Randomized clinical trial of self-acupressure for aromatase-inhibitor associated musculoskeletal symptoms

Half of aromatase inhibitor (AI)-treated patients with early stage breast cancer discontinue therapy early, primarily because of AI-associated musculoskeletal symptoms (AIMSS). Acupuncture reduces AIMSS, but uptake is limited. Prior studies demonstrated reduction in pain with self-acupressure. We examined the effectiveness of 12 weeks of true (TA) versus sham (SA) acupressure for treating AIMSS. Patients with ≥4/10 new or worsening worst pain since starting AI therapy and no recent acupuncture were eligible. Median age was 51.6 years and 83% were white. Symptoms were assessed weekly using the Brief Pain Inventory (BPI). Primary endpoint was change in BPI worst pain by 12 weeks, analyzed using a linear mixed model. For the TA group ( n = 25), worst pain decreased from 5.12 (SD 0.36) to 4.32 (SD 0.37). For the SA group ( n = 23), worst pain decreased from 5.71 (SD 0.38) to 4.87 (SD 0.51). Difference by group over 12 weeks was not significant ( p = 0.88). For those with both BPI assessments, 10 of 20 (50%) performing TA had ≥2 point improvement in worst pain, compared to 7 of 17 (41.2%) performing SA ( p = 0.59). Although joint pain and stiffness improved with TA, improvements were not superior to SA. Acupressure using this acupoint formula does not appear to be effective for treatment of AIMSS.