Auricular electrostimulation or auricular electroacupuncture devices involve the stimulation of acupuncture points on the ear by using an electrical pulse rather than a needle or wire. These devices (e.g. AcuStim®, P-Stim™, e-Pulse® UH 900, Elexoma™ Medic, CES Ultra™, NSS-2 Bridge) are worn behind either one or both ears with a pre-programed pulse duration and frequency with an electrode patch placed over the acupuncture points. They have been developed to provide ambulatory electrical stimulation over a period of several days.
Auricular electrostimulation has been proposed as a treatment for a variety of conditions, including the treatment of acute pain from surgical procedures, chronic back pain, osteoarthritis, rheumatoid arthritis, neck pain, insomnia, anxiety, opioid withdrawal, and obesity.
Electrical stimulation of auricular acupuncture points is considered investigational.
Any specific products referenced in this policy are just examples and are intended for illustrative purposes only. It is not intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available. These examples are contained in the parenthetical e.g. statement.
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There is a lack of evidence to evaluate the effect of auricular stimulation to improve acute and/or chronic pain or any other conditions or to improve health outcomes.
BlueCross BlueShield Association. Medical Policy Reference Manual. (2:2017). Cranial electrotherapy stimulation and auricular electrostimulation (8.01.58). Retrieved January 4, 2018 from BlueWeb. (18 articles and/or guidelines reviewed)
Laing, Y., Xu, B., Zang, X., Zong, L., and Chen, Y. (2014, March) Comparative study on effects between electroacupuncture and auricular acupuncture for methamphetamine withdrawal syndrome. Chinese Acupuncture Journal, 34(3), 219-24. Abstract retrieved January 4, 2018 from PubMed database.
Miranda, A. and Taca A. (2017, February) Neuromodulation with percutaneous electrical nerve field stimulation is associated with reduction in signs and symptoms of opioid withdrawal: a multisite, retrospective assessment. The American Journal of Drug and Alcohol Abuse, 44(1), 56-63. (Level 4 evidence)
Michalek-Sauberer, A., Heinzl, H., Sator-Katzenschlager, S. M., Monov, G., Knolle, E. & Kress, H. G. (2007). Perioperative auricular electroacupuncture has no effect on pain and analgesic consumption after third molar tooth extraction. Ambulatory Anesthesia, 104, 542-547. (Level 2 evidence - Independent)
Schukro, R., Heiserer, C., Michalek-Sauberer, A., Gleiss, A., and Sator-Katzenschlager, S. (2014, February) The effects of auricular electroacupuncture on obesity in female patients--a prospective randomized placebo-controlled pilot study.Complimentary Therapies in Medicine, 22(1), 21-25. Abstract retrieved January 4, 2018 from PubMed database.
U. S. Food and Drug Administration. (2009, December) Center for Devices and Radiologic Health. 510(k) Premarket Notification Database K09187S (E-pulse™). Retrieved March 7, 2016 from http://www.fda.gov.
U. S. Food and Drug Administration. (2006, March) Center for Devices and Radiologic Health. 510(k) Premarket Notification Database K050123 (AcuStim®). Retrieved January 4, 2018 from http://www.fda.gov.
Yeh, C., Chiang, Y., Hoffman, S., Liang, Z., Klem, M., Tam, W., et al. (2014). Efficacy of auricular therapy for pain management: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2014, Article 934670. (Level 2 evidence - Independent)
ORIGINAL EFFECTIVE DATE: 2/12/2012
MOST RECENT REVIEW DATE: 2/8/2018
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