Clinical research has provided valuable insights into the application of acupuncture for fibromyalgia, focusing on specific techniques, acupoint selections, and their physiological impacts. A randomized controlled trial investigated the effects of acupuncture on fibromyalgia symptoms and associated biochemical markers [1].
This study involved 75 female patients diagnosed with fibromyalgia, randomly assigned to three groups: real acupuncture (AcG), sham acupuncture (ShG), and simulated acupuncture (SiG). The AcG received treatment at 18 specific acupoints: GV14 (Da Zhui), SI15 (Jian Zhong Shu), LI4 (He Gu), LI11 (Qu Chi), HT7 (Shen Men), PC6 (Nei Guan), CV6 (Qi Hai), CV12 (Zhong Wan), CV4 (Guan Yuan), LV3 (Tai Chong), ST36 (Zu San Li), SP6 (San Yin Jiao), GB34 (Yang Ling Quan), and BL23 (Shen Shu). Except for GV14, CV6, Ren4, and CV12, all points were needled bilaterally [1].
Sterile stainless steel needles measuring 0.25 mm in diameter and 25 mm in length were inserted perpendicularly to a depth of 10–30 mm, depending on the point’s location and the patient’s body habitus. Manual stimulation was applied to elicit the deqi sensation. Each session lasted 25 minutes, conducted twice weekly over four weeks, totaling eight sessions [1].
The ShG received needle insertion at nonacupuncture points located 1–2 cm away from the true points, without manual stimulation or elicitation of deqi. The SiG underwent simulated acupuncture without skin penetration, using a blunt needle to mimic the sensation of insertion [1].
Patients were evaluated using several clinical scales, including the Visual Analog Scale (VAS) for pain, Number of Tender Points (NTP), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Nottingham Health Profile (NHP). Assessments occurred at baseline, after the final treatment session, and at one and three months posttreatment [2].
The real acupuncture group (AcG) exhibited significant improvements across all clinical parameters posttreatment, with effects persisting at the three month followup. Specifically, VAS scores for pain decreased markedly, indicating substantial pain relief, while the NTP reduced significantly, reflecting decreased tenderness. FIQ scores improved, denoting better overall health status and daily functioning. BDI scores decreased, suggesting alleviation of depressive symptoms. In contrast, the ShG showed transient improvements in some parameters, which were not sustained at followup, while the SiG demonstrated minimal changes [2].
HealthCMi staff acupuncturists note that the findings are consistent with other studies. Specifically, real acupuncture produces significant clinical outcomes that last; however, sham and simulated acupuncture may initially produce minimal placebo effects but they do not last over time.
The study also measured serum levels of serotonin and substance P (SP), neurotransmitters implicated in pain modulation. Posttreatment, the AcG showed a significant increase in serotonin levels and a decrease in SP levels, correlating with clinical improvements. These biochemical changes were not observed in the ShG or SiG, indicating that true acupuncture modulates these neurotransmitters, contributing to its therapeutic effects [3].
For licensed acupuncturists treating fibromyalgia, the treatment protocol of twice weekly sessions over four weeks may serve as a practical framework [1]. Monitoring biochemical markers like serotonin and SP could further elucidate individual responses to acupuncture, although this is more applicable in a research setting than routine practice [3].
This research provides evidence supporting acupuncture’s role in alleviating fibromyalgia symptoms, with specific techniques and acupoint selections contributing to its effectiveness. The modulation of serotonin and substance P levels offers a potential mechanism for its analgesic and mood enhancing effects. Licensed acupuncturists can integrate these findings into practice, employing detailed protocols to optimize patient outcomes [1][3].
Sources:
1. Karatay, S., et al. (2018). Effects of Acupuncture on Clinical Symptoms and Serum Serotonin and Substance P Levels in Patients with Fibromyalgia. Pain Medicine, 19(3), 615624.
2. Analog Scale (VAS) and clinical metrics such as Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Nottingham Health Profile (NHP) as utilized in the study are widely used tools to assess pain intensity, depression, and quality of life in fibromyalgia patients. Details were extracted from the original publication.
3. Biochemical data, including significant increases in serotonin and decreases in substance P levels posttreatment, were reported by Karatay et al. and correlated with symptom improvement.
