When people visit the emergency department for acute musculoskeletal pain, it’s typically severe, and the usual treatment includes medications. When the pain is poorly controlled, it can lead to chronic pain and disability, as well as increased opioid use.
A randomized, controlled clinical trial conducted in the Duke University Hospital emergency department shows that providing acupuncture to treat acute musculoskeletal pain in addition to usual care is feasible even in this busy setting, and can reduce pain better than usual care alone.
“Musculoskeletal pain is really hard to treat in the emergency department, and medication alone only achieves a one-to-two-point reduction in pain scores on average,” said first author Stephanie Eucker, MD, PhD, assistant professor of emergency medicine at Duke University School of Medicine. “We were able to get at least that much, if not more, of a pain reduction on average in patients who received acupuncture. We found there was an additive effect of additional pain relief with acupuncture on top of what patients were already experiencing with medications alone.”
The study was published in October 2024 in the journal Annals of Emergency Medicine. An accompanying editorial highlighted the study as one of the few randomized controlled trials of acupuncture in the emergency department to date and called the results “promising,” though noting that further study is needed.
The researchers conducted the trial with 236 patients and two different types of acupuncture performed for 20-30 minutes in a treatment area in the emergency department.
Working with licensed acupuncturists, some patients received usual care plus battlefield acupuncture, which is administered to five different spots on each ear. Other patients received usual care plus peripheral acupuncture, which is administered to various points on the arms, leg, head, and neck. A third group of patients received usual care alone.
After initial analysis, the researchers found no difference in pain relief between the two types of acupuncture, so the entire study continued using both types.
Eucker pointed out that historically minoritized and medically underserved populations have worse pain outcomes and that there are significant health disparities in treatment of pain in the emergency department.
“We see the whole spectrum of people from all walks of life and all socioeconomic backgrounds,” she said. “I wanted to know; how can I treat the patient in front of me better?
“I have low back pain myself, and I’ve tried a lot of non-medication treatments, like physical therapy, yoga, and acupuncture,” Eucker said. “When I started practicing emergency medicine, I discovered most of the patients I was seeing hadn’t even heard of these things. But there’s data out there that some of these non-medication methods work better than medications because they’re treating the underlying problem.”
The study was conducted in collaboration with Duke Integrative Medicine and funded by the Substance Abuse and Mental Health Services Administration and the Duke Endowment.