PEP Topic 
Peripheral Neuropathy
Acupuncture is a  method of producing analgesia or altering the function of a body system by inserting fine, wire-thin needles (about the diameter of a strand of hair) into acupoints along a specific meridian. (Meridians are channels in the body that transport energy.) The needles are twirled or energized electronically or are warmed and left in place for 20–30 minutes. The acupuncture point P6 is most commonly used for treatment of nausea and vomiting (Gamaluddin & Kirchner, 2006). Acupuncture has been evaluated in regard to treatment of anxiety, chemotherapy-induced nausea and vomiting, dyspnea, pain, hot flashes, depression, lymphedema, sleep-wake disturbances, peripheral neuropathy, and fatigue.
Gamaluddin, S., & Kirchner, J.T. (2006). Acupuncture: What the evidence shows now. Family Practice Recertification, 28(9), 26–28,33–37.

Effectiveness Not Established

Research Evidence Summaries

Donald, G.K., Tobin, I., & Stringer, J. (2011). Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy. Acupuncture in Medicine, 29, 230–233.

doi: 10.1136/acupmed.2011.010025

Study Purpose:

The aim of the study is to explore the potential effectiveness of acupuncture in the treatment of chemotherapy-induced peripheral neuropathy.

Intervention Characteristics/Basic Study Process:

Once a patient's clinical condition had been assessed as suitable for acupuncture, he or she was initially offered a course of six weekly treatments. Patient suitability to receive acupuncture was assessed prior to each session. All acupuncturists were qualified nurses trained in the Western medical approach (WMA) and needles remained in situ for 30–45 minutes. Acupuncturists selected points to be used based on patient presentation at each session. Treatments took place either in an outpatient clinic, chemotherapy day case ward, or a drop-in clinic based in a physiotherapy gym. An evaluation form was completed by the therapist prior to the first session and on completion of the final (sixth) session. A different member of the team completed this final evaluation to minimize bias.

Sample Characteristics:

  • A total of 17 participants were enrolled.
  • The mean age was 51.83 years (SD = 12.97), and women (53%) slightly outnumbered men (47%).
  • Key disease characteristics of the participants include a variety of solid tumors and hematologic malignancies.
  • Another key characteristic is peripheral neuropathy refractory to standard care.


The study was conducted in a single-site outpatient setting at an acute cancer care hospital in northwest England.

Phase of Care and Clinical Applications:

Phase of care

  • Active treatment
  • Transitions


  • Late effects or survivorship

Study Design:

The study was a retrospective service evaluation.

Measurement Instruments/Methods:

  • No validated instruments were used. Instead, patients were asked to categorize their symptoms  as improved, unchanged, aggravated, increased, or other.
  • Additional benefits were recorded, including relaxation, reduced stress, better sleep, improved mood, less medication, and other.   


Patients reported improved neuropathy symptoms following acupuncture.


  • The study was a published QA project plagued with risks to validity, including the possibility of social response bias.
  • Other limitations include a small sample size, a retrospective design, and a lack of validated instruments.

Nursing Implications:

No implications for nursing can be made from this study.