In a pilot study with eight patients to test the feasibility of the program, there were significant reductions in the CAPS (Clinician Administered Assessment of PTSD) inventory from baseline to post treatment (P = .03) and in the Pain Catastrophizing Scale (P = .05). There were also nonsignificant reductions in the Numerical Rating Scale, Beck Depression Inventory, and Anxiety Sensitivity Index.
"We had great feedback from the patients. They all really enjoyed learning skills for pain and PTSD," Dr. Otis said. There were no dropouts.
The investigators are continuing to study the treatment, and if it proves to be successful in a larger treatment sample it could be a first step to help veterans of current wars to learn how to effectively cope with pain and PTSD in their daily lives, Dr. Otis concluded.
Acupuncture Near the Front Line
In a related presentation, Dr. Koffman discussed the use of acupuncture as a pain-relief and relaxation technique for active duty military.
"Acupuncture is now listed as one of the acceptable modalities" in the Department of Defense/VA clinical practice guideline, he said.
The guidelines note that research focusing on the efficacy of acupuncture "is still relatively limited. The few available studies are well done and demonstrate significant improvement in both PTSD and PTSD-associated symptomatology. A larger numbers of studies exist, concluding acupuncture’s efficacy in pain management, insomnia, depression, and substance abuse."
A recent, unpublished, Department of Defense/VA randomized controlled trial cited in the guidelines looked at 55 active-duty service members with PTSD who were randomized to treatment as usual with or without acupuncture sessions. The study showed that a 4-week course of twice-weekly 90-minute acupuncture sessions was associated with significantly greater improvement in PTSD symptoms and depression and pain scores.
The guidelines also state that "CAM approaches that facilitate a relaxation response [such as mindfulness, yoga, acupuncture, massage, and others] may be considered for adjunctive treatment of hyperarousal symptoms, although there is no evidence that these are more effective than standard stress inoculation techniques."
Dr. Otis and Dr. Koffman presented their research at a symposium supported by the Home Base Program, a joint project of the Red Sox Foundation and Massachusetts General Hospital. Neither clinician reported relevant conflicts of interest.