,” Dr Cohen said. "But it's clear we need more research overall to develop better medical approaches to pain management, as the study also showed patients initially remained in some pain, no matter what treatment they received."

Included in the study were 528 patients with acute low back pain, migraine, or ankle sprains who visited the emergency departments of 4 hospitals between January 2010 and December 2011.

Patients who reported having pain scaling at least a 4 out of 10 were randomized to receive 1 of 3 treatments: acupuncture monotherapy, acupuncture plus prescription drugs, or prescription drug monotherapy.

One hour after treatment, less than 40% of all patients experienced significant pain reduction. Approximately 80% of patients continued to have a pain rating of 4 or higher on a scale from 1 to 10, according to the study.

Another 48 hours after treatment, a majority of patients reported that the treatment they received was acceptable.

The authors found that 82.8% of patients who received only acupuncture would probably or definitely receive the treatment again. Approximately 80.8% of patients in the combined group indicated they would receive the therapy again, while 78.2% in the prescription drug monotherapy group reported desire for the same treatment in the future if they experienced pain, according to the study.

"Some Australian emergency departments already offer acupuncture when trained staff are available but further studies are needed on ways to improve pain management overall in emergency departments, and the potential role for acupuncture in this," Dr Cohen said.

If implemented in the United States, acupuncture has the potential to reduce the prevalence of opioid misuse and abuse that has resulted in thousands of overdoses and deaths.

Additional studies are needed to better determine which patients should receive acupuncture and how cost-effective the approach may be.

"We need to determine the conditions that are most responsive to acupuncture, the feasibility of including the treatment in emergency settings, and the training needed for doctors or allied health personnel,” Dr Cohen concluded.