Hemophilia

BUENOS AIRES — Sticking needles into patients with a blood-clotting disease may seem counterintuitive, but researchers here said that acupuncture appears to alleviate some joint pain commonly experienced by people living with hemophilia.

In a pilot study, six of nine patients achieved substantial pain relief, including one patient whose visual analog pain scale score dropped from 10 to 5, said Angela Lambing, MSN, nurse practitioner coordinator at Henry Ford Health System, Detroit, at her poster presentation during the Hemophilia 2010 World Congress.

In the quality-of-life survey using the Short Form (SF-36) questionnaire, patients reported improvement in physical functioning, emotional problems, mental health, pain relief and positive changes in health.

“Importantly, we saw no bleeding in any person. We saw no bleeding after any treatment session. And we didn’t see any bleeding if the patient was taking blood factor to prevent bleeding episodes or was not on those treatments,” said Lambing.

“The number of patients is really too small to do any meaningful statistical analyses,” she told MedPage Today, “but I consider this a successful trial.”

The trial was conducted in Detroit and in Karnataka, India, part of the “twinning” program that connects treatment centers around the world.

Lambing said she really didn’t expect any bleeding issues with the acupuncture needles because the instruments used are 36-gauge needles — about the width of a human hair, and the needles do not penetrate all the way through the skin.

The acupuncture treatment program involved two sessions a week for four weeks, followed by weekly sessions for six weeks. Lambing said the long course of treatment probably reduced the enrollment in the trial. She said the small number of patients is a limitation of the study.

“This is an interesting study,” commented Johan Eerens of the Belgian Haemophilia Society. “I think it could be part of the treatment plan for individuals who are having difficulty getting relief of pain. It would be worth a try.”

Adults diagnosed with hemophilia were eligible for the study if they reported chronic pain and were diagnosed with severe hemarthrosis. They were treated with acupuncture at 20 sites, including specific points in the knee, ankle, lower back, and elbow for patients experiencing pain in those areas.

“Obviously we need larger randomized studies,” Lambing said. “But as an alternative therapy, acupuncture may provide some benefit to chronic pain patients with hemophilia in a multimodal approach.”

Primary source: World Federation of Hemophilia
Source reference:
Lambing A, et al “Acupuncture for the management of chronic pain in the hemophilia population” WFH 2010; Abstract 31P14.