Pressure pain threshold and perceived impact of pain differentially predict short-term and long-term pain reduction following acupuncture in fibromyalgia

Murphy AE, Arewasikporn A, Taylor-Swanson L, Williams DA, Harris RE · Journal of Integrative Medicine · 2025 March

DOI 10.1016/j.joim.2025.01.005

Objective

To investigate predictors of short- and long-term analgesic response in fibromyalgia patients undergoing acupuncture treatment.

Conclusions

Lower pressure pain thresholds at baseline were associated with greater analgesia immediately following sham treatment, while greater perceived impact of pain at baseline predicted greater short-term analgesia regardless of treatment. Self-reported pain outcomes were found to predict long-term analgesia following acupuncture in fibromyalgia.

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Insights

Acupuncture's effectiveness in treating fibromyalgia can be predicted by patients' self-reported pain outcomes and initial pressure pain thresholds.

The methodology involved a secondary analysis of a single-center, randomized, sham-controlled, and blinded, longitudinal acupuncture clinical trial for individuals suffering from fibromyalgia. Baseline characterization considered factors such as pressure pain threshold and pain interference. The main measure of outcome was the residualized change in pain intensity from the initial stage to the follow-up. The participants were segregated into two groups, one receiving verum acupuncture treatment and the other receiving a sham treatment, over a span of twelve weeks (comprising 18 treatments). The participants were observed for 37 weeks starting from the initiation of treatment. The results showed that lower pressure pain thresholds at the starting point were linked with a higher amount of analgesia in the sham treatment group right after the treatment. Conversely, individuals with higher pressure pain thresholds experienced greater analgesia with verum treatment. Moreover, a stronger perceived impact of pain at the beginning was indicative of higher short-term analgesia, regardless of the treatment type. Pressure pain threshold was not a reliable predictor of long-term differential treatment response. There was a noteworthy disparity in the connection between the perceived impact of pain at the start and the ensuing long-term analgesia between the two groups. It was seen that the patients with a higher perceived impact of pain showed improved, long-term analgesia for verum acupuncture compared to the sham group.