Study Supports Acupuncture Effects in Pain Control

By: International Anesthesia Research Society (IARS)

The scientific validity of traditional Chinese medicine for the treatment of pain received a nod of support in the May issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

Dr. Philip Lang and colleagues of the University of Munich used quantitative sensory testing to identify changes in pain sensitivity with acupuncture in 24 healthy volunteers. After applying acupuncture to the leg, the researchers found that pain thresholds increased by up to 50 percent. Effects were noted in both the treated leg and the untreated (contralateral) leg.

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Study Maps Effects of Acupuncture on the Brain

ScienceDaily (Feb. 5, 2010) – Important new research about the effects of acupuncture on the brain may provide an understanding of the complex mechanisms of acupuncture and could lead to a wider acceptability of the treatment.

The study, by researchers at the University of York and the Hull York Medical School published in Brain Research, indicates that acupuncture has a significant effect on specific neural structures. When a patient receives acupuncture treatment, a sensation called deqi can be obtained; scientific analysis shows that this deactivates areas within the brain that are associated with the processing of pain.

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Chinese Acupuncture Affects Brain’s Ability To Regulate Pain, UM Study Shows

ScienceDaily (Aug. 11, 2009) – Acupuncture has been used in East-Asian medicine for thousands of years to treat pain, possibly by activating the body’s natural painkillers. But how it works at the cellular level is largely unknown.

Using brain imaging, a University of Michigan study provides novel evidence that traditional Chinese acupuncture affects the brain’s long-term ability to regulate pain. The results appear online ahead of print in the September Journal of NeuroImage.

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Mariah Carey Reveals Acupuncture Helped Her Conceive

Pop diva Mariah Carey has revealed how daily acupuncture sessions helped her get pregnant. The 40-year-old singer-actress claims the treatment reduced her stress levels – deemed to be an important factor for women trying to conceive. “I was doing it once a day at least. It was on a schedule,” she said during an interview on US television. “For the first time in my life, I spent time in one place.”

Carey, who suffered a miscarriage in 2008, said she decided to give acupuncture a go after fellow songstress Celine Dion spoke about it in a magazine interview. “She was talking about acupuncture. I used to get acupuncture, but I never thought about it with regards to the trying to conceive situation. I put my body through a whole kind of cleansing situation and prepared,” she said.

The Hero singer also revealed how taking the hormone progesterone caused her to put on weight – and led to people spotting her pregnancy. “I did end up being on progesterone every month to go through the cycles – especially after going through operations and stuff,” she said. “It helps seal the pregnancy, but it also bloats you, it also puts on weight. Then everybody’s like, ‘The weight gain? She’s definitely pregnant’.” Carey and husband Nick Cannon, 30, revealed that they have already picked out baby names – but remained tight-lipped on what they were. “We’re not telling you,” Cannon said. “We have names from the first day that we met.”

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According to results of the research conducted by experts from the Memorial Sloan-Kettering Cancer Center’s Integrative Medicine Service, acupuncture can ease the side effects and symptoms associated with cancer and its treatment, like pain, fatigue, dry mouth, nausea and vomiting.

Acupuncture was a traditional Chinese medicine used to stimulate one ore more predetermine points of the body for therapeutic effects. In the said procedure, heat, pressure or electricity is added to intensify the effect of acupuncture needles and specific acupoints were stimulated to augment energy flow in various organs and tissues of the body.

They did their study on 58 patients who suffered from chronic pain or dysfunction attributed to neck dissection. They were divided into two groups, one receiving weekly acupuncture session, while the ogher group only received their standard care. They found that those patients who received acupuncture sessions experienced vital reduction of pain and dysfunction than those who had standard care.

In this connection, researchers suggests that cancer patients who are interested to have acupuncture should seek licensed or certified acupuncturist with training and experience in working with individuals with cancer.

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Recently I’ve been involved in creating and hosting a series of documentaries on integrative medicine. The three films are aimed at healthcare professionals. The first is about the science of tai chi, the second is about the science of meditation and the third is about the science of acupuncture. I’ve just wound up the last on-location filming (interviewing experts) for the acupuncture film, and am struck by how this ancient healing modality is blossoming in popularity across the country.

A healing tool of Traditional Chinese Medicine (TCM), acupuncture has been successfully administered for more than 2,500 years. According to the TCM view, a vital energy called qi flows through the body along channels called meridians. I like to think of these channels as a sprinkling system for the body, bringing qi to vital organs and extremities in much the way hoses bring water to your garden. In the TCM model of health and disease, when qi flow is blocked it stagnates. Stagnating qi causes illness. Acupuncture therapy unblocks the qi flow, strengthens or weakens the qi (think opening and closing the garden spigot) and directs it to areas of need.

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“Acupuncture” can be applied through various mechanisms all with differing results and more, or less, appropriate for certain conditions. Along with common needling, acupressure, moxibustion, pricking, medical qi gong, and lasers can all be used to manipulate acupuncture points for any number of conditions. A team of researchers from the Department of Chinese Medicine at Chang Gung University College of Medicine in Taiwan recently looked at using laser acupuncture for basic weight loss cases (i.e. those without known problems such as thyroid imbalances, diabetes, etc.).

As published in the American Journal of Chinese Medicine, this study found a relatively simple laser acupuncture protocol was helpful in reducing both body weight and body mass index ratings for the 73 woman and 22 men who participated in the study over 5 weeks. The points used with .25 J of energy (3x/week) were the auricular points “Stomach”, and “Hunger” and the body points, ST 25, ST 28, ST 40, SP 14 and CV 9. The average weight loss was 7lbs (3.17 kg). The study also used a calorie restrictive diet tailored to each person (females 1620kcal/day and males 1894.2kcal on average).

What this study didn’t compare was differences in results between body acupuncture and the laser therapy. Generally, however, these tend to be quite similar from previous studies.

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Some proponents of acupuncture suggest that the needle-based alternative therapy can help promote weight loss. Long practiced in traditional Chinese medicine, acupuncture is thought to stimulate the body’s flow of vital energy (or “chi”) and, in turn, improve several factors known to contribute to weight problems and obesity.
How Does Acupuncture Promote Weight Loss?

Although scientists aren’t sure how acupuncture might promote weight loss, it’s thought that undergoing acupuncture may suppress appetite, boost metabolism, and reduce stress. However, these theories have yet to be extensively tested in scientific studies.
Research on Acupuncture for Weight Loss

Although there is relatively little scientific support for the theory that acupuncture can promote weight loss, some studies suggest that acupuncture may be of some benefit to people looking to lose weight. In a research review published in 2009, for instance, scientists analyzed 31 studies (with a total of 3,013 participants) and found that acupuncture was associated with a significant reduction of average body weight and improvement in obesity. However, the review’s authors caution that many of the reviewed studies were of poor quality.

Other research on acupuncture’s effects on weight loss has yielded mixed results. For instance, a 1999 study of 40 obese people found that 12 weekly acupuncture sessions led to significant improvement in anxiety and depression but failed to promote weight loss. In study published the previous year, however, frequent acupuncture (administered twice daily for four weeks) was found to suppress appetite and promote weight loss among overweight participants.

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A study recently conducted by researchers at several major universities concludes that acupuncture is significantly beneficial in depression during pregnancy. “The short acupuncture protocol demonstrated symptom reduction and a response rate comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy.” Below is the Abstract…

OBJECTIVE: To estimate the efficacy of acupuncture for depression during pregnancy in a randomized controlled trial.

METHODS: A total of 150 pregnant women who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder were randomized to receive either acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). Junior acupuncturists, who were not told about treatment assignment, needled participants at points prescribed by senior acupuncturists. All treatments were standardized. The primary outcome was the Hamilton Rating Scale for Depression, administered by masked raters at baseline and after 4 and 8 weeks of treatment. Continuous data were analyzed using mixed effects models and by intent to treat.

RESULTS: Fifty-two women were randomized to acupuncture specific for depression, 49 to control acupuncture, and 49 to massage. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity (P<.05) compared with the combined controls (Cohen’s d=0.39, 95% confidence interval [CI] 0.01-0.77) or control acupuncture alone (P<.05; Cohen’s d=0.46, 95% CI 0.01-0.92). They also had significantly greater response rate (63.0%) than the combined controls (44.3%; P<.05; number needed to treat, 5.3; 95% CI 2.8-75.0) and control acupuncture alone (37.5%; P

CONCLUSION: The short acupuncture protocol demonstrated symptom reduction and a response rate comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy.

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Patients resistant to normal treatment from dysmennorrhea were given treatment with acupuncture and received positive results.
The study is called “Acupuncture Treatment of Dysmenorrhea Resistant to Conventional Medical Treatment” by Italian doctors V. Iorno, R. Burani, B. Bianchini, E. Minelli, F. Martinelli and S. Ciatto

They evaluated the effect of acupuncture on NSAID resistant dysmenorrhea related pain [measured according to Visual Analogue Scale (VAS)] in 15 consecutive patients. Pain was measured at baseline (T1), mid treatment (T2), end of treatment (T3) and 3 (T4) and 6 months (T5) after the end of treatment. Substantial reduction of pain and NSAID assumption was observed in 13 of 15 patients (87%). Pain intensity was significantly reduced with respect to baseline (average VAS = 8.5), by 64, 72, 60 or 53% at T2, T3, T4 or T5. Greater reduction of pain was observed for primary as compared with secondary dysmenorrhea. Average pain duration at baseline (2.6 days) was significantly reduced by 62, 69, 54 or 54% at T2, T3, T4 or T5. Average NSAID use was significantly reduced by 63, 74, 58 or 58% at T2, T3, T4 or T5, respectively, and ceased totally in 7 patients, still asymptomatic 6 months after treatment. Our findings suggest that acupuncture may be indicated to treat dysmenorrhea related pain, in particular in those subjects in whom NSAID or oral contraceptives are contraindicated or refused.

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In a randomized, two-group clinical study, researchers used acupuncture for relieving menopausal hot flushes, sleep disturbances and mood changes. The experimental acupuncture treatment consisted of specific acupuncture body points related to menopausal symptoms. The comparison acupuncture treatment consisted of a treatment designated as a general tonic specifically designed to benefit the flow of Qi.

Results from the experimental acupuncture treatment group showed a decrease in mean monthly hot flush severity for site-specific acupuncture. The comparison acupuncture treatment group had no significant change in severity from baseline over the treatment phase. Sleep disturbances in the experimental acupuncture treatment group declined over the study. Mood changes in both the experimental acupuncture treatment group and the comparison acupuncture treatment group showed a significant difference between the baseline and the third month of the study. The researchers conclude that acupuncture using menopausal-specific sites holds promise for nonhormonal relief of hot flushes and sleep disturbances.

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Twenty patients participated in this study. There were twelve men and eight women ranging in ages between 6-67 years old. They have all complained of food allergy gastritis after eating certain foods. The main symptoms were abdominal pain and distention, indigestion and diarrhea. A few had nausea and vomiting and some had complained of hives after eating the allergenic food. There were reports of asthma and joint pain. Some of the offending foods were shellfish, cow?s milk, walnuts, lamb and pork.

A daily formula was decocted and administered to each patient that consisted of Huang Qi, Bai Jiang Cao, Ma Chi Xian, Di Ku Dan, stir-fried Shan Zha, Bai Zhu, Fu Ling, Huang Qin, Hou Po, Huang Lian and Huo Xiang with some modifications for particular presenting symptoms.

According to the study, a cure was defined as a complete disappearance of symptoms, a negative skin patch test, a lowering of IgE levels to normal, and the ability to eat the offending foods without presenting symptoms for up to one year. Fourteen out of twenty were considered cured. Five patients improved and one patient did not improve. Improvement was defined as the disappearance of symptoms, lowering of IgE levels to normal, a positive skin patch test and some allergic symptoms after eating allergenic foods. Overall, there was a 95% effective rate.

Zhang Xin-Cheng, et al. Xin Zhong Yi (New Chinese Medicine). #9 pp.59-60. 2002

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Sok, S.R., et al. Effects of acupuncture therapy on insomnia. Journal of Advanced Nursing 44(4):375-84.

Acupuncture therapy, commonly used in clinical practice in Asian cultures, has the potential to produce a positive effect with patients experiencing insomnia. The purpose of this systematic review was to: 1) assess the trends across intervention studies using acupuncture for insomnia from 1975 to 2002; 2) examine dependent variables and 3) evaluate the effects of acupuncture therapy on insomnia in older people.
Data were collected from November 2001 to January 2003 from a wide range of electronic databases. Half the studies that met the researchers? criteria had small samples (50 subjects or fewer), which were composed mainly of older women who had a variable duration of insomnia from three days to 34 years. The main methods used to assess outcomes were questionnaires. All the studies reported statistically significant positive results.

The results of this review suggest that acupuncture may be an effective intervention for the relief of insomnia. Further research, using a randomized clinical trial design, is necessary to determine the effectiveness of acupuncture. More work is also needed to promote the long-term therapeutic effects of acupuncture and to compare it with other therapies for insomnia.

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Acupuncture has been proven to be successful in both clinical settings and under controlled experimental conditions. The results obtained from a one year acupuncture detoxification program study in Portland, Oregon and a blind study of acupuncture treatment with chronic alcoholics in Hennepin County, Minnesota are:

People who received acupuncture detoxification treatment were two times more likely to continue in rehabilitation therapy than people who did not receive acupuncture treatment.

More than 70% of people treated with acupuncture successfully completed detoxification, compared with only 50% of those who did not receive the treatment. For those detoxifying from alcohol, the success rate was 90%.
Recidivism (tendency to relapse) of alcohol and drug addicts decreased from 20-25% to 5% for patients receiving acupuncture detoxification treatments.

In a blind study of chronic alcoholics in Hennepin County, 37% of the treatment group receiving acupuncture completed the program. Only 7.4% of the control group had a successful completion of the program.

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The purpose of the study is to compare the efficacy of electro-acupuncture with placebo-acupuncture for the treatment of shoulder pain. The participants are patients aged from 25 to 83 years with shoulder pain. They were randomly given two treatments over eight weeks, with electro-acupuncture or skin non-penetrating placebo-acupuncture, both able to take diclofenac, a NSAID, if needed for intense pain. The main outcome measure was the difference between groups in pain intensity (visual analogue scale-VAS). Secondary outcomes were differences between groups in pain intensity measured by Lattinen index, in range of motion (goniometer), functional ability (SPADI), quality of life (COOP-WONCA charts), NSAIDS intake, credibility (Borkoveck and Nau scale) and global satisfaction (10 points analogue scale). Assessments were performed before, during and three and six months after treatment. At six months, the acupuncture group showed a much greater improvement in pain intensity compared with the placebo group. The acupuncture group had consistently better results in every secondary outcome measure than the placebo group. Acupuncture is an effective long-term treatment for patients with shoulder pain (from soft tissues lesions).

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Acupuncture has become a widely used treatment modality in various musculoskeletal pain conditions. Acupuncture is also shown to enhance blood flow and recovery in surgical flaps due to certain substances released by needle stimulation. In a previous study on healthy subjects, researchers found that stimulation into the anterior tibial muscle increased both skin and muscle blood flow. The aim of this study was to examine the effect of needle stimulation on local blood flow in the anterior tibial muscle and overlying skin in patients suffering from a widespread chronic pain condition.

Fifteen patients with fibromyalgia participated in the study. The authors performed two modes of needling — deep muscle stimulation and subcutaneous needle insertion — at the upper anterior aspect of the tibia, and assessed the resulting blood flow.

The results of the present study were partly similar to those earlier found at a corresponding site in healthy female subjects. However, in fibromyalgia patients subcutaneous needle insertion was followed by a significant increase in both skin and muscle blood flow, in contrast to findings in healthy subjects where no significant blood flow increase was found following the subcutaneous needling. The different results of subcutaneous needling between the groups may be related to a greater sensitivity to pain and other somatosensory input in fibromyalgia.

Sandberg M, et al. Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia. European Journal of Pain 8(2):163-71.

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British Journal of Rheurnatology, 1994 Dec, 33(12):1162-5. (UI: 95093857)

Pub type: Clinical Trial; Journal Article; Randomized Controlled Trial.

Abstract: The immediate analgesic effect of a single non-segmental acupuncture stimulation treatment on chronic tennis elbow pain was studied with placebo-controlled single-blind trial completed by 48 patients. Before and after treatment, all patients were examined physically by an unbiased independent examiner. Eleven-point box scales were used [13] for pain measurement. Patients in the verum group were treated at non-segmental distal points (homolateral leg) for elbow pain following Chinese acupuncture rules, whereas patients in the placebo group were treated with placebo acupuncture avoiding penetration of the skin with an acupuncture needle.

Overall reduction in the pain score was 55.8% (S = 2.95) in the verum group and 15% (S = 2.77) in the placebo group. After one treatment 19 out of 24 patients in the verum group (79.2%) reported pain relief of at least 50% (placebo group: six patients out of 24). The average duration of analgesia after one treatment was 20.2 h in the verum group (S = 21.54) and 1.4 h (S = 3.50) in the placebo group. The results are statistically significant (P < 0.01); they show that non-segmental verum acupuncture has an intrisic analgesic effect in the clinical treatment of tennis elbow pain which exceeds that of placebo acupuncture.

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The researchers determined the effects of acupuncture on patients with chronic headaches, particularly migraines. They randomly allocated patients to receive up to 12 acupuncture treatments over three months or to a control intervention offering usual care. After a year headaches were lower in the acupuncture group than in controls. Patients in the acupuncture group experienced the equivalent of 22 fewer days of headache per year (8 to 38). Compared with controls, patients randomized to acupuncture used 15% less medication, made 25% fewer visits to general practitioners and took 15% fewer days off sick. The researchers concluded that acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine.

Vickers AJ, et al. BMJ Epub 2004 Mar 15.

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Acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective addition to standard care, according to a landmark study published in the Annals of Internal Medicine. The study, funded in part by NCCAM and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, was conducted across three sites and is the longest and largest clinical trial of acupuncture to date.

The researchers enrolled 570 patients with osteoarthritis of the knee, aged 50 and older, to receive one of three treatments: acupuncture, simulated acupuncture (procedures that mimic acupuncture, sometimes also referred to as “placebo” or “sham”), or participation in a control group. The control group followed the Arthritis Foundation’s self-help course for managing their condition over 12 weeks. Participants in the actual and simulated acupuncture groups received 23 treatment sessions over 26 weeks. All study participants continued to receive standard medical care from their primary physicians, including anti-inflammatory medications and opioid pain relievers.

At the start of the study, participants’ pain and knee function were assessed using standard arthritis research survey instruments and measurement tools; their progress was assessed at 4, 8, 14, and 26 weeks. By week 8, participants receiving actual acupuncture showed a significant increase in function and by week 14 a significant decrease in pain, compared with the simulated and control groups. These results sustained through week 26. Overall, participants in the acupuncture group had a 40 percent decrease in pain and a nearly 40 percent improvement in function compared to their assessments at the start of the study.

Findings from this study begin to shed more light on acupuncture’s possible mechanisms and potential benefits, especially in treating painful conditions such as arthritis.

Reference: Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of Internal Medicine. 2004;141(12):901?910.

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A pilot study shows that acupuncture may help people with posttraumatic stress disorder. Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Michael Hollifield, M.D., and colleagues conducted a clinical trial examining the effect of acupuncture on the symptoms of PTSD. The researchers analyzed depression, anxiety, and impairment in 73 people with a diagnosis of PTSD. The participants were assigned to receive either acupuncture or group cognitive-behavioral therapy over 12 weeks, or were assigned to a wait-list as part of the control group. The people in the control group were offered treatment or referral for treatment at the end of their participation.

The researchers found that acupuncture provided treatment effects similar to group cognitive-behavioral therapy; both interventions were superior to the control group. Additionally, treatment effects of both the acupuncture and the group therapy were maintained for 3 months after the end of treatment.

The limitations of the study are consistent with preliminary research. For example, this study had a small group of participants that lacked diversity, and the results do not account for outside factors that may have affected the treatments’ results

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Researchers at the University of Arizona have tested the value of acupuncture in the treatment of depression. 38 women aged 18 to 45 and suffering from major depression were divided into three groups. One group received eight weeks of acupuncture treatment specifically designed to target their depression. A second group waited for eight weeks and then received the treatment. A third group received a form of placebo acupuncture which was not designed to treat depression but rather headache or back pain, then received the depression-specific treatment for eight weeks. The symptoms of all three groups got better over time, but the group that received the depression-specific treatment immediately improved much more quickly, and once the other two groups got the specific treatment their symptoms also improved at a much faster rate. According to John Allen who led the study “These findings from a small sample of women with major depression suggest that acupuncture may hold sufficient efficacy to warrant a larger clinical trial”. He said that although drugs and psychotherapy provide significant relief for 50 to 70 percent of patients, “about a third of people seeking treatment end that treatment prematurely, citing factors such as dissatisfaction with their current treatment or intolerable side effects. These statistics suggest that alternative treatments may be welcomed by those suffering from depression.” (Psychological Science 1998;9:397-40)

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