07. November 2018 · Comments Off · Categories: Acupuncture

Acupuncture is significantly more effective than physical exercise or medication for improving physical function in patients with lumbar spinal stenosis (LSS), report the authors of a study from Japan. One hundred and nine patients with L5 root radiculopathy associated with LSS were assigned to one of three treatments – medication (paracetamol), exercise or acupuncture – for a four week period. Acupuncture points used were Shenshu BL-23, Dachangshu BL-25, Baohuang BL-53, Zhibian BL-54, Weizhong BL-40, Yanglingquan GB-34 and Shengshan BL-57. All three groups were allowed to use additional non-steroidal anti-inflammatory drugs when needed for pain control. Symptom severity scores improved significantly after treatment in all three groups, however physical function scores improved significantly only in the acupuncture group. Treatment satisfaction was reported as significantly greater for acupuncture than for medication.

A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study). BMC Complement Altern Med. 2018 Jan 19;18(1):19.

07. November 2018 · Comments Off · Categories: Back Pain, Cupping

German clinicians have determined that adding cupping to analgesic medication can reduce lower back pain more effectively than medication alone. In a randomised trial, 110 patients with chronic low back pain (cLBP) received eight sessions of pulsatile cupping (using a vacuum therapy device) plus paracetamol on demand, minimal cupping (with reduced pressure) plus paracetamol on demand, or paracetamol on demand only, over a period of four weeks. Both forms of cupping were effective in reducing cLBP after four weeks compared with the medication only group. There were no significant differences between pulsatile cupping and minimal cupping at the end of the four week treatment period, however eight weeks later only the pulsatile cupping group showed significant benefits relative to control in most of the outcome parameters measured.

Pulsatile dry cupping in chronic low back pain – a randomized three-armed controlled clinical trial. BMC Complement Altern Med. 2018 Apr 2;18(1):115.

07. November 2018 · Comments Off · Categories: Acupuncture, Back Pain, Pain, Pregnancy

Acupuncture provides clinically meaningful symptom reduction for pregnant women suffering from low back and pelvic pain, concludes a trial carried out in a New Zealand hospital clinic. The observational study examined data from 81 pregnant women with lumbopelvic pain, who received weekly acupuncture treatment based on TCM principles. Clinicians used palpation to identify appropriate points for needling and cupping. A clinically meaningful symptom reduction was reported by 88.9% of patients following treatment.

Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. J Acupunct Meridian Stud. 2018 Feb;11(1):25-30.

07. November 2018 · Comments Off · Categories: Acupuncture, Tinnitus

Iranian investigators have found that acupuncture can reduce the severity of tinnitus. In their randomised trial, 88 patients suffering from chronic tinnitus were allocated to either verum or sham acupuncture. Those in the verum acupuncture group were needled at Tinghui GB-2, Fengchi GB-20, Ermen SJ-21, Tinggong SI-19, Tianrong SJ-17, Zhongzhu SJ-3, Waiguan SJ-5, Hegu L.I.-4 and Yanglao SI-6. Sham consisted of needling at adjacent non-acupoints. Patients received 15 acupuncture sessions three times per week for five weeks. Loudness and severity of tinnitus improved significantly over the course of the treatment in both groups, however only the verum acupuncture group experienced continued improvement in symptom scores in the three weeks following the end of the treatment period.

Acupuncture for chronic nonpulsatile tinnitus: A randomized clinical trial. Caspian J Intern Med. 2018 Winter;9(1):38-45.

07. November 2018 · Comments Off · Categories: Acupuncture, Chronic Pain

Acupuncture is a feasible treatment for chronic pain, and is well received by low-income patients in the government-fundedMedicaid programme, according to research carried out in the USA. Previous studies have shown that one of the main barriers to the utilisation of acupuncture and other non-pharmacological treatments for chronic pain is a lack of health insurance coverage. This barrier has a disproportionate effect on the financially disadvantaged Medicaid population, whose members are especially affected by the country’s current prescription opioid crisis. In a pragmatic randomised trial, Medicaid patients with chronic pain were offered up to 12 acupuncture treatments in a 60-day period. Acupuncturists were allowed to perform whatever style of acupuncture they felt was appropriate for each patient, and were permitted to include a full range of supplementary modalities including manual therapy, cupping, herbal medicine and lifestyle advice. Patients were also allowed access to usual care during the study. A total of 156 patients with a wide range of pain complaints received a mean of 8.2 treatments during the intervention period. Measurements over the course of the treatment period showed significant improvements in pain intensity, pain interference, physical function, fatigue, anxiety, depression, sleep disturbance and social isolation. Fifty-seven per cent of patients using non-opioid analgesic medication reported reductions in use. Thirty-two percent of patients using opioid medication reported reductions in its use following the intervention. Seventy-four per cent of employed patients reported improved capacity to work. Ninety-six per cent of patients said that they would recommend acupuncture to others with chronic pain, and 91 per cent reported qualitative improvements, including physical (31%), functional/behavioral (29%) and psycho-emotional (24%) benefits.

Acupuncture for Chronic Pain in the Vermont Medicaid Population: A Prospective, Pragmatic Intervention Trial.Glob Adv Health Med. 2018 Apr 10;7:2164956118769557.

07. November 2018 · Comments Off · Categories: Acupuncture, Allergies, Hayfever

Seasonal allergic rhinitis (SAR) patients who have acupuncture treatment can significantly reduce their antihistamine use while improving their symptoms, according to a German trial. At the beginning of the pollen season, 414 patients were randomised into three study groups: acupuncture plus rescue medication (RM – cetirizine), sham acupuncture plus RM, and RM alone. The patients documented their medication use before and during the eight week intervention period. The acupuncture group received 12 sessions of semi-standardised acupuncture and the sham group received 12 sham acupuncture sessions. Patients in the acupuncture group were needled at bilateral Hegu L.I.-4, Quchi L.I.-11, Yingxiang L.I.-20 and Yintang (M-HN-3), along with three points chosen from Bitong M-HN-14, Fengchi GB-20, Taichong LIV-3, Lieque LU-7, Zusanli ST-36, Sanyinjiao SP-6, Tianrong SJ-17 or Feishu BL-13, plus at least three additional points. The results showed that eight weeks of acupuncture led to significantly fewer days of antihistamine use in patients with SAR compared with both sham acupuncture and RM alone. From the onset to the peak of the pollen season, patients treated by acupuncture did not need to increase their number of days of antihistamine use to alleviate their symptoms, in contrast to patients who used RM alone. In addition, fewer patients in the acupuncture group started using antihistamines during the intervention period compared with both other groups. Approximately 38% of the acupuncture group did not use any antihistamines at all, compared with only 16% in the RM group.

Impact of acupuncture on antihistamine use in patients suffering seasonal allergic rhinitis: secondary analysis of results from a randomised controlled trial. Acupunct Med. 2018 Feb 10. pii: acupmed-2017-011382.

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.