1. Both electroacupuncture and acupuncture alleviated symptoms of cold hypersensitivity in the hands and feet and increased quality of life compared to no treatment, with electroacupuncture showing longer-lasting improvements.

Evidence Rating Level: 1 (Excellent)

Cold hypersensitivity in the hands and feet (CHHF) is characterized by abnormal sensitivity to temperatures, resulting in discomfort, impaired daily activities, and reduced quality of life, and it is predominantly observed in women. Electroacupuncture (EA) is a modern variation of acupuncture (AC) that involves applying mild electrical currents through acupuncture needles to enhance therapeutic effects. Although AC and EA have been recommended for treating CHHF, evaluation of their efficacy in alleviating CHHF symptoms is lacking. This randomized, controlled, three-arm clinical trial evaluated the efficacy of AC and EA IN treating CHHF, and included women aged 19-59 with CHHF across 3 Korean hospitals. Participants were included and randomized 1:1:1 to either the AC treatment, EA treatment, or no-treatment (control) group. AC and EA groups received treatment twice weekly for 5 weeks. CHHF symptoms were assessed using the visual analog scale (VAS) scores, and quality of life was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores. Assessments were completed at pre-treatment, post-treatment, and follow-up (4 weeks post-treatment). Due to participants lost to follow-up, 68 out of the 72 participants included were analyzed (AC group: N = 24, mean [SD] age = 38.5 [13.9] years, BMI [SD] = 21.5 [1.66] kg/m2; EA group: N = 24, mean [SD] age = 35.3 [12] years, BMI [SD] = 21.3 [2.89] kg/m2; control group: N = 24, mean [SD] age = 42.2 [12.2] years, BMI [SD] = 20.4 [2.18] kg/m2). Immediately post-treatment, both EA and AC groups showed reduced VAS scores and increased scores in several WHOQOL-BREF domains compared to pre-treatment (p < 0.05). At follow-up, the EA group demonstrated sustained reductions in feet VAS scores and increased scores in several WHOQOL-BREF domains (p < 0.05). Interestingly, reduced VAS scores at follow-up were also observed in the control group and were attributed to natural variability of cold extremity symptoms and psychological factors. Effect size (Cohen’s d) comparisons groups revealed that immediately after treatment, VAS scores were lower in both EA (hand VAS score: d = -0.89, 95%CI = -1.48, -0.29, feet VAS score: d = -1.11 (-1.72, -0.50) and AC groups (hand VAS score: d = -0.93, 95%CI = -1.52, -0.33, feet VAS score: d = -0.77 (-1.36, -0.19) compared to the control group. At follow-up, the EA group showed sustained lower feet VAS scores (d = -0.82, 95%CI = -1.40, -0.23) and higher scores in several WHOQOL-BREF domains compared to the control group. Finally, interaction effects between group and time indicated that changes over time in the EA and AC groups were meaningfully different from those in the control group. Overall, this study found that both EA and AC treatments alleviated CHHF symptoms and improved quality of life, and that EA provided longer-lasting improvements than AC. Thus, EA and AC may be promising non-pharmacological interventions for women with CHHF. Future studies are needed to validate study findings.

Click to read the study in PLOSONE

Image: PD

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