Acupressure Reduces Bone Biopsy Pain

A VARIATION OF ACUPUNCTURE significantly reduced the proportion of patients who reported severe pain during bone marrow aspiration and biopsy, data from a small, randomized clinical trial showed.

Patients treated with acupressure were 89% less likely to find the bone marrow procedure severely painful (P=0.049), compared with patients who had sham acupressure, as defined by scores on a visual analog scale (VAS). The only notable adverse effects of acupressure were mild bruising or rash at the application site.

“Acupressure requires minimal training and expense and is not associated with adverse events,” Ting Bao, MD, of the University of Maryland in Baltimore, said during a presentation at the American Society of Hematology meeting. “It could be readily incorporated as a treatment option in the patient population undergoing bone marrow aspiration and biopsy.”

A majority of patients undergoing bone marrow aspiration and biopsy report moderate to severe pain, creating a need for a simple method to reduce it and improve quality of life for cancer patients, said Bao.

Acupressure is a traditional Chinese medicine technique that involves applying pressure with the hands, elbows, or a device to acupoints on the patient. Advocates say the technique offers a safe and effective alternative to acupuncture and avoids needle insertion.

Bao and colleagues evaluated magnetic acupressure as a means of minimizing or avoiding pain associated with bone marrow aspiration and biopsy. The technique involved use of suction cups to apply pressure to the large intestine 4 (LI4) acupoint near the space between the thumb and forefinger.

Investigators randomized 77 patients undergoing bone marrow aspiration and biopsy to real or sham acupressure. The sham procedure involved placement of the suction cups to a nonacupoint behind the small finger. Patients, bone marrow operator, and data collector were all blinded to treatment assignment.

The acupressure and sham groups did not differ significantly with respect to age (57), sex (60% male), body mass index (27 to 28), use of pain medications within 12 hours of the bone marrow procedure (30% to 35%), number of prior bone marrow procedures (about five), or pain score prior to bone marrow aspiration and biopsy (<1 on a 10-point vas).

Procedurally, the two groups differed only in the number of instances when a suction cup fell off during the procedure (an average of 0.8 with real acupressure and 1.9 with sham acupressure, P=0.007).

Eight of 40 (20%) patients randomized to sham acupressure reported severe pain during their bone marrow procedures, as defined by a vas score ³7.

That compared with one of 37 patients (2.7%) assigned to real acupressure (P=0.03). after adjustment for differences in cup loss and other variables, real acupressure reduced the odds of severe pain by 89.2% (P=0.049).

Ten patients in both groups combined reported mild bruising or rash associated with cup placement, and about half of the patients in each group requested acupressure for future bone marrow procedures.

Primary source: American Society of Hematology
Source reference:
Bao T, et al “The analgesic effect of magnetic acupressure during bone marrow aspiration and biopshy procedure in cancer patients: a randomized, blinded, controlled trial” ASH 2009; Abstract 71.