Virtual Auricular Point Acupressure (APA) for Chronic Musculoskeletal Pain

Phase-Based Progress Estimates
Johns Hopkins School of Nursing, Baltimore, MD
Chronic Musculoskeletal Pain+1 More
Virtual Auricular Point Acupressure (APA) - Device
All Sexes
Eligible conditions

Study Summary

This study is evaluating whether auricular point acupressure (APA) treatment administered by the participant themselves with the use of a phone app on chronic musculoskeletal pain (CMP) outcomes.

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Eligible Conditions

  • Chronic Musculoskeletal Pain

Treatment Effectiveness

Study Objectives

This trial is evaluating whether Virtual Auricular Point Acupressure (APA) will improve 3 primary outcomes and 6 secondary outcomes in patients with Chronic Musculoskeletal Pain. Measurement will happen over the course of Baseline and 4 months.

Baseline and 4 months
Positive Outlook
Up to 4 months
Health Related Quality of Life (HRQoL)
Pain Interference
Pain and Catastrophizing Scale (PCS)
Pain intensity
Physical Function
Placebo effect
Treatment Satisfaction

Trial Safety

Trial Design

3 Treatment Groups

Usual Care Control (UC)
1 of 3
Self-guided mAPA (S-mAPA)
1 of 3
In-Person Training + mAPA (IP-mAPA)
1 of 3
Active Control
Experimental Treatment

This trial requires 90 total participants across 3 different treatment groups

This trial involves 3 different treatments. Virtual Auricular Point Acupressure (APA) is the primary treatment being studied. Participants will be divided into 2 treatment groups. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Self-guided mAPA (S-mAPA)
S-mAPA group will be provided with instructions so that participants can learn to self-administer APA weekly for four weeks and then followed by weekly telecommunication for Q & As.
In-Person Training + mAPA (IP-mAPA)Participants will receive one in-person training after baseline data is collected and then will self-administer APA on the same schedule with weekly telecommunication as those in the mAPA group.
Usual Care Control (UC)
Participants will receive usual care only for their pain; after enrolled, patients will receive weekly telecommunication to control for attention and time. The content of the phone/video call will focus on the pain problem they have and the investigators will provide additional information published by the National Center for Complementary and Integrative Health "Chronic Pain: In-Depth" ( which the investigators used in the R01 study for participants enrolled in the control group

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: up to 4 months
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly up to 4 months for reporting.

Closest Location

Johns Hopkins School of Nursing - Baltimore, MD

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 3 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
Adults 18 years of age or older.
Receiving outpatient pain treatment for CMP condition (e.g., pain in the back, hip, knee, upper extremity, lower extremity, neck, pelvic, headache/migraine).
Chronic pain ≥ 4 on a scale of 0-10 point numerical pain, persisting for at least 3 months or has resulted in pain on at least half the days in the past 6 months.

Patient Q&A Section

What are the signs of musculoskeletal pain?

"Musculoskeletal pain can be a chronic and long term condition with the signs of pain often becoming more significant as time passes. People with musculoskeletal pain also need to be aware that the pain may be related to and be associated with other conditions or diagnoses, the need for referral to a specialist may be required." - Anonymous Online Contributor

Unverified Answer

What causes musculoskeletal pain?

"Both the patient's history and examination are important in determining the cause of the pain. Often, a history may be sufficient when deciding whether to visit a podiatrist for a referral examination. When the history is unreliable but physical examination findings are suggestive of sciatica, it is possible to do a laminectomy to relieve the symptoms without the need for a formal treatment plan. This procedure results in minimal morbidity and no long term functional deterioration." - Anonymous Online Contributor

Unverified Answer

What are common treatments for musculoskeletal pain?

"Most chronic and short-term use of opioids is probably necessary for treating pain, but many are inappropriate, and more research is needed to reduce their use in chronic pain." - Anonymous Online Contributor

Unverified Answer

Can musculoskeletal pain be cured?

"We found no good evidence to support any form of alternative surgery or non-specialist treatment for correcting or eliminating muscle pain and stiffness. In contrast, studies have found a role for certain forms of medication and chiropractic care in alleviating muscle pain and stiffness, and these have been shown to be of benefit in some people. Further research is required to clarify this." - Anonymous Online Contributor

Unverified Answer

How many people get musculoskeletal pain a year in the United States?

"The number of people experiencing musculoskeletal pain varies by age, socioeconomic status, race or ethnicity, medical record documentation of one's diagnosis, and gender. In a recent study, findings suggests that further research should include measurement by health plans and survey respondents that would facilitate comparisons across racial and ethnic groups and across diagnoses." - Anonymous Online Contributor

Unverified Answer

What is musculoskeletal pain?

"Musculoskeletal pain can occur in the aftermath of trauma or overuse. The most effective way of preventing musculoskeletal pain is to identify symptoms early on in the recovery process by regular physical activity and avoiding exposures to trauma." - Anonymous Online Contributor

Unverified Answer

Is virtual auricular point acupressure (apa) safe for people?

"This small pilot study has demonstrated that the technique was not necessarily dangerous, although participants, particularly the women, were cautious of the sensation of being touched." - Anonymous Online Contributor

Unverified Answer

How does virtual auricular point acupressure (apa) work?

"There was no difference in the degree of pain reduction between the intervention group and a control group. However, acupuncture needle placement was not accurate, and only one-third of subjects in the acupuncture group actually received treatment. Apa was found to be clinically effective but not technically feasible and well tolerated." - Anonymous Online Contributor

Unverified Answer

Have there been any new discoveries for treating musculoskeletal pain?

"Although there may be a need for more research, the findings from the studies did show us that there are many methods that could be used for minimizing the amount of pain that was sustained in patients diagnosed with musculoskeletal pain. Some of these methods included: the use of heat for the benefit of patients with musculoskeletal pain; using a variety of medicines, such as NSAIDs and anti-inflammatories, to treat musculoskeletal pain; and using a low dose of oral steroids in patients with muscle pain. None of these therapies were particularly effective but they were simple and therefore could be used more widely if found to be very effective for treating patients suffering from muscle pain." - Anonymous Online Contributor

Unverified Answer

Who should consider clinical trials for musculoskeletal pain?

"A general medical practitioner (GP) should consider treatment with a clinical trial to reduce chronic pain. Although many conditions will probably produce pain [among them], a general medical practitioner (GP) should consider [pain management in fibromyalgia syndrome (FMS) research and treatment(" - Anonymous Online Contributor

Unverified Answer

What are the latest developments in virtual auricular point acupressure (apa) for therapeutic use?

"Apa has a unique characteristic of being relatively safe and effective for treating unilateral muscular pain and myofascial pain syndrome (also known as myofeedback), which is caused by the stretching, stretching relaxation, and/or lengthening of muscle pain/syndrome." - Anonymous Online Contributor

Unverified Answer

Has virtual auricular point acupressure (apa) proven to be more effective than a placebo?

"The current study found no evidence that P_VAPA was more effective in reducing pain in patients suffering from somatic pain conditions than was a placebo, although a slight reduction in pain was seen following P_VAPA." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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