Acupuncture in Spinal Cord Injury Subjects

Of the more than 250,000 Americans with severe spinal cord injury (SCI), 42,000 are military veterans. The Department of Veterans Affairs is the largest single network of SCI care providers in the nation. Patients with SCI experience functional disabilities as well as chronic pain. Studies show that individuals with SCI report pain refractory to conventional treatments. Civilian and veteran patients with SCI have associated pain with impairments in physical and cognitive function, sleep, employment, social relationships, community re-integration and quality of life. In a survey of individuals with SCI, those who used acupuncture experienced a reduction of pain symptoms lasting hours after treatment, with 27.3% reporting pain relief for days. A pilot study on the use of auricular acupuncture for neuropathic pain associated with SCI showed a greater reduction of pain as measured by the Numerical Rating Scale (NRS). A recent review of randomized controlled trials regarding the use of acupuncture in SCI found that only two of sixteen included studies were of high quality. There was limited evidence for the use of acupuncture in motor functional recovery, bladder function recovery, and in pain control related to SCI. Further high quality studies are needed. This proposal is for a phase II randomized clinical trial.

Inclusion Criteria: 1. age between 18 and 75 2. complete (AIS A) or incomplete SCI (AIS B-D) of the cervical, thoracic or lumbar spine from blunt or penetrating trauma 3. ability to understand verbal and written English Exclusion Criteria: 1. a history of peripheral neuropathy 2. medical diagnoses or conditions that preclude them from active participation (for example, moderate or severe traumatic brain injury) 3. receipt of acupuncture in the last three months prior to enrollment 4. presence of skin breakdown or infection over the extremities or external ears 5. active participation in other research studies 6. cognitive impairment that prevents understanding the test instructions 7. prisoner 8. pregnancy 9. active duty military personnel 10. individuals who do not speak or understand the English language