22. February 2018 · Comments Off · Categories: Acupuncture, Headache, Migraine

Acupuncture may help restore impaired homeostasis of the trigeminovascular pain pathway in migraines. In a collaboration between US and Chinese researchers, 100 migraine without aura (MwoA) patients and 46 matched healthy controls (HCs) were recruited. Patients were randomised to four weeks of verum acupuncture, sham acupuncture or a waiting list. HCs had resting state fMRI scans at baseline, while patients underwent scans before and after treatment. Patients received 20 acupuncture sessions over a period of four weeks, using one of three acupuncture protocols (VA1 – Yanglingquan GB-34, Qiuxu GB-40 and Waiguan SJ-5; VA2 – Xiyangguan GB-33, Diwuhui GB-42 and Sanyangluo SJ-8; VA3 – Zusanli ST-36, Chongyang ST-42 and Pianli L.I.-16). Sham acupuncture consisted of needling at non-acupoints. Compared with HCs, MwoA patients showed increased spontaneous activity at rest in several brain regions involved in pain information processing (posterior insula and putamen/caudate). Reduced spontaneous activity at rest was also seen in MwoA patients in brainstem regions connected with input from the trigeminovascular nociceptive pathway (trigeminocervical complex) and output via the descending pain modulatory system (rostral ventromedial medulla). This decreased activity was observed to have normalised after verum (but not sham) acupuncture treatment.

Acupuncture modulates the abnormal brainstem activity in migraine without aura patients. Neuroimage Clin. 2017 May 22;15:367-375.

22. February 2018 · Comments Off · Categories: Acupuncture, Knee Osteoarthritis, Surgery

A systematic review by American authors has concluded that acupuncture and electrotherapy can reduce opioid consumption after total knee arthroplasty. Thirty-nine randomised trials (2391 patients), which examined the use of various drug-free interventions (passive motion, preoperative exercise, cryotherapy, electrotherapy and acupuncture), were included in their meta-analysis. Moderate-certainty evidence showed that electrotherapy reduced the use of opioids and that acupuncture delayed opioid use. There was also low-certainty evidence that acupuncture improved pain, based on visual analogue scores. None of the other therapies studied showed any significant effects on either pain or opioid use.

Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. JAMA Surg. 2017 Aug 16:e172872.

22. February 2018 · Comments Off · Categories: Acupuncture

Electro-acupuncture (EA) at Zusanli ST-36 can affect oesophageal motility, report Brazilian investigators. Sixteen healthy volunteers underwent an oesophageal function test using high-resolution manometry. The test was performed in three phases: basal measurements, and 20 min after acupuncture stimulation of either Zusanli ST-3, or a sham point (five centimetres medial to ST-36), in a crossover design. The results showed that both verum and sham acupuncture resulted in a subtle change in the wave velocity of the oesophageal contraction pattern. Verum acupuncture at Zusanli ST-36, but not sham, was observed to significantly decrease lower esophageal sphincter (LES) resting pressure, suggesting a potential therapeutic role for EA in the treatment of conditions involving oesophageal spasticity.

Changes in Esophageal Motility after Acupuncture. J Gastrointest Surg. 2017 Aug;21(8):1206-1211.

15. February 2018 · Comments Off · Categories: Ear Acupuncture

The analgesic effects of auricular acupuncture (AA) may be explained by stimulation of the auricular branch of the vagal nerve (ABVN). German investigators extracted data on the localisation of AA points commonly used to treat pain from a meta-analysis of 17 RCTs, and evaluated them according to an anatomical map of auricular afferent nerve supply. Fifteen out of 20 AA points used in the treatment of pain were found to be situated in areas mostly innervated by the ABVN, whereas sham points were generally located on the helix of the auricle, which is innervated by cervical nerves.

Transcutaneous auricular vagal nerve stimulation (taVNS) might be a mechanism behind the analgesic effects of auricular acupuncture. Brain Stimul. 2017 Aug 2. pii: S1935-861X(17)30853-7.

15. February 2018 · Comments Off · Categories: Acupuncture, TMD

Acupuncture appears to relieve myofascial pain in temporomandibular disorder (TMD) report the Portuguese authors of a systematic review. A total of four randomised trials using acupuncture for TMD treatment were included. Results for acupuncture were observed to be similar to those for treatment with occlusal splints and significantly superior to those for placebo acupuncture.

Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review. J Oral Facial Pain Headache. 2017 Summer;31(3):225-232.

Acupuncture is an effective and safe treatment for gastro-oesophageal reflux disease (GORD/GERD) according a systematic review by authors from the USA and China. A total of 12 trials involving 1235 patients were included in their meta-analyses, which demonstrated that patients receiving (manual or electro-) acupuncture combined with Western medicine (WM) demonstrated superior global symptom improvement compared with those receiving WM alone. In addition, recurrence rates for those receiving acupuncture alone were found to be lower than those receiving WM alone, while global symptom improvement and symptom scores were similar for both therapies. Acupuncture was also observed to improve quality of life in patients with GORD.

Acupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis. Acupunct Med 2017;0:1–6.

15. February 2018 · Comments Off · Categories: Ear Acupuncture, Substance Abuse

Ear acupuncture improves quality of life and helps maintain positive outcomes in substance abuse treatment, report American investigators. In a randomised study, 100 patients enrolled in a substance abuse programme received either usual care alone, or usual care plus acupuncture using the National Acupuncture Detoxification Association (NADA) ear acupuncture protocol. NADA patients received at least two twice-weekly bilateral ear acupuncture treatments, while seated together in a group of up to 20 patients. Patients self-reported alcohol, tobacco and drug use prior to starting the programme at programme completion and at three and six month follow-up. Participation in the NADA group was positively associated with quality of life scores, feeling better about oneself, improved energy, likelihood of employment upon discharge, along with decreased alcohol and tobacco use at three- and six-month follow up. The results also showed that patients in higher risk populations (non-white, criminal history, initial positive drug test) were more likely to complete the treatment programme when participating in NADA treatment.

NADA Ear Acupuncture: An Adjunctive Therapy to Improve and Maintain Positive Outcomes in Substance Abuse Treatment. Behav Sci (Basel). 2017 Jun 16;7(2). pii: E37.

15. February 2018 · Comments Off · Categories: Acupuncture, Community Acupuncture, Pain

A feasibility study carried out by a US research team suggests that acupuncture offered in a group setting is effective for reducing pain and depression in patients with chronic pain or osteoarthritis. In a non-randomised, quasi-experimental trial, 113 subjects with chronic pain of the neck, back, shoulder, or osteoarthritis of any region, received eight weekly acupuncture therapy sessions in a group setting. Acupuncture therapy included a combination of acupuncture, tui na, gua sha and auricular treatment. The results showed a statistically and clinically significant decrease in pain severity, pain interference and depression in the study population over eight weeks of treatment. This benefit was sustained through follow up at 24 weeks with no additional intervention. The authors conclude that group acupuncture may be considered an effective treatment option for chronic pain, capable of producing clinically relevant and long-lasting pain reduction, in a setting that potentially improves access for patients of a lower socioeconomic status.

Acupuncture Therapy in a Group Setting for Chronic Pain. Pain Med. 2017 Jun 8. doi: 10.1093/pm/pnx134. [Epub ahead of print].

15. February 2018 · Comments Off · Categories: Back Pain, Gua Sha

Gua sha may elicit a more long-lasting anti-inflammatory effect relative to hot pack treatment, leading to better pain relief and mobility in elderly patients with chronic low back pain (cLBP). In a pilot study, clinicians in Hong Kong randomised 12 elderly patients with non-specific cLBP to a single 15-minute session of either gua sha or hot pack treatment in a crossover design. Both interventions were shown to be effective, and no significant difference was observed between the two for any outcome measures until the one-week follow up period. At this time point, pain reduction (21-25 per cent versus 16-18 per cent) and disability improvement (45-52 per cent versus 39-42 per cent) were significantly greater in the gua sha group compared with the hot pack group. Decreasing trends were observed in salivary levels of the pro-inflammatory cytokine tumour necrosis factor-alpha (TNF-α) and the cytoprotective enzyme heme-oxygenase-1 (HO-1) following gua sha. In the gua sha group, improvement of physical disability was found to be strongly correlated with a decrease in salivary levels of TNF-α.

The effects of Gua sha on symptoms and inflammatory biomarkers associated with chronic low back pain: A randomized active-controlled crossover pilot study in elderly. Complement Ther Med. 2017 Jun;32:25-32.