Acupressure

The Acupressure recommendation has been downgraded two levels because of inconsistent evidence.

Three high quality (Feng 2017, He 2013, Chang 2012) papers focusing on acupressure were evaluated.  Two papers showed decreased opioid consumption and improved function with acupressure versus sham; one of these also showed improved pain and decreased side effects (nausea, vomiting, and dizziness) with acupressure versus sham.  A third paper showed no difference in side effects with acupressure versus sham.

Benefits/Harms of Implementation

Overall, effect size is limited with these studies, however the low cost and risk to the patient of acupressure weigh positively in considering use of this physical treatment. 

Cost Effectiveness/Resource Utilization

Minimal cost and resource utilization, however acupressure-trained professional would have to be hired/available.

Acceptability

May have some challenge gaining acceptability in Western medicine, however acupuncture is more widely acknowledged as a reasonable medical treatment than in prior decades.

Feasibility

Most patients would have no limitation in receiving this treatment, however feasibility may be limited by the number of skilled acupressure professionals available.

Future Research

Increased studies with larger patient populations evaluating acupressure with better examination of pain and opioid consumption after these interventions, better examination of functional scores and outcomes after this intervention