O'Gorman P1, Hegarty D2
1South Infirmary Victoria University Hospital, Physiotherapy, Cork, Ireland, 2South Infirmary Victoria University Hospital, Pain Management, Cork, Ireland
Background: Complex Regional Pain Syndrome (CRPS) is a painful and highly disabling disorder that presents a substantial treatment challenge to the multidisciplinary team. Physiotherapy in conjunction with occupational therapy and pain management play key roles in rehabilitation of CRPS in the South Infirmary Victoria University Hospital (SIVUH), Cork, Ireland. Acupuncture was offered as an adjunct modality in SIVUH in recent years for patients diagnosed with CRPS who were showing a poor response to conventional evidence-based care. Positive feedback from this initial cohort of patients encouraged further investigation of the role of acupuncture in CRPS.
Purpose: Although acupuncture is widely used to manage headache, chronic low back pain and other musculoskeletal disorders, the role of acupuncture in CRPS has not been characterized. This study aimed to retrospectively evaluate patients´ perception of outcome following acupuncture for CRPS with a view to incorporating acupuncture as a standard treatment modality for this condition in SIVUH.
Methods: All patients from 2013 - 2017, diagnosed with CRPS of the upper limb (using the Budapest Criteria) who had received acupuncture as part of their treatment, were invited to complete a retrospective patient satisfaction questionnaire. Current pain intensity scores (VAS Pain), current Sheehan Disability Scales and questions related to clinical outcome following acupuncture treatment (ability to sleep, emotional wellbeing, improvements in pain intensity etc.) were recorded as well as overall satisfaction with treatment to evaluate patients´ perception of outcome. Demographic and clinical details were retrieved from hospital medical charts. A single physiotherapist had provided all acupuncture treatments.
Results: 10 patients met the inclusion criteria; 9 patients (90%) returned questionnaires for analysis (M:F = 3:6, mean age 53.3 +/- 8.3 years). Typically acupuncture was commenced 15.4 +/- 10.9 weeks post injury, with 16 +/- 9 acupuncture sessions provided. Average follow-up time was 23.8 +/- 14.1 months (range 2 - 44 months). Individuals reported being 'very much better' and 'quite a bit better' in terms of ability to sleep (89%), emotional well-being (89%), social functioning (78%) and improvements in pain intensity (78%) post acupuncture. Overall patient satisfaction with acupuncture treatment was high with all patients reporting benefit from acupuncture; all would recommend acupuncture to family members or friends; all would receive acupuncture treatment again.
Conclusion(s): Despite the limitations of a retrospective design, possible response bias, and overlap from other therapies, results suggest that there is a role for acupuncture as an adjunct modality to conventional medicine in the treatment of CRPS. Patients´ evaluation of acupuncture as a treatment modality for this challenging and highly disabling condition was positive. Future prospective RCTs are necessary to ascertain clinical effectiveness and viability of acupuncture in the management of CRPS.
Implications: Acupuncture should be considered as an adjunct treatment modality for the highly disabling and challenging condition of CRPS, especially for patients having a poor response to conventional therapies. Patients in this study reported considerable benefits with ability to sleep, emotional well-being and improvements in pain intensity post treatment all leading to improved quality of life.
Keywords: CRPS, Acupuncture
Funding acknowledgements: This work was not funded.
Purpose: Although acupuncture is widely used to manage headache, chronic low back pain and other musculoskeletal disorders, the role of acupuncture in CRPS has not been characterized. This study aimed to retrospectively evaluate patients´ perception of outcome following acupuncture for CRPS with a view to incorporating acupuncture as a standard treatment modality for this condition in SIVUH.
Methods: All patients from 2013 - 2017, diagnosed with CRPS of the upper limb (using the Budapest Criteria) who had received acupuncture as part of their treatment, were invited to complete a retrospective patient satisfaction questionnaire. Current pain intensity scores (VAS Pain), current Sheehan Disability Scales and questions related to clinical outcome following acupuncture treatment (ability to sleep, emotional wellbeing, improvements in pain intensity etc.) were recorded as well as overall satisfaction with treatment to evaluate patients´ perception of outcome. Demographic and clinical details were retrieved from hospital medical charts. A single physiotherapist had provided all acupuncture treatments.
Results: 10 patients met the inclusion criteria; 9 patients (90%) returned questionnaires for analysis (M:F = 3:6, mean age 53.3 +/- 8.3 years). Typically acupuncture was commenced 15.4 +/- 10.9 weeks post injury, with 16 +/- 9 acupuncture sessions provided. Average follow-up time was 23.8 +/- 14.1 months (range 2 - 44 months). Individuals reported being 'very much better' and 'quite a bit better' in terms of ability to sleep (89%), emotional well-being (89%), social functioning (78%) and improvements in pain intensity (78%) post acupuncture. Overall patient satisfaction with acupuncture treatment was high with all patients reporting benefit from acupuncture; all would recommend acupuncture to family members or friends; all would receive acupuncture treatment again.
Conclusion(s): Despite the limitations of a retrospective design, possible response bias, and overlap from other therapies, results suggest that there is a role for acupuncture as an adjunct modality to conventional medicine in the treatment of CRPS. Patients´ evaluation of acupuncture as a treatment modality for this challenging and highly disabling condition was positive. Future prospective RCTs are necessary to ascertain clinical effectiveness and viability of acupuncture in the management of CRPS.
Implications: Acupuncture should be considered as an adjunct treatment modality for the highly disabling and challenging condition of CRPS, especially for patients having a poor response to conventional therapies. Patients in this study reported considerable benefits with ability to sleep, emotional well-being and improvements in pain intensity post treatment all leading to improved quality of life.
Keywords: CRPS, Acupuncture
Funding acknowledgements: This work was not funded.
Topic: Musculoskeletal: upper limb; Pain & pain management
Ethics approval required: Yes
Institution: South Infirmary Victoria University Hospital, Cork, Ireland.
Ethics committee: CREC (Clinical Research Ethics Committee of the Cork Teaching Hospitals).
Ethics number: 0
All authors, affiliations and abstracts have been published as submitted.
