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Up to 80% of people living with dementia also experience chronic pain, but opioid medication, which is risky for everyone, is even trickier to use safely when a person is experiencing cognitive decline. People with dementia have higher rates of falls, confusion, and delirium when they use opioids to treat pain. Opioids can also accelerate cognitive decline.
Bianca Shieu, PhD, RN, is an assistant professor at the School of Nursing at UT Health San Antonio, and she’s studying a non-pharmacological alternative for pain relief: ear acupressure.
Ear acupressure is similar to acupuncture, but instead of needles, tiny seeds from the Vaccaria plant are taped to specific spots in the ear. These seeds create pressure points that, when pressed or massaged, release calming chemicals that can relieve pain, Shieu said.
“You feel a tingling, and that means you hit the right area,” she said. “So you press it for about five seconds for each seed.”
Shieu is getting ready to launch a year-long feasibility study involving people with cognitive impairment and chronic pain, and their caregivers.
“We are going to measure outcomes like pain and quality of life for the patient. For the caregiver, we are going to look at their stress levels and other clinical outcomes that we are interested in,” she said.
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Shieu’s team has developed a digital training program for caregivers to teach them the technique. The caregivers learn how to locate the correct ear points and how to apply and secure the seeds. The online training tool will allow ear acupressure for pain relief to be managed at home, making it accessible to more people, including those in rural areas who may have to travel long distances to see a clinician.
“As an online version, they will have more flexibility to be able to access this type of treatment and then learn it themselves,” Shieu said.
Those enrolled in the study will be allowed to continue taking their prescription pain medications, but Shieu hopes they’ll reduce their reliance on them over time.
“Acupressure is something like exercise. You need to do it regularly. You cannot just do one day and expect not to have chronic pain anymore,” Shieu said. “We have to be patient, just like when we exercise, in order to see the maximum effect.”
Depending on the outcome of this study, Shieu would like to expand her research to other groups, including people with cancer and those seeking alternatives to opioid-based pain relievers.
Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio, about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
