Efficacy of Fire Acupuncture in Pain Management after Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

Objective: As an increasingly popular treatment, fire acupuncture is used to alleviate postoperative pain; however, its therapeutic effects have not been thoroughly investigated. This study aimed to assess the analgesic efficacy of fire acupuncture in patients undergoing unilateral total hip arthroplasty (THA).

Methods: This prospective, randomised controlled study set out to assess the analgesic efficacy of fire acupuncture on patients undergoing unilateral total hip arthroplasty. We enrolled patients scheduled for primary THA and assigned them to either the fire acupuncture group or a sham acupuncture group in a double-blind manner. Outcomes included pain severity, the use frequency and dosage of rescue anesthetic medications, and related biological indicators.

Results: The fire needle group demonstrated significantly lower pain scores at all postoperative time points and required less rescue morphine within 0-24 hours (18.5 ± 6.3 mg vs. 32.4 ± 8.1 mg, P<0.001) compared to the sham fire needle group. Additionally, morphine consumption remained significantly lower in the fire needle group during the 24–48 and 48–72 hour periods( P<0.001). Levels of pro-inflammatory markers (IL-1β, IL-6, TNF-α, CRP) and the neuropeptide Substance P were significantly reduced in the fire needle group (all P<0.001). The intervention also led to superior hip function recovery (Harris Hip Score) (all P<0.001) and improved quality of life, particularly in bodily pain domains (SF-36) at 1 and 3 months ( P<0.001). The fire needle group experienced fewer opioid-related side effects (notably nausea). Furthermore, the fire needle treatment itself demonstrated a favorable safety profile, with only minor local adverse events (e.g., minor bleeding: 6.0%, P>0,05) and no serious complications such as infection or burns.

Conclusion: Fire needle therapy appears to be effective in reducing postoperative pain, opioid use, and inflammation while promoting early functional recovery after THA. Although fire acupuncture may help to some extent with the pain after total hip replacement surgery, more experimental research needs to be carried out at present.