Electroacupuncture May Improve Burning and Electric Shock-Like Neuropathic Pain: A Prospective Exploratory Pilot Study

Abstract

<b><i>Objective:</i></b> To test the effectiveness of electroacupuncture (EA) for managing intractable neuropathic pain (NeP) and assess the protocol for a larger confirmatory trial. <b><i>Design:</i></b> A prospective, multicenter, single-armed, add-on, pilot study. <b><i>Settings/location:</i></b> At two tertiary university-based hospitals in Seoul, Republic of Korea. <b><i>Subjects:</i></b> Patients with chronic peripheral NeP, who have received conventional oral medications but complained of moderate to severe pain. <b><i>Interventions:</i></b> Two Korean medicine doctors conducted 12 sessions of EA (2 sessions per week for 4 weeks, followed by 1 session per week for the second month) in addition to conventional treatment. <b><i>Outcome measures:</i></b> During the 8-week treatment period, pain intensity, pain natures such as burning, electric shock-like, temperature or mechanical hyperalgesia, and numbness, Short Form of the McGill Pain Questionnaire (SF-MPQ) and the Brief Pain Inventory (BPI-SF), the EuroQol five dimensions questionnaire, patients' satisfaction, and adverse events were evaluated. The primary endpoint was a change in pain intensity (%) at 4 weeks from the baseline. <b><i>Results:</i></b> Among 22 patients, 19 finished the protocol. The eight EA sessions over a month reduced pain intensity from 6.0 ± 1.6 at baseline to 3.2 ± 0.9 at 4 weeks, which was a 46.7% reduction (<i>p</i> < 0.001). The incidences of severe burning, electric shock-like pain, and mechanical hyperalgesia reduced at 8 weeks [36%-16% (<i>p</i> = 0.04), 53%-21% (<i>p</i> = 0.009), and 53%-26% (<i>p</i> = 0.03), respectively]. The affective dimensions in the SF-MPQ (<i>p</i> = 0.007) and the pain interference parameters, including mood (<i>p</i> = 0.02), relations with other people (<i>p</i> = 0.03), and enjoyment of life (<i>p</i> = 0.002) in the BPI-SF, were improved at 4 and 8 weeks. The majority of patients (68%) responded that their pain was "much or somewhat improved." Overall, 84.2% expressed "satisfaction" with their multidisciplinary management. <b><i>Conclusions:</i></b> EA might decrease the intensity of NeP, in particular, such as burning, electric shock-like pain, and mechanical hyperalgesia, which was accompanied by psychosocial and functional improvement. A larger study is warranted to prove the effectiveness of EA for managing refractory NeP. <b>Trial registration:</b> ClinicalTrials.gov: NCT03315598. Retrospectively registered on October 20, 2017.