Electroacupuncture and auricular acupuncture were more effective at reducing chronic musculoskeletal pain in cancer survivors than usual care. These findings, from a randomized clinical trial, were published in JAMA Oncology.

The opioid crisis has challenged musculoskeletal pain management in cancer survivors, and nonpharmacologic methods are needed. Although acupuncture is proven to have clinical benefit, its effectiveness in cancer survivors is unknown. Therefore, researchers conducted a randomized trial to determine the effectiveness of 2 types of acupuncture compared with usual care for musculoskeletal pain in 360 cancer survivors.

For the study, cancer survivors were recruited between 2017 and 2019 for the Personalized Electroacupuncture vs Auricular Acupuncture Comparative Effectiveness (PEACE) trial (ClinicalTrials.gov Identifier: NCT02979574). Patients who reported musculoskeletal pain for at least 3 months were randomly assigned in a 2:2:1 ratio to receive electroacupuncture (145 patients), auricular acupuncture (143 patients), or usual care (72 patients). The electroacupuncture comprised targeting 8 spots — 4 spots near the pain location that were electrically stimulated with 2 Hz and 4 other spots — for 30 minutes over 10 weekly treatments. The auricular acupuncture targeted up to 10 points and needles remained in place for 3 to 4 days, for a total of 10 weekly sessions.

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The participants were mean age 62.1 years (standard deviation [SD], 12.7), 69.7% were women, 24.4% were non-White, Brief Pain Inventory (BPI) score was 5.2 points (SD, 1.7), 60.5% used pain medication, and pain was experienced for 5.3 years (SD, 6.5).

Compared with usual care, electroacupuncture reduced BPI by 1.9 points (97.5% CI, 1.4-2.4; P <.001) and auricular acupuncture by 1.6 points (97.5% CI, 1.0-2.1; P <.001). BPI score was more greatly reduced among patients who received electroacupuncture than auricular acupuncture (0.36 points) but was not statistically superior (P =.055).

Adverse events included bruising among recipients of electroacupuncture (10.3%) and ear pain among recipients of auricular acupuncture (18.9%). A significant proportion of the auricular acupuncture group discontinued treatment due to ear pain (10.5%; P <.001).

This study was limited by not including a sham control, it remains unclear whether the unblinded design included any placebo effect.

These data indicated chronic musculoskeletal pain among survivors of cancer may be ameliorated more effectively by electroacupuncture or auricular acupuncture than usual care.

Disclosure: Multiple authors declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original article for a full list of disclosures.


Mao JJ, Liou KT, Baser RE, et al. Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial. JAMA Oncol. Published online March 18, 2021. doi:10.1001/jamaoncol.2021.0310