Evoked pressure pain sensitivity is associated with differential analgesic response to verum and sham acupuncture in fibromyalgia

Noah A. Zucker, Alex Tsodikov, Scott Mist, Stephen Cina, Vitaly Napadow, Richard E. Harris

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective. Fibromyalgia is a chronic pain condition with few effective treatments. Many fibromyalgia patients seek acupuncture for analgesia; however, its efficacy is limited and not fully understood. This may be due to heterogeneous pathologies among participants in acupuncture clinical trials. We hypothesized that pressure pain tenderness would differentially classify treatment response to verum and sham acupuncture in fibromyalgia patients. Design. Baseline pressure pain sensitivity at the thumbnail at baseline was used in linear mixed models as a modifier of differential treatment response to sham versus verum acupuncture. Similarly, needleinduced sensation was also analyzed to determine its differential effect of treatment on clinical pain. Methods and Patients. A cohort of 114 fibromyalgia patients received baseline pressure pain testing and were randomized to either verum (N=59) or sham (N=55) acupuncture. Participants received treatments from once a week to three times a week, increasing in three-week blocks for a total of 18 treatments. Clinical pain was measured on a 101-point visual analog scale, and needle sensation was measured by questionnaire throughout the trial. Results. Participants who had higher pain pressure thresholds had greater reduction in clinical pain following verum acupuncture while participants who had lower pain pressure thresholds showed better analgesic response to sham acupuncture. Moreover, patients with lower pressure pain thresholds had exacerbated clinical pain following verum acupuncture. Similar relationships were observed for sensitivity to acupuncture needling. Conclusions. These findings suggest that acupuncture efficacy in fibromyalgia may be underestimated and a more personalized treatment for fibromyalgia may also be possible.

Original languageEnglish (US)
Pages (from-to)1582-1592
Number of pages11
JournalPain Medicine (United States)
Volume18
Issue number8
DOIs
StatePublished - Aug 1 2017

Fingerprint

Fibromyalgia
Acupuncture
Analgesics
Pressure
Pain
Pain Threshold
Therapeutics
Acupuncture Analgesia
Visual Analog Scale
Chronic Pain
Needles
Linear Models
Clinical Trials
Pathology

Keywords

  • Acupuncture
  • Fibromyalgia
  • Needling sensation
  • Pressure pain threshold
  • Quantitative sensory testing

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Evoked pressure pain sensitivity is associated with differential analgesic response to verum and sham acupuncture in fibromyalgia. / Zucker, Noah A.; Tsodikov, Alex; Mist, Scott; Cina, Stephen; Napadow, Vitaly; Harris, Richard E.

In: Pain Medicine (United States), Vol. 18, No. 8, 01.08.2017, p. 1582-1592.

Research output: Contribution to journalArticle

Zucker, Noah A. ; Tsodikov, Alex ; Mist, Scott ; Cina, Stephen ; Napadow, Vitaly ; Harris, Richard E. / Evoked pressure pain sensitivity is associated with differential analgesic response to verum and sham acupuncture in fibromyalgia. In: Pain Medicine (United States). 2017 ; Vol. 18, No. 8. pp. 1582-1592.
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