Post-rehab Pain Management Using Jain Auricular Acupuncture for Pain (JAAP): A Case Report

Research Objectives: To investigate the effects of acupuncture in the management of pain after hip arthroplasty.

Design: Case report.

Setting: The ambulatory setting was at an academic center.

Participants: A 75-year-old female underwent a left hip arthroplasty for proximal femur fracture followed by acute inpatient rehab. Allergies to multiple medication complicated the patient’s medical management. She was given acetaminophen and carisoprodol every 8 hours as needed. At the time of clinic follow-up 10 days after discharge, the patient complained of 8 out of 10 hip pain, achy and sharp in nature. The patient used a wheelchair, which she does not usually need, to get to the appointment due to pain in her hip. The patient stated she did not want to add to any other medications.

Interventions: At this point, Jain Auricular Acupuncture for Pain (JAAP) was introduced.  Battlefield acupuncture (BFA) is a type of auricular acupuncture that gained traction due to its use in the management of pain for injured U.S. soldiers. Advanced BFA protocol only utilizes areas for cingulate gyrus and Thalmus. These protocols use ASP needles. We modified the advanced BFA by utilizing Pyonex needles and used Shen Men point in addition to the Prefrontal cortex, Cingulate gyrus, and Thalamus areas. Needling Shen Men point activates other dormant points and by using acupuncture mechanical probe, active points in the selected areas were selected and Pyonex needles were inserted.

Main Outcome Measures: Primary outcome measure is objective pain rating on a scale of 0-10. Patient comfort while ambulating was the secondary outcome measure.

Results: Immediately after acupuncture placement, the patient rather her pain as a 2 out of 10. During physical exam, the patient was able to walk without the walker and stated she felt great relief.

Conclusions: This highlights the need for education about the possible benefits and risks of acupuncture and how it can be incorporated into the treatment plan. Along with medical management and therapies, acupuncture can be an adjuvant therapy in the post-acute setting following a hip fracture. This is crucial to consider in cases of patients with multiple medications or those wanting to avoid the addition of medications.

Author(s) Disclosures: None