Acupuncture for orofacial pain

Orofacial pain or facial pain described as an ache in the front part of the head (including the oral cavity) is a common presentation in primary care. Nearly a quarter of patients in a British primary care study (2504 adult patients) reported orofacial pain. The pain may be musculoskeletal, dental, neural, or sinogenic in origin.

Acupuncture releases orofacial pain effectively. This is recognised by dentists. UCLA School of Dentistry is offering a unique, evidence-based program to train dentists in the basics of acupuncture and Traditional Chinese Medicine (TCM) theory. By combining TCM principles with Western allopathic Medicine modalities, participants will feel comfortable diagnosing and understanding the pathophysiology of both acute and chronic oral pain conditions from an integrative East-West perspective. Moreover, graduates will learn basic acupuncture treatments that can be safely delivered to patients.

If you see dentists for toothaches or facial pain, you may get acupuncture treatment.

References

https://www.bmj.com/content/361/bmj.k1517

https://www.dentistry.ucla.edu/learning/acupuncture-integrative-oral-medicine

Maternity acupuncture in the UK, what do you know about it?

Women are seeking acupuncture treatments for a variety of women's health–related conditions. A European Union (EU)/China survey from acupuncturists indicated that 41% of EU respondents commonly treated obstetric/gynecologic issues, of which half of them from the UK. Another U.K. survey of acupuncturists reported that fertility acupuncture is 15% of their treatments. Maternity acupuncture is also popular. In pregnancy, the most-common conditions were nausea and vomiting, lower-back or pelvic-girdle pain (LBPGP), and labor preparation and induction. Acupuncture during pregnancy and labor has been evaluated as safe when used by a suitably qualified practitioner, and a growing willingness to refer for pregnancy-related acupuncture has been reported from Western health practitioners.

The majority of acupuncturists in countries, such as the United States, the United Kingdom, Australia, and New Zealand, offer maternity treatment through private clinics. In contrast, the majority of maternity acupuncture care in European countries—such as Denmark, Finland, Germany, Norway, Sweden, and Switzerland—is administered by hospital midwives who take short training courses.

A recent survey from the UK shows that the most-common maternity situations encountered were: birth preparation [96.5%]; nausea & vomiting [94.2%]; and inducing labor [90.8%]. More than 50% of the practitioners were also treating lower-back and pelvic pain [88.5%], breech presentations [85.0%], threatened miscarriages [63.2%], and headaches/migraines [52.8%]. Only a minority (8 [9.1%]) attended births. A greater number of referrals were received from medical health professionals for pregnancy [65.8%] than for fertility [19.5%] or menstrual conditions [9.7%].

References
Debra Betts, Med Acupunct. 2019 Oct 1; 31(5): 274–280.

Acupuncture can help with dental pain

Acute dental pain is the main reason for seeking dental services. Have you tried acupuncture for reduce your dental pain? There is a study aimed to evaluate the use of acupuncture in reducing the intensity of acute dental pain in pre-dental care in patients waiting for emergency dental care, and was conducted at the After-Hours Emergency Dental Clinic of Piracicaba Dental School, and at the Emergency Center Dental Specialties I in Piracicaba, São Paulo, Brazil. 120 patients participated the study. The Visual Analog Scale (VAS) was used to measure pain intensity. All patients underwent one session of acupuncture. Reduction in pain was observed in all120 patients. The results of this study indicate that acupuncture analgesia could be a technical adjunct to pain control in patients with acute dental pain, contributing to the restoration of health with social benefit. It is worth trying acupuncture for your dental pain.

References

Grillo CM J Acupunct Meridian Stud. 2014 Apr;7(2):65-70. doi: 10.1016/j.jams.2013.03.005. Epub 2013 Apr 11.

Referred pain makes acupuncture points sensitized and tender.

Referred pain is the pain felt in somewhere in the body other than in the site of origin. Pain referral has a neural basis. Specific pathways and neural connections in the brain are thought to lead to the possibility of pain referral.

One group of nerve fibres conduct information about touch and another group conduct information about tissue damage or noxious stimulation via different sensory nerves. Many sensory fibres from different parts of the different area can terminate on the same set of second order neurons. The second order neurones are part of the pathway that sends sensory information to higher centres for perception. However, since there is so much convergence of sensory information from different body parts onto the same second order neurones, these second order neurones may provide ambiguous information as to the exact location of the noxious stimulus. This neural mechanism is thought to be one way whereby the higher centres of the brain can become "confused" as to the exact location of the noxious stimulus.

Another explanation of pain referral is the activating of silent or latent synaptic connections. When there is prolonged and/or intense noxious stimulation, some of these ineffective synapses may become effective connections. The information is transmitted from other parts unrelated to the source of the pain. The brain therefore can become confused as to the correct location of the pain.

Recent research has investigated correlation between referred pain distribution and acupoint sensitization in patients with intestinal diseases. In clinical research, 443 patients from 8 hospitals were recruited, including the outpatients and inpatients of Crohn's disease, ulcerative colitis, chronic appendicitis and other intestinal diseases. The site with tenderness on the body surface and the morphological changes of local skin were observed and recorded in the patients. Using a sensory tenderness instrument, the pain threshold at the sensitization point was measured in 60 patients with ulcerative colitis. The referred pain on the body surface in the patients with intestinal diseases was mainly located in the lower abdomen, the lumbar region and the lower legs. The diameter of tenderness region was 1.5 to 2.5 cm. Compared with the region without sensitization, the pain threshold of the sensitization point in the patients with ulcerative colitis was reduced significantly. The referred pain on the body surface in the patients with appendicitis was located in the right lower abdomen, the waist and back and the right lower limbs on the medial side. The tenderness region was 1 to 2 cm in diameter and was irregular in form. Intestinal diseases induce referred pain on the body surface where is the same as or adjacent to the location of the spinal segment corresponding to the affected intestinal section. These sensitization regions are related to the locations of acupoints.

References
Cui X et al Zhongguo Zhen Jiu 2019 Nov 12;39(11):1193-8. doi: 10.13703/j.0255-2930.2019.11.016.

Acupuncture for miscarriage

Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management.

A study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage. The result has shown that for women receiving acupuncture there was a statically significant reduction with threatened miscarriage symptoms including bleeding, cramping and back pain compared with the control. They conclude that acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention. Further research is required to further explore acupuncture use for this common complication and whether it can reduce the incidence of miscarriage.

References

Betts D et al BMC Pregnancy Childbirth. 2016 Oct 7;16(1):298.

Suffer from depression? Acupuncture can help

Depression is commonly treated with anti-depressant medication and/or psychological interventions. Patients with depression are common users of complementary therapies, such as acupuncture, either as a replacement for, or adjunct to, their conventional treatments.

Current models of depression suggest that changes in the hypothalamic–pituitary–adrenal (HPA) axis, dysfunction among stress hormones, and imbalance in neurotransmitters, such as noradrenaline, serotonin, and dopamine, may be key factors in the onset and maintenance of major depressive disorder. Results from animal experiments suggest a multitarget antidepressant effect of acupuncture, which may be related to amino acid metabolism and inflammatory pathways, especially the Toll-like receptor signaling pathway, tumor necrosis factor (TNF) signaling pathway, and nuclear factor kappa light chain enhancer of activated B cells (NF-kappa B) signaling pathway. In addition, similar to antidepressant medications, acupuncture is capable of affecting the neurotransmitter levels of serotonin and noradrenaline, along with the adenylate cyclase cyclic adenosine monophosphate-protein kinase A (AC-cAMPPKA) cascade within the central nervous system.

A recent review and meta-analysis examined the effectiveness of acupuncture in major depressive disorder. This review analysed 29 studies with 2268 participants and found that acupuncture showed clinically significant reductions in the severity of depression compared to usual care. There is a link between numbers of acupuncture treatments and the reduction of depression: more treatments, the more reduction in the severity of depression.

References

Armour M et al J Clin Med. 2019 Jul 31;8(8). pii: E1140. doi: 10.3390/jcm8081140.

Acupuncture for Depression: A Systematic Review and Meta-Analysis.