Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis?

Rubi‐Klein, K; Kucera-Sliutz, Elisabeth; Nissel, Helmut; Bijak, Michaela; Stockenhuber, Daniela; Fink, Matthias; Wolkenstein, E.

doi:10.1016/j.ejogrb.2010.06.023

Cited by 60 publications

(80 citation statements)

References 15 publications

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“…In contrast, Chinese herbal enemas decrease dysmenorrhea comparable to danazol (Kong et al 2014), and CM and herbal enema combination is superior to danazol in decreasing pain symptoms (Flower et al 2012). An acupuncture study in addition to conventional medical therapy significantly decreases pelvic pain by 5 to 6 points on the 10-point VAS (Rubi-Klein et al 2010). Pelvic physical therapy includes internal manual treatment to stretch pelvic floor muscles, myofascial release, biofeedback, and trigger point release.…”

Section: Treatmentsmentioning

confidence: 99%

Endometriosis: where are we and where are we going?

Greene¹,

Lang²,

Kendziorski³

et al. 2016

Reproduction

142

106

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Endometriosis currently affects ∼5.5 million reproductive-aged women in the U.S. with symptoms such as painful periods (dysmenorrhea), chronic pelvic pain, pain with intercourse (dyspareunia), and infertility. It is defined as the presence of endometrial tissue outside the uterine cavity and is found predominately attached to sites within the peritoneal cavity. Diagnosis for endometriosis is solely made through surgery as no consistent biomarkers for disease diagnosis exist. There is no cure for endometriosis and treatments only target symptoms and not the underlying mechanism(s) of disease. The nature of individual predisposing factors or inherent defects in the endometrium, immune system, and/or peritoneal cavity of women with endometriosis remains unclear. The literature over the last 5 years (2010-2015) has advanced our critical knowledge related to hormones, hormone receptors, immune dysregulation, hormonal treatments, and the transformation of endometriosis to ovarian cancer. In this review, we cover the aforementioned topics with the goal of providing the reader an overview and related references for further study to highlight the progress made in endometriosis research, while concluding with critical areas of endometriosis research that are urgently needed.

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Section: Treatmentsmentioning

confidence: 99%

Endometriosis: where are we and where are we going?

Greene¹,

Lang²,

Kendziorski³

et al. 2016

Reproduction

142

106

View full text Add to dashboard Cite

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“…In addition, the recruitment methods, safety and the acceptability of a twice weekly acupuncture intervention and the appropriateness of the three biomarkers as outcome measures are vital feasibility components that need to be understood prior to embarking on a fully powered randomised controlled trial. A fixed point selection was chosen as this has shown effectiveness in a previous clinical trial on TCM acupuncture for endometriosis [16]. This reduces the effect of treatment variation between practitioners but at the expense of ecological validity; however, as this is a feasibility study, this is not a significant issue.…”

Section: Discussionmentioning

confidence: 99%

“…This reduces the effect of treatment variation between practitioners but at the expense of ecological validity; however, as this is a feasibility study, this is not a significant issue. Previous trials for endometriosis have shown promising results after 10 treatments delivered twice per week [16] and after 16 treatments delivered twice per week [17]. In this study, we decided to treat twice weekly for 8 weeks (16 treatments) as this gives a greater cumulative dose of acupuncture delivered [53].…”

Section: Discussionmentioning

confidence: 99%

“…Acupuncture treatment will be delivered using a standardised fixed set of acupuncture points, based on those used in a previous pilot clinical trial using a traditional Chinese medicine (TCM) framework to treat endometriosis [16]. The set acupuncture points that will be delivered every session are SP6, SP8, SP10, ST29, ST36, CV3, CV4 and LR3.…”

Section: Methodsmentioning

confidence: 99%

“…Surgical interventions are costly and invasive, and recurrence rates for pain are high, with 50% of women having pain recurrence at 5 years post-surgery [3, 13]. Early evidence from two recent studies comparing verum (true) acupuncture to sham acupuncture have shown promise in reducing endometriosis-related CPP using a short course (10–16 sessions) of treatment [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

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Manual acupuncture plus usual care versus usual care alone in the treatment of endometriosis-related chronic pelvic pain: study protocol for a randomised controlled feasibility study

Armour

Smith

Schabrun

et al. 2017

Pilot Feasibility Stud

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BackgroundEndometriosis is the most common cause of chronic pelvic pain worldwide. Non-surgical treatments are effective for only 30–50% of women and have a significant side effect burden that leads to high discontinuation rates. Surgery can be effective but is expensive and invasive, and symptoms tend to recur within 5 years. There is early evidence that acupuncture may be effective in treating endometriosis-related chronic pelvic pain, showing clinically significant analgesia. Both levels of inflammation and pain processing have been shown to be altered in women with chronic pelvic pain. Acupuncture has been shown to reduce inflammation and change central pain processing in other conditions, but research on women with endometriosis is currently lacking. The aim of this feasibility study is to provide data on recruitment rates, retention, appropriateness of outcome measures, minimal clinically important difference in numeric rated scales for pain and the potential effect of acupuncture on pain processing and markers of inflammation in endometriosis-related CPP.MethodsWe will include women aged 18–45 years with a diagnosis of endometriosis via laparoscopy in the past 5 years. A total of 30 participants will be recruited and randomly allocated in a 1:1 ratio to receive acupuncture or usual care. Women in the acupuncture group will receive two 45-min treatment sessions per week for 8 weeks (total of 16 sessions). Women in the usual care group will continue with their current treatment regimen. The primary feasibility outcomes are recruitment rates, retention rates and the safety and acceptability of the intervention; secondary patient-centred outcomes include a change in 0–10 daily pelvic pain ratings, the Endometriosis Health Profile 30 (EHP-30) and changes in conditioned pain modulation, resting and task-related EEG activity and inflammatory markers. Analyses will be performed blind to group allocation.DiscussionThis is a two-armed, assessor blind, randomised controlled feasibility trial. Data will be compared at baseline and trial completion 8 weeks later. Outcomes from this feasibility study will inform a larger, fully powered clinical trial should the treatment show trends for potential effectiveness.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12617000053325 (http://www.ANZCTR.org.au/ACTRN12617000053325.aspx).Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-017-0152-9) contains supplementary material, which is available to authorized users.

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