Efficacy of acupuncture as a treatment for chronic shoulder pain.

OBJECTIVES

The aim of this study was to evaluate the efficacy of acupuncture as a treatment for chronic shoulder pain and to compare the efficacy of individualized acupuncture to fixed, standard point acupuncture treatment.

DESIGN

The study was a single-blind randomized, controlled trial.

SETTINGS/LOCATION: The study was conducted in an outpatient rheumatology clinic at the VA Medical Center of Philadelphia.

SUBJECTS: The participants were adults with shoulder pain for at least 8 weeks with a diagnosis of osteoarthritis or rotator cuff tendonitis and a total Shoulder Pain and Disability Index (SPADI) score of > or =30.

INTERVENTIONS: Thirty-one (31) subjects were randomized to one of three treatment groups: individualized acupuncture points according to the approaches of Traditional Chinese Medicine; fixed, standard acupuncture points conventionally used for shoulder pain; and sham nonpenetrating acupuncture. Subjects received 12 treatments over 6 weeks and were reassessed using the SPADI at the end of the 6 weeks.

OUTCOME MEASURES: The primary outcome evaluated was the mean change in total SPADI score in each group from baseline to 6 weeks.

RESULTS

After 6 weeks of treatment, the mean total SPADI score improved in all three groups, but the change was clinically significant (> or =10 points) only in groups 1 and 2 (-20.3 and -20.4, respectively, versus -6.5 in group 3). The treatment effects of groups 1 and 2 compared to the sham acupuncture group were -13.8 (95% confidence interval: -2.2 to -25.4, p < 0.015) and -13.9 (-2.0 to -25.8, p < 0.013), respectively. There was no difference between the individualized acupuncture and standardized acupuncture treatments.

CONCLUSIONS

Acupuncture may be an effective treatment for chronic shoulder pain. There may be no difference in efficacy between individualized and standardized acupuncture treatment. This suggests that the use of standard points may make treatment easier for patient care and for further research studies.