PAIN TREATMENT OF FIBROMYALGIA BY ACUPUNCTURE

The lack of objective parameters makes the measurement of pain and the efficacy of pain treatment in patients with chronic pain very difficu lt. We performed acupuncture therapy in fibromyalgia patients and esta blished a combination of methods to objectify pain measurement before and after therapy. The parameters corresponded to patients' self-repor t. Twenty-nine fibromyalgia patients as defined by ACR-criteria (25 wo men, 4 men) with a mean age of 48.2+/-2.0 years and a mean disease dur ation of 6.1+/-1.0 years participated in the study. Pain levels and po sitive tender points were assessed using the visual analogue scale (VA S, i.e., range 0-100 mm) and dolorimetry. Serotonin and substance P le vels in serum and the serotonin concentration in platelets were measur ed concomitantly. During acupuncture therapy no analgesic medication w as allowed. The VAS scores decreased from 64.0+/-3.4 mm before therapy to 34.5+/-4.3 mm after therapy (P<0.001). Dolorimetry revealed a decr eased number of tender points after therapy from 16.0+/-0.6 to 11.8+/- 1.0, P<0.01. Serotonin levels decreased from 715.8+/-225.8 mu g/10(12) platelets to 352.4+/-47.9 mu g/10(12) platelets (P<0.01), whereas the serum concentration increased from 134.0+/-14.3 ng/ml to 171.2+/-14.6 ng/ml (P<0.01), Substance P levels in serum increased from 43.4+/-3.5 pg/ml to 66.9+/-8.8 pg/ml (P<0,01). Acupuncture treatment of patients with fibromyalgia was associated with decreased pain levels and fewer positive tender points as measured by VAS and dolorimetry. This was a ccompanied by decreased serotonin concentration in platelets and an in crease of serotonin and substance P levels in serum. These results sug gest that acupuncture therapy is associated with changes in the concen trations of pain-modulating substances in serum. The preliminary resul ts are objective parameters for acupuncture efficacy in patients with fibromyalgia.