Dyson-Hudson et al. 2007
USA
PEDro=9
RCT
N=17

Population: Mean age=39.9yrs; Gender: males=18, females=5; Level of injury” tetraplegia=8, paraplegia=15; Type of pain: nociceptive musculoskeletal shoulder pain.
Treatment: SCI individuals were administered 10 treatments/2xweek (acupuncture or sham acupuncture) for 5 weeks.
Outcome Measures: WUSPI, NRS

1. Both groups experienced significant reduction in shoulder pain (p<.005), as indicated by WUSPI.
2. Greater reduction in pain in acupuncture group vs. sham acupuncture group (66% vs. 43%) was noted; however there was no statistically significant difference in pain reduction between the two groups on WUSPI.
3. No significant differences in NRS between the two groups, though both had significant pain reduction.

Dyson-Hudson et al. 2001
USA
PEDro=7
RCT
N=21

Population: Age = 28-69 yrs; Gender: males = 18, females = 6; Level of injury: paraplegia, tetraplegia; Time since injury = 5-33 yrs; Length of shoulder pain = 4 mths-22 yrs.
Treatment: Subjects received either acupuncture treatments (sessions lasted 20 to 30 min) or Tager Psychophysical Integration - sessions lasted approx 45 min. Consisted for both table work and mentastic exercises.
Outcome Measures: Intake questionnaire (demographics and medical history), Weekly log, WUSPI, Numeric rating scale, Verbal rating scale, range of motion.

1. Analysis of treatment on PC-WUSPI scores using ANOVA showed a significant effect of time for both treatments (Acupuncture p<0.001 and Trager p=0.001).
2. Overall a reduction of the PC-WUSPI could be seen when looking at the data from the beginning of treatment to the end for both groups (p<0.05).
3. Looking at the effect of treatment on the numeric rating scores, the ANOVA showed a significant effect of time for both acupuncture and Trager groups for average pain & most severe pain (p<0.01, p<0.001 respectively), for the least severe pain the acupuncture group showed a significant reduction (p<0.01) compared to the Trager group.
4. Verbal response scores-Looking at the effect of treatment on the VRS scores for both groups; there was a statistically significant effect for both groups (p=0.001).

Nayak et al. 2001
USA
Downs & Black score=21
Pre-post
Initial N=31; Final N=22

Population: Mean age = 43.14 yrs; Gender: males = 15, females = 7; Level of injury: C1-L3; Severity of injury: AIS: A, C, D; Time since injury = 8.49 yrs; Length of pain = 8.46 yrs.
Treatment: 15 acupuncture treatments were administered over a 7.5-week period using a specific set of acupuncture points with additional points being selected by subjects based on individual history and clinical examination.
Outcome measures: Pain intensity: numeric rating scale, general health: individualized symptom rating scale, pain impact and interference: activity scale, mood, psychological well being-general well being schedule and expectations.

1. When looking at the 3 pain measures, pain intensity decreased over time-worst pain: (p<0.05), average pain: (p<0.01), present pain: (p<0.01).
2. Post-treatment decline in pain intensity was maintained at 3mth follow-up (pre-treatment vs. follow-up: p<0.01).
3. A difference in the ratings of pain intensity between pre and post-treatment (p<0.001) was noted and this was maintained 3 mths after the end of treatment (pre-treatment vs. follow-up: p<0.01).
4. Those that did report pain relief at 3-mth follow up reported only moderate levels of pain intensity on the NRS at the beginning of the study (7.83 ± .75) compared to those who did not report pain relief (9.67 ± .58, p<0.01).
5. Pain interference: a decrease in pain interference with ADLs was also noted (p<0.05). Respondents showed a reduction in interference with ADLs at post-treatment (p<0.01).

Rapson et al. 2003 Canada
Downs & Black score=14
Pre-Post
N=36

Population: Age = 17-75 yrs; Gender: males = 23, females = 13; Level of injury: cervical to lumbar; Length of pain = 1 mth to >15yrs.
Treatment: SCI patients were given acupuncture treatment s.
Outcome measures: Pain.

1. 24 participants improved in response to electro-acupuncture while 12 showed no improvement.
2. Bilateral pain (n=21) more likely to respond to electro-acupuncture than those with unilateral pain (n=3) (p=0.014).
3. Those with symmetric pain had a higher response to treatment than those who asymmetric pain (p=0.26).
4. It was also noted that those with burning pain that was bilateral and symmetric (p=0.006) was more likely to improve after electro-acupuncture.
5. Similar findings were noted for those who experienced bilateral symmetric constant burning pain (p=0.005).