Operation Acupuncture Case Study

Fibromyalgia (FM) is a syndrome of widespread pain associated with sleep disturbance, fatigue, depression, headache, abdominal pain, and poor concentration (Clauw). The American College of Rheumatology updated the diagnostic criteria for FM in 2010 to include these accompanying symptoms in addition to widespread pain (Wolfe). FM is associated with significant personal and socioeconomic costs, including limitations in work ability and high health care utilization (Palstam, Wolfe, Berger, White). The prevalence of FM among the general population in the United States is estimated to be between 1.1% and 6.4% (Vincent). FM is more common in both civilian and veteran women than men (Marques, Higgins). The prevalence of FM among veterans of Operation

A Cochrane review found low-to-moderate quality evidence that acupuncture improves pain and stiffness, but the effect was similar to that of sham acupuncture. In addition, in this Cochrane review, the benefit only lasted up to 1 month after therapy. There was also a suggestion that electroacupuncture, in which current is conducted through electrodes attached to acupuncture needles, may be more effective than manual acupuncture. However, this review was also limited by a paucity of large, well-designed trials. Acupuncture is traditionally used as only one component of a holistic, individualized treatment plan. One recent RCT (N=162) evaluated acupuncture in a more naturalistic clinical setting (Vas). In this study, women with fibromyalgia were referred from their primary care doctors to Traditional Chinese Medicine (TCM) practitioners who applied customized acupuncture treatments in 20-minute weekly sessions for 9 weeks based on the patient’s TCM diagnosis. The control intervention was the sham application of empty guide tubes to the back without puncturing the skin. At 6-month follow up, there was a small improvement in overall well-being, moderate improvement in pain, and moderate improvement in physical function. These effects were attenuated at 1 year, but there were additional confounders such as increased antidepressant use at this time point. In this setting, EULAR recommends acupuncture with a “weak for” rating, but further high-quality research using acupuncture in its intended context is