CONCLUSION
Auricular acupuncture is an integrative, complementary, and promising health practice for the treatment of back pain, since it considerably reduced pain intensity scores in relation to a control group. However, the high heterogeneity present in the RCT limited the findings.
Nonetheless, a possible protocol may be established for this clinical condition : the application of the technique in 5 weekly sessions, with seeds or semi-permanent needles in the Shenmen points (central nervous system), kidney, sympathetic (sympathetic nervous system or neurovegetative), subcortex, liver, bladder, and points in the pain site (cervical, thoracic, and/or lumbar), unilaterally, changing the ear at each session, and mean time of 4 days with the devices kept on, with a maximum of 7 days. In addition, the use of an electric detector of acupoints is recommended to guide directions to the site, based on patient complains, and use of an auricular map. The most common outcomes to assess this clinical condition were pain intensity, medication consumption, physical disability, quality of pain, and quality of life.
This protocol needs validation by further studies, including the exact site of the point called pain relief, in order to verify whether it matches the subcortex points.
Chart 3 – Auricular acupuncture intervention protocol for treating chronic back pain – Belo Horizonte, MG, Brazil, 2018.
Study identification Treatment line Number of sessions Treatment duration Application device Time the device was kept in place Type of stimulus Application points Uni- / bilateral application Location of the points
| Ushinohama et al., 2016(17) // 1 20 minutes Systemic needles (0.15x30mm – Dong Bang) 20 minutes // Shenmen Pain relief Lumbar pain // // |
| Yeh et al., 2015(18) Chinese 4 4 weeks Vaccariae seeds 5 days Manual (orientation : press the seeds 3x/day for 3 min each time, even without symptoms). Shenmen Sympathetic Nerve Subcortex Points inside two regions for lumbar pain Bilateral According to the map of Chinese standard acupoints. |
| Eberhardt et al., 2015(30) Brazilian (Marcelo Pereira de Souza) 1 7 days Semi-permanent needles (1.5mm in length) 7 days Without stimulus (orientation : do not stimulate the needles). Shenmen Kidney Sympathetic Pain relief Muscle relaxation Thoracic vertebrae Lumbar vertebrae // According to Marcelo Pereira de Souza. |
| Silva et al., 2015(27) French (Nogier’s method) 1 30 minutes Sterile acupuncture needles (0.25x3mm – Suzhou Huanqiu Acupuncture Medical Appliance Co, Ltd.) 30 minutes // Scapular waist Shoulder // According to Nogier’s method. |
| Yeh et al., 2014(19) Chinese 4 4 weeks Non-specific seeds (2 mm diameter) 5 days Manual (orientation : press the seeds 3x/day for 3 min each time. And for 3 min always when experiencing pain). Shenmen Sympathetic Nerve Subcortex Active points corresponding to chronic lumbar pain Bilateral Electric detector of acupoints. |
| Vas et al., 2014(31) Chinese 8 8 weeks Vaccariae seeds 7 days Manual (orientation : perform 10 pressures with the finger in each point 3x/day). Shenmen Thalamus Points were added according to sensibility in auricular zones Unilateral (Ear alternation, starting at the most sensitive ear) According to Chinese mapping / Pressure detector of 250 g. |
| Marignan, 2014(20) // // // Electrical Stimulator // Electric (30 s in each point). Spinal cord Cerebellar peduncles Cerebellar formation Vestibular nuclei Uni- or bilateral (in case of pain in one or both ears) Electric detector of acupoints. |
| Yeh et al., 2013(21) Chinese 4 4 weeks Vaccariae seeds 5 days Manual (orientation : press the seeds 3x/day for 3 min each time. And for 3 min always when experiencing pain). Shenmen Sympathetic Nerve Sub-cortex Acupuncture points corresponding to lower part of the back. // Electric detector of acupoints. |
| Hunter et al., 2012(22) // 6 6 weeks Conventional auricular needles (1.80x0.26 mm – Seirin Pyonex, Japan) 2 days Manual (orientation : to record the rate of manual stimulation of needles during 48 hours treatment period in a weekly logbook during the intervention phase). Shenmen Lumbar spine Cushion // // |
| Zhangxiu et al., 2011(23) Chinese 4 2 weeks Patches of Vaccariae seeds // Manual (orientation : press the patches 3x/day, 3-5 minutes each time). Shenmen Kidney Ashi Points Lumbosacral vertebrae Liver Sub-cortex Unilateral (Ear alternation) According to the MTC* holistic concept, and guided by the theories of Zang-Fu and the meridians. |
| Suen, Wong, 2008(24) Chinese 7 3 weeks Magnetic pellets and Vaccariae seeds (control) 3 days Without stimulation (orientation : do not press the seed / magnet pellets). Shenmen Kidney Bladder Lumbosacral vertebrae Buttocks Liver Spleen Unilateral (Ear alternation) Electric detector of acupoints. |
| Suen et al., 2007(25) Chinese 4 3 weeks Magnets (66 gauss, 0.13 cm diameter) and Vaccariae seeds (control) 3 days Without stimulation (orientation : do not press the seed / magnet pellets). Shenmen Kidney Urinary bladder Lumbosacral vertebrae Buttocks Liver Spleen Unilateral (Ear alternation) Electric detector of acupoints / According to the map of Chinese standard acupoints. |
| Ceccherelli et al., 2006(28) // 8 8 weeks Disposable Sedatelec® needles (300 µmx18 mm) (group 1) / Auricular needles (group 2) // Manual (rotational movement, for 20 s, at the time of insertion and for the appearance of sensation of –qi (except point SI) (Group 1) / Auricular needles : rotating movement for 20 s, only at the time of insertion (Group 2). Shenmen Lung Cervical spine region Occipital // // |
| Sator-Katzenschlager et al., 2004(26) French (Nogier’s nomenclature) 6 6 weeks Disposable titanium needles (27 gauge, 3 mm in length) linked to P-Stim ™ device (Biegler GmbH, Mauerbach, Austria) 2 days Electric (electric stimulation with low continuous frequency using P-Stim ™ – constant current : 1 Hz 2-phase, 2 mA). Shenmen Lumbar spine Cushion Unilateral (Ear alternation, starting at the dominant side) Electric detector of acupoints. |
| Sator-Katzenschlager et al., 2003(29) French (Nogier’s nomenclature) 6 6 weeks Disposable titanium needles (27 gauss, 3 mm in length) linked to P-Stim ™ device (Biegler GmbH, Mauerbach, Austria) 2 days Electric (needles were continuously stimulated with 2 mA of constant current with low frequency of 1 Hz during 48 h). Shenmen Cervical spine Cushion Unilateral (Ear alternation, starting at the dominant side) Electric detector of acupoints. |
Points d’auriculothérapie / Auriculotherapy Points
Cartographie synthétique et évolutive
