I am very tired. It is not a rare complaint. Everyone must ever feel tired sometimes, but the tiredness would go away after rest or sleep. If it does not go away, it is a problem. Constant fatigue is the main symptom of chronic fatigue syndrome (CFS). CFS refers to severe exhaustion during and after daily activities or to a lack of energy which is prolonged for 6 or more months and resting and sleeping cannot make fatigue go. CFS affects about 1 in 300 people in the UK. It is about three times as common in women as in men. Most common age group developing CFS is 20-45 and it occurs more in women than in men. Apart from constant fatigue feeling, there are also other symptoms associated with severe fatigue, such as muscle and joint pain, headache, insomnia and poor short term memory etc.
The cause is not clear but there are a few theories including: a viral infection, immune system problems, neuroendocrine dysfunction causing hormones imbalance and psychiatric problems, such as stress and emotional trauma, various inflammatory conditions, central nervous system impairments, and stress. Recently a reduced blood flow in some brain region is found. Some biochemical changes were found in the brain. The purpose of the treatment is to improve the symptoms. Treatments include cognitive behavioural therapy, a structured exercise programme called graded exercise therapy, medication to control pain, nausea and sleeping problems. Acupuncture helps improves symptoms such as reducing pain, stress and improving sleep. This will help improve quality of life in patients with CFS.
Effectiveness of acupuncture on chronic fatigue syndrome
There is no known cure for this condition although treatment may help to ease symptoms. Recently much research has been done to show acupuncture is helpful for chronic fatigue syndrome. For example, one study compared the effects of acupuncture, warm needle and non acupoint groups. They have shown that in comparison with pre-treatment, the scores of Chalder Fatigue Scale including physical and mental fatigue and total score were significantly decreased in both acupuncture and warm-needling groups but not in the non-acupoint group. The physical, mental and total scores of the acupuncture and warm-needling groups were significantly lower than those of the non-acupoint group. Another study compared the effect of acupuncture and prednisone. They have shown that after one course of treatment, the BELL's scores of both groups were obviously improved, but there was no significant difference between groups; after two courses of treatment, the BELL's score in acupunctureand cupping group improved more obviously than that in Prednisone group, and the total effective rate of 91.9% (34/37) in acupuncture and cupping group was superior to that of 71.4% (25/35) in Prednisone group. There was a study compared the effect of acupuncture on chronic fatigue syndrome with herb injection. They found that acupuncture had better effect than herb injected on fatigue scores and symptoms improved.
Recently Zhang W et al studied the effect of acupuncture of Back-shu acupoints in patients with CFS. This was a randomised controlled trial involved in 120 patients with CFS. These patients were equally divided into two groups: acupuncture group and control group. General health was measured and fatigue was measured using Chalder fatigue scale. At the end of the treatment and follow up survey at 4 weeks and 3 months after the treatment, mental and physical function, pain sensation as well as Chalder fatigue scale was improved significantly in acupuncture group compared with those control group. They concluded that acupuncture is effective on chronic fatigue syndrome both on immediate and mid- term basis.
Ng SM &Yiu YM studied the effect of acupuncture on chronic fatigue syndrome (CFS). The participants were 99 patients with chronic fatigue syndrome. This study was well designed with randomized, controlled and single blinded methods. These participants were divided into two groups: acupuncture group and control group with sham acupuncture. The interventions were given twice a week for 4 weeks. They found that physical and mental fatigue was significantly decreased after the treatments. Health related quality of life was improved significantly. Surprisingly there was therapeutic effect with sham acupuncture which was considered due to pressure on the acupuncture points from the sham needles in addition to normal placebo effects. However acupuncture has significantly greater effects than that for sham acupuncture.
When is the best time for acupuncture treatment for chronic fatigue syndrome?
Acupuncture is use to treat chronic fatigue syndrome effectively. In modern era, people are busy at work and they usually go to acupuncture treatment in the evening after finish a day’s work. For chronic fatigue syndrome treatment with acupuncture, is there different effect when acupuncture is received during different time of the day? Ling JY et al investigated this aspect using acupuncture in selective time 9:00 am to 11:00 am in the morning and compared the effect with acupuncture at any time apart from the selective time. 80 patients with chronic syndrome are participated the study. The results have shown that the improvements in the scores of the selective-time-acupuncture group were superior to the anytime acupuncture group. More specifically in the anytime acupuncture group, the total score of fatigue and the score of physical fatigue were reduced after treatment as compared with those before treatment. In the selective-time -acupuncture group, the total score of fatigue, the score of physical fatigue and the score of mental fatigue after treatment were reduced obviously as compared with those before treatment. The ratio of CD3+ and CD8+ T cells was increased obviously after treatment in both groups and the ratio of CD4+ and CD8+ T cells was reduced obviously in the selective-time-acupuncture group, which was better than that in the anytime acupuncture group. The total effective rate was 95.0% (38/40) in the selective-time-acupuncture group, which was better than 80.0% (32/40) in the anytime acupuncture group. They concluded that the acupuncture therapy at selective time is effective in the treatment of chronic fatigue syndrome, which is especially better at relieving mental fatigue. The effect of this therapy is achieved probably by improving the immune function via the regulation of the ratios among CD3+, CD4+ and CD8+ T cells.
Recently a clinical trial studied the effect of acupuncture on CFS. The Fatigue Severity Scale (FSS) score, the Stress Response Inventory (SRI), the Beck Depression Inventory (BDI) and the Numeric Rating Scale (NRS) were used to assess the effect. After 5 weeks of acupuncture treatment, FSS score, SRI and NRS were significantly lower in the treatment group compared to the control group. After 13 weeks of treatment BDI score was significantly lower in acupuncture group. Body acupuncture in addition to usual care may help improve fatigue in CFS patients.
Ling JY et al Zhongguo Zhen Jiu (2013) 33:1061-4
Zhang W et al Zhen Ci Yan Jiu (2011) 36:437-41
Ng SM & Yiu YM Altern Ter Health Med 2013 19:21-6
Couilliot MF et al J Integr Med (2013) 11:26-31
Lu C et al Zhen Ci Yan Jiu (2014) 39:313-317
Kim JE et al Trials (2015)16:314
Welcome to my blog, discover acupuncture with Dr Maggie Ju
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.
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