Acupressure does not appear to be an effective way of managing Raynaud’s phenomenon, according to a small clinical trial comparing the intervention to patient education.
The trial (NCT01784354) also noted that accurate and reliable assessments of effectivity are difficult in Raynaud’s, where a large placebo response is known to complicate measurements. To get around this, researchers suggest that future trials consider using combined measures.
The study, “A randomized controlled trial of acupressure for the treatment of Raynaud’s phenomenon: the difficulty of conducting a trial in Raynaud’s phenomenon,” was published in the Journal of Scleroderma and Related Disorders.
The trial, performed by researchers at the University of Michigan, randomized 23 patients with either primary or secondary Raynaud’s to receive acupressure or education. The study explored two different acupressure methods; one focused on relieving blood vessel constriction, and the other on relaxation.
During the trial, which ran for eight weeks, patients were asked to keep a diary in which they noted the frequency and duration of Raynaud’s attacks, the type and severity of experienced symptoms, and reported on the Raynaud’s Condition Score, a tool measuring the impact of disease.
A research team member contacted patients each week to assess any adverse events, difficulties in performing acupressure, or difficulties with diary recording.
In addition to the severity of Raynaud’s, measured both at the study’s start and end, researchers also analyzed levels of a range of serum markers believed to mirror the severity of disease and the ability of blood to flow freely after an artery was blocked. The method is used to assess the ability of blood vessels to dilate when needed.
Of the 23 patients who entered the study, seven quit before the study concluded. A majority, five patients, stated a lack of time as the reason for leaving the trial.
After eight weeks, there was no difference in the frequency or duration of attacks between patients receiving acupressure and those in the education group. Neither did any of the secondary measures, including blood flow and serum markers, showed that acupressure benefitted patients.
A closer look at the results, however, revealed a large variation in how patients responded. Earlier research has suggested that grouping measures together may yield better results, so the team analyzed if patients with at least 10%, 20% or 30% improvement in three-to-four measures were different from patients who did not have such improvements.
Although the team could not find that this type of analysis showed acupressure to be beneficial, they noted that analyzing responses in this way reduced the placebo effect from 37.5% to 6.3%.
Researchers admit, however, that the trial may have been too small to detect changes triggered by the treatment.