Combined Acupuncture And Spiritual Care Treatments In An Acute Pain Service: Two Case Reports

Abstract

Case One: Acupuncture and Spiritual Care in the Management of Pain for Necrotizing Soft Tissue Infection

This report outlines the multifaceted management of a 48-year-old female with a severe necrotizing soft tissue infection (NSTI) and bilateral osteomyelitis in the greater trochanters and left ischial tuberosity, secondary to a large decubitus ulcer and noncompliance with care.

The patient's complex medical history included bipolar 2 disorder, anxiety disorder, chronic Clostridioides difficile infection, type 2 diabetes mellitus, severe protein malnutrition, insomnia, and hypokalemia. This case highlights the challenges in managing NSTI alongside multiple comorbidities and the need for a holistic treatment approach.

On hospital admission, treatment commenced with a broad spectrum of antibiotics for NSTI and osteomyelitis. The acute pain service was enlisted post-debridement and allograft to manage the patient’s uncontrollable pain. Notably, she declined autografting surgery. As part of the integrative acute pain service, tandem acupuncture and spiritual care treatments were introduced, resulting in improved pain management, better healing, and enhanced patient compliance with care. These non-pharmaceutical interventions, alongside conventional medical treatments, showed the importance of a biopsychosocial-spiritual approach in complex cases.

This case report demonstrates the effectiveness of combining traditional medical treatments with integrative therapies to manage pain and support overall healing in patients with multiple health problems. It emphasizes the need for a comprehensive, patient-centered care model that addresses patients' physical, psychological, and spiritual needs, particularly in cases of severe infections and chronic conditions.

Case Two: Managing Pain from Multiple Bone Fractures Using Acupuncture and Spiritual Care

Managing pain following severe trauma such as bone fractures from a motor vehicle accident (MVA) poses a significant challenge, especially in patients with complex medical histories. This case report describes integrating acupuncture and spiritual care with standard medical treatment in managing post-surgical pain in a 60-year-old male patient with multiple fractures and a history of opioid use disorder (OUD).

The patient experienced extensive fractures from a drunk driver MVA affecting his left lisfranc joint, proximal phalanges, medial cuneiform, dorsal talus, fibular head, septal area, left sacral ala, and right posterior iliac. His medical background included conditions like colon adenoma, chronic hepatitis C, cirrhosis, an elevated cancer risk, portal hypertension, and issues related to his right wrist, among others. He underwent surgery including irrigation and debridement, and ORIF for his left foot injuries. Considering his history of opioid use disorder (OUD), a unique pain management strategy was adopted.

Beyond standard post-operative care, the patient received three sessions of tandem acupuncture and spiritual care over a period of nine days starting from the day after surgery. The interventions led to significant improvements in pain, allowing for reduced reliance on medication. The patient showed enhanced scores in all outcome measures, indicating better pain control, emotional well-being, and overall quality of life. He was discharged feeling confident, supported, and empowered, demonstrating the potential of acupuncture and spiritual care in complementing conventional medical treatments.