Acupuncture relieves pain in emergency patients: studyDate: 19/06/2017
The world’s largest randomised controlled trial of the use of acupuncture in emergency departments has found the treatment is a safe and effective alternative to pain-relieving drugs for some patients.
Led by RMIT University, the study found acupuncture was as effective as pain medicine in providing long-term relief for patients who came to emergency in considerable pain.
The study, published in the Medical Journal of Australia and funded by a grant from the National Health and Medical Research Council, involved 528 patients experiencing acute lower back pain (270), migraine (92) or ankle sprains (166) who presented at the emergency departments of the Alfred Hospital, Cabrini Malvern, Epworth Hospital and Northern Hospital between January 2010 and December 2011.
Study co-author Dr Michael Ben-Meir, Director of Cabrini Hospital's emergency department, is an emergency physician who practises acupuncture. He says that it is reasonable to conclude from the study that acupuncture is a mild-to-moderate analgesic, equivalent to existing pharmacotherapy. “If and how acupuncture is incorporated into standard emergency care is a complex challenge yet to be tackled,” he said. “I envisage most ED physicians could quickly and easily develop adequate skills to allow them to provide this treatment to suitable and consenting patients.”
The trial showed pain management remains a critical issue. According to lead investigator Professor Marc Cohen of RMIT’s School of Health and Biomedical Sciences, pain is the most common reason people came to emergency, but was often inadequately managed. “While acupuncture is widely used by practitioners in community settings for treating pain, it is rarely used in hospital emergency departments,” he said. “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.
Professor Cohen says the study demonstrates that 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. “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.”
Patients who identified their level of pain as at least four on a ten-point scale randomly received one of three types of treatment:
- acupuncture alone (177 patients)
- acupuncture plus pharmacotherapy (178 patients)
- pharmacotherapy only (173 patients)
One hour after treatment, less than 40 per cent of patients across all three groups felt any significant pain reduction (two or more pain points), while more than 80 per cent continued to have a pain rating of at least four. Forty-eight hours later, most found their treatment acceptable.
Eighty-three per cent of patients who received only acupuncture said they would probably or definitely repeat their treatment, compared with 81 per cent in the combined group, and 78 per cent in the pharmacotherapy-only group.
FURTHER QUOTATIONS ATTRIBUTABLE TO CABRINI EMERGENCY DEPARTMENT DIRECTOR DR MICHAEL BEN-MEIR
“While the study did not test whether the pharmacotherapy provided to the patient sample was evidence-based, the analgesia decisions were made by physicians who would be competent in treating pain according to the guidelines.”
“This study occurred at four major Australian hospital emergency departments, with treatment at the discretion of treating emergency physicians whose knowledge of analgesia options and assessing pain is excellent and who were utilising drugs in a timely manner.”
“Emergency physicians are specialists in the management of acute pain, with 60 per cent of emergency attendances presenting with pain as their main complaint.”
“Our main need for pain management specialists is the management of complex chronic-pain syndromes with acute exacerbations, which is a relatively small proportion of ED presentations.”
For more information or to request an interview with Dr Michael Ben-Meir, Director of Cabrini’s emergency department, please contact Christine Elmer ph (03) 9508 3551 or 0459 811 693, Cabrini marketing and community relations department.