Review Article

Efficacy of Auricular Therapy for Pain Management: A Systematic Review and Meta-Analysis

Table 1

Studies of auricular therapy for pain management.

Author (year of publication) SamplePower estimateBlindingIntention to treatDiagnosisSide effectsSite of studyAcupuncture point selectionMethod to locate pointsTreatment sessionSide treated
SizeInterventionControlAcupuncturePatientData collectorPoint selectionSham selection

Alimi et al. (2003) [20] 90AA [ = 29]Sham AA
= 31
Sham AP
= 30
0.9, α: 0.05NoYesYesYes (no dropout)Cancer painNoneFranceElectrodermal response at the points on the ear where pain projectedOutside corresponding pain areaElectronic 2 tx, 1 m apartNot specified

Allais et al. (2011) [21]89AA [ = 43]Sham
= 46
n/aNoYesYesNoMigraine attackUnbearable exacerbation of pain ( )ItalyHead zone (using pain pressure test)Sciatic nerve zoneAlogometric1 tx (no mention of duration)Not specified

Barker et al. (2006) [22]38AP [ = 18]Sham AP
= 20
0.8, α: 0.05Yes YesYesYes (no dropout)Hip fracture n/aAustriaShenmen, hip, valium pointTip of the concha None specified1 txBilateral

Goertz et al. (2006) [23]100AA [ = 50]Standard
care
= 50
n/aNoNoYesYesAcute painn/aU.S.Cingulate gyrus and thalamic nuclei (mediate acupuncture analgesia)NoneNone specified1 tx (4–6 days until fell out)Not specified

Hunter et al. (2012) [24]51AA + exercise [ = 24]Exercise
alone
= 27
0.8, α: 0.05, (56/group in full trial)NoNoYesNoChronic low back painPain, redness, minor bleedingNorth
Ireland
Shenmen, lumbar spine and cushionn/aNone specified6 tx (AA for 48 hrs until fell out), 6 wksNot specified

Kindberg et al. (2009) [25]207AA [ = 105]Local
anesthetics
= 102
0.8, α: 0.05NoNoYesYesIntended vaginal deliveryNoneDenmarkHelix (genital), shenmen, bladder 36, governor vessel 20 (general relaxation) (4 points)n/aNone specified1 txBilateral

Lewis et al. (1990) [26]11EA [ = 11] Placebo pill
= 11
(crossover)
n/aNoYesNoNoBurns with painn/aU.S.Shenmen, lung, dermis, three more per burn locale (6 points)Placebo pill Electronic 1 txBilateral

Longobardi et al. (1989) [27]15EA [ = 8] Sham
= 7
n/aNoYesNoNoDistal extremity painn/aU.S.Shenmen, lung, dermis, two more due to painful extremity (corresponding points)n/aElectronic 1 tx (10 min)Bilateral

Romoli et al. (2000) [28]60EAS + mobilization
= 20
Body EAS + mobilization 
= 20 , 
mobilization 
= 20
0.9, α: 0.05NoNoYesNoShoulder pain (chronic pain)n/aItalyCorresponding point of shouldern/aProbe 1 tx (15–20 min), 5 wks Bilateral

Sator- Katzenschlager et al. (2006) [29]94AA [ = 32]
EAS [ = 32]
Control
= 30
0.8, α: 0.05n/aYesYesYesPerioperative painNoneAustriaUterus, shenmen and cushionn/aElectronic 1 tx (3 hrs)Dominant side

Usichenko et al. (2005) [30]18AA [ = 10]Sham
= 8
n/aNoYesYesNoPost-knee surgery painNoneGermanyShenmen, lung, kneeNonacupuncture points (helix)Electronic1 txNot specified

Usichenko et al. (2005) [31]54AA [ = 29]Sham
= 25
0.8, α: 0.05YesYesYesNoPost-hip surgery painPain from needle, hemorrhages, headacheGermanyShenmen, lung, thalamus and hip pointsNonacupuncture points (helix)Electronic1 tx (stay for 3 days)Not specified

Yeh et al. (2010) [32] 74AP [ = 36]Control
= 38
0.8, α: 0.05NoYesNoNoPostoperative painn/aTaiwanShenmen, occipital, lumbar-sacrum vertebra, stomach, cardia, endocrinen/aIdentified by two clinical acupuncture experts 1 tx (72 hrs)Unilateral

Yeh et al. (2013) [33]19AP [ = 10]Sham
= 9
n/aNoYesNoNoChronic low back painAllergy to tape, pain on ear pointsU.S.Shenmen, subcortex, sympathetic, corresponding pointsStomach, duodenum, mouth, kidneyElectronicWeekly tx, 4 wksBilateral

Yeh et al. (2013) [34]100AP + interactive Internet based intervention [ = 50] AP only
= 50
0.8, α: 0.05n/an/an/aNoDysmenorrhean/aTaiwanShenmen, kidney, liver, internal genitals, central rim, endocrinen/aIdentified by two acupuncturists1 tx (after pain relief 48 hrs later)Not specified

Wang et al. (2009) [35]159AA [ = 58]Sham
= 54 ;  
Control
= 47
0.85, : 0.05NoYesYesNoLow back and/or posterior pelvic painn/aU.S.Shenmen, kidney, analgesiaWrist, shoulder, extra auricular pointsZone system1 tx (1 wk)Unilateral

Wang et al. (2007) [36]80AP [ = 40] Usual care
= 40
n/an/an/an/aNoLaparoscopic cholecystotomyn/aChinaShenmen, subcortex, sympathetic, pancreas, bile, liver, shoulder, endocrine, duodenum, spleenn/aNone specified1 tx (press 20 min/
time, 3 times/day)
Not specified

Yang and Zhang (2011) [37]60AP [ = 30]Pain medication
= 30
n/an/an/an/aNoHemorrhoid n/aChinaShenmen, subcortex, corresponding point (anal)n/aProbe 1 tx (press 30–50 times, 3–4 times/day)Unilateral

Ma and Fang (2011) [38]80AP [ = 40]Usual care and pain medication
= 40
n/an/an/an/aNoRenal colic painn/aChinaKidney, sympathetic, ureter, san jiao n/aNone specified1 tx (press 1-2 min, repeat per 5 minutes)Not specified

Zhang and Tzu (2011) [39]100AP [ = 50]Usual care
= 50
n/an/an/an/aNoReplantation of digitsn/aChinaShenmen, subcortex, sympathetic, corresponding pointn/aNone specified1 tx (press 3–5 min, 3 times/day)Bilateral

Li et al. (2012) [40]180EAS [ = 60]EAS
= 60 ,  
Control
= 60
n/an/an/an/aNoCesarean sectionn/aChinaShenmenEyeNone specified1 tx (stim. 30 min, repeat at 4th, 10th, 22nd hr)Not specified

Wang et al. (2012) [41]60AA [ = 30]No AA
= 30
n/an/an/an/aNoHip replacementn/aChinaShenmen, kidney, subcortex hipn/aNone specified1 tx (press 5–10 min/time, 4 times/day)Not specified

AA: auricular acupuncture; EAS: auricular electroacupuncture stimulation/TENS; AP: auricular acupressure; n/a: no report.