Acupuncture provides short-term pain relief for patients in a total joint replacement program

Pain Med. 2015 Jun;16(6):1195-203. doi: 10.1111/pme.12685. Epub 2015 Jan 13.


Objective: Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. We investigated acupuncture as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain.

Design: A total joint replacement program using fast-track physiotherapy offered elective postsurgical acupuncture to all patients, at no additional cost, as an adjunct therapy to opioids for pain management.

Setting: The Joint Replacement Center at Abbott Northwestern Hospital, a 630-bed teaching and specialty hospital in Minneapolis, Minnesota from 2010 to 2012.

Subjects: Our sample included 2,500 admissions of total hip (THR) and total knee replacement (TKR) patients.

Methods: Self-reported pain was assessed before and after acupuncture using a 0-10 scale and categorized as none/mild (0-4) and moderate/severe pain (5-10).

Results: Seventy-five percent of admissions included acupuncture. Women (Odds Ratio: 1.48, 95% Confidence Interval (CI): 1.22, 1.81) had higher odds of receiving acupuncture compared to men, and nonwhite patients (Odds Ratio: 0.55, 95% CI: 0.39, 0.78) had lower odds of receiving acupuncture compared to white patients. Average short-term pain reduction was 1.91 points (95% CI: 1.83, 1.99), a 45% reduction from the mean prepain score. Forty-one percent of patients reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after acupuncture.

Conclusions: Acupuncture may be a viable adjunct to pharmacological approaches for pain management after THR or TKR.

Keywords: Acupuncture; Integrative Medicine; Multimodal Pain Management; Postoperative Pain; Total Joint Replacement.

Publication types

  • Observational Study

MeSH terms

  • Acupuncture Therapy / methods*
  • Acupuncture Therapy / trends
  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / trends
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Arthroplasty, Replacement, Knee / trends
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Management / methods*
  • Pain Management / trends
  • Pain Measurement / methods
  • Pain Measurement / trends
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Pain, Postoperative / therapy*
  • Retrospective Studies
  • Time Factors