Eficácia da auriculoterapia para redução da dor crônica na coluna vertebral em trabalhadores da saúde: ensaio clínico randomizado

Abstract

The hospital environment has several risk factors that can influence the health of health workers. Among the health problems, the occurrence of musculoskeletal pain (MSD) stands out. Auriculotherapy can be an important strategy for pain relief. Aimed to evaluate the effectiveness of auriculotherapy in reducing chronic MSD in the spine of health workers. This is a triple-blind randomized clinical trial developed with health workers from a public hospital in southern Brazil. Workers who had a diagnosis of pain in the spinal region, least three months and intensity of four or more, were considered eligible. Data were collected from March 2021 to January 2022. Eight sessions of auriculotherapy were applied twice a week. Participants were randomized into two groups: intervention group (IG), in which seeds were applied to auricular points related to the outcome (n=34); and control group (CG), with seed application at points not related to the outcome (n=33). Four assessments were performed (1st, 4th and 8th sessions and follow up) using the Numerical Pain Scale (END), Brief Pain Inventory, Roland-Morris Disability Questionnaire and SF-36. Data were entered into the Epiinfo program and analyzed using PASW 18.0 for Windows. Descriptive and inferential statistics (protocol and intention-to-treat analysis) were performed. Study approved by the Research Ethics Committee under Opinion n. 3,897,861 and registered with REBEC n. RBR-3jvmdn. It was evidenced that, in the last year, MSD prevailed in the neck (89.6%), shoulders (86.6%), lumbar spine (86.6%) and thoracic spine (68.2%). Pain intensity with a median of 7.00 (min. 4 and max. 10). In the NDT assessment, groups showed a reduction in pain intensity, however there was no statistical difference (p>0.05). In the follow-up segment, there was a statistically significant reduction of 34% in the mean of the IG (3.32 ± 0.42) in relation to the CG (5.00 ± 0.43) (p=0.007). In the assessment of quality of life, auriculotherapy proved to be effective in the vitality domain (p=0.012) between the IG (1st session 56.32 ± 2.66; follow up 64.21 ± 3.25) and the CG (1st session 48.03 ± 2.70; follow up 55.64 ± 3.27); and in the domain limitation due to emotional aspects in the assessment in the 4th session between the IG (78.71 ± 5.63) and CG (60.13 ± 5.80) (p=0.025). The relationship between auriculotherapy, physical disability and pain interference did not differ between groups (p>0.05). In the regarding the use of medication, during the follow-up, it was found that 77.8% of the participants in the CG maintained the medication dosage, compared to 22.2% in the IG (p=0.013). The IG (73.3%) reported more discomfort during seed applications, compared to the CG (26.3%) (p=0.011). It is concluded that auriculotherapy in the IG and the CG had the same effect on pain intensity during the eight sessions, with greater durability in the follow-up, in which a significant effect was demonstrated; in addition, it improved the parameters of the quality of life, especially in the domains of vitality and limitation due to emotional aspects, when IG and CG were compared.