Effectiveness of acupuncture therapy as treatment for tinnitus: a randomized controlled trial

This randomized controlled trial investigated the effectiveness of Chinese scalp acupuncture combined with bilateral electroacupuncture in the treatment of tinnitus, a condition that affects approximately 17% of the Brazilian population and significantly impacts quality of life. Tinnitus is characterized by the subjective perception of sound in the absence of an external stimulus, and in 15-25% of cases it causes major deterioration in quality of life. There is currently no specific effective pharmacologic treatment, making the investigation of alternative therapies such as acupuncture necessary. The study included 50 participants between 50 and 85 years of age with continuous moderate to severe tinnitus for at least one year, randomized into two groups: 25 in the acupuncture group and 25 in the control group with no treatment.

Exclusion criteria included active cardiovascular disease, pacemaker use, metal implants, and cases with mild interference in quality of life as measured by the THI questionnaire. The treatment protocol consisted of 10 sessions of bilateral Chinese scalp acupuncture along the vestibulocochlear line, performed twice weekly for 5 weeks, lasting 40 minutes per session. The vestibulocochlear line is located 1.5 cm above the apex of the ear, in a 4 cm horizontal segment, and was stimulated with bilateral electroacupuncture. Primary outcomes were assessed using the Visual Analog Scale (VAS) for tinnitus intensity and the Tinnitus Handicap Inventory (THI) questionnaire for quality of life.

The VAS uses a scale of 0 to 10, where 0 represents complete absence of the symptom and 10 indicates maximum intensity. The THI consists of 25 questions scored from 0 to 100, assessing functional, emotional, and catastrophic reactions to tinnitus. The results demonstrated a statistically significant difference in the primary outcome, with reduction in tinnitus intensity (p = 0.0001) and improvement in quality of life (p = 0.0001) in the acupuncture group. There was an approximately 50% reduction in tinnitus intensity when comparing the acupuncture and control groups.

The acupuncture group improved from severe to mild in the degree of tinnitus interference with quality of life, while the control group remained at the severe degree. The median VAS decreased from 8 to 4 points in the acupuncture group, while it remained at 8 points in the control group. On the THI, the median decreased from 56 to 28 points in the acupuncture group and remained at 58-68 points in the control group. The clinical implications are relevant, as Chinese scalp acupuncture proved to be a safe and effective therapeutic option for short-term reduction of tinnitus symptoms.

The technique may represent an important alternative considering the absence of effective specific pharmacologic treatments. The proposed mechanism involves the introduction of electrical charges that generate action potentials to rebalance the auditory system, correcting the abnormal neuronal activity characteristic of tinnitus.