Pain location & earpoint sensitivity - poor results from Sweden

October 28, 2007

Hi Terry, & All,

Terry Oleson wrote:

> I would need to see the full text article before I could comment

> competently on it. Do you have an electronic version of the full text

> study or the email address of the authors? My website has been

> corrected, so www.auriculotherapy.com should work again.

The full-text article " Are auricular maps reliable for chronic musculoskeletal

pain disorders? A double-blind evaluation " . ACUPUNCTURE IN MEDICINE

2007;25(3):72-79 is online free at:

http://www.acupunctureinmedicine.org.uk/servearticle.php?artid=627

The abstract is: Aim: To examine the proposed somatotopic relation

between the regions in which patients report musculoskeletal pain and

tender points located on the external ears according to a map based on

commonly used auricular acupuncture maps. Methods: 25 patients (16

women) from a chronic pain clinic were included. Patients were asked,

before examination of the external ears, if they had past or present

musculoskeletal pain in any of 11 body regions. An ear map, collapsed into

11 zones representing the musculoskeletal system, was used. The ear

examiner was blinded to the patients´ pain conditions, medical history and

ongoing treatment. Patients communicated with the examiner only to

express if tenderness was present in the external ear on palpation using a

spring-loaded pressure stylus commonly used for auricular acupuncture.

The degree of tenderness was registered on a 5-point scale and

dichotomised (no tenderness or tenderness). Agreements between the

patients´ painful body regions and tenderness in the external ear zones were

presented as percentage, kappa values, sensitivity and specificity. Results:

The 25 patients reported 116 past or present musculoskeletal pain regions

and had 110 tender ear zones. No statistically significant agreements were

found between the painful body regions and the corresponding tender ear

zones. Conclusions: Our results did not show agreements between patients´

reported musculoskeletal pain regions and tender zones in the external ears

assessed according to commonly used maps in auricular acupuncture using

a pressure stylus. However, very tender points occur on the external ear in a

population with chronic musculoskeletal pain.

You can reach Dr. Christer Carlsson at <akusyd,

Florencekliniken, Masvagen 14, S-227 33 LUND, Sweden. Tel home: +46 4

621 10 818 Tel office: +46 46 389040 Fax home: 46 46 15 75 12 Fax office:

46 46 389093

I hope that Terry will contact Dr. Carlsson and cooperate in a follow-up study

to re-examine the issue.

I wrote earlier:

> Re the recent disappointing results in the recent paper " Are auricular

> maps reliable for chronic musculoskeletal pain disorders? A

> double-blind evaluation. Acupunct Med. 2007 Sep;25(3):72-9, which

> concluded ... No statistically significant agreements were found

> between the painful body regions and the corresponding tender ear

> zones ...

> (1) The abstract gave no address but the study probably was done in

> Sweden by Andersson E, Persson AL, Carlsson CP.

> As regards the credentials of the research team, the first two authors

> (Anderson E and Persson AL) have published on other topics but may not

> be acupuncturists because neither has hits on acupuncture on Medline

> before this paper.

> However the TEAM probably was competent to conduct the study because

> Carlsson CP (third author) has published (at least) 9 articles on

> acupuncture (with good results in some) from the address: Clinical

> Science, Department of Neurosurgery, Lund University, University

> Hospital, Lund, Sweden. See Carlsson's acupuncture papers at

> http://tinyurl.com/2lkwkz

> (2) It is a pity that the study design included PAST areas of pain.

> IMO the test should have been to see if the patterns of earpoint

> sensitivity correlated with CURRENT or current + very recent pain

> locations.

Correction re my comments on the credentials of the research team:

The first author IS listed as an acupuncturist:

Elisabeth Andersson, physiotherapist, medical acupuncturist, Department of

Rehabilitation, Lund University Hospital Lund, Sweden

Ann L Persson researcher, physiotherapist, Rehabilitation and Research

Centre for Torture Victims, Copenhagen, Denmark

Christer PO Carlsson, researcher, anaesthesiologist, pain specialist,

Department of Neurosurgery, Clinical science, Lund University Lund,

Sweden;

Correspondence: Christer PO Carlsson <christer

Best regards,

October 28, 2007

For an auricular class project I had students look at 10 persons - 20 ears-

before and/or

after a listing of symptoms. About a half of the ears showed definite

corrolation and

actually fairly high in the specific areas of the ear matching the symptoms. Not

very

scientific or a controlled study but interesting for me. Generally if there was

a spot there

was a symptom but often people had complaints but no ear abnormality.

Doug

, " " < wrote:

>

> Hi Terry, & All,

>

> Terry Oleson wrote:

> > I would need to see the full text article before I could comment

> > competently on it. Do you have an electronic version of the full text

> > study or the email address of the authors? My website has been

> > corrected, so www.auriculotherapy.com should work again.

>

> The full-text article " Are auricular maps reliable for chronic musculoskeletal

> pain disorders? A double-blind evaluation " . ACUPUNCTURE IN MEDICINE

> 2007;25(3):72-79 is online free at:

> http://www.acupunctureinmedicine.org.uk/servearticle.php?artid=627

>

> The abstract is: Aim: To examine the proposed somatotopic relation

> between the regions in which patients report musculoskeletal pain and

> tender points located on the external ears according to a map based on

> commonly used auricular acupuncture maps. Methods: 25 patients (16

> women) from a chronic pain clinic were included. Patients were asked,

> before examination of the external ears, if they had past or present

> musculoskeletal pain in any of 11 body regions. An ear map, collapsed into

> 11 zones representing the musculoskeletal system, was used. The ear

> examiner was blinded to the patients´ pain conditions, medical history and

> ongoing treatment. Patients communicated with the examiner only to

> express if tenderness was present in the external ear on palpation using a

> spring-loaded pressure stylus commonly used for auricular acupuncture.

> The degree of tenderness was registered on a 5-point scale and

> dichotomised (no tenderness or tenderness). Agreements between the

> patients´ painful body regions and tenderness in the external ear zones were

> presented as percentage, kappa values, sensitivity and specificity. Results:

> The 25 patients reported 116 past or present musculoskeletal pain regions

> and had 110 tender ear zones. No statistically significant agreements were

> found between the painful body regions and the corresponding tender ear

> zones. Conclusions: Our results did not show agreements between patients´

> reported musculoskeletal pain regions and tender zones in the external ears

> assessed according to commonly used maps in auricular acupuncture using

> a pressure stylus. However, very tender points occur on the external ear in a

> population with chronic musculoskeletal pain.

>

October 28, 2007