Acupuncture has a well-established reputation for alleviating discomfort. In a new study published in the journal JAMA Oncology, researchers reveal that two specific types of the needle-based therapy are particularly effective at mitigating chronic musculoskeletal pain in people who have survived cancer.
The need for better chronic pain management is urgent. Five million cancer survivors in the United States experience chronic pain after treatment, a condition that costs as much as $635 billion annually. It is often treated with narcotics, such as fentanyl and oxycodone, but the national opioid crisis, which claimed almost half a million lives between 1999 and 2019, has spurred a search for nonpharmacological interventions.
Enter acupuncture. The term refers to the practice of inserting thin needles into the skin at specific points on the body. It has been an established pain-management technique in China for millennia and might have originated during the Neolithic period, according to the Oxford Academic Journals. In the United States, it is so widely accepted that many major cancer centers offer it as part of complementary oncology services.
The researchers considered two types of acupuncture: electroacupuncture, or acupuncture paired with an electrical current, and auricular acupuncture, which involves inserting studs into the ears for a period of days. They recruited 360 people with a prior cancer diagnosis and a history of chronic pain to assess differences in efficacy between pain medication, electroacupuncture and auricular acupuncture.
Notably, the study—the largest of its kind to date—included people with a range of cancer types, including lymphoma, breast cancer and prostate cancer. “A lot of previous acupuncture studies focused on women with breast cancer,” said senior author Jun Mao, MD, chief of the integrative medicine service at Memorial Sloan Kettering Cancer Center, in a press release.
The 360 participants were randomly assigned to receive electroacupuncture, auricular acupuncture or standard care for 10 weeks. (Standard care included medication, physical therapy and glucocorticoid injections.) Before, during and after treatment, participants were asked to rate their pain severity on a scale of zero (absence of pain) to 10 (the worst pain imaginable).
The researchers then compared the ratings. They found electroacupuncture reduced pain severity by an average of 1.9 points and auricular acupuncture reduced pain severity by an average of 1.6 points compared with standard care. Even a “one-point reduction in pain is clinically meaningful, so this is a pretty big drop,” Mao said.
In addition, the reduction was more durable. It was still apparent 14 weeks after the 10th and final session. “The pain relief of acupuncture lasts for months, which differs from pain medications, which must be taken frequently,” Mao said.
The electroacupuncture and auricular acupuncture arms of the study experienced corresponding increases in function and overall quality of life. However, electroacupuncture was better tolerated than auricular acupuncture, which had a higher discontinuation rate. Ear pain was a common adverse effect of auricular acupuncture.
Mao hopes his findings will encourage insurers to expand coverage.
“In 2020, Medicare started covering acupuncture for lower back pain. The acupuncture coverage for pain in cancer survivors, however, is inconsistent,” he said. “Hopefully, these data will encourage health care regulators to expand coverage. The urgency is huge: People from lower socioeconomic statuses may not have the same access to acupuncture if it remains uncovered.”
To learn more about cancer-pain management strategies, read “Managing Cancer Pain.” And to learn more about acupuncture and its applications for a range of health issues, read “What Acupuncture Can Do” and “Got Pain? Can’t Sleep? Try Acupuncture.”