The following is a summary of “Temporal Summation but not Expectations of Pain Relief Predict Response to Acupuncture Treatment in Fibromyalgia,” published in the July 2024 issue of Pain by Murphy et al.
Fibromyalgia (FM) is a prevalent chronic pain condition increasingly treated with acupuncture, without a standard predictor for individual treatment efficacy.
Researchers conducted a retrospective study evaluating predictors of pain relief following acupuncture in patients with FM.
They assigned 76 subjects with FM to electroacupuncture or placebo mock laser acupuncture. Outcomes were measured by clinical pain severity (Brief Pain Inventory, BPI), nociplastic pain degree (Fibromyalgia Survey Questionnaire, FSQ), and pressure pain tolerance. Measures of temporal summation of pain and treatment expectations at baseline were used as primary predictors.
The result showed that both groups had significant reductions in BPI (electroacupuncture: P<0.001; mock laser: P=0.018) and FSQ (electroacupuncture: P=0.032; mock laser: P=0.002) post-treatment, with no significant change in pressure pain tolerance. In the group receiving electroacupuncture, lower baseline temporal summation correlated with greater BPI improvement (rho=0.389, P=0.025) but was not observed in the group receiving mock laser (rho=-0.272, P=0.109). Lower baseline temporal summation correlated with more reductions in pressure pain tolerance after electroacupuncture (rho=0.400, P=0.040), while mock laser treatment showed the opposite trend (rho=-0.562, P=0.001). Baseline treatment expectations were not correlated with any outcomes in either treatment group.
Investigators concluded that utilizing temporal summation of pain as a quantitative sensory testing metric, rather than treatment expectations, was supportive in predicting analgesic responses to acupuncture treatment for pain.