Acupuncture for chronic shoulder pain in persons with spinal cord injury: a small-scale clinical trial.

OBJECTIVE:

To determine the efficacy of acupuncture in the treatment of chronic musculoskeletal shoulder pain in subjects with spinal cord injury (SCI).

DESIGN:

Randomized, double blind (participants, evaluator), placebo (invasive sham) controlled trial.

SETTING:

Clinical research center.

PARTICIPANTS:

Seventeen manual wheelchair-using subjects with chronic SCI and chronic musculoskeletal shoulder pain.

INTERVENTIONS:

Participants were randomly assigned to receive 10 treatments of either acupuncture or invasive sham acupuncture (light needling of nonacupuncture points).

MAIN OUTCOME MEASURE:

Changes in shoulder pain intensity were measured using the Wheelchair User's Shoulder Pain Index.

RESULTS:

Shoulder pain decreased significantly over time in both the acupuncture and the sham acupuncture groups (P=.005), with decreases of 66% and 43%, respectively. There was no significant difference between the 2 groups (P=.364). There was, however, a medium effect size associated with the acupuncture treatment.

CONCLUSIONS:

There appears to be an analgesic effect or a powerful placebo effect associated with both acupuncture and sham acupuncture. There was a medium treatment effect associated with the acupuncture, which suggests that it may be superior to sham acupuncture. This observation, along with the limited power, indicates that a larger, more definitive randomized controlled trial using a similar design is warranted. Copyright © 2007 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation