07. January 2016 · Comments Off · Categories: Acupuncture, Cancer, Pain

Acupuncture appears to be effective for reducing pain and other symptoms in cancer patients, according to an open clinical trial carried out by clinicians in the USA. Fifty-seven cancer patients who reported significant pain levels were seen in an open treatment program. A semi-structured acupuncture protocol was designed to target pain, as well as anxiety, depression, fatigue and nausea. Twenty-five patients were considered to have completed treatment after receiving nine or more acupuncture sessions of acupuncture. Pain severity was found to decrease by 32% from baseline to the last session, and pain interference with daily living decreased by 40%. Symptoms of pain, nausea and fatigue decreased by 50%, while anxiety dropped by 44%. All changes in symptom scores except for nausea were found to be significant.
Acupuncture for Cancer-Related Pain: An Open Clinical Trial. Medical Acupuncture. June 2015, 27(3): 188-193.

01. October 2015 · Comments Off · Categories: Acupuncture, Dental Pain, Pain

Stimulation of Hegu L.I.-4 can reduce pain in children during dental anaesthetic injection. Children scheduled for dental treatment using local anaesthesia received bilateral acupuncture at Hegu L.I.-4 (using intradermal needles). During the dental treatment, the patients’ parents stimulated the needles with massage. Two different treatment regimes were compared: standardised local anaesthetic (LA) injection given five minutes after acupuncture, and LA injection without acupuncture. The order of treatment was randomised, with the two treatments performed in a crossover manner on different days. Data were obtained from 49 patients. Patients reported less pain when acupuncture was used (mean pain score 2.3 versus 3.9). In addition, the heart rate of patients who received acupuncture remained low throughout dental treatment compared to treatment without acupuncture, indicating that they experienced less autonomic distress. Acupuncture was also found to increase satisfaction levels in both the patients and their parents compared to LA injection alone. (Acupuncture Reduces Pain and Autonomic Distress During Injection of Local Anesthetic in Children – A Pragmatic Crossover Investigation. Clin J Pain. 2015 Feb 25. [Epub ahead of print]).

Pain intensity and cervical range of motion improves in women with myofascial pain who are treated with acupuncture. Sixty women presenting with at least one trigger point in the upper trapezius involving local or referred pain lasting more than six months, were randomised into electro­acupuncture (EA), acupuncture (AC) and sham groups. Eight treatment sessions were carried out and a follow-up was conducted after 28 days. There was a significant reduction in general pain levels in both the EA and AC groups after eight sessions compared with sham. EA was shown to be better than AC for local pain relief. Both treatments also resulted in small increases in cervical range of motion. (Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial. Braz J Phys Ther. 2014 Nov 28;0:0. [Epub ahead of print]).

Trigger point acupuncture (TrPAcu) is significantly better than sham treatment at reducing pain and improving function in patients with chronic shoulder pain, say Japanese investigators. Eighteen patients with non-radiating shoulder pain for at least six months were randomised into two groups who received five treatment sessions. The TrPAcu group received treatment at muscular trigger points, while the sham group received acupuncture treatment on the same muscle. After five weeks of treatment, pain intensity in the TrPAcu group was found to have decreased significantly from baseline, while shoulder function had increased significantly. Comparison between the two groups demonstrated a significant difference in favour of TrPAcu. (Randomized trial of trigger point acupuncture treatment for chronic shoulder pain: a preliminary study. J Acupunct Meridian Stud. 2014 Apr;7(2):59-64). http: / /www.ncbi.nlm.nih.gov / pubmed / 24745863

Acupuncture has been found to outperform counselling and usual care for patients suffering from depression complicated by pain. A secondary analysis of data from 755 patients in a UK-based pragmatic randomised controlled trial found that patients with moderate-to­extreme pain did better at three months if they received acupuncture compared to those who received counselling or usual care. Reductions in both depression and pain were most marked in the acupuncture group, followed by the counselling group and then the usual care group. (Acupuncture, counselling or usual care for depression and comorbid pain: secondary analysis of a randomised controlled trial. BMJ Open. 2014 May 2;4(5):e004964). http:/ /www.ncbi.nlm.nih.gov/ pubmed /24793257

 

A secondary analysis of data from the Acupuncture Trialists’ Collaboration has shown that acupuncture is significantly superior to control, irrespective of the type of control used. Data came from a large individual patient data meta-analysis of acupuncture trials involving patients with headache and migraine, osteoarthritis and back, neck and shoulder pain. Twenty-nine trials met the inclusion criteria, 20 involving sham controls (n=5,230) and 18 non-sham controls (n=14,597). Sham controls included non-needle sham, penetrating sham needles and non-penetrating sham needles. Non-sham controls consisted of non-specified routine care and protocol-guided care. The results showed that acupuncture was significantly superior to all categories of control group. For trials that used penetrating needles as sham control, acupuncture had smaller effect sizes than for trials with non-penetrating needles or controls without needles. In trials with non-sham controls, larger effect sizes were associated with acupuncture vs. non-specified routine care than vs. protocol-guided care. The authors conclude that penetrating needles appear to elicit important physiological activity and recommend that this type of sham be avoided in acupuncture studies. (Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One. 2014 Apr 4;9(4):e93739). http:/ /www.ncbi.nlm.nih.gov/ pubmed /24705624

Chronic low back pain (CLBP) is associated with changes in connectivity in the brain’s default mode network (DMN), but acupuncture can reverse these changes as well as provide pain relief. The DMN, which is associated with pain and emotional processing, consists of brain regions that are more active during rest than during active task performance. Previous studies have shown that disruptions of the DMN may underlie the cognitive and behavioural impairments that accompany chronic pain. Chinese scientists used resting-state functional MRI (rsfMRI) to scan the brains of 20 patients with CLBP, before and after four weeks of acupuncture treatment. They compared the scans with those from 10 age- and gender-matched healthy controls. Less connectivity was found within the DMN in patients with CLBP compared with healthy controls (mainly in the dorsolateral prefrontal cortex, medial prefrontal cortex, anterior cingulate gyrus and precuneus). After acupuncture, connectivities in the patients’ DMNs were restored almost to the levels seen in the healthy controls. Furthermore, reductions in clinical pain were correlated with increases in DMN connectivity. (Acupuncture treatment of chronic low back pain reverses an abnormal brain default mode network in correlation with clinical pain relief. Acupunct Med. 2013 Dec 3. doi: 10.1136/ acupmed-2013-010423. [Epub ahead of print]).

According to American researchers, weekly acupuncture is associated with improvements in pain and quality of life when used as an adjunct to usual treatment for chronic pain in urban health centres. In a quasi-experimental trial, 226 of 495 referred patients initiated acupuncture. Back pain was the most common referring diagnosis, followed by osteoarthritis. Patients were found to be older, often receiving disability payments, and in poor or fair overall health with high baseline levels of pain. Following a mean of 9.7 acupuncture treatments, the results showed a significant improvement in pain severity and physical wellbeing at 12 and 24 weeks compared with baseline. Outcomes of acupuncture for chronic pain in urban primary care. J Am Board Fam Med. 2013 Nov-Dec;26(6):692-700).

The first pragmatic randomised controlled trial of tai chi for people with low back pain has shown that it can improve pain and disability outcomes in this population. Australian researchers randomised 160 volunteers with persistent non-specific low back pain to either tai chi or a wait-list control group, who continued with their usual health care. The tai chi intervention consisted of 18 forty-minute group sessions over a 10-week period delivered by a qualified instructor. Tai chi was found to reduce the bothersomeness of back symptoms by 1.7 points and pain intensity by 1.3 points (on a 10-point scale). It was also found to improve self-reported disability by 2.6 points on a 24-point scale. (Tai chi exercise for treatment of pain and disability in people with persistent low back pain: a randomized controlled trial. Arthritis Care Res (Hoboken). 2011 Nov;63(11):1576-83).

Yoga is a more effective treatment for chronic lower back pain than conventional GP care, according to the UK’s largest ever study into its benefits. The trial involved 313 people who were receiving GP care for chronic back pain. Participants were randomised to receive usual care alone, or usual care plus 12 weeks of group yoga classes specially designed for those with lower back pain. The results showed that the yoga group had better back function at three, six and 12 months compared with the usual care group. Around 60% of people in the yoga group continued with their practice after the end of the classes. (Yoga for chronic low back pain: a randomized trial. Ann Intern Med. 2011 Nov 1;155(9):569-78). In another study from the USA, 228 adults with chronic low back pain were randomised to 12 weekly classes of yoga, conventional stretching exercises or a self-care book. Yoga was found to be more effective in improving function and reducing symptoms than self-care (-2.5 versus -1.1 points on a 23-point disability scale), but not more effective than stretching (at six, 12 and 26 weeks). (A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain. Arch Intern Med. 2011 Dec 12;171(22):2019-26).