Use of acupuncture in the management of chronic haemophilia pain

Abstract

Persons with haemophilia experience persistent pain resulting in chronic arthritic symptoms. The older person with haemophilia who did not benefit from primary prophylaxis are particularly at risk for persistent pain in multiple target joints as a result of repeated joint bleeding with delayed treatment received. The National Pain Study, Ref. [11] identified over 700 persons with haemophilia who rated daily persistent pain as 4.22/10 (SD ± 2.05) using a visual analogue scale. The study suggests that persons are continually seeking additional resources to relieve pain. This study seeks to identify: (i) effects of acupuncture use for persons with haemophilia who experience persistent joint pain as a result of repeated haemarthrosis and (ii) document no reported increased bleeding risk as a result of acupuncture use. End points include the subjects reported perception of reduction in pain via the 10-point visual analogue pain scale and bleeding. Nine subjects participated in the study, some who received a factor replacement to 15% correction and others who did not receive factor prior to any acupuncture sessions totaling 14 acupuncture treatments. No one of the subjects experienced bleeding or bruising. Six of the nine subjects reported an improvement in pain scores by at least 50%. Seven of the nine quality of life (QOL) domains within the QOL SF-36 questionnaire improved, suggesting a perception by subjects of improvement. This study suggests that acupuncture therapy can be a safe additional modality for pain management therapies in persons with haemophilia, although larger randomized studies are needed for further validation.

Comprehensive management of chronic pain in haemophilia

“…Acupuncture has been evaluated for chronic pain treatment in PWH in two small studies, only one of which was controlled. In a small study of nine adults with haemophilia of all severities, seven reported improvement in pain VAS ratings after a total of 14 acupuncture sessions . Four PWH in this study reported at least a 50% improvement in VAS ratings, including one individual with severe haemophilia B whose rating dropped from 10 to 5 .…”

“…In a small study of nine adults with haemophilia of all severities, seven reported improvement in pain VAS ratings after a total of 14 acupuncture sessions . Four PWH in this study reported at least a 50% improvement in VAS ratings, including one individual with severe haemophilia B whose rating dropped from 10 to 5 . The frequency of analgesic use was reduced in three of these PWH .…”

Physiotherapy Treatment in Patients with Hemophilia and Chronic Ankle Arthropathy: A Systematic Review

“…Although acupuncture has been used as a treatment of physiotherapy, the article of Lambing et al [44] has not been included in this review because the authors do not apply it as a physiotherapy treatment. Two articles [40, 45], despite their good methodological quality, include patients with other coagulation deficits (von Willebrand disease-vWD).…”

A Model for Pain Self-Management of Patients with Haemophilia: Peer Education

“…A bleed into a joint can ca use acute, severe pain whereas the long-term effects of recurrent bleeds can lead to chronic and disabling symptoms [1][2][3]. Quality of life assessments identified pain occurs in 71% of patients with haemophilia and about 4% of patients with severe pain, and about 50% of haemophilia patients have more than one type of pain, in addition to joint pain.The older person with haemophilia who did not benefit from primary prophylaxis are particularly at risk for persistent pain in multiple target joints as a result of repeated joint bleeding with delayed treatment receive [4][5][6][7][8][9]. Besides being the leading cause of disability, chronic pain affects patients' overall quality of life including their ability to function and socialize, as well as impacting their family life [10].…”