Effectiveness of Acupuncture and Infrared Therapies for Reducing Musculoskeletal Pain in the Elderly

This randomized clinical trial conducted in Indonesia investigated the effectiveness of different non-pharmacological therapies for musculoskeletal pain in older adults, a population particularly vulnerable to the adverse effects of nonsteroidal anti-inflammatory drugs. The study arose from the need to find safe and effective alternatives for the treatment of pain in the elderly, considering that according to the WHO, musculoskeletal problems are the most frequent complaints in this population. The research was conducted at an integrated health unit for older adults in Klodran, Karanganyar, Central Java, in May 2016. The researchers recruited 60 older adult participants with musculoskeletal pain through simple random sampling.

The studied population had a mean age of 68.7 years, with 65% being women, with predominance in the 60-74 age range. The most common types of pain were shoulder pain (28.3%), knee pain (13%), and low back pain (12%). The experimental design divided participants into four groups of 15 people each: control group with acupressure, acupuncture group, infrared group, and combined therapy group. The protocol included 12 sessions distributed over three sessions per week.

Acupuncture was performed with filiform needles until obtaining the De Qi sensation. The infrared therapy used electromagnetic waves with a wavelength of 770 nm-106 nm, applied until producing heat and erythema on the skin. Acupressure was performed with digital pressure on acupuncture points. The primary outcome was measured using the visual analog scale (VAS) before and after treatment.

The results demonstrated statistically significant differences between groups (p<0.001). The combined therapy of acupuncture and infrared showed the greatest effectiveness, with a mean reduction of 3.9 points on the VAS scale. Acupuncture alone resulted in a 2.3-point reduction, followed by infrared with 1.6 points and acupressure with 1.3 points. Post-hoc tests revealed that the combined therapy was significantly superior to all other treatments.

The mean difference between the combined therapy and acupressure was 2.53 points (p<0.001). The proposed mechanisms include the action of acupuncture through four domains: local inflammatory reaction, intercellular meridian transduction, cutaneo-somato-visceral reflex, and neural transmission to the brain. Infrared therapy acts through gentle warming that produces a sedative effect on superficial nerve endings. The clinical implications suggest that the combination of therapies may offer synergistic benefits superior to isolated treatments.

However, the study presents important limitations, including small sample size, absence of long-term follow-up, and lack of detail about the acupuncture points used. Generalization of the results is also limited by being conducted in a single locality with specific cultural characteristics.