Imagined and Actual Acupuncture Effects on Chronic Low Back Pain: A Preliminary Study

Abstract

<jats:p><jats:italic>Background</jats:italic>. Research suggests that imagined experiences can produce brain responses similar to those produced by actual experiences. Shared brain responses that support both imagination and perception may underlie the functional nature of mental imagery. In a previous study, we combined acupuncture and imagery to develop a new treatment method, video-guided acupuncture imagery treatment (VGAIT). We found that VGAIT significantly increased pain thresholds in healthy subjects. The aim of this study is to extend our previous finding by investigating whether VGAIT can relieve symptoms in patients with chronic low back pain. <jats:italic>Methods</jats:italic>. We first performed a single-arm study in which we administered video-guided acupuncture imagery treatment (VGAIT) on patients with chronic low back pain (cLBP) (Study 1, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn>18</mml:mn></mml:math>, 12 females). We then compared our findings to those from a recently published study in which real or sham acupuncture treatment was applied on patients with cLBP (Study 2, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn>50</mml:mn></mml:math>, 31 females) using a similar protocol. All patients in Studies 1 and 2 received 6 treatments over 4 weeks. <jats:italic>Results</jats:italic>. All three treatments (VGAIT, real, and sham acupuncture) significantly reduced pain severity as measured by a low back pain bothersomeness score. VGAIT produced similar effects to real acupuncture (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.97</mml:mn></mml:math>) and nonsignificantly greater pain bothersomeness relief compared to sham acupuncture (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.14</mml:mn></mml:math>). Additional analysis showed that there was no significant difference on the sensations evoked by different treatment modalities. <jats:italic>Conclusion</jats:italic>. These findings support VGAIT as a promising method for pain management.</jats:p>

Modulatory Effects of Actual and Imagined Acupuncture on the Functional Connectivity of the Periaqueductal Gray and Ventral Tegmental Area

“…Based on aforementioned findings, we have recently developed a complementary intervention, namely, video-guided acupuncture imagery treatment (VGAIT), that incorporates acupuncture and guided imagery to activate/deactivate brain regions that can also be activated/deactivated by real acupuncture. As a support, our previous studies have shown that VGAIT may produce analgesic effects comparable to acupuncture in both healthy controls (23) and patients with chronic low back pain (24).…”

Applying the Power of the Mind in Acupuncture Treatment of Pain

“…36 In a more-recent pilot study, Cao and colleagues found that 1 month of VGAIT (6 treatments) reduced the severity of cLBP significantly. 37 A comparison between this study 37 and a previous acupuncture study from the current author's laboratory using the same treatment paradigm showed that VGAIT produced similar effects to real acupuncture, and marginally greater low back-pain relief, compared to sham acupuncture. 11,12 These findings indicate a new way to apply the power of the mind in pain management.…”

Acupuncture as Part of Multimodal Analgesia for Chronic Pain

“…37 Similar results were found in a 2020 trial using video-guided acupuncture, which were compared with results from a previous study on sham acupuncture, finding no difference in outcomes between modalities. 38 A 2013 multi-center study (n = 130) found that traditional acupuncture resulted in a greater reduction in the visual analogue score (3.36) than sham acupuncture (2.27), indicating efficacy of traditional acupuncture in reducing pain in patients with chronic lower back pain. 41 A 2017 single-center trial (n = 154) found a greater reduction in neck pain from traditional acupuncture at both 2 and 6 week marks (intergroup mean differences: -5.75; 95% confidence interval [CI], -9.48 to -2.03; p = 0.008 than sham acupuncture -8.65; 95% CI, -12.13 to -5.16; P < 0.001, respectively).…”