29. August 2017 · Comments Off · Categories: Acupuncture, Carpal Tunnel Syndrome

Acupuncture may achieve long-term pain relief in carpal tunnel syndrome (CTS) by rewiring the brain, according to findings by an American research team. Previous studies have shown that the brain’s primary somatosensory cortex, which receives incoming signals related to the sense of touch, is pathologically remapped in CTS. Specifically, brain cells that usually respond to touch from specific fingers start to respond to signals from multiple fingers (measured as reduced cortical separation distance). In a sham-controlled neuroimaging study of acupuncture for CTS, researchers divided 80 patients into three groups. One group received electro-acupuncture on the hand and arm near the site of their pain (local), the second received electro-acupuncture on the ankle opposite the wrist with the pain (distal), while the third received sham electro-acupuncture with non-penetrating needles near the site of carpal tunnel pain. Each patient received 16 treatments over two months. At the end of the treatment period, the researchers found that all three interventions improved patient-reported CTS symptoms. However, only verum (local and distal) acupuncture produced improvements in neurophysiological outcomes, both local to the wrist (median sensory nerve conduction speed) and in the brain (cortical separation distance). Local verum acupuncture led to measurable improvements in outcomes both at the affected wrist and in the brain, while distal verum acupuncture produced improvement at the wrist only. Brain remapping seen after local verum acupuncture was correlated with sustained improvements in symptom severity at three-month follow-up. No physiological improvements resulted from sham acupuncture. The authors propose that while sham acupuncture may provide short-term benefits by modulating known placebo circuitry in the brain, real acupuncture can lead to lasting improvement in CTS symptoms by rewiring the primary somatosensory cortex, in addition to modulating local blood flow to the peripheral nerve in the wrist.
Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain. 2017 Apr 1;140(4):914-927.

25. July 2017 · Comments Off · Categories: Acupuncture, Babies, Colic

Acupuncture can reduce crying in infants with colic, according to a Swedish study. In a three-armed randomised trial, 147 infants received usual care together with either standardised minimal acupuncture (at Hegu L.I.-4), or semi-standardised individual acupuncture based on TCM (any combination of Sifeng M-UE-9, Hegu L.I.-4 and Zusanli ST-36), twice a week for two weeks. The effect of the two types of acupuncture was similar and both were superior to standard care alone. Relative to baseline, there was a greater reduction in time spent crying by the second week in infants receiving both types of acupuncture.
Effect of minimal acupuncture for infantile colic: a multicentre, three-armed, single-blind, randomised controlled trial (ACU-COL). Acupunct Med. 2017 Jan 16. pii: acupmed-2016-011208. [Epub ahead of print].

25. July 2017 · Comments Off · Categories: Acupuncture, Anxiety, Auricular Acupuncture
25. July 2017 · Comments Off · Categories: Acupuncture, Neck Pain

Acupuncture-related lifestyle advice helps patients with chronic neck pain improve the way they care for themselves and is associated with reductions in pain and disability. In a three-armed, randomised trial, British researchers randomly allocated 517 patients to received acupuncture (up to 12 sessions), Alexander technique or usual care. For each acupuncture patient, practitioners were encouraged to practice as closely as closely as possible to how they routinely would, and to provide treatment that included an acupuncture-related diagnosis and associated lifestyle advice. Lifestyle advice was found to be provided by practitioners to 84% of patients, and was most commonly related to exercise, relaxation, diet, rest and work. Compared with those receiving usual care alone, the authors found that patients in the acupuncture group made more lifestyle changes and improved their ability to reduce their neck pain without resorting to medication. These characteristics of the acupuncture group were found to be associated with significant reductions in pain and disability scores at 12 months. The authors conclude that lifestyle advice based on acupuncture theory leads to active patient engagement, which in turn is an important contributor to overall treatment benefits over the long-term.
Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial. J Altern Complement Med. 2017 Mar;23(3):180-187.

25. July 2017 · Comments Off · Categories: Acupuncture, Asthma

Adding acupuncture to routine asthma care is associated with increased disease-specific and health-related quality of life compared with routine care alone, according to German researchers. A total of 1,445 patients were included in their analysis. Patients were randomised to receive up to 15 acupuncture sessions over three months, or to a control group that received routine care alone. Treatment, including the number of needles used and sites of needle placement, was left to the practitioner’s discretion. Acupuncture was associated with a significant improvement in asthma-related quality of life, as well as in general physical and mental health compared to the control group, after three months of treatment. The improvements seen immediately after completion of acupuncture treatment continued persisted at least to the end of the six-month study period.
Acupuncture in Patients with Allergic Asthma: A Randomized Pragmatic Trial. J Altern Complement Med. 2017 Apr;23(4):268-277.

25. July 2017 · Comments Off · Categories: Acupuncture, Back Pain

The American College of Physicians’ new guidelines on the treatment of chronic low back pain strongly recommend the use of acupuncture as a first-line treatment, finding it to be more effective for pain relief and improvement in function than pharmaceutical drugs. The Clinical Guidelines Committee based their recommendations on a systematic review of RCTs covering pharmacological and non-pharmacological treatments for low back pain published up until the end of November 2016 (see below). Clinical outcomes evaluated included reduction of low pain, improvement in function, improvement in quality of life, reduction in disability, number/frequency of back pain episodes, patient satisfaction and adverse effects. The recommendation states that when treating low back pain, doctors should initially select non-pharmacological treatments (exercise, rehabilitation, acupuncture and mindfulness-based stress reduction, which are backed up by moderate-quality evidence, or tai chi, yoga, progressive relaxation, biofeedback, laser therapy, cognitive behavioral therapy and spinal manipulation, which are backed up by low-quality evidence) and that drug treatment should only be considered for patients who do not improve with non-pharmacological interventions. Non-steroidal anti-inflammatory drugs, which were found to have only a small to moderate effect on pain and at best a small effect on function, were recommended over opioids, which the authors concluded should be considered only in patients for whom other therapies have failed because of the substantial harms with which they are associated. The guidelines also recommend acupuncture as a first-line treatment for acute low back pain (along with heat, massage and spinal manipulation), although the evidence for this is considered to be of lower quality.
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530.

A systematic review of non-pharmacological therapies for low back pain carried out for the American College of Physicians concludes that several of them, including acupuncture and tai chi, are associated with small to moderate effects on pain. Data came from randomised trials of nine non-pharmacological treatment options versus sham treatment, wait list, usual care or each other. Acupuncture was evaluated in 49 trials. The data showed that for acute low back pain, real acupuncture decreased pain intensity more than sham, but had no clear effects on function. Compared with non-steroidal anti-inflammatory drugs (NSAIDs), acupuncture was associated with a slightly greater likelihood of overall improvement at the end of treatment. The evidence for acupuncture’s effects in chronic low back pain was more convincing. Acupuncture was associated with lower pain intensity and better function compared with no acupuncture. Acupuncture also decreased pain intensity more than sham acupuncture immediately after the intervention and through to 12 week follow-up. Compared with medications (NSAIDs, muscle relaxants, or analgesics), acupuncture resulted in greater pain relief and better function immediately after the intervention. Tai chi and mindfulness-based stress reduction were also found to be moderately effective for chronic low back pain.
Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017 Apr 4;166(7):493-505.

25. May 2017 · Comments Off · Categories: Acupuncture, Insomnia, Menopause

Acupuncture is associated with a significant reduction in sleep disturbances in menopausal women, conclude the authors of a systematic review from Taiwan. Meta-analysis of data from 31 randomised trials involving a total of 2,433 participants found that acupuncture was associated with a significant reduction in the likelihood of sleep disturbances, along with a significant increase in the secretion of serum oestradiol and a reduction in the secretion of follicle-stimulating hormone and luteinising hormone. Further analyses showed that studies in which Sanyinjiao SP-6 was used were associated with a larger increase in serum oestradiol level, compared with those that used other points. Larger increases in oestradiol levels due to acupuncture were associated with lower odds of sleep disturbances.
Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstet Gynecol. 2016 Mar;127(3):507-15.

25. May 2017 · Comments Off · Categories: Acupuncture, Chronic Prostatitis Pain

Acupuncture compares favourably with drug treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), according to Chinese authors. Network meta-analysis, which allows the comparative effectiveness of interventions that have not been directly evaluated against each other to be calculated, was carried out on data from twelve trials involving 1203 participants. The results showed that, compared with placebo, electro-acupuncture was the most efficacious in improving total symptom scores, followed by manual acupuncture, dual drug therapy (a combination antibiotics and alpha-blockers), antibiotics, sham acupuncture and alpha-blockers. In addition, the incidence of adverse events for acupuncture was relatively rare compared with the other treatments.
Network Meta-Analysis of the Efficacy of Acupuncture, Alpha-blockers and Antibiotics on Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Sci Rep. 2016 Oct 19;6:35737.

25. May 2017 · Comments Off · Categories: Acupuncture, Antidepressants, Depression

Acupuncture may enhance the effect of antidepressant drugs by improving connectivity in brain networks involved in emotional processing and stress. In a Chinese/Korean/American research collaboration, 46 depressed female patients were randomised into either a verum acupuncture plus fluoxetine group, or a sham acupuncture plus fluoxetine group, for eight weeks. The abdominal acupuncture protocol used was: Zhongwan REN-12, Xiawan REN-10, Qihai REN-6, Guanyuan REN-4, Shangqu KID-17 (bilateral), Huaroumen ST-24 (bilateral), and Qipang M-CA-23 (bottom two points only), once a day for the first three days and then once every three days for the remainder of the eight-week trial. Sham treatment consisted of guide tubes without needles being tapped against the same points. Resting-state fMRI data were collected before the first and last treatments. Results showed that, compared with those in the sham acupuncture group, verum acupuncture patients showed greater clinical improvement. Increased resting state functional connectivity between the amygdala and the anterior cingulate cortex was positively associated with clinical improvement in the verum group.
Repeated acupuncture treatments modulate amygdala resting state functional connectivity of depressive patients. Neuroimage Clin. 2016 Jul 27;12:746-752.
The researchers also found that acupuncture had a positive effect on the brain’s motivation/reward circuitry in the same patient group. Previous studies have shown that this corticostriatal reward circuitry is associated with the pathophysiology of major depressive disorder. Increased resting state functional connectivity between the striatum and medial prefrontal cortex following verum acupuncture was significantly positively associated with decreased clinical depression scores.
Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder. J Psychiatr Res. 2017 Jan;84:18-26.

25. May 2017 · Comments Off · Categories: Acupuncture, COPD

Acupuncture can be used as an adjunctive therapy to reduce dyspnoea in patients with chronic obstructive pulmonary disease (COPD). In a randomised trial, 72 participants with COPD received either real or sham needling at the same acupoints (bilateral Zhongfu LU-1, Taiyuan LU-9, Futu L.I.-18, Zusanli ST-36, Wangu GB-12, Feishu BL-13, Pishu BL-20 and Shenshu BL-23) three times per week for eight weeks, in addition to daily medication. At the end of eight weeks of treatment, six-minute walking distance and health-related quality of life were significantly better in the real acupuncture group compared with the sham group.
Acupuncture for chronic obstructive pulmonary disease (COPD): A multicenter, randomized, sham-controlled trial. Medicine (Baltimore). 2016 Oct;95(40):e4879.