Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2016

01-12-2016 | Original Article

Effects of acupuncture on quality of life and pain in patients with osteoporosis—a pilot randomized controlled trial

Authors: Joerg Schiller, Christoph Korallus, Matthias Bethge, Matthias Karst, Marie-Lena Schmalhofer, Christoph Gutenbrunner, Matthias Georg Fink

Published in: Archives of Osteoporosis | Issue 1/2016

Login to get access

Abstract

Summary

In this sham-controlled study, 53 patients received 10 sessions of acupuncture treatment over 5 weeks to investigate the effects of acupuncture on the pain and quality of life of patients with osteoporosis. The results showed significant favorable effects of verum acupuncture on quality of life. Both interventions showed sustained and clinically relevant effects on pain.

Purpose

Standard analgesic treatment is associated with adverse events in patients with osteoporosis, especially elderly and/or comorbid patients. As acupuncture has gained widespread acceptance as a complementary treatment modality with few side effects, the aim of this study was to evaluate the effects of acupuncture on the pain and quality of life of patients with osteoporosis.

Methods

In total, 53 patients with vertebral compression fractures, osteoporosis-associated spinal deformities, and resultant pain were randomly allocated to the verum acupuncture with deep needling of specific points following the principles of traditional Chinese medicine (n = 29) or control acupuncture group with superficial needling of non-acupuncture points (n = 24). All patients received 10 sessions of standardized verum or control acupuncture treatment over 5 weeks. Pain (VAS score 1–100) and quality of life (QUALEFFO-41) were measured at the start of treatment (T0), before each acupuncture session (T1), and at 1 (T2) and 3 months (T3) post-treatment.

Results

Both acupuncture treatments significantly reduced activity-related pain and pain at rest over time. The verum acupuncture group experienced a significantly greater reduction in mean pain intensity at rest than the control group. In the control group, quality of life improved only temporarily post-treatment (T2) and slightly declined at the end of the follow-up period (T3). In contrast, patients in the verum acupuncture group experienced continuous and significant improvements in quality of life up to 3 months after treatment (T3).

Conclusions

Both types of acupuncture were equally effective in producing sustained, clinically relevant pain relief in patients with osteoporosis. Verum acupuncture had stronger and longer-lasting effects on quality of life and pain at rest. The possible reasons for these findings include the specificity of acupuncture point selection and the performance of needle stimulation.
Literature
1.
Cockerill W, Lunt M, Silman AJ et al (2004) Health-related quality of life and radiographic vertebral fracture. Osteoporos Int 15:113–119CrossRefPubMed
2.
Fechtenbaum J, Cropet C, Kolta S, Horlait S, Orcel P, Roux C (2005) The severity of vertebral fractures and health-related quality of life in osteoporotic postmenopausal women. Osteoporos Int 16:2175–2179CrossRefPubMed
3.
Lips P, van Schoor NM (2005) Quality of life in patients with osteoporosis. Osteoporos Int 16:447–455CrossRefPubMed
4.
Fink HA, Ensrud KE, Nelson DB, Kerani RP, Schreiner PJ, Zhao Y, Cummings SR, Nevitt MC (2003) Disability after clinical fracture in postmenopausal women with low bone density: the fracture intervention trial (FIT). Osteoporos Int 14:69–76CrossRefPubMed
5.
Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674CrossRefPubMed
6.
Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112CrossRefPubMed
7.
Marcovitz PA, Tran HH, Franklin BA, O’Neill WW, Yerkey M, Boura J, Kleerekoper M, Dickinson CZ (2005) Usefulness of bone mineral density to predict significant coronary artery disease. Am J Cardiol 96:1059–1063CrossRefPubMed
8.
Sennerby U, Melhus H, Gedeborg R, Byberg L, Garmo H, Ahlbom A, Pedersen NL, Michaelsson K (2009) Cardiovascular diseases and risk of hip fracture. JAMA 302:1666–1673CrossRefPubMed
9.
Carbone LD, Johnson KC, Robbins J, Larson JC, Curb JD, Watson K, Gass M, Lacroix AZ (2010) Antiepileptic drug use, falls, fractures, and BMD in postmenopausal women: findings from the women’s health initiative (WHI). J Bone Miner Res 25:873–881PubMed
10.
Tamblyn R, Abrahamowicz M, du Berger R, McLeod P, Bartlett G (2005) A 5-year prospective assessment of the risk associated with individual benzodiazepines and doses in new elderly users. J Am Geriatr Soc 53:233–241CrossRefPubMed
11.
Wagner AK, Zhang F, Soumerai SB, Walker AM, Gurwitz JH, Glynn RJ, Ross-Degnan D (2004) Benzodiazepine use and hip fractures in the elderly: who is at greatest risk? Arch Intern Med 164:1567–1572CrossRefPubMed
12.
Wu Q, Liu J, Gallegos-Orozco JF, Hentz JG (2010) Depression, fracture risk, and bone loss: a meta-analysis of cohort studies. Osteoporos Int 21:1627–1635CrossRefPubMed
13.
Brinkhaus B, Witt CM, Jena S, Linde K, Streng A, Wagenpfeil S, Irnich D, Walther HU, Melchart D, Willich SN (2006) Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med 166:450–457PubMed
14.
Witt CM, Jena S, Selim D, Brinkhaus B, Reinhold T, Wruck K, Liecker B, Linde K, Wegscheider K, Willich SN (2006) Pragmatic randomized trial evaluating the clinical and economic effectiveness of acupuncture for chronic low back pain. Am J Epidemiol 164:487–496CrossRefPubMed
15.
Haake M, Muller HH, Schade-Brittinger C, Basler HD, Schafer H, Maier C, Endres HG, Trampisch HJ, Molsberger A (2007) German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med 167:1892–1898CrossRefPubMed
16.
Brinkhaus B, Witt CM, Jena S et al (2006) Interventions and physician characteristics in a randomized multicenter trial of acupuncture in patients with low-back pain. J Altern Complement Med 12:649–657CrossRefPubMed
17.
Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH (1990) Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol 17:1022–1024PubMed
18.
19.
Todd KH, Funk KG, Funk JP, Bonacci R (1996) Clinical significance of reported changes in pain severity. Ann Emerg Med 27:485–489CrossRefPubMed
20.
Lips P, Agnusdei D, Caulin F et al (1996) The development of a European questionnaire for quality of life in patients with vertebral osteoporosis. Scand J Rheumatol Suppl 103:84–85 discussion 86-88CrossRefPubMed
21.
Oleksik AM, Ewing S, Shen W, van Schoor NM, Lips P (2005) Impact of incident vertebral fractures on health related quality of life (HRQOL) in postmenopausal women with prevalent vertebral fractures. Osteoporos Int 16:861–870CrossRefPubMed
22.
Lips P, Cooper C, Agnusdei D et al (1997) Quality of life as outcome in the treatment of osteoporosis: the development of a questionnaire for quality of life by the European Foundation for Osteoporosis. Osteoporos Int 7:36–38CrossRefPubMed
23.
Rabe-Hesketh S, Everitt BS (2004) A handbook of statistical analyses using stata. CRC Press, Boca Raton
24.
25.
Weidenhammer W, Linde K, Streng A, Hoppe A, Melchart D (2007) Acupuncture for chronic low back pain in routine care: a multicenter observational study. Clin J Pain 23:128–135CrossRefPubMed
26.
Gewandter JS, Dworkin RH, Turk DC et al (2014) Research designs for proof-of-concept chronic pain clinical trials: IMMPACT recommendations. Pain 155:1683–1695CrossRefPubMedPubMedCentral
27.
28.
Quante S (2010) Wirksamkeit und Akzeptanz der Akupunktur bei Patienten mit chronischen Rückenschmerzen-Ergebnisse einer prospektiven, randomisierten Studie. Med. Diss. Universität Göttingen
29.
Usichenko TI, Dinse M, Hermsen M, Witstruck T, Pavlovic D, Lehmann C (2005) Auricular acupuncture for pain relief after total hip arthroplasty—a randomized controlled study. Pain 114:320–327CrossRefPubMed
30.
Wetzel B, Pavlovic D, Kuse R, Gibb A, Merk H, Lehmann C, Wendt M, Usichenko TI (2011) The effect of auricular acupuncture on fentanyl requirement during hip arthroplasty: a randomized controlled trial. Clin J Pain 27:262–267CrossRefPubMed
31.
Usichenko TI, Dinse M, Lysenyuk VP, Wendt M, Pavlovic D, Lehmann C (2006) Auricular acupuncture reduces intraoperative fentanyl requirement during hip arthroplasty—a randomized double-blinded study. Acupunct Electrother Res 31:213–221CrossRefPubMed
32.
Streng A, Linde K, Hoppe A, Pfaffenrath V, Hammes M, Wagenpfeil S, Weidenhammer W, Melchart D (2006) Effectiveness and tolerability of acupuncture compared with metoprolol in migraine prophylaxis. Headache 46:1492–1502CrossRefPubMed
33.
Zheng Z, Guo RJ, Helme RD, Muir A, Da Costa C, Xue CC (2008) The effect of electroacupuncture on opioid-like medication consumption by chronic pain patients: a pilot randomized controlled clinical trial. Eur J Pain 12:671–676CrossRefPubMed
34.
Fink MG, Kunsebeck H, Wipperman B, Gehrke A (2001) Non-specific effects of traditional Chinese acupuncture in osteoarthritis of the hip. Complement Ther Med 9:82–89CrossRefPubMed
35.
Fink MG, Kunsebeck HW, Wippermann B (2000) Effect of needle acupuncture on pain perception and functional impairment of patients with coxarthrosis. Z Rheumatol 59:191–199CrossRefPubMed
36.
Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, Sherman KJ, Witt CM, Linde K (2012) Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 172:1444–1453CrossRefPubMedPubMedCentral
37.
Yuan J, Purepong N, Kerr DP, Park J, Bradbury I, McDonough S (2008) Effectiveness of acupuncture for low back pain: a systematic review. Spine 33:E887–E900CrossRefPubMed
38.
Kim DH, Vaccaro AR (2006) Osteoporotic compression fractures of the spine; current options and considerations for treatment. Spine J 6:479–487CrossRefPubMed
39.
Fernandez-de-las-Penas C, Hernandez-Barrera V, Alonso-Blanco C, Palacios-Cena D, Carrasco-Garrido P, Jimenez-Sanchez S, Jimenez-Garcia R (2011) Prevalence of neck and low back pain in community-dwelling adults in Spain: a population-based national study. Spine 36:E213–E219CrossRefPubMed
40.
Chou YC, Shih CC, Lin JG, Chen TL, Liao CC (2013) Low back pain associated with sociodemographic factors, lifestyle and osteoporosis: a population-based study. J Rehabil Med 45:76–80CrossRefPubMed
41.
Sinaki M, Pfeifer M, Preisinger E, Itoi E, Rizzoli R, Boonen S, Geusens P, Minne HW (2010) The role of exercise in the treatment of osteoporosis. Curr Osteoporos Rep 8:138–144CrossRefPubMed
42.
Nagae M, Hiraga T, Wakabayashi H, Wang L, Iwata K, Yoneda T (2006) Osteoclasts play a part in pain due to the inflammation adjacent to bone. Bone 39:1107–1115CrossRefPubMed
43.
Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456CrossRefPubMed
44.
Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, Segal M, Genant HK, Cummings SR (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800CrossRefPubMed
45.
Matthis C, Weber U, O’Neill TW, Raspe H (1998) Health impact associated with vertebral deformities: results from the European Vertebral Osteoporosis Study (EVOS). Osteoporos Int 8:364–372CrossRefPubMed
46.
Bowsher D (1990) Physiology an pathophysiology of pain. Acupunct Med 7:17–20CrossRef
47.
Le Bars D, Dickenson AH, Besson JM (1979) Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat. Pain 6:283–304CrossRefPubMed
48.
Le Bars D, Dickenson AH, Besson JM (1979) Diffuse noxious inhibitory controls (DNIC). II. Lack of effect on non-convergent neurones, supraspinal involvement and theoretical implications. Pain 6:305–327CrossRefPubMed
49.
50.
51.
Myers SS, Phillips RS, Davis RB et al (2008) Patient expectations as predictors of outcome in patients with acute low back pain. J Gen Intern Med 23:148–153CrossRefPubMed
52.
Wasan AD, Kong J, Pham LD, Kaptchuk TJ, Edwards R, Gollub RL (2010) The impact of placebo, psychopathology, and expectations on the response to acupuncture needling in patients with chronic low back pain. J Pain 11:555–563CrossRefPubMedPubMedCentral
Metadata
Title
Effects of acupuncture on quality of life and pain in patients with osteoporosis—a pilot randomized controlled trial
Authors
Joerg Schiller
Christoph Korallus
Matthias Bethge
Matthias Karst
Marie-Lena Schmalhofer
Christoph Gutenbrunner
Matthias Georg Fink
Publication date
01-12-2016
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2016
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-016-0288-x

Other articles of this Issue 1/2016

Archives of Osteoporosis 1/2016 Go to the issue

Obituary

In memoriam: Silvano Adami

Review

A systematic review of intervention thresholds based on FRAX

Case Report

Bilateral non-traumatic hip fractures in a heavy smoker COPD patient on inhaled steroids

Original Article

Vitamin D deficiency in patients admitted to the general ward with breast, lung, and colorectal cancer in Buenos Aires, Argentina

Short Communication

Secondary prevention of osteoporosis following fragility fractures of the distal radius in a large health maintenance organization

Original Article

Vitamin D status in healthy Moroccan men and women aged 50 years and older: a cross-sectional study