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Chinese Medicine
Published in: Chinese Medicine 1/2017

Open Access 01-12-2017 | Research

Temporal divergence of changes in pain and pain-free grip strength after manual acupuncture or electroacupuncture: an experimental study in people with lateral epicondylalgia

Authors: Jaewon Jeon, Erin Bussin, Alex Scott

Published in: Chinese Medicine | Issue 1/2017

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Abstract

Background

The objective of this study was to examine, in individuals with lateral epicondylalgia (LE), the acute time course of acupuncture-induced hypoalgesia and change in pain-free grip strength (PFGS).

Methods

This was an experimental study, conducted at a single research center in Vancouver, BC. Twenty-one participants with unilateral LE lasting more than 6 weeks duration were enrolled. Participants received a single treatment of acupuncture (either electroacupuncture, 10–30 Hz, or manual acupuncture, assigned randomly). The primary outcome measure was pain level (0–10) during tendon loading (while making a fist) immediately after treatment, and over a 72 h follow-up period. Secondary outcome measures included pain-free grip strength (N).

Results

There was a small but statistically significant reduction in participants’ perceived pain level immediately after acupuncture (mean improvement of 1.2, 95% CI 0.45–1.9). This change in pain was not accompanied by a change in PFGS. No difference was observed between the two types of acupuncture at any time point.

Conclusions

The use of acupuncture or electroacupuncture, as administered in the current study, is unlikely to acutely enhance the ability of people with LE to engage in pain-free rehabilitation exercise.
Trial registration Registered February 25, 2015. ISRCTN14667535, http://​www.​isrctn.​com/​ISRCTN14667535
Appendix
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Literature
1.
du Toit C, Stieler M, Saunders R, et al. Diagnostic accuracy of power Doppler ultrasound in patients with chronic tennis elbow. Br J Sports Med. 2008;42:872–6.PubMed
2.
Jespersen A, Amris K, Graven-Nielsen T, et al. Assessment of pressure-pain thresholds and central sensitization of pain in lateral epicondylalgia. Pain Med. 2013;14:297–304.CrossRefPubMed
3.
Kraushaar BS, Nirschl RP. Tendinosis of the elbow (tennis elbow). Clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J Bone Joint Surg Am. 1999;81:259–78.CrossRefPubMed
4.
Peterson M, Svardsudd K, Appel L, et al. PET-scan shows peripherally increased neurokinin 1 receptor availability in chronic tennis elbow: visualizing neurogenic inflammation? PLoS ONE. 2013;8:e75859.CrossRefPubMedPubMedCentral
5.
Scott A, Backman LJ, Speed C. Tendinopathy: update on pathophysiology. J Orthop Sports Phys Ther. 2015;45:833–41.CrossRefPubMed
6.
Coombes BK, Bisset L, Vicenzino B. Thermal hyperalgesia distinguishes those with severe pain and disability in unilateral lateral epicondylalgia. Clin J Pain. 2012;28:595–601.CrossRefPubMed
7.
8.
Nirschl RP. Elbow tendinosis/tennis elbow. Clin Sports Med. 1992;11:851–70.PubMed
9.
Coombes BK, Bisset L, Vicenzino B. A new integrative model of lateral epicondylalgia. Br J Sports Med. 2009;43:252–8.CrossRefPubMed
10.
Bisset L, Beller E, Jull G, et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333:939.CrossRefPubMedPubMedCentral
11.
Raman J, MacDermid JC, Grewal R. Effectiveness of different methods of resistance exercises in lateral epicondylosis—a systematic review. J Hand Ther. 2012;25:5–25 (quiz 26).CrossRefPubMed
12.
Coombes BK, Bisset L, Brooks P, et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA. 2013;309:461–9.CrossRefPubMed
13.
De Das S, Vranceanu AM, Ring DC. Contribution of kinesophobia and catastrophic thinking to upper-extremity-specific disability. J Bone Joint Surg Am. 2013;95:76–81.CrossRef
14.
Vicenzino B. Lateral epicondylalgia: a musculoskeletal physiotherapy perspective. Man Ther. 2003;8:66–79.CrossRefPubMed
15.
Vicenzino B, Scott A, Bell S, et al. Elbow and arm pain. In: Brukner P, Kahn K, editors. Clinical sports medicine. 5th ed. Sydney: McGraw Hill; 2017. p. 439–62.
16.
Deare JC, Zheng Z, Xue CC, et al. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013;5:CD007070.PubMedCentral
17.
Paley CA, Johnson MI, Tashani OA, et al. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2015;10:CD007753.
18.
Manheimer E, Cheng K, Linde K, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev. 2010;1:CD001977.
19.
Manheimer E, Cheng K, Wieland LS, et al. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2012;5:CD005111.PubMedCentral
20.
Kim TH, Lee MS, Kim KH, et al. Acupuncture for treating acute ankle sprains in adults. Cochrane Database Syst Rev. 2014;6:CD009065.
21.
Boldt I, Eriks-Hoogland I, Brinkhof MW, et al. Non-pharmacological interventions for chronic pain in people with spinal cord injury. Cochrane Database Syst Rev. 2014;17:CD009177.
22.
Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;6:CD001218.
23.
Green S, Buchbinder R, Hetrick S. Acupuncture for shoulder pain. Cochrane Database Syst Rev. 2005;2:CD005319.
24.
Casimiro L, Barnsley L, Brosseau L, et al. Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005;4:CD003788.
25.
Furlan AD, van Tulder MW, Cherkin DC, et al. Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev. 2005;25:CD001351.
26.
Smith CA, Collins CT, Crowther CA, et al. Acupuncture or acupressure for pain management in labour. Cochrane Database Syst Rev. 2011;7:CD009232.
27.
Green S, Buchbinder R, Barnsley L, et al. Acupuncture for lateral elbow pain. Cochrane Database Syst Rev. 2002;1:CD003527.
28.
Bisset L, Paungmali A, Vicenzino B, et al. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39:411–22 (discussion 11–22).CrossRefPubMedPubMedCentral
29.
Webster-Harrison P, White A, Rae J. Acupuncture for tennis elbow: an E-mail consensus study to define a standardised treatment in a GPs’ surgery. Acupunct Med. 2002;20:181–5.CrossRefPubMed
30.
Guowei L, Rongzhao L, Jingqiang X, et al. Role of peripheral afferent nerve fiber in acupuncture analgesia elicited by needling point zusanli. Sci Sin. 1979;22:680–92.PubMed
31.
Kong J, Kaptchuk TJ, Polich G, et al. Expectancy and treatment interactions: a dissociation between acupuncture analgesia and expectancy evoked placebo analgesia. Neuroimage. 2009;45:940–9.CrossRefPubMed
32.
Mayer DJ, Price DD, Rafii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res. 1977;121:368–72.CrossRefPubMed
33.
Moret V, Forster A, Laverriere MC, et al. Mechanism of analgesia induced by hypnosis and acupuncture: is there a difference? Pain. 1991;45:135–40.CrossRefPubMed
34.
Chapman CR, Benedetti C, Colpitts YH, et al. Naloxone fails to reverse pain thresholds elevated by acupuncture: acupuncture analgesia reconsidered. Pain. 1983;16:13–31.CrossRefPubMed
35.
Cheng LL, Ding MX, Xiong C, et al. Effects of electroacupuncture of different frequencies on the release profile of endogenous opioid peptides in the central nerve system of goats. Evid Based Complement Alternat Med. 2012;2012:476457.PubMedPubMedCentral
36.
Molsberger A, Hille E. The analgesic effect of acupuncture in chronic tennis elbow pain. Br J Rheumatol. 1994;33:1162–5.CrossRefPubMed
37.
38.
Baeumler PI, Fleckenstein J, Takayama S, et al. Effects of acupuncture on sensory perception: a systematic review and meta-analysis. PLoS ONE. 2014;9:e113731.CrossRefPubMedPubMedCentral
39.
Bisset LM, Collins NJ, Offord SS. Immediate effects of 2 types of braces on pain and grip strength in people with lateral epicondylalgia: a randomized controlled trial. J Orthop Sports Phys Ther. 2014;44:120–8.CrossRefPubMed
40.
Vicenzino B, Brooksbank J, Minto J, et al. Initial effects of elbow taping on pain-free grip strength and pressure pain threshold. J Orthop Sports Phys Ther. 2003;33:400–7.CrossRefPubMed
41.
McLean S, Naish R, Reed L, et al. A pilot study of the manual force levels required to produce manipulation induced hypoalgesia. Clin Biomech. 2002;17:304–8.CrossRef
42.
Davidson J, Vandervoort A, Lessard L, et al. The effect of acupuncture versus ultrasound on pain level, grip strength and disability in individuals with lateral epicondylitis: a pilot study. Physiother Can. 2001;53:195–202.
43.
Fink M, Wolkenstein E, Luennemann M, et al. Chronic epicondylitis: effects of real and sham acupuncture treatment: a randomised controlled patient- and examiner-blinded long-term trial. Forsch Komplementarmed Klass Naturheilkd. 2002;9:210–5.CrossRefPubMed
44.
Haker E, Lundeberg T. Acupuncture treatment in epicondylalgia: a comparative study of two acupuncture techniques. Clin J Pain. 1990;6:221–6.CrossRefPubMed
45.
Bowsher D. Mechanisms of acupuncture. In: Filshie J, White A, editors. Medical acupuncture: a Western scientific approach. Edinburgh: Churchill-Livinstone; 1998.
46.
Ghoname ES, Craig WF, White PF, et al. The effect of stimulus frequency on the analgesic response to percutaneous electrical nerve stimulation in patients with chronic low back pain. Anesth Analg. 1999;88:841–6.CrossRefPubMed
47.
White PF, Li S, Chiu JW. Electroanalgesia: its role in acute and chronic pain management. Anesth Analg. 2001;92:505–13.CrossRefPubMed
48.
Stratford P, Spadoni G. The reliability, consistency, and clinical application of a numeric pain rating scale. Physiother Can. 2001;53:88–91.
49.
Preston CC, Colman AM. Optimal number of response categories in rating scales: reliability, validity, discriminating power, and respondent preferences. Acta Psychol. 2000;104:1–15.CrossRef
50.
Madsen MV, Gotzsche PC, Hrobjartsson A. Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ. 2009;338:a3115.CrossRefPubMedPubMedCentral
51.
Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008;9:105–21.CrossRefPubMed
52.
Plaster R, Vieira WB, Alencar FA, et al. Immediate effects of electroacupuncture and manual acupuncture on pain, mobility and muscle strength in patients with knee osteoarthritis: a randomised controlled trial. Acupunct Med. 2014;32:236–41.CrossRefPubMed
53.
Tsui P, Leung MC. Comparison of the effectiveness between manual acupuncture and electro-acupuncture on patients with tennis elbow. Acupunct Electrother Res. 2002;27:107–17.CrossRefPubMed
54.
Kivrak Y, Kose-Ozlece H, Ustundag MF, et al. Pain perception: predictive value of sex, depression, anxiety, somatosensory amplification, obesity, and age. Neuropsychiatr Dis Treat. 2016;12:1913–8.CrossRefPubMedPubMedCentral
55.
Thompson T, Correll CU, Gallop K, et al. Is pain perception altered in people with depression? a systematic review and meta-analysis of experimental pain research. J Pain. 2016;17:1257–72.CrossRefPubMed
56.
Alizadehkhaiyat O, Fisher AC, Kemp GJ, et al. Pain, functional disability, and psychologic status in tennis elbow. Clin J Pain. 2007;23:482–9.CrossRefPubMed
Metadata
Title
Temporal divergence of changes in pain and pain-free grip strength after manual acupuncture or electroacupuncture: an experimental study in people with lateral epicondylalgia
Authors
Jaewon Jeon
Erin Bussin
Alex Scott
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Chinese Medicine / Issue 1/2017
Electronic ISSN: 1749-8546
DOI
https://doi.org/10.1186/s13020-017-0143-z

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