The Use of Acupuncture in Potentiating Functional Recovery in Spinal Cord Injury Subjects
Abstract
Objectives/Rationale: The objectives of the proposed clinical trial is to compare pain, quality of life, and neurological functional outcomes in patients with new traumatic spinal cord injury (SCI)-treated with acupuncture in addition to standard pain management, to patients treated with standard pain management alone. Patients with SCI often experience chronic pain that is difficult to manage with only the use of typical pain medications. They report that their inadequate pain control leads to a poorer quality of life, and many state they are willing to sacrifice regaining movement in exchange for pain relief. There is limited high-quality data on the use of acupuncture in treating SCI. A few studies completed previously suggest that acupuncture may reduce pain, improve quality of life, and improve neurological outcome in patients with SCI. Applicability/Impact: Individuals with SCI experience a variety of neurological deficits including: paralysis, muscle weakness, problems with coordination, stiff muscles, muscle spasms, lack of sensation, overactive reflexes, and lack of bowel and bladder control. In addition, chronic pain, and specifically pain classified as “neuropathic pain” (pain from damaged nerves) associated with SCI increases the risk of opioid dependency and possible overdose when opioid drugs are prescribed. SCI-related pain leads to patients not wanting, or able, to participate in rehabilitative activities, and thus they do not become as functional as those without pain. More effective pain management for these individuals is sorely needed. Patient Population: SCI disproportionately affects younger individuals and military Veterans. Individuals with severe SCI require a lifetime of care. Unfortunately, a significant component of the outcome after SCI is unmodifiable. There are no current treatments that can reverse the damage of the initial SCI, thus medical care of patients with SCI is focused on providing intensive rehabilitation and on managing the associated symptoms. This proposed study may be beneficial for patients who sustained their SCI from either a blunt (e.g., fall, motor vehicle accident, etc.) or penetrating injury (gunshot injury, stabbing, etc.) Benefits/Risks: Acupuncture is a modality of traditional Chinese medicine that has been practiced for over 2,500 years. In 1997, the National Institutes of Health published a statement on acupuncture as an effective modality for pain management. Acupuncture has been found to be effective for postoperative dental pain, headache, low back pain, carpel tunnel syndrome, and fibromyalgia. Studies have shown that the use of acupuncture in SCI can lead to reduced pain that lasts for hours to weeks after treatment. There are limited risks associated with the practice of acupuncture. This therapy is performed by credentialed acupuncturists who use single-use stainless steel or gold plated needles, thereby reducing the risk of infection. One potential risk with acupuncture in SCI is a dysfunction of the autonomic nervous system; however, none has been noted in prior studies. Projected Time to Outcome: Prior studies have shown improvement of pain after treatment with acupuncture that lasted for hours. We anticipate that we will see improvement of pain levels after every week of acupuncture treatment that is incremental over the 8-week treatment period and lasts through follow-up at 3 and 6 months. We anticipate seeing similar improvement of patient-reported quality of life at similar time points. We also anticipate that we may see improvement in the neurological function of patients treated with acupuncture at 3 and 6 months. Advancement of SCI Research: Current management of SCI-related pain is limited to traditional pain medications that are not effective and associated with various side effects. Innovative pain management modalities such as acupuncture may reduce pain levels experienced by individuals with SCI, thereby
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710658
Entities
People
- Deborah Stein
Organizations
- United States Army
- University of Maryland, Baltimore