Adolescent Acupuncture

Study Finds Most Pediatric Patients Find Pain Relief through Acupuncture

By Michael Devitt

Despite a wide range of evidence showing its effectiveness as a form of pain relief in adults, acupuncture is not usually thought of as a primary option for relieving pain in children and adolescents.

One theory behind this curious phenomenon holds that because acupuncture treatment most often involves the use of needles, and because most children are afraid of needles, they would be unwilling to undergo (and their parents would not want to subject their children to) a form of care that involves needling.

A new study¹ published in the April issue ofPediatrics may help dispel this theory. The study, conducted by a team of scientists at Harvard Medical School, detailed the experience of pediatric patients and their parents with acupuncture. Their findings showed that acupuncture treatment appears to relieve pain for a variety of conditions, and that both patients and parents consider acupuncture "pleasant and helpful."

The study was led by Dr. Kathi J. Kemper, an associate professor at the school's department of pediatrics. After undergoing treatment from a licensed acupuncturist at Children's Hospital in Boston, Massachusetts, patients and their families were contacted by telephone and asked a series of questions about the quality of care they received. Of 50 eligible families, 47 agreed to be interviewed. In some instances, the child answered the questions personally; in other cases, a parent answered the questions in place of (or in addition to) the child.

The median age of the patients was 16 years; a majority (79%) of which were female. The most common complaints seen included migraine headache, endometriosis and reflex sympathetic dystrophy. The most common therapies used were needle insertion (98%), followed by heat/moxibustion (85%), magnets (26%) and cupping (26%); some patients received more than one therapy. An average of eight treatments were used per patient.

Patient and Parent Opinions Toward Acupuncture

Of the 30 patients who were interviewed, two-thirds reported that acupuncture had been a positive experience, while 70% felt that treatment had definitely helped their pain. One patient, a 17-year old boy, described his experience as such: "It was strange and weird, but then it became pleasant. I felt calm; it was better than taking all the meds (medications)." An 18-year old girl with reflex sympathetic dystrophy added that "At first I was really scared, but then it wasn't so bad."

Only four patients reported having a negative experience with acupuncture, while none of the patients said the therapy made their pain worse. Although acupuncture appeared to make no difference in some patients, at least one expressed his willingness to undergo more treatment. One teenager with endometriosis stated, "No, acupuncture did not help, but I'm open to having it again."

Table I: Patient/parent experience with acupuncture.
Experience	Patient	Parent
Positive or pleasant (e.g., "relaxing")	20 (67%)	25 (60%)
Negative or unpleasant (e.g., "scary")	4 (13%)	3 (7%)
Other/neutral (e.g., "strange")	6 (20%)	14 (33%)
Total	30 (100%)	42 (100%)

Table II: Patient/parent feelings as to whether acupuncture treatment helped or hurt.
Helpfulness	Patient	Parent
Yes, improved	21 (70%)	26 (59%)
No better, no worse	8 (27%)	15 (34%)
Worse, side effects	0 (0%)	1 (2%)
Neutral, not sure	1 (3%)	2 (5%)
Total	30 (100%)	44 (100%)

Similar sentiments were echoed by the parents of the acupuncture patients. While none of the parents underwent acupuncture themselves, a majority (60%) believed the experience was positive; 59% also felt that the treatment improved their child's condition. One father said that his daughter's visits to the acupuncturist "were anticipated positively, and she had a better attitude for studying, better appetite, and less pain afterward." Another father, whose daughter had suffered with endometriosis for four years, said that acupuncture "appears to have helped enormously" and helped produce "a miraculous recovery."

Not all parents were completely happy with the overall care their children received, however. While only one parent reported that their child's pain seemed worse after receiving acupuncture, a dozen families mentioned incidental things they did not like about treatment. These included an initial fear of needles; a dislike for the smell of burning moxa; and the time spent for commuting and treatment.

Still, many parents expressed their satisfaction with the treatment, even if it didn't seem to have an effect on their child. As the mother of one child whose symptoms were not helped by acupuncture said, "I'm very grateful for the acupuncture. It had great value for me, let me feel like I was doing something, like I was a good mom."

Limitations and Implications for Future Research

In their conclusion, the researchers noted a number of possible limitations to their work, including the fact that care was performed by a pediatric acupuncturist at a children's hospital. Treatment settings may be different at a typical acupuncturist's office, and not all practitioners are trained to administer acupuncture to children, which could lead to different outcomes among patients and parents.

The survey was also limited to patients who actually went to see the acupuncturist, leading the researchers to believe their data may overestimate the acceptance of (and positive experience with) acupuncture. And although 47 families agreed to be interviewed, only 30 patients responded directly, leaving open the possibility that non-respondents had more negative attitudes toward acupuncture.

Despite these limitations, the researchers believe their study offers important information about acupuncture therapy for children, specifically in the fact that it is accepted by pediatric patients and appears to offer clear benefits (particularly pain relief) that other forms of care have been unable to achieve. They also believe their survey opens the way for larger, more controlled studies in the future, and that based on their results, pediatricians can begin to consider acupuncture "a potentially helpful and acceptable treatment option, at least for some children and families."

Reference

1. Kemper K, Sarah R, Silber-Highfield E, Xiarhos E, Barnes L, Berde C. On pins and needles? Pediatric pain patients experience with acupuncture. Pediatrics April 2000;105(4):941-947.