Changes in pain, mood, and functional connectivity following cryo-auriculotherapy in adults with chronic refractory low back pain: An open-label preliminary study

Introduction This report describes the effects of auriculotherapy (AT) using cryogenic needles in a small cohort of chronic low back pain patients. Methods The effects of AT on pain, mood, and functioning were recorded in 10 patients with chronic back pain before and after cryogenic AT using patient-reported outcome instruments: Brief Pain Inventory (BPI), Patient Health Questionnaire (PHQ-9), General Anxiety Disorder (GAD-7), and Patient-Reported Outcomes Measurement Information System (PROMIS-29). In addition, resting-state MRI data collected before and 5-7 days after AT treatment were analyzed for changes in functional connectivity in 4 patients. Results GAD-7 scores decreased from 10.0 to 7.7 (95% confidence interval of difference= 0.2 – 4.4, p=0.036). Other patient-reported outcomes showed non-significant differences in this pilot cohort. Significant functional MRI connectivity changes were observed in 4 patients, suggesting that AT affected areas of the brain involved in pain processing. Conclusion Cryogenic AT is a technique that may reduce the psychological burden of low back pain, but further study is needed. Preliminary functional connectivity changes support the concept that the effect of AT is centrally mediated.