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Different protocols for the administration of acupuncture influence its effect on chronic pain, conclude the authors of a review from China. They reviewed 24 trials with 3461 patients, and analysed factors relating to treatment schedule (D, duration of each treatment session; N, number of treatment sessions; T, total duration of treatment in weeks) from each of the trials, relating these to pain relief measured at the end of the treatment period and at follow-up. The concept of ‘DOSE’, a measure of the dose of acupuncture administered, was defined by the authors as DOSE = D×N/T (measured in minutes per week). Their results showed that a lower frequency of acupuncture treatment (two sessions/week) achieved the same effect as a higher treatment frequency (greater than two sessions/week), when pain relief was measured at the end of the treatment period. They further found that a higher DOSE of acupuncture did not guarantee better post-treatment pain relief. The rate of pain relief increased slightly as the DOSE of acupuncture increased, peaked at a DOSE of 30 mins/week of acupuncture, and then declined steadily with further increases of DOSE. For pain relief measured at follow up, less time spent in each individual acupuncture session, along with a lower DOSE was observed to result in better pain outcomes. Either shortening the treatment time for each session, or decreasing the DOSE of treatment per week, resulted in better treatment outcomes at follow up. The authors also found that the rate of pain relief remained at a level greater than 20% up to 18 weeks following the end of treatment, but then dropped sharply below 10% when the follow-up period was extended further.

What Is the Appropriate Acupuncture Treatment Schedule for Chronic Pain? Review and Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2019 Jun 18;2019:5281039


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