Acupuncture for chronic shoulder pain in persons with spinal cord injury: A small-scale clinical trial

Objective: To determine the efficacy of acupuncture in the treatment of chronic musculoskeletal shoulder pain in subjects with spinal cord injury (SCI). Design: Randomized, double blind (participants, evaluator), placebo (invasive sham) controlled trial. Setting: Clinical research center. Participants: Seventeen manual wheelchair-using subjects with chronic SCI and chronic musculoskeletal shoulder pain. Interventions: Participants were randomly assigned to receive 10 treatments of either acupuncture or invasive sham acupuncture (light needling of nonacupuncture points). Main Outcome Measure: Changes in shoulder pain intensity were measured using the Wheelchair User's Shoulder Pain Index. Results: Shoulder pain decreased significantly over time in both the acupuncture and the sham acupuncture groups (P=.005), with decreases of 66% and 43%, respectively. There was no significant difference between the 2 groups (P=.364). There was, however, a medium effect size associated with the acupuncture treatment. Conclusions: There appears to be an analgesic effect or a powerful placebo effect associated with both acupuncture and sham acupuncture. There was a medium treatment effect associated with the acupuncture, which suggests that it may be superior to sham acupuncture. This observation, along with the limited power, indicates that a larger, more definitive randomized controlled trial using a similar design is warranted.