Acupuncture and subtypes of chronic pain: assessment of long-term results.

OBJECTIVE

To determine patients' opinions of pain relief for a longer time after one treatment period of acupuncture for chronic pain.

PATIENTS AND SETTING

Two hundred and eleven patients had acupuncture treatment for chronic pain at the Pain Clinic of Malmö University Hospital during 1983-5. Their mean duration of pain was 10.4 years prior to treatment.

INTERVENTION

The patients were treated with needle acupuncture with a combination of local and distal points every 1-2 weeks. Both manual and electrical stimulation was utilized. The mean number of treatments was 7.8.

DESIGN

In 1988, all patient documents were screened, and the pain conditions were classified as nociceptive, neurogenic, or psychogenic. Of the 211 treated patients, initial results could be evaluated from the clinic records in 202 cases. Eighty-five of these patients (42.1%) experienced pain relief immediately after the treatment period. These patients were sent a 1-page questionnaire by mail in 1988.

OUTCOME MEASURES

Pain relief over defined time periods (yes/no); do more work at home or at workplace (yes/no); analgesic consumption.

RESULTS

Only 35 patients (17.3% of all patients) still experienced pain relief 6 months after treatment. Among those with nociceptive pain, 70 of 142 (49%) had experienced initial pain relief, while those with neurogenic or psychogenic pain experienced relief in only 11 of 34 and four of 26 of the cases, respectively. Pain relief for > 6 months was experienced by 33 of 142 of the cases with nociceptive pain, but by only two of 34 of those with neurogenic pain, and by none of those with psychogenic pain.

CONCLUSION

Only patients with nociceptive pain can be expected to get pain relief for > 6 months after one treatment period of acupuncture, and of these only a small proportion will be helped.