Are Auricular Maps Reliable for Chronic Musculoskeletal Pain Disorders?: A Double-Blind Evaluation

Abstract

Aim To examine the proposed somatotopic relation between the regions in which patients report musculoskeletal pain and tender points located on the external ears according to a map based on commonly used auricular acupuncture maps. Methods Twenty-five patients (16 women) from a chronic pain clinic were included. Patients were asked, before examination of the external ears, if they had past or present musculoskeletal pain in any of 11 body regions. An ear map, collapsed into 11 zones representing the musculoskeletal system, was used. The ear examiner was blinded to the patients' pain conditions, medical history and ongoing treatment. Patients communicated with the examiner only to express if tenderness was present in the external ear on palpation using a spring-loaded pressure stylus commonly used for auricular acupuncture. The degree of tenderness was registered on a 5-point scale and dichotomised (no tenderness or tenderness). Agreements between the patients' painful body regions and tenderness in the external ear zones were presented as percentage, kappa values, sensitivity and specificity. Results The 25 patients reported 116 past or present musculoskeletal pain regions and had 110 tender ear zones. No statistically significant agreements were found between the painful body regions and the corresponding tender ear zones. Conclusions Our results did not show agreements between patients' reported musculoskeletal pain regions and tender zones in the external ears assessed according to commonly used maps in auricular acupuncture using a pressure stylus. However, very tender points occur on the external ear in a population with chronic musculoskeletal pain.

Is Commercially Available Point Finder Accurate and Reliable in Detecting Active Auricular Acupuncture Points?

“…9 Although we understand the different phases described in the literature, the reference of auricular map used in this study was used in previous publications for either persistent or chronic musculoskeletal pain. 10,11 (4) The somatotopic organization of external auricles: Although auricular acupuncture maps have been used for several decades as guides for diagnosis and treatment, scientists have not yet been able to demonstrate or validate such a highly specific functional map of the external auricles. 10,14 A clinical study 10 indicated the lack of agreement between the region of patients' reported musculoskeletal pain and location of the tender zones of the external ears as assessed by a pressure stylus with an auricular acupuncture map used in the landmark auricular acupuncture research article.…”

“…In order to maintain consistency with studies published in the literature, the study protocol was based on two previous studies. 10,11 All of the participants were asked to fill out an anonymous self-report inventory, which allowed them to report whether they experienced any musculoskeletal pain and to specify its location and duration. Once a participant filled out the inventory sheet, he/she was escorted to an isolated room with a comfortable recliner.…”

“…French somatotopic map, published in a previous study, 10,11 was used as a guide of corresponding body regions in this study. For example, if the respondent self-reported neck pain in the intake sheet, based on auricular theory the ''neck'' region of the external auricle should have low skin resistance and it was detected by Pointer Plus, they classified it as ''true positive.''…”

“…10 Low skin resistance is often described in the classic acupuncture textbooks as one of the characteristics of traditional body acupuncture points. 1,8,9 As a result, many instruments have been developed and became commercially available to guide the acupuncturists, researchers, and educators in facilitating the localization of acupuncture points and active reflex auricular points.…”

Ear Acupoint Detection before and after Hysteroscopy: Is it Possible to Clarify the Representation of the Uterus on the Outer Ear?

“…Both tenderness and low electrical resistance were signifi cantly more present at corresponding points. 5 In a subsequent study Andersson and colleagues 6 could not replicate Oleson's positive results, but their study was limited by small sample size, failure to examine the posterior surface of the ear and arbitrary, non-standard classifi cation of zones.…”