{"entity":{"id":"acupuncture-aromatase-inhibitor-arthralgia","kind":"technology","name":"Acupuncture for aromatase-inhibitor joint pain","aka":[],"tldr":"Joint pain and stiffness are the main reason women stop aromatase-inhibitor tablets early. In a large randomised trial, twelve weeks of acupuncture reduced that pain more than sham needling or no treatment, and the benefit lasted after the sessions ended.","summary":"The SWOG S1200 trial (Hershman et al., JAMA 2018) randomised 226 postmenopausal women with early breast cancer and aromatase-inhibitor arthralgia to true acupuncture, sham acupuncture or waitlist control for six weeks twice weekly then six weekly maintenance sessions. At six weeks the mean worst-pain score fell by 2.05 points with true acupuncture versus 1.07 with sham and 0.99 with waitlist on a 0 to 10 scale; the difference against sham was statistically significant and persisted at 24 and 52 weeks. Adverse events were minor bruising. The 2022 SIO-ASCO pain guideline recommends acupuncture for aromatase-inhibitor-related joint pain, the only complementary therapy to receive a firm recommendation for a specific cancer-treatment pain syndrome. Whether it improves persistence with endocrine therapy, and therefore recurrence, has not been shown.","status":"established","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Acupuncture","links":[{"label":"SWOG S1200: acupuncture for aromatase inhibitor-related joint pain (JAMA 2018)","url":"https://doi.org/10.1001/jama.2018.11350"},{"label":"SIO-ASCO guideline: integrative medicine for pain management in oncology (JCO 2022)","url":"https://doi.org/10.1200/JCO.22.01357"}],"tags":["complementary","supportive-care","evidence:strong"],"related":[],"cancers":["breast-hr-positive"],"sections":["supportive-care","hormonal"],"technologies":["endocrine-therapy","integrative-oncology","pain-management"],"targets":[],"drugs":["letrozole","exemestane"],"companies":[],"institutions":[],"pathways":[],"terms":["aromatase-inhibitor","placebo"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":["paper-mao-j-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"principle":"Needling at standard and joint-specific points modulates central pain processing and local inflammation; a sham-needle arm controls for expectation, and the true-acupuncture arm still outperformed it.","strengths":["Multicentre randomised trial with a sham arm","Effect maintained a year after treatment","Firm SIO-ASCO 2022 recommendation"],"limitations":["Access and cost of a course of sessions","Not yet shown to improve adherence to endocrine therapy","Effect size against sham is modest"]},"route":"/technologies/acupuncture-aromatase-inhibitor-arthralgia/","neighbours":{"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"}],"section":[{"id":"hormonal","kind":"section","name":"Hormonal Therapy","route":"/fronts/hormonal/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"pain-management","kind":"technology","name":"Cancer pain management","route":"/technologies/pain-management/"},{"id":"endocrine-therapy","kind":"technology","name":"Endocrine therapy (SERMs, AIs, SERDs)","route":"/technologies/endocrine-therapy/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"}],"drug":[{"id":"exemestane","kind":"drug","name":"Exemestane","route":"/drugs/exemestane/"},{"id":"letrozole","kind":"drug","name":"Letrozole (and other aromatase inhibitors)","route":"/drugs/letrozole/"}],"term":[{"id":"aromatase-inhibitor","kind":"term","name":"Aromatase inhibitor","route":"/terms/aromatase-inhibitor/"},{"id":"placebo","kind":"term","name":"Placebo","route":"/terms/placebo/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-mao-j-clin-oncol","kind":"paper","name":"Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline","route":"/key-papers/paper-mao-j-clin-oncol/"}],"roadmap":[{"id":"hormonal-therapy-roadmap","kind":"roadmap","name":"Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test","route":"/roadmaps/hormonal-therapy-roadmap/"}]}}