Doctor who is passionate about acupuncture

Doctor who is passionate about acupuncture

Welcome to my blog

Leading acupuncture specialist for facial rejuvenation, pain relief, stress and anxiety relief, fertility and miscarriage, fatigue, acne and insomnia
Based in London Kensington, Chelsea and Richmond . Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Monday, 10 November 2014

Endometriosis associated infertility with acupuncture treatment

Women’s uterus wall has three layers: inner layer is called endometrium; middle layer is smooth muscle; outer layer is myometrium. Endometrium of uterus is special. It undergoes cyclic change and regeneration. During the period cycle, this layer grows thicker and is full of blood vessels and glands. It provides best hospitable environment for implantation of a fertilised egg. If pregnancy does not occur, the inner layer will shed away causing bleeding and the layer will redevelop. Sometimes, if things go wrong, the endometrial tissue can grow outside of uterus. This is a condition called endometriosis. The most common places where this tissue was mislaid are ovaries, fallopian tubes and the pelvic cavity. This misplaced tissue is also responding women’s period cycles, but it could not shed. As a result it will cause inflammation, scar and adhesion. Endometriosis could present chronic pelvic pain including period pain, and intercourse pain, irregular period and associated with infertility.

Endometriosis affects up to 10% of reproductive age of women. Endometriosis is associated with infertility. At least one third of women with endometriosis have infertility. Women with infertility are 6-8 times more likely to have endometriosis. Some women with endometriosis will conceive without difficulty, while others may have difficulty to conceive. Some controlled trial study showed that women with endometriosis were 10% less likely to conceive than those without the condition. The pregnancy success rate among women with endometriosis associated infertility was lower than those with unexplained infertility. A study of 14 randomised controlled trials showed that women with endometriosis were less likely than women with tubal-factor infertility to conceive by means of IVF. Endometriosis is also associated to lower live birth rate.

The mechanisms of association between endometriosis and infertility are not fully understood. Moderate to severe cases can lead to infertility. The connection between severe endometriosis and infertility is due to severe pelvic adhesions which cause a variety of anatomical abnormalities. This can affect ovum capture and transport. The severe ectopic endometrial lesions is also decreasing implantation rates, decreasing egg retrieval rates and decreasing pregnancy rates.

Most of endometriosis cases are mild. Some women with mild endometriosis have also had infertility and many women with infertility have had mild endometriosis. The cause and effect relationships between mild endometriosis and infertility are not clear. Severe endometriosis can cause reproductive organs scarring and distortion. The association of minimal and mild endometriosis with infertility is also possible. This is because endometriosis causes ovulatory dysfunction, impaired follicle development, defective implantation, eutopic endometrium abnormalities, abnormal immunological environment and luteal phase problems. Luiz Fernando et al collected the data from 1985 -2011 to investigate the association between mild endometriosis and infertility. They found there were two randomized controlled trials for this study. In 1997 Marcoux et al conduceted a randomized controlled trial studied the association between endometriosis and pregnancy rates. They compared pregnancy rates in 172 women with stage I and II endometriosis who underwent laparoscopic removing all visible endometrial lesions with 169 women who underwent diagnostic laparoscopy only. All women were followed postoperatively for 36 weeks. The cumulative pregnancy probability rate for the surgery group was 30.7% while pregnancy rate for the diagnostic group was 17.7%. This result showed significant differences between two groups indicating the association of mild endometriosis and infertility. This suggestion was supported by another study. The conclusion is that minimal to mild stages of endometriosis plays an important role related to infertility and has negative impact on pregnancy rate.

In summary, the association between endometriosis and infertility may be caused a few mechanisms.

Distorted pelvic anatomy: endometriosis could cause pelvic adhesions. These organs can adhere to the uterus, bowel or pelvic wall. This distortion of reproductive organs could cause infertility. if the eggs in the ovaries are damaged by the misplaced tissues egg quantity and quality could be compromised which results ovulation abnormalities which can impair egg release from the ovary and egg pickup after being released; The tubes can be damaged and blocked; ovaries can contain cysts formed from misplaced tissue it also can block sperm entry into the distal tube.

Altered peritoneal environment: Also Altered peritoneal function and impaired endometrium and implantation are also contributing to the infertility. women with endometriosis have increased volume of peritoneal fluid, increased immune cells and concentrations of prostaglandin etc. These may impair egg, sperm, embryo and fallopian tube function.

Altered system immune function: women with endometriosis may have increased antibodies and lymphocytes and this may alter endometrial acceptance to embryo implantation.

Endocrine and ovulatory abnormalities: Women with endometriosis may also present abnormal follicle growth, the luteinized unruptured follicle syndrome, luteal phase dysfunction and premature and multiple LH surges.

Abnormal tubal function: egg capture inhibitor was reported present in peritoneal fluid from women with endometriosis.

Abnormal fertilization and implantation: fertilization and implantation may be impaired in women with endometriosis. Endometrial function may be not normal.

Medications could improve the quality of life for many women with endometriosis; however their contraceptive effects are limited their application. There were many researches showing that acupuncture is effective of releasing pain associated with endometriosis. Acupuncture also stops misplaced tissue growing, regulates period and improves fertility. According to traditional Chinese medicine theory, endometriosis is caused by blood stagnation. Acupuncture improves blood flow; this will release the pain and improve other symptoms.

There was a case report about acupuncture treatment for endometriosis associated infertility from China. 25 patients with endometriosis associated with infertility were treated with acupuncture. After 2 months of treatment, 9 patients achieved pregnancy.

A report in Zhong Guo Zhen Jiu (1996) also studied effectiveness of acupuncture on endometriosis associated with infertility. There were 72 women with endometriosis associated with infertility involved. The acupuncture treatment duration is 3-9 month. 42 women achieved pregnancy. Success rate was 58.33%.

References
Zhou et al (2009) Afr J Tradit Complement Altern Med 6: 494-517
http://www.cnki.com.cn/Article/CJFDTotal-ZGZE602.020.htm
Luiz Fernando et al Rev Assoc Med Bras (2012) 58:607-614

Friday, 7 November 2014

Inflammation plays a role in infertility and acupuncture treatment

Inflammation is a basic reaction that our body responds to infection, irritation or other injury. Inflammation is a complex biological response of vascular tissue to harmful stimuli. Without inflammation, wound and infection would never heal. Inflammation is a defense and has two aspects of effects: beneficial and harmful. If our body suffered from infection or injury, the defense system tend to remove harmful stimuli, initiating healing process for repair and regeneration. This is beneficial effect. The process of acute inflammation is initiated by local blood vessels with related chemicals accumulated into tissue. Increased blood flow causes characteristic swelling, redness and heat. As a consequence, vasodilation and increased permeability cause slowing of blood flow. Inflammation could stimulates nerves causing pain. It also could damage organs and their function if the inflammation is too strong which is harmful. Inflammation has a significant role in gynecology and infertility, affecting the ovary, uterus as well as the embryo and implantation.

Inflammation is present in women’s reproductive system physiology. There is temporary changes reflected inflammation process observed in the ovary during follicular development, ovulation and luteal formation. Immune cells accumulate in the inner lining of the uterus during the secretary phase of the menstrual cycle indicating inflammation involved in the endometrial cycles in the uterus. Recent research found that a special protein which can inhibits immune cell function and has local anti-inflammatory effect prevented immune attack to the embryo and created a local hospitable environment in the uterus in early pregnancy without compromising maternal system immune function. Inflammation plays an important role in implantation as well.

Inflammation is involved in infertility. There are two major types of problems that account for most of women’s infertility: anatomic abnormality and ovulatory problems. Most anatomic abnormalities such as tube blockage that cause infertility are acquired. Infection, inflammation, ischemia and surgical injury may be the causes. Anatomic abnormalities may be asymptomatic or may be presenting pelvic pain, pelvic adhesions and infertility. Inflammation causes tissue damage and distortion. The most significant cause of inflammatory infertility is Chlamydia trachomatis infection that may result in infertility in 10-30% of infertile couples in developed countries. Inflammation causes ovulatory abnormalities. Premature ovarian failure (POF) is a typical example of the relationship between ovulatory infertility and inflammation. The incidence of POF is 1% of women under the age of 40. About 50% of POF cases have attributed to immune problems which are involved in inflammation. Antiovarian antibodies have been found in some of these cases and accumulation of immune cells in ovaries has been noted as well. Women with endometriosis are also responding to inflammation differently from those women without endometriosis. There are increased immune cells and antibodies against inner lining of uterus.

Acupuncture reduces inflammation to improve fertility. Inflammation is present in infertility. This was noted in ancient Chinese Medicine. The phenomena were explained that dampness and heat accumulate and blood stagnates in pelvis. This blocks meridian and stops energy flow causing infertility. Acupuncture treating infertility has a long history, but the effect of acupuncture is doubted because it relies on concept of changing the flow of energy on meridian which is not accepted by evidence based medicine. Recently researchers provided evidence that needles insertion into the skin and deeper tissues results in a particular pattern of afferent activity in peripheral nerves. This improves blood circulation of ovaries and uterus etc. As a result it reduces local inflammation and improves infertility.

In men, infection and inflammation of the reproductive tract including testes are widely accepted as important factors of male infertility. Inflammation is associated with disruption of testicular function leading to low sperm count and low quality of sperms. Acupuncture improves sperm count and quality of sperms. This is because acupuncture increased blood supply of testicular artery and acupuncture stimulated immune response and reduced inflammation.

References
Weiss G et al Reprod Sci (2009) 16: 216-229

Monday, 8 September 2014

Acupuncture is effective on dysfunctional uterine bleeding and restoring ovulation

As we all know, women have menstrual cycles which occurs as a result of cyclic hormonal changes are usually 21-40 days long, with bleeding duration of 3-7 days and an average blood loss of 20-80 ml. Many women experience some kind of menstrual cycle disturbance; this could be minor disorders or a sign of malignant diseases. Malignant endometrial and cervical disorders include endometrial carcinoma, endometrial heperplasia, cervical cancer and cervical intra-epithelial neoplasia which could present abnormal uterine bleeding.

If a woman is pregnant, vaginal bleeding is abnormal. This often occurs in early pregnancy and is often associated with miscarriage or ectopic pregnancy. Ectopic pregnancy is one of the most severe pregnancy related conditions in women with abnormal uterine bleeding. Threatened miscarriage and miscarriage also present abnormal uterine bleeding.

Benign endometrial and cervical diseases: Fibroids is benign smooth muscle tumors in uterus which is either asymptomatic or presenting abnormal uterine bleeding. Endometrial polyps are a significant cause.

More frequent vaginal bleeding could be caused by pelvic inflammatory disease which is caused by sexually transmitted diseases such as Chlamydia or gonorrhoea. This causes inflammation in the uterus. Endometriosis can also cause more frequent vaginal bleeding. Polycystic ovary syndrome is also the underline causes of abnormal uterine bleeding. Irregular interval of vaginal bleeding could be caused by oral contraceptive pills and perimenopause.

Abnormality presents as duration, interval and amount of the bleeding, if a woman is not pregnant and ovulates regularly.

Very heavy vaginal bleeding: This could be caused by benign conditions including uterine fibroids, endometrial polyps, adenomyosis, intrauterine devices, hypothyroidism, an autoimmune disorders, blood clotting disorders and medications disturbing blood clotting.

Lighter vaginal bleeding could be caused by hyperthoroidism, oral contraceptive pills.

Bleeding between periods could be caused by contraceptive pills, intrauterine device, psychological stress and anticoagulant medications.

If a woman does not ovulate reduction of periods or period blood flow could be seen in some conditions, such as, some chronic conditions and physical and psychological stress, hypothalamus dysfunction, anorexia nervosa, and polycystic ovarian syndrome.

Majority of women with abnormal uterine bleeding do not have structural and histological abnormalities fortunately. Dysfunctional uterine bleeding is not due to certain pelvic disease, complications of pregnancy or systemic illness but mostly related to hormonal dysfunction. These affect 30% of women in reproductive age. Dysfunctional uterine bleeding is a common condition in women in reproductive age. This could be caused by psychological and/or physical stress, malnutrition, or systematic disorders which affect hypathalumic-pituitary-ovarian axis. They present with heavy abnormal uterine bleeding patterns: longer bleeding days, heavy blood loss, more frequent period cycles. In such cases, it is likely associated with aovulations. Changes of normal menstrual cycles are normally caused by disturbances of the hypothalamus-pituitary-ovarian axis. Most cases of anovulatory bleeding are caused by estrogen withdrawal or estrogen breakthrough bleeding. This could present midcycle spotting or intermittent spotting. This also could present irregular or prolonged heavy bleeding. In the case of no ovulation, the uterine endometrium at the presence of estrogen stimulation reaches abnormal heights and lacks structural support and it becomes fragile. The fragile endometrium breaks down and bleeding occurs. The fundamental issue in anovulatory bleeding is that the ovary does not function well causing hormonal imbalance. If a woman with anovulatory bleeding is trying to conceive, she would have difficulty to get pregnant because of anovulation. Improving ovary function is the key to treat anovulatory bleeding.

In Traditional Chinese Medicine (TCM) dysfunctional uterine bleeding can be divided into three types

1. Spleen and kidney yang deficiency, the symptoms include prolonged uterine bleeding, heavy periods, light red without clot, excessive vaginal discharge, tireness, lower back pain, feeling cold, cold hands and feet, diarrhoea, swelling tongue with light white coating, and week and sink pulse.

2. liver and kidney yin deficiency, the symptoms include irregular periods, prolonged uterine bleeding, red blood, dizziness tinnitus, lower backpain, dry mouth, red tongue, week and sink pulse.

3. kidney deficiency and liver stagnation, the symptoms include irregular periods, breast pain, lower back pain, lower tummy pain, excessive vaginal discharge, light tongue and week and sink pulse.

Apart from medication and surgery treatments, acupuncture is an effective treatment for dysfunctional uterine bleeding

Acupuncture could stimulate nerve end to improve ovarian blood circulation. This could improve ovarian function, restore hormonal balance and ovulation and stop abnormal vaginal bleeding and improve fertility.

Zeng et al conducted a controlled trial to investigate effectiveness of acupuncture on dysfunctional uterine bleeding. It was involved in 252 patients. These patients were divided into three groups acupuncture group, Chinese medicine group and conventional medicine group with 84 patients in each group. The result showed that acupuncture has the best effect compared with Chinese medicine and conventional medicine groups. Dr Cheng reported 90 cases of dysfunctional uterine bleeding treated with acupuncture or acupuncture and moxbustion. These women were aged between 16-46, most of them were 25-35. Uterine bleeding days were from 9 days to 65 days. They found that acupuncture and moxibustion are effective treatments for women with dysfunctional uterine bleeding.

References
http://www.acumoxj.com/readlist.asp?id=383
Hickey M et al. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD001895.
http://journal.9med.net/html/qikan/zxyjh/zhzxyzz/20047514/zyzy/20080903023004133_2488.html
http://www.cqvip.com/QK/92077A/200404/9576315.html

Wednesday, 16 July 2014

Not ovulate, acupuncture improves ovulation

There are many factors that cause anovulation and here are some common causes of anovulation.

Hypothalamic-pituitary causes

Hypothalamus-pituitary-ovarian-axis dysfunction. This is caused by problems of hypothalamus or pituitary gland in the brain. As a result the hormones are not balanced which does not trigger ovulation and leads to infertility. The reasons that affect hormone balance include stress (see below); the other common causes are excessive exercises and/or underweight.

As we already known that subtle environmental changes may alter the menstrual cycle and cause anovulation. For example, summer camp menstrual disturbances and exam anovulation. Women in emotional stress could have no ovulation. This is temporary situation. If women get out of the stress environment, menstruation and ovulation could be returned. However if this situation is prolonged, anovulation could be persistent. Finding the causes of stress situation and avoiding the causes are the keys for ovulation to return. Many therapies could help reduce stress, such as psychological therapy, yoga and acupuncture etc.

Ovarian causes. If ovary does not respond to FSH and LH, this also causes ovulation problem.

Polycystic ovary syndrome (PCOS). This is commonest cause of anovulation related infertility. It explained 70% of the cases. Women with PCOS have imbalanced hormone levels. This may produce multiple cysts in ovaries, irregular period cycle, anovulation, infertility, acne and excessive hair growth and other symproms.

Premature ovarian failure (POF). In women with POF, their ovaries fail to function properly before menopause occurs. The ovaries don’t respond to FSH and there is no ovulation. They have difficulty to get pregnant.

Treatments that reduce stress can be effective to improve ovulation. Acupuncture helps treating anovulation by stimulating nerve endings and correcting hormonal imbalance. Acupuncture is very effective treatment for anovulation. Acupuncture reduces stress by regulating response to stress and altering stress related chemical substances levels; improves hypothalamus-pituitary-ovarian axis function and regulates blood hormone level. As a consequence, it improves ovulation and pregnancy rate.

Here are some clinical reports about the effectiveness of acupuncture on anovulation.

There was a control trial with acupuncture group and control group (treated with Clomephene). 25 cases in each group were given 6 cycles treatments. And then ovulation and pregnancy rate were compared between the two groups. Ovulation rate is not significantly different between the two groups. The pregnancy rate is higher (44%) in the acupuncture group than in the control group (16%).

There was a case report from a reproductive health institute center in Sichuan in China. They reported the effectiveness of acupuncture on women with anovulation. Ovulation rate was from 70-80% and pregnancy rate was from 40% - 60%.

Recently Yan and Liu summarised some case reports about effectiveness of acupuncture on increasing ovulation. They collected 21 papers which used acupuncture treated anovulation associated infertility.

Here are some typical cases.

Chen et al treated 42 patients with infertility associated with anovulation. 41 of them ovulated.

Kou et al used acupuncture treatment for 50 cases of anovulation associated infertility. 40 of 50 patients achieved pregnancy.

Chang et al used acupuncture for 32 patients with anovulation associated infertility. 9 patients achieved pregnancy during 1-3 month of acupuncture treatment. 22 patients achieved pregnancy over 4 months of acupuncture treatments.

Case report for effectiveness of acupuncture on infertility caused by anovulation

There was a study about effectiveness of acupuncture for infertility without ovulation. There were 50 women with infertility without ovulation. There women were divided into two groups: acupuncture group and control group. Control group was treated with clomiphere and injection of chorionic gonadotropin. The period of treatment was 6 cycles and ovulation rate and pregnancy rate were measured. The results showed that there was no difference in the ovulation rate between the acupuncture group and clomiphere group. However the pregnancy rate in acupuncture group was significantly higher (44%) than that for control group (16%). In addition the score of mucus and endometrial thickness was greater in acupuncture group.

This is a case report on effect of acupuncture treatment of infertility caused by ovulatory problems. 120 patients with infertility caused by ovulatory problems were divided into two groups: acupuncture group and clomiphene control group. 3 treatment cycles were applied. Result showed that similar ovulation rate was observed in both group, but pregnancy rate was higher and abortion rate was lower in acupuncture group compared to control group.

References
Yan and Liu Shanghai J Acu-mox, (2005) 24:40-42 (针灸促排卵临床概况)
Song FJ et al Zhongguo Zhen Jiu (2008) 28:21-23
Jiang and Ding Zhongguo Zhen Jiu (2009) 29:21-4

Tuesday, 24 June 2014

Acupuncture helps improving foot drop

Foot drop, sometimes called drop foot is a muscular weakness or paralysis that makes it difficult to lift the front part of your foot and toes. This causes the toes to drag along the ground while walking. To avoid dragging the toes, people with foot drop may lift their knee higher than normal. Or they may swing their leg in a wide arc. Foot drop can happen to one foot or both feet at the same time. Foot drop is a symptom rather than a condition. The causes could be muscle disorders, nerve damage in the leg, or brain and/or spinal injury. Muscles disorders including muscular dystrophy, amyotrophic lateral sclerosis and polio cause the muscles to progressively weaken causing foot drop. Some conditions including sports injuries, diabetes, spending long hours sitting cross-legged or squatting, hip or knee replacement surgery, childbirth etc could cause peroneal nerve damage or compressed causing foot drop. Brain or spinal disorders including stroke, multiple sclerosis (MS) and cerebral palsy also can cause foot drop.

The treatments depend on the causes of the foot drop which include physiotherapy, wearing an ankle-foot orthosis, electrical nerve stimulation and surgery. Acupuncture was also reported to be useful to help improving foot drop.

References
Jagirdar PC Indian J Lepr (1986 58:618-22
Liu ZP et al Zhongguoe Zhen Jiu (2012) 32:293-6

Wednesday, 11 June 2014

Acupuncture is effective for diabetic and idiopathic peripheral neuropathy

Acupuncture is effective for diabetic peripheral neuropathy

Diabetic neuropathy is that the nerves in the patients with diabetes were damaged which is caused by high blood sugar levels and decreased blood flow. In a high blood sugar environment nerve cells as well as repair mechanisms are more likely to be damaged. About 50% of patients with diabetes will develop nerve damage many years later after they have been diagnosed diabetes. Many nerves could be affected including cranial nerves (nerves in the skull), autonomic nerves (nerves for internal organs such as heart, stomach etc) and of course peripheral nerves (for instance, nerves for arms and legs). Symptoms may vary depending on which nerves are injured

If peripheral nerves (nerves for the arms and legs) are damaged, this is called peripheral neuropathy which occurs in 50% of the diabetes 2 patients. The early sign of peripheral nerve damage is abnormal sensation such as pain and numbness often started in the toes and feet. The symptoms tingling and burning pain and numbness could be present in the arms and legs. Some pain could be very severe. The nerve conduction became slow. Foot ulcer may occur because of poor blood supply to the skin. The symptoms are worsening with times and age.

The treatment for diabetic peripheral neuropathy included two aspects: first is to keep blood sugar controlled in a normal level to prevent further nerve damage; second is to reduce symptoms. Many medicines are available to relive pain symptoms. Long term use of these medicines could cause kidney damage. Recently there are many studies supporting using acupuncture for the treatment of peripheral neuropathy.

Recent research by Chinese clinicians showed that acupuncture helps improving symptoms of peripheral neuropathy. Chen etc (2009) and Ji XQ (2010) used randomized controlled trials to study effect of acupuncture on nerve conduction velocity in patients with diabetic peripheral neuropathy. They found that acupuncture significantly increased nerve conduction speed. Tong Y (2010) etc compared the effect of acupuncture in patients with diabetic peripheral neuropathy with that of sham acupuncture using randomised trials. After 15 sessions of acupuncture treatment, acupuncture significantly improved nerve conduction speed; acupuncture also significantly improved numbness, pain and rigidity in the arms and legs; vibration and temperature sensations were improved after acupuncture treatment. As we already know that acupuncture has analgesic effect and also acupuncture improves local blood flow, these could contribute to the effectiveness of the treatment.

Positive result of acupuncture in the treatment of diabetic painful neuropathy from Manchester

Role of acupuncture in the management of diabetic painful neuropathy (DPN) was studied by Garrow AP et al in Tameside Hospital NHS foundation Trust, Diabetes Center in greater Manchester UK. In this study, there were 45 patients involved and allocated to two groups real acupuncture group and sham acupuncture group which is a control group. A 10 week course acupuncture was offered to these patients and five standardised acupuncture points on the lower limb of each leg were used in the study: LR3, KI3, SP6, SP10 and ST36. Assessment was done before and after acupuncture treatments. Over the 10-week treatment period, small improvements were seen in Visual Analogue Scale which was used to assess lower limb pain, Measure Yourself Medical Outcome Profile and resting diastolic blood pressure in the true acupuncture group and little changes were in sham acupuncture group. They demonstrated the potential practicality and feasibility of acupuncture as an additional treatment for people with DPN. Acupuncture treatment was well tolerated with little side effects.

Peripheral nerve injury with acupuncture treatment

Peripheral nerve injury can occur through various traumas and it became increasingly common condition. Injury to motor nerves may produce symptoms including muscle weakness, atrophy, twitching and paralysis. Injury to sensory nerve may produce symptoms including continuous burning pain, sensitivity, numbness, tingling or pricking and problems with positional awareness. A first degree injury or neuraplaxia will recover quickly within a few months. The recovery will be completed with no lasting muscle or sensory problem. More severe injuries may take longer to recover completely or may not be fully recovered. The recovery depends on the severity of the injury and the time to get the treatment. Nerve injuries should be treated as early as possible. Apart from surgical treatment, nonsurgical treatments for nerve injuries include medication, massage therapy, orthotics, physical therapy and acupuncture. Studies showed that acupuncture has significantly better effect for nerve injuries than those without acupuncture treatment. Acupuncture provided immediate symptom relief for patients with peripheral nerve injuries. Acupuncture has effect to reduce pain sensation. Acupuncture also improves motor nerve recovery. In addition acupuncture improves nerve conduction over the period of treatment and has been shown effective for nerve repair. This indicates that acupuncture may help nerves regeneration. Acupuncture is a promising approach for nonsurgical treatment of peripheral nerve injuries.

Acupuncture helps with peripheral neuropathy

Peripheral neuropathy is a condition affecting nerves causing impaired sensation, movement, or other organ dysfunction. There are many factors causing the condition, such as diabetes, vitamin deficiency, medication, injury or infection etc. If the cause is unknown, this is called idiopathic neuropathy. The symptoms depend on which nerves are affected. For example, if motor nerves are affected, it could present painful cramps, muscle twitching, muscle weekness, muscle loss, bone degeneration, impaired balance and coordination. If sensory nerves are affected, it may present numbness, loss of sensation, poor balance and coordination, tingling, burning pain etc. If autonomic nerves are affected, it may present poor bladder control, abnormal blood pressure and heart rate, sweat changes abnormally.

Acupuncture can help with peripheral neuropathy, by improving blood supply to the nerves, reducing inflammation and increasing nerve conductivity.

Acupuncture helps motor nerve injury recovering

Recent research from China reported the effectiveness of acupuncture for peripheral nerve injury. Xiao GR et al did a control trial study which investigated and compared the effects of acupuncture on peripheral nerve injury with that of function training and no treatment. They recruited 90 patients and allocated them into three groups: acupuncture group, function training group and control group with each group of 30 patients. After three months of treatments basic function, practical function, EMG, nerve conduction velocity were compared among the 3 groups. They found that the acupuncture group achieved the best recovery; the function training group is the second. They suggested that acupuncture plus function training can accelerate nerve repair, promote functional recovery of the muscles.

Another case report was from Millea PJ in Medical College of Wisconsin USA. A 41-year old female with a 1 week history of inability to write or extend the right wrist received 1 session of acupuncture treatment. Wrist motion returned strait away after the treatment. After acupuncture treatment wrist splint was then used. On the same day, the patient reported increasing strength in wrist and finger extension. On the next day, the patient cancelled the second session of acupuncture treatment, because of her hand recovered. 4 month followup found all wrist and finger extension, sensation and return of the brachioradialis reflex were normal. 1 year followup showed fully recovery to normal. Acupuncture potentially facilitates recovery and may accelerate peripheral motor nerve injury recovery. Although evidence that acupuncture is effective for any type of motor nerve injury is limited to case reports and case series, these findings are beneficial.

Common peroneal nerve palsy, acupuncture can help.

Common peroneal nerve palsy is damage to the peroneal nerve which is a branch of the sciatic nerve and supplies movement and sensation to the lower leg, foot and toes. Common peroneal nerve palsy is a type of peripheral neuropathy. This condition can affect people of any age. The peroneal nerve palsy leads to loss of movement or sensation in the foot and leg. There is a loss of feeling, muscle control, muscle tone, and eventual loss of muscle mass because the nerves aren't stimulating the muscles.

The causes include Trauma or injury to the knee, fracture of the fibula (a bone of the lower leg), use of a tight plaster cast (or other long-term constriction) of the lower leg, crossing the legs regularly, regularly wearing high boots, pressure to the knee from positions during deep sleep injury during knee surgery or from being placed in an awkward position during anesthesia, or unknown reasons. People who have diabetes or exposed certain toxins are in high risk.

The symptoms include decreased sensation, numbness, or tingling in the top of the foot or outer part of the upper or lower leg, foot drops, walking problems including slapping gait and toes drag while walking, weakness of the ankles or feet. Examination shows Loss of muscle control in the lower legs and feet, atrophy of the foot or leg muscles, difficulty lifting up the foot and toes and making toe out movements. Nerve conduction tests show reduced conduction velocity.

Treatments including surgery, physiotherapy etc are aimed for improving mobility and independence. Acupuncture helps improve recovery of peroneal nerve function and increase nerve conductivity. Acupuncture can also reduce pain caused to nerve injury.

References
Chen YL Journal of Chinese integrative medicine (2009), 7:273
Ji XQ Zhen ci yan jiu (2010), 35; 443-7
Tong Y J Acupunct Meridian Stud. (2010) 3:95-103.
Millea PJ J Altern Complement Med (2005) 11: 167-9
King JC. Peroneal neuropathy. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal disorders, pain and rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 66.
Yao ZH et al J Tradit Chin Med (1984) 4:97-100
Xiao GR et al Zhongguo Zhen Jiu (2007) 27:329-32
Garrow AP et al Acupunct Med (2014) Mar 21. doi: 10.1136/acupmed-2013-010495

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