Chronic pain is a significant public health problem that affects anywhere from 11 to 47 percent of the U.S. population. Experts estimate the cost burden to be between $560 billion to $635 billion. Pain medications, meant to alleviate chronic pain, have resulted in the current opioid crisis. What if there were a new way to treat chronic pain — without pills? A substantial body of evidence shows that acupuncture is effective for chronic pain.
Robert Davis, MS, L.Ac, a licensed acupuncturist affiliated with University of Vermont Integrative Health and the UVM Medical Center Comprehensive Pain Program has evaluated the effectiveness of acupuncture as an alternative to opiates for chronic pain.
Listen to the audio interview below, or read the transcript that follows.
Acupuncture: What is it?
Robert Davis: When people hear the word acupuncture, they think of a needling procedure. That’s part of what acupuncturists do, but acupuncture is actually a whole way of talking with patients and looking at the body. It’s a comprehensive treatment. This includes dietary and lifestyle advice and wellness care that goes beyond just the delivery of a needling intervention.
How safe is acupuncture?
Robert Davis: That is actually a really huge point in the context of the opioid crisis. On the one hand, opiates are effective at controlling pain in the short-term, but they’re very dangerous, and that’s the problem. Ironically, for long-term use, opiates are not necessarily efficacious or safe because there’s something called opioid hyperalgesia, which means people become more sensitive to pain when they’re on opioids for a long period of time.
The point of our study wasn’t to document safety. That’s been demonstrated in other larger trials. That said, we saw no adverse events in our study. The safety record of acupuncture is extremely important when you consider the alternatives.
Opiates: Researching acupuncture as an alternative
Robert Davis: Our study is titled “Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial.” The Vermont Legislature initiated the research. They were working on the Opioid Bill (Act 173) to combat the opioid crisis in Vermont. They reviewed literature and reports from around the country about the inclusion of non-pharmacologic treatments for chronic pain. When you look at the evidence, acupuncture treats chronic pain very well. The Legislature wondered whether we could incorporate acupuncture as a treatment option for chronic pain in Vermont.
They funded a study to help them make some decisions about whether to include acupuncture in the care of our patients with chronic pain. We had a compressed timeframe and a limited budget, so we decided to conduct a pragmatic study, the goal of which was to answer as many real world questions as possible. During our research, we discovered there was a lot of demand for acupuncture.
Who participated in the study?
Robert Davis: We recruited 150 patients within a two-month period, which is remarkable, and we could have had more. There was a long waiting list. We thought people would say, “Acupuncture? That’s weird and scary,” but it was very well-received.
We included 29 acupuncturists. We also learned that Vermont physicians were willing to make a referral to acupuncture because patients were willing, happy and excited about it. They were enthusiastic about the opportunity to do this.
What did you learn from the study?
Robert Davis: We examined a wide range of outcomes using validated scales and measures, including pain intensity, pain interference – which is how much pain interferes with your life on a daily basis – sleep disturbance, fatigue, depression, anxiety, physical function and social isolation.
We selected a broad set of scales for a reason. The Legislature wanted to know how acupuncture affects people’s social, psychological and occupational outcomes, not just their pain. That’s because chronic pain is a what we call biopsychosocial disease. In other words, when you transition from acute pain to chronic pain, it interferes with your life in ways that go beyond simply, “I’m in pain.” It starts to make you less sociable, makes you less able to function, and may result in depression or anxiety.
We were pleased to see that there were significant changes in the positive direction on all of our measures. So, it really had a positive impact on patients.
“My acupuncture was life-changing.”
Robert Davis: We asked patients to tell us how it impacted them, and they told us it was very helpful. One person said, “My acupuncture was life-changing. I saw and felt and continue to feel a marked difference in my pain and mental clarity. I believe it saved my life.”
My favorite quote shows how acupuncture care addresses the whole person and can create a positive spiral in a person’s life beyond pain relief, beyond analgesia, but getting a person to engage in a healthy way with their life.
This patient said:
“I was very skeptical about this treatment being effective. As the weeks went by, I noticed different changes taking place in my body. My digestive system functioned much better, so my diet improved. I required less sleeping medications because my sleep was better. My pain level was much decreased. I had more genuine energy, and most especially, I had better mobility. The mobility change enabled me to walk more in fresh air and increased my good energy level. A circle of reinforcements that has made my life much better, more productive, and happier. It has cut down my need for other medical interventions like physical therapy and medications for various ailments. People have noticed the outward improvement.”
As an acupuncturist, this is what we’re striving for. An interaction with a licensed acupuncturist is not just “lay on the table and we’re going to stick a couple needles in” type of relationship. We are building a relationship with you where we’re asking about your lifestyle habits and we’re trying to coach and encourage you and empower you to live your best, healthiest life.
Read: “Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial,” published in the peer-reviewed journal Global Advances in Health and Medicine.