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

Abstract

To determine the efficacy of acupuncture in the treatment of chronic musculoskeletal shoulder pain in subjects with spinal cord injury (SCI). Randomized, double blind (participants, evaluator), placebo (invasive sham) controlled trial. Clinical research center. Seventeen manual wheelchair-using subjects with chronic SCI and chronic musculoskeletal shoulder pain. Participants were randomly assigned to receive 10 treatments of either acupuncture or invasive sham acupuncture (light needling of nonacupuncture points). Changes in shoulder pain intensity were measured using the Wheelchair User's Shoulder Pain Index. 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. 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.