Release neck pain with acupuncture, supported by research evidence.

Neck pain is a common condition. Neck pain has a wide differential diagnosis, but most cases seen are musculoskeletal in nature. Neck muscles can be strained from poor posture. It is strongly linked to office and computer work. Most of the cases are muscular. Osteoarthritis also is a common cause of neck pain. The symptoms of neck pain include pain at the neck that is worse when you hold the head in one position for long periods of time. It is accompanied with muscle tightness and spasms, and reduced mobility of the head and neck. If the pain spread out up to the head and down to the arm, it can be associated with headaches and arm and forearm pain. 

Neck pain can be classified into acute or chronic pain. Acute neck pain is pain that last for weeks to months, but the pain goes after this short period of time. Chronic neck pain is pain that last longer than 3 - 6 months.  About 50% - 85% of patients with acute neck pain will go on to develop chronic neck pain.  The causes of neck pain include muscle strains, worn joints, nerve compression, injuries and diseases such as arthritis etc. ​

Much research has shown that acupuncture has both immediate and long-lasting effect on neck pain. For example, a large sample size German study with more than 14,000 participants evaluated adding acupuncture to usual care for neck pain. They found that participants reported greater pain relief than those who didn’t receive it. 

A recent research paper studied the research trends on acupuncture for neck pain treatment. Publications related to acupuncture for neck pain treatment from 2000 to 2020.

They Analysed 325 articles and the result has shown that the total number of publications has steadily increased over the last 20 years indicating that acupuncture is becoming more popular among researchers, clinicians, and patients. The top five countries researching on this topic is the US, China, England, the Republic of Korea, and Germany.

Amnon A. Berger et al reviewed neck pain background, acupuncture and the evidence that exist to support acupuncture use in chronic neck pain. They found that clinical trials studying acupuncture for neck pain have shown significant reduction in both pain and associated symptoms. Acupuncture is effective in alleviating pain both immediately after treatment, as well as provide long-lasting relief. These treatments are generally safe and inexpensive and should be considered as part of a multimodal approach for the treatment of neck pain. 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520472/

Amnon A. Berger et al Anesth Pain Med. 2021 Apr; 11(2): e113627.

 

Neck pain is not only affecting your neck, but also affecting your brain.

Pain related brain functional connectivity is altered in neck pain patients. Research shows that after acupuncture treatment, significant improvement in neck functional ability and reduced neck pain and acupuncture treatment reduced the intensity and frequency of muscle pain, and the degree of headaches related to neck pain. After acupuncture treatment, brain functional connectivity was improved significantly compared to that before treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8981480/

Does acid reflex need to be treated?

Gastro-oesophageal reflux disease (GORD) or acid reflux disease is a common condition, where acid produced by the stomach leaks up into the oesophagus. At the entrance to the stomach, there is a lower oesophageal sphincter which is a ring muscle that closes the stomach as soon as food passes through into the stomach. If this sphincter becomes loos or opens too often the acid produced in the stomach and go back up to the oesophagus causing acid reflux disease. The symptoms mainly include heart burn and sore throat. Heart burn is a burning sensation in the chest just below the breastbone and it sometimes can spread to the throat. The burning sensation is worse after eating, or lying down or bending over. Sore throat is that acid produced in the stomach is brought back up into the throat and mouth which make you constantly clear the throat (persistent coughing) and sour taste at the throat or at the back of the mouth. Other symptoms include bad breath, bloating, feeling sick, pain when swallowing, difficulty swallowing, tooth decay and gum disease. Certain food and drinks can make acid reflux worse such as citrus, tomato, chocolate, mint, garlic, onions and spicy or fatty foods; alcohol, carbonated drinks, coffee or tea etc. There are some complications with acid reflux such as oesophageal ulcers, scarred and narrow oesophagus, barrett’s oesophagus and oesophageal cancer.

Do you know acupuncture can help reducing acid reflux?

Recently much research has been done to investigate the effectiveness of acupuncture on acid reflux. For example, a study compared the effect of acupuncture with that of Omeprazole capsules. They showed that the effect of acupuncture is much superior to this medication to improve acid reflux symptoms. Another study has shown that acupuncture improved functional state of esophagus, neurohumoral regulation of lower esophageal sphincter, decrease of acid producing function of stomach. A review analyzed current status of acupuncture on acid reflux. They suggested that acupuncture inhibits acid production, increases gastric and oesophageal motility, improves esophageal peristalsis, limits lower esophageal sphincter relaxation and decreases pain perception.

References

Gao &Bai (2016) Zhen Ci yan Jiu 41:150-3

Efendieva (2013) Eksp Klin Gastroenterol 5:49-52

Patrick (2011) Altern Med Rev 16:116-33

Had miscarriages? Do you know that acupuncture can help recovery?

What is miscarriage?

A miscarriage is the spontaneous loss of a pregnancy before the 20th week. About 10 to 20 percent of known pregnancies end in miscarriage. An early miscarriage is the loss of pregnancy at ≤13 weeks’ pregnancy. About one in four pregnancies, where a woman has missed a menstrual period and has a positive pregnancy test, ends in early miscarriage. 3 or more miscarriages in a row are known as recurrent miscarriages.

The impact of a miscarriage on women

Miscarriage can be a physical and emotional challenge. It can have a potentially devastating psychological impact on the woman in addition to the physical effects such as bleeding and pain after all the excitement and expectation by discovering the pregnancy. It is very common to feel sad and tearful after being shocked by the tragic event. Feeling angry, jealous or guilty is also common. There are feelings of emptiness and loneliness that others cannot understand; feeling not able to cope with daily life. There is fear of not being pregnant again or having another loss. Research study has shown that one month after pregnancy loss, nearly a third of women suffered post-traumatic stress while one in four experienced moderate to severe anxiety, and one in ten had moderate to severe depression; after nine months, nearly 1 in 5 women had post-traumatic stress; moderate to severe anxiety, and 1 in 20 had moderate to severe depression. One in six women experience long-term post-traumatic stress following miscarriage or ectopic pregnancy. (https://www.imperial.ac.uk/news/194715/miscarriage-ectopic-pregnancy-trigger-long-term-post-traumatic/).

Most women will have a healthy pregnancy after a miscarriage. About 20% of women who have had a miscarriage have another miscarriage the next time they become pregnant. Some of them have difficulty to get pregnant again.

After miscarriage, the women’s body need to recover physically and in particular emotionally. Physical recovery can take a couple of months to get hormones rebalanced, get rid of the inflammation from the miscarriage and get the period started. Emotional recovery can take much longer.

Will acupuncture help with a miscarriage recovery?

Acupuncture can be very useful in the recovery from a miscarriage physically and emotionally.

Acupuncture helps to rebalance hormones; improves ovarian and uterine blood flow to get good quality of eggs and good uterine linings and receptivity. Acupuncture reduces inflammation and stress and anxiety to get one ready to get pregnant again physically. More importantly acupuncture can help release stress, anxiety and emotions and help recovery emotionally to be ready to get pregnant psychologically. Acupuncture can help regulate brain region where controlling emotions such as amygdala and nervous system and balance chemicals which plays a vital role in emotional processing to help mental and emotional release.

If women have difficulty to conceive after miscarriage, acupuncture can help to get pregnant faster.

What does research say about acupuncture for miscarriages

Acupuncture can be helpful to prevent from miscarriages. A study found that there was a significant reduction with threatened miscarriage symptoms including bleeding, cramping and back pain for women receiving acupuncture compared with the control. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055689/).

Is acupuncture effective in improving pain relief for low back pain? What do medical doctors say about it?

Acupuncture is an effective treatment for relief from low back pain, even when compared with other interventions (sham acupuncture, usual care, or no treatment), with stronger effects observed immediately after treatment. Clinically significant reduction in pain is more reliably observed in chronic rather than acute low back pain (strength of recommendation: A, based on systematic review and meta-analysis of randomized controlled trials [RCTs]).

The American College of Physicians issued a clinical practice guideline recommending acupuncture as a first-line therapy for acute and chronic nonradicular low back pain along with other nondrug therapy including stretching, heat application, massage, and manual spinal manipulation.5 The National Institutes of Health’s National Center for Complementary and Integrative Health considers acupuncture to be a safe treatment when done by trained acupuncturists using sterile needles.

Research evidence from systematic reviews

Systematic review and meta-analysis involved in 6656 participants comparing acupuncture with other treatments (sham acupuncture, no treatment, transcutaneous electrical nerve stimulation, medications, usual care) found that acupuncture was clinically superior to sham acupuncture in pain reduction for patients with chronic low back pain (CLBP) immediately after and up to 3 months following treatment. Further, acupuncture provided more pain relief in CLBP compared with no treatment and usual care, which typically consisted of nonacupuncture care like physical therapy, massage, and medication.

Systematic reviews involved in 11 682 participants comparing acupuncture with sham acupuncture, no treatment, or acupuncture plus conventional treatment, which included physical therapy, exercise, and medication, revealed inconsistent evidence of benefit in acute low back pain. Acupuncture was consistently found to provide superior pain relief for CLBP lasting greater than 3 months in the short term.

Systematic reviews involved in 7958 participants analysed acupuncture versus sham acupuncture for chronic low back pain and found that acupuncture significantly reduced pain intensity immediately and 12 weeks after treatment. Compared with medications (nonsteroidal anti-inflammatory drugs, muscle relaxants, or analgesics), acupuncture provided greater pain relief and improved function.

Neuroimaging Studies of Acupuncture on Low Back Pain suggested that improving abnormal structure and functional activities in the brain of the LBP patient is an important mechanism of acupuncture treatment for LBP. The brain regions involved in acupuncture analgesia for LBP were mainly located in the pain matrix, default mode network (DMN), salience network (SN), and descending pain modulatory system (DPMS).

References

Roselyn Clemente Fuentes et al Can Fam Physician. 2020 Mar; 66(3): 186–187.

Qiao Wen et al Front Neurosci. 2021; 15: 730322.

Skin blood flow decreased with aging, acupuncture improves blood flow and slows down skin aging.

Skin blood flow significantly decreased with increase in age. Skin blood flow is 40% less at age 65 than at age 25. This is because skin blood flow decreases with decreased pumping blood from heart; skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure; less blood is redirected to the skin from other part of the body; blood vessel movement is impaired with aging and blood vessels are not relaxed to increase the blood flow.

Acupuncture increases blood perfusion and reduces skin aging

Acupuncture is used to treat many conditions in China. Its mechanism is based on meridian theory which is not accepted by Western medicine theory. Recent years researchers are trying to find how acupuncture works from a scientific aspect. Many research data suggested that acupuncture improves blood perfusion. For example, there was a study of acupuncture on 140 healthy volunteers. In this study, acupuncture was applied in LI4’ skin blood flow was measured using a Moor full-field laser perfusion imager before and after acupuncture stimulation. Recently study has shown that stimulating LI4 also increased facial blood flow and hand blood flow. After acupuncture of the right LI4 acupuncture the change ratio of mean blood flux in the left LI4 was increased significantly compared with the control group 60 minutes after acupuncture stimulation. Another study has shown that acupuncture at LI4 and LI11 increased blood circulation along the meridian. Study at ST36 point also has suggested increased skin blood perfusion around the acupuncture point in healthy subjects. In 22 healthy volunteers acupuncture at PC6 point increased microcirculation blood perfusion units along the meridian. Increased blood circulation was also seen at the back acupuncture point study. This also demonstrated in some conditions For example, in a study patients with dysmenorrhea were treated with acupuncture. After 10 sessions of acupuncture treatment, microcirculation was increased and the symptom scores, pain index, and visual analog scale decreased significantly in treatment group.



References

Tsuchida Y J Dermatol Sci (1993) 5:175-81

Guanjun W et al J Altern Complement Med (2012) 18:784-8

Huang H et al Evid Based Complement Alternat Med (2012) 2012:604590

Wang SY et al Zhen Ci Yan Jiu (2012) 37:482-7

Li X et al Evid Based Complement Alternat Med (2013) 2013:452697

Min Set al J Altern Complement Med (2014) Oct 29

Zheng SX et al BMC Complement Altern Med (2014) 14:323

An Y et al Med Devices (Auckl) (2014) 7:17-21

Xu QY et al Zhen Ci Yan Jiu (2013) 38:52-6

Huang T et al J Tradit Chin Med (2013) 33:757-60

Enlarged prostate? can acupuncture help?

Enlarged prostate, can acupuncture help?

Prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a common condition in men. It is usually not a serious threat to health, but it does affect quality of life. If the prostate becomes enlarged, it can place pressure on the bladder and urethra. It may cause difficulty starting urination, a frequent need to urinate, and difficulty fully emptying the bladder. Current treatment options for BPH include watchful waiting, lifestyle modifications, alpha blockers, 5 alpha-reductase inhibitors, phytochemicals, and BPH-related surgery. Although most of the aforementioned therapies have various degrees of documented effectiveness in the management of BPH, the use of these interventions are limited to specific patient populations or have certain side effects that interfere with patient's quality of life


Acupuncture is also used to treat BPH to improve the symptoms in china. Recent research provided evidence for the effectiveness of acupuncture on BPH. There was a study participated with 91 patients with BPH. After 4 weeks ofacupuncutre treatment, the Prostatic Symptom Score Prostatic Symptom Score (IPSS) which was used to assess BPH lowered, the maximal urinary flow rate increased, the post-voided residual urine volume decreased, the urinary symptom bother score reduced, times of holding urine in 24 h (HU) and the times of night-urinating (NU). Another study in 138 patients with BPH also showed that acupuncture were effective in improvement of IPSS cumulative score, life quality index cumulative score, nocturia times, urine stream state, hypogastrium symptom, maximal volume of urine flow, residual urine volume, prostatic volume.


References

Yang T et al Zhongguo Zhong Xi Yi Jie He Za Zhi (2008) 28:998-1000

Liu QG et al Zhongguo Zhen Jiu (2008) 28:555-9

Acupuncture improves uterine receptivity and helps embryo implantation

Acupuncture helps implantation

When an egg is fertilised by a sperm, an embryo is formed and developing. At the same time, there are also changes in the uterus to prepare the arrival of the embryo. When an embryo arrives at the uterus, it will implant into uterine wall. A successful implantation depends on the synchronous development of both the endometrium and embryo. Uterine inner lining gets thicker, uterine smooth muscles are relaxed after ovulation. There is also communication between the uterine cells and the embryo to get the best time of implantation. Delayed implantation time will lead to implantation failure or miscarriage. During the development of uterine inner lining uterine blood circulation is the key factor to get ready for implantation. After embryo implanted, the embryo initially takes nutrients and oxygen from maternal blood circulation system and removes the waste via maternal blood circulation system. Good uterine blood circulation is essential for early stage of embryo development. To improve uterine blood circulation, acupuncture is the best candidate. Since a decade ago, acupuncture was suggested that it increases uterine blood flow. This will help embryo implantation and embryo development in the uterus. 

Acupuncture improves uterine receptivity

If an egg is fertilised, it will be transported to the uterus and it will be implanted into uterine endometrium. Within the uterus, the foetus develops during pregnancy. Endometrium is the inner lining of uterus. It goes cyclic changes responding to ovarian hormone oestrogen and progesterone levels and sheds off each month with new endometrial lining replaced, if the egg is not fertilised. If pregnancy occurs, the endometrium will retain. After ovulation, the uterine endometrium becomes thicker to prepare for embryo implantation. If endometrium is not thick enough (less than 6 cm), implantation does not occur. If the thickness of endometrium is greater than 12 cm, there were three times more chances to get pregnant. To get embryo implanted, there must be a receptive uterus. Ovarian hormones oestrogen and progesterone are involved in regulating uterine receptivity. Uterine smooth muscles tend to contract especially at low progesterone level. Increased progesterone level makes uterus more relaxed. The thickness of endometrium and contractility of uterine smooth muscles are the key factors for the uterus becomes receptive.

Age and uterine receptivity

Women’s fertility is declining with advanced age which is attributed to declining of egg quality. A significant low success rate in IVF is an example. Success rate could be 48.8% for women younger than 30 years old while in comparison to 13.6% in women with 42 years old. Embryo implantation rates also decline in a linear fashion, from 29% in women younger than 34 years to approximately 5% at age 42. Apart from egg quality what other factors contribute to this change? This could be because of poor uterine receptivity in women with advanced age. This was suggested that in the case of egg donation, there was also low pregnancy rate in women with increased age.

Conditions of the uterus that affect uterine receptivity

Luteal phase deficiency (LPD) is a condition in which there is either no enough progesterone production or poor endometrial response. This is a major cause of infertility and recurrent pregnancy loss. In luteal phase defect, there is no enough progesterone produced which shows either low progesterone or too much fluctuation of progesterone levels. Or the uterine endometrium does not respond well to the progesterone stimulation because of lack of progesterone receptors or lack of cell surface adhesive proteins. There is poor endometrial development or delayed endometrial development, as a consequence, uterine receptivity is poor and the embryo loses its chance to implant.

Endometriosis

Uterine endometrial tissues grow outside of uterus. Women with endometriosis were found to have decreased fertility. Poor egg development and poor egg quality, impaired fertilization lower the embryo ability to implant. Also failing to respond to progesterone well makes their uterine endometrium less receptive.  

Hydrosalpinx

Hydrosalpinx is distally blocked, dilated, fluid-filled fallopian tube caused by infectious diseases. Women with haydrosalpinx have difficulty to get pregnant. Tube blockage is not the only factor that is contributed to the cause. Women with hydrosalpinx have lower implantation, pregnancy and delivery rates and a higher incidence of spontaneous miscarriage after IVF–embryo transfer compared with women with tubal infertility of other causes. The inflammation of the tubes could spread to the uterus and make inflammatory environment in the uterus.

Uterine fibroids

Uterine fibroids are the most common uterine benign tumours in women of reproductive age. They can distort the uterine cavity or obstruct the fallopian tubes or cervical canal affecting women’s fertility. They may also change uterine receptivity and cause infertility.

Endometrial polyp

Endometrial polyps are benign, localized overgrowths of endometrium. It may affect infertility by mechanically disrupting the transport of sperm and embryo and making endometrium not responding to progesterone.

Polycystic ovarian syndrome (PCOS)

PCOS is a common endocrinological disorder in women of reproductive age. Infertility associated with PCOS is mainly because there is no ovulation or less frequent ovulation. When ovulation was introduced by drugs in women with PCOS, implantation rates are lower than fertile controls and early pregnancy loss rates are increased which suggested that implantation failure is also contributing to the causes. The hormone imbalance in women with PCOS makes the endometrium less receptive.

Endometritis

Chronic endometritis causes prolonger inflammation in endometrium and affects endometrial receptivity which is associated with infertility and implantation failure.

Acupuncture can help uterine receptivity by regulating hormone balance, increasing uterine blood flow and relaxing the uterine smooth muscles. Whether you like to get pregnant naturally or via IVF, acupuncture can help your uterine receptivity to increase your chance to get pregnant and stay in pregnancy.

 

 

Skin loose, tightening the skin with acupuncture.

Acupuncture improves collagen production and resumes younger looking skin.

How the skin looking, young or old depends on the nature and organization of dermal collagen and the elastic fibers network. The collagens give the mechanical strength of the skin, whereas the elastic fibers are responsible for elasticity to the skin. They give skin elasticity and provide firm skin so that skin can bounce back when stretched.

The patterns of collagen organisation depend on the collagen types and other characteristics such as fiber length, fiber volume fraction and collagen molecular stretching, as well as the tilt angle of collagens determining its orientation. These change with age, becoming denser and begin to disorganise and contribute to the appearance of wrinkles and sagging skin. Both elastin and collagen production decline as people age. These two proteins can also become deteriorated by external factors over time, such as: UV exposure, smoking, pollutants in the environment, excess alcohol, poor nutrition etc. Not taking care of your skin or health can speed up the process of skin aging. This can make your skin look saggy and wrinkled at a younger age. Saggy skin, on both the face and body, is also associated with the loss of fat.

Saggy skin can happen almost anywhere on the body. Common areas include eyelids, jaw, chin, throat, upper arms and stomach.

Acupuncture improves collagen and elastin production resulting in younger looking skin. This is proved by recent research study. In this study, 52 patients were participated. The result was assessed by an independent dermatologist. The result shows that skin laxity and tone had markedly improved in all patients resulting in a younger, fresher, healthier and brighter appearance of the patients' skin. Moreover, a reduction of wrinkles and fine lines was observed, as well as an increase in skin collagen and elasticity, with the skin looking more plumed and naturally ‘lifted’ without the aid of foreign substances that can sometimes alter facial features.

The laboratory analysed samples from a biopsy pre- and post-treatment and found that both the macroscopic, as well as histological characteristics of the skin were significantly improved. Trichrome staining demonstrated a more compact dermis, with a healthy matrix network Specifically, the collagen fibers were larger and thicker with a more ordered alignment of fibers of the treated skin as compared to the pre-treatment condition.This finding was also confirmed by electron microscopy which demonstrated an increased dermis thickness compared with the pre-treatment condition. collagen the fibers were disorganized and of poorer quality before treatment and were better organized, good quality fibers of a more ordered alignment after the treatment.

References
Maria Sifaki et al Exp Ther Med. 2020 Jan; 19(1): 717–721.

Having thyroid problems? tried acupuncture?

Thyroid gland is located at the neck below the thyroid cartilage. It produces thyroid hormones including triiodothyronine (T3) and thyroxine (tetraiodothyronine, T4). These hormones regulate the metabolism rate of the body and affect growth and function of other part of the body. These hormones are important to maintain normal reproductive function. It has been extensively agreed that there are significant associations between thyroid disorders and abnormalities of the reproductive system; both hyperthyroidism and hypothyroidism in males and females affect reproductive function.

Changes of the thyroid function can lead to infertility both in male and female. In male, hyperthyroidism is associated with low sperm count and low sperm motility. Erectile function is also affected by thyroid function. These factors may contribute to male infertility. Restore of thyroid function after treatment results in sperm count increased and sperm motility improved. Erectile function is also improved after treatment. Hypothyroidism may cause testicular pathology, low testosterone levels and sperm abnormality.

Thyroid dysfunction and autoimmunity are common among women in reproductive age. In women with hyperthyroidism blood hormone levels including testosterone, adrostenedione, oestrogen (E2), luteinizing hormone (LH) and follicle stimulating hormone (FSH) are increased. Abnormal period is noted in women with hyperthyroidism. Absence of period is very common. Reduced infertility is found in women with hyperthyroidism. Likewise hormonal changes and period cycle disturbances are also present in women with hypothyroidism.

The prevalence of thyroid dysfunction during pregnancy is about 2-3% and is mainly caused by chronic autoimmune thyroiditis. Thyroid auto-antibodies are found in 5-15% of women in reproductive age with or without thyroid dysfunction. Either thyroid dysfunction or thyroid autoimmunity is associated with negative pregnancy outcomes during pregnancy. Emmyvan den Boogaard et al conducted a systematic review on the clinical significance of thyroid dysfunction and thyroid autoimmunity prior to conception and in early pregnancy. They found that subclinical hypothyroidism (with high Thyroid stimulating hormone-TSH and normal free T4) in early pregnancy was associated with hypertension in pregnancy and perinatal mortality. Presence of thyroid antibodies was associated with an increased risk of unexplained subfertility, miscarriage, recurrent miscarriage, preterm birth and maternal post-partum thyroiditis.

More recently acupuncture was reported in regulating thyroid function and treating thyroid function disorders. There was a report of effectiveness of acupuncture on hyperthyroidism. This was involved in 125 patients. After acupuncture treatment symptoms were controlled completely in 71 patients which were 56.8%. Other 41 patient’s symptoms were partly controlled.  Recent study by Lyzina KE et al investigated the effect of acupuncture in 27 female patients with subclinical hypothyroidism. The treatment period was 3-4 month. They found that after the treatment, the initial clinical symptoms decreased significantly; TSH level decreased to normal range; the quality of life was improved. They concluded that acupuncture may be an alternative therapy for patients with subclinical hypothyroidism.

Acupuncture is used to treat hyperthyroidism as an adjunct therapy

Hyperthyroidism or overactive thyroid is a common hormonal condition in which too much thyroid hormone is produced in the thyroid gland. Excessive thyroid hormones can speed up metabolism causing a series symptoms. These include that anxiety, irritability and nervousness, insomnia, fatigue, muscle weakness, sensitive to heat, excessive sweating, weight loss, frequent passing stolls and urination, light periods or infrequent periods or missing periods, infertility. Physical signs include that enlarged thyroid gland, fast heart beat, tremor, warm skin, redness on the palms of the hands, hives, hair loss twitching in the face and limbs. Blood tests show that low level of thyroid-stimulating hormone (TSH) and high level of thyroxine and triiodothyronine (the thyroid hormones). The most common used medication is thionamides, such as carbimazole and propylthiouracil. In China, acupuncture is used as adjunct therapy together with these medications to increase the effect of medications and reduce the side effect of medications. As early as 1934 acupuncture was reported to treat thyperthyroidism. In 1970s, there were more researches on this subject.  Now many researches were done and provided the evidence that acupuncture improves metabolism, improves symptoms, reduces side effect of the medications and reduces recurrence rate. For example, there was a report with 125 cases of hyperthyroidism. After acupuncture treatment, the symptoms were controlled in 71 cases, improved in 41 cases, no effect in 13 cases. More recently a research studied the therapeutic effect and side effect of treatment on hyperthyroid exophthalmos with the combination of acupuncture and medication. Fifty-two cases were randomly divided into an acupuncture and medication group (27 cases) and a medication group (25 cases). Acupuncture in combination of oral taking of Thiamazole and Euthyrox were adopted for the acupuncture and medication group. And acupoints such as Jingming (BL 1), Chengqi (ST 1) and Sizhukong (TE 23) etc. were selected. Western medication for oral taking was applied as the only treatment for the medication group. The results have shown that the improvement of the objective marks of eye syndrome in the acupuncture and medication group was better than that in the medication group.  There were 4 cases with hypoleucocytosis, 3 cases with rash and 3 cases with aggravated symptom of exophthalmos in the medication group during the treatment, while no case with side effects was observed in the acupuncture and medication group.

References

Emmyvan den Boogaard et al Human Reproduction Update (2011) 17:605-619

Vopr Kurortol Fizioter Lech Fiz Kult (2011) 5:29-33

http://www.pharmnet.com.cn/tcm/zjdq/zjzl/100091.html

Xia Y et al Zhongguo Zhen Jiu (2010) 30:806-9

 

 

Do you know that acupuncture is effective for diabetic and idiopathic 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 

Absence of menstrual periods, can acupuncture help?

 Absence of menstrual periods and acupuncture treatment

Regular menstrual periods are a sign of well functioned reproductive system in women. Menstrual cycles are very important in women not only for reproduction but also for general health. If a woman’s periods are missing, this could cause infertility as well as some other health problems such as cardiovascular problems and osteoporosis.

Absence of menstruation is called amenorrhea in medical field which is a condition that menstrual periods have stopped for more than three cycles. This is not rare condition and many factors affect menstruation. If your periods are missing, If your periods disappeared for some time, you need to get it checked with your doctor and you need to rule out of pregnancy and menopause depending on your age. If you are not pregnant and you don’t have periods, it is most likely that your ovary is not working.

Common conditions that could cause absent periods are those affecting hypothalamus, pituitary gland, ovarian axis. These cause hormonal level changes responsible for reproductive function. For example, extreme weight loss, emotional or physical stress, high intensive exercise and severe illness could affect the hypothalamus and cause absent periods; pituitary gland conditions lead to increasing level of hormone prolactin, hypothyroidism causing missing periods; If you are under extreme stress, this could be the reason for disappeared periods. Though it has long been recognised, there are no specific diagnostic tests for this and diagnosis is usually made by exclusion. The mechanisms how psychological stress affects the women’s period cycle are still not clear. But it is widely accepted that it is linked to hypothalamic pituitary axis. In the situation of stress, corticotrophin-releasing hormone (CRH) production from hypothalamus is increased. The effects of increased CRH on the hypothalamic-pituitary axis reduce circulating luteinising hormone (LH) levels. Absence of period cycle caused by psychological stress may last from a few months to many years. Women with stress related absence of period cycle have increased basal plasma cortisol and decrease response to CRH administration. In many cases, normal periods return after the psychological problems are overcome. But in other cases, missing periods could cause new stress and help is needed to get periods return.

Ovarian conditions can also cause absence of periods, which include premature ovarian failure, polycystic ovary syndrome. It is very common that menstrual period does not return after stop taking contraceptive pills in three months. Infertility is one of the complications of absence of periods. Treatments are also depending on the causes. Correcting hormone imbalance is the target of the treatments to reestablish menstrual cycles and prevent complications.

In traditional Chinese medicine (TCM), missing periods are divided into five types according to the symptoms:

1 kidney and liver deficiency, symptoms include missing menstrual periods or light or less frequent periods, feeling week, lower back pain, dizziness, tinnitus, red tongue and week pulse.

2 qi and blood deficiency, symptoms include missing menstrual periods, dizziness, blur vision, short of breath, tiredness, pale, light tongue and week pulse.

3 yin deficiency, symptoms include missing menstrual periods, hot flashes, fever, night sweating, cough with blood, red tongue, week pulse.

4 qi and blood stasis, symptoms include missing menstrual periods, depression, feeling anger, feeling bloated, lower tummy pain, dark tongue, floating pulse.

5 dampness and phlegm blockage, obesity, cough with phlegm, swelling, excessive vaginal discharge, thick tongue coating, and slippery pulse.

Acupuncture could help correcting hormonal imbalance, reducing stress level and resuming menstrual cycles by stimulating nerve ends at particular acupuncture points and improving hypothalamus function.

There were some researches showing that effectiveness of acupuncture on resuming menstruations. Here are some examples.

There was a study with women with premature ovarian failure. 11 women had absence of periods. They received 3 month acupuncture treatments. 10 women had resumed their periods.

There was a random control clinical trials with women diagnosed with polycystic ovarian syndrome. 16 weeks of acupuncture treatment, menstruation frequency is increased.

There was a case report from China. In this report, 33 women aged from 23 -45 had absence of periods for 3 months to 3 years. They were received acupuncture treatments and 29 women out of 33 resumed their periods; 4 women did not respond to acupuncture treatments. About 63% had regular periods during the course of 6 months followup and about 24% had irregular periods during that time.

Stop taking the pills and no periods, acupuncture could help

When will your periods come back after you stop taking the pills? This is a good question. This is may vary depending on individuals. It could take a while for your periods to come back after you stop taking the pill. Most women will have a period two to four weeks after stopping the pill. It could take longer. Your periods may not be regular when you first stop the pills and this could take six months to become normal again. If your periods never come back, this may suggest a problem in your ovaries and you need to see your doctor to investigate what is wrong. Contraceptive pills suppress ovulation and follicle developments. Acupuncture could help ovarian blood flow to help restoring ovarian function when stopping the pills. Regular periods indicate that your ovaries are functioning well. If your ovaries are functioning well, your periods would come back and become regular.   

References

Zhou K Evid Based Complement Alternat Med (2013) 2013:657234

Jedel E et al Am J Physiol Endocrinol Medtab (2011) 300:E37-45   

Han Y J Trads Chin Med (2004) 24:42-43 

 

Having spotting to get pregnant, can acupuncture help?

Women have monthly menstrual cycles which start from bleeding from the vagina for a few days. A typical cycle is 28 days and period last about 5 days. The blood is red on the heaviest days and it is pink, brown on the lighter days. There should be no vaginal bleeding between the periods. Some women have light bleeding between the periods or so-called spotting. This is considered not normal. There are many causes leading to spotting. Some of them can be serious; some of the cause of spotting cannot be found. Hormone imbalance is a common cause for spotting. Estrogen and progesterone are two hormones that regulate the menstrual cycles. If these hormones are out of balance and their levels drop causing uterine lining breaking down, spotting may occur. These two hormones are produced in ovaries, this could indicate that the ovaries are not functioning properly. Thyroid gland problem could be one of the causes.

Of course, starting or stopping birth control pills can cause spotting. If you want to get pregnant, and you have spotting, this could be a problem. If you have spotting between periods, the egg quality is not good enough, because it does not produce enough hormones to sustain the uterine lining; the uterine lining is not good enough either because the lining is breaking down during spotting and it causes inflammation in the uterus. These affect fertilization and implantation. As a result, you would have difficulty to conceive or have miscarriage. Acupuncture can help regulate hormones and reduce inflammation to help to get pregnant.

For example, spotting could be caused by low progesterone level. Progesterone is produced by corpus luteum which is the remaining part of the follicle after egg is released. If corpus luteum is not high quality and it dies early, there is no enough progesterone produced which could cause spotting or short luteal phase of the period. In both circumstances, it could cause fertility problem. Corpus luteum requires large amount of blood flow to support its function. If your circulation in ovary is not good enough, corpus luteum would not function well and cannot produce enough progesterone to support endometrium which causes spotting.

Poor corpus luteum could relate to poor egg quality. This is because corpus luteum is formed by a part of follicle which contains vascular blood vesicles to supply nutrition to egg. If this part of blood circulation is poor, both egg quality and corpus luteum quality could be compromised. As a result, it may cause difficulty to conceive.

The key to solve the problem is to improve circulation in ovaries. Acupuncture could be a good candidate to treat spotting. Acupuncture stimulates nerve ending to reduce sympathetic nerve activities, this relaxes blood vesicles in ovaries and improves ovarian circulation. As a consequence, corpus luteum and egg quality are improved. This increases your chance to conceive.

Parkinson's disease with acupuncture treatment.

1 in 500 people are affected by Parkinson’s disease (PD), a condition caused by loss of nerve cells in the part of the brain. It is the second most common neurodegenerative disease after Alzheimer’s disease. These cells produce a chemical called dopamine. Because of the loss, dopamine production was reduced leading to three main symptoms of the condition, tremor, muscle stiffness and physical slow movement. Numerous nonmotor symptoms including neuropsychiatric disturbance, abnormal sensation, sleep disorders, and autonomic dysfunction are also present. Complementary and alternative medicine (CAM) plays an important part in the treatment of the condition.

Lokk J and Nilsson M studied use of CAM in patients with Parkinson’s disease at a neurological outpatient clinic Sweden. They studied the frequency, type and factors associated with the use of CAM in all patients with PD 421 in the outpatient clinic. The patients received questionnaire. 172 men and 153 women responded the questionnaire. 30% and 39% women used CAM and acupuncture usage was in the highest frequency.

Acupuncture, is used to treat PD in China. Although the therapeutic effect of acupuncture in PD is under debate, increasing evidence shows that it can alleviate motor symptoms and nonmotor symptoms, such as sleep and pain and mood disturbances and improve the quality of life in PD patients.

The effectiveness of acupuncture in treating PD was observed in research. Recently researchers used the magnetic resonance imaging (MRI) to investigate the effect of acupuncture stimulation in brain activity. They found that acupuncture stimulation in aupoint GB34 increased neural responses in regions including substantia nigra, caudate, thalamus and putamen which are the impaired regions caused by PD.

There was a study on effectiveness of acupuncture on twenty patients with PD with mean age 68 years disease duration 8.5 years. On the patient questionnaire, 85% of patients reported subjective improvement of individual symptoms including tremor, walking, handwriting, slowness, pain, sleep, depression, and anxiety. There were no adverse effects. Acupuncture therapy is safe and well tolerated in PD patients.

Recently Zeng et al have shown that acupuncture stimulation in Parkinson'smodels had generated valuable mechanistic insight of Parkinson's and showed that acupuncture treatment is a neuroprotective therapy that increase the release of various neuroprotective agents such as brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, and cyclophilin A. In addition, acupuncture therapy slows cell death process and attenuates oxidative stress to dopaminergic neurons in the substantia nigra. Further, acupuncture therapy modulates neuronal activity of the basal ganglia output structures. These results suggest that early application of acupuncture therapy to Parkinson's patients may be helpful for the best efficacy of acupuncture treatment. It is hopeful that translation of achievement in acupuncture research in Parkinson's models will maximize the potentials of acupuncture treatment.

Recently more studies were published showing that acupuncture activates brain in patients with Parkinson’s disease and patients with mild cognitive impairment. For example, magnetic resonance imaging (MRI) is a new technique that helps researcher and clinicians understand brain function. Using this technique, we can see how acupuncture stimulates the brain and alters brain function. There was a study in which brain activation in response to acupuncture in a group of 12 patients with Parkinson’s disease was compared with a group of 12 healthy participants. Acupuncture was conducted on a specific acupoint, the right GB 34 (Yanglingquan), which is a frequently used acupoint for motor function treatment. The result has shown that Acupuncture stimulation on this acupoint activates the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD. Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially visible in the left hemisphere.

Another study investigated whether acupuncture at Taixi (KI3) acupoint in elderly patients with mild cognitive impairment can activate neurons in some brain regions. Results showed that 20 brain regions were activated in participants, including the bilateral anterior cingulate gyrus (Brodmann areas [BA] 32, 24), left medial frontal cortex (BA 9, 10, 11), left cuneus (BA 19), left middle frontal gyrus (BA 11), left lingual gyrus (BA 18), right medial frontal gyrus (BA 11), bilateral inferior frontal gyrus (BA 47), left superior frontal gyrus (BA11), right cuneus (BA 19, 18), right superior temporal gyrus (BA 38), left subcallosal gyrus (BA 47), bilateral precuneus (BA 19), right medial frontal gyrus (BA 10), right superior frontal (BA 11), left cingulate gyrus (BA 32), left precentral gyrus (BA 6), and right fusiform gyrus (BA 19).

More recently acupuncture as an additional treatment with drugs was studied. In this study, patients with PD were allocated into two groups, acupuncture plus drug group and drug only group. The result has shown that tremor, rigidity, and bradykinesia, are all significantly decreased in acupuncture group. Sleep quality and depression were also significantly improved in acupuncture group.

A group of experiments from animal models of PD indicate that acupuncture is effective in reducing oxidative stress , decreasing neuroinflammation with a major feature of microglial activation, stimulating release of neurotrophic factors, and regulating homeostasis of the network between cortex and striatum.

Acupuncture reduces oxidative stress of the cells

Oxidative stress is a sign of the imbalance between the production of reactive oxygen species and detoxification of the antioxidant system. As a result, this causes cell function damage and diseases. Oxidative stress is a critical feature in the pathological process of various diseases such as vascular dementia, Alzheimer’s disease and Parkinson’s disease. Recent research from last 5 years has shown that acupuncture treatment could decrease oxidative stress of the body and increase antioxidant system ability. Because of this acupuncture could improve memory impairment in vascular dementia and Alzerimer’s disease and reduce brain damage. Increased oxidative stress and depletion of the antioxidant are important mechanisms of the onset and progression of Parkinson’s disease. Acupuncture could reduce oxidative stress, inhibit cell death in the neurons and protect neurons improving motor function.

Recently a study assessed the effect of acupuncture for PD. In this study 19 randomized controlled trials were included and it found that acupuncture was effective in relieving PD symptoms compared with no treatment and conventional treatment alone, and acupuncture plus conventional treatment had a more significant effect than conventional treatment alone. Acupuncture does have positive effect for patients with PD.


References
Loddk J and Nilsson M Parkinsonism Relat Disord (2010) 16:540-4
Yeo S et al CHS Neurosci Ther (2012) 18:781-90
Shulman LM et al Mov Discord (2002) 17:799-802
Zeng et al (2013) Int Rev Neurobiol (2013) 111:141-58
Yeo Et al BMC Complement Altern Med (2014) 14:336
Chen et al Neural Regen Res (2014) 9:1163-8
Wang F et al Evid Based Complement Alternat Med (2015) 2015:692795
Zeng XH et al Evid Based Complement Alternat Med (2014) 2014:483294
Lee SH et al Medicine (Baltimore) (2017) Jan;96(3):e5836. doi: 10.1097/MD.0000000000005836.

Motion sickness solution

Motion sickness is known as travel sickness, seasickness, car sickness or air sickness. You may have dizziness, nausea and vomiting symptoms when you are travelling. In most cases, symptoms of motion sickness improve as your body adapts to the conditions causing the problem. However, some people do not adapt and have symptoms until they leave the environment that is causing them.

Do you know that acupuncture can help, if you have motion sickness? There was a study on the effect of acupuncture on patients with motion sickness. In this study, sixty volunteers of motion sickness were randomized into an acupuncture group and a delayed acupuncturegroup, 30 cases in each one. In the acupuncture group, acupuncture was given at Baihui (GV 20), Sishencong (EX-HN 1), Neiguan (PC 6), Zusanli (ST 36) and Hegu (LI 4). The needles were retained for 20 min. The treatment was given twice a week and 10 treatments were required. In the delayed acupuncture group, acupuncture was postponed, meaning noacupuncture during observation stage. Graybel scale was adopted to observe the score of symptoms and physical signs of the subjects of motion sickness before and after intervention. The efficacy was compared between the two groups. Result has shown that the score of symptoms and physical signs of motion sickness was reduced significantly after treatment in the acupuncture group as compared with that before treatment. The score in the acupuncture group was lower apparently than that in the delayed acupuncture group. The total effective rate was 96.0% in the acupuncture group, which was significantly better than the delayed acupuncture group.

References
Lu Y et al Zhongguo Zhen Jiu (2014) 34:543-6

What is restless legs? can acupuncture help?

Restless legs syndrome is a common condition affecting nervous system. It causes an urge to move the legs and an uncomfortable sensation in the legs and sometimes arms, chest and face. It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. These symptoms can be mild or unbearable and are usually worse in the evening or during the night. These unpleasant sensations can often be relieved by moving or rubbing the legs. It can be difficult to sit for a long period of time. In severe cases, restless legs syndrome can be very distressing and disrupt a person's daily activities. About half of people with restless legs syndrome have some degree of lower back pain. Over 80% of people with restless legs syndrome also have a condition that is known as periodic limb movements (PLM). The symptoms of PLM are jerky or twitchy leg involuntary movements, usually at night while you are asleep. The cause of restless legs syndrome is not clear. A theory suggested that it is related to the falling of dopamine in the part of the brain. Having chronic conditions such as diabetes, parkinson’s disease etc is likely to trigger restless leg syndrome development. Iron deficiency anaemia is a trigger for the syndrome. Dopamine agonists are used to treat restless leg syndrome.

There were many case reports with acupuncture treating restless legs syndrome. Acupuncture helps with reducing severity of the symptoms and decreasing the frequency of the symptoms. For example a study has shown that acupuncture helps to improve abnormal leg activity. In this study, significant improvement was seen after 4 week and 6 week acupuncture treatments. There were no side effects found during the treatments.

More recently a study has investigated the effect of acupuncture on restless leg syndrome. There were 46 patients with restless legs syndrome participated the study. These patients were either received 10 session of acupuncture plus gabapentin or gabapentin alone over 4 weeks. The symptoms of patients were assessed at baseline (before treatment), just after the therapeutic course and 8 weeks later. The criteria used for the assessment included the Visual Analogue Scale (VAS), the International Restless Legs Syndrome Rating Scale (IRLSRS), and the Pittsburgh Sleep Quality Index (PSQI). The result has shown that VAS, IRLSRS, and PSQI improved greater in acupuncture group. After a treatment course and in 8 weeks follow up, VAS and IRLSRS had a significant improvement in both groups, but PSQI improved significantly just in the acupuncture group. Based on the findings of the present study, acupuncture was suggested to improve restless legs syndrome.

References

Wu et al Zhongguo Zhen Jiu (2008) 28:27-9

Pan W etc Evid Based Complement Alternat Med (2015) 2015:343201

Raissi GR et al J Acupunct Meridian Stud (2017) 10:346-350

Acupuncture can help anorexia, is this something new to you?

 Anorexia nervosa with acupuncture treatment

Anorexia nervosa is an eating disorder and mental health condition. It is a severely debilitating psychiatric disorder characterized by relentless self-starvation with compulsive behaviour. It is associated with low rates of recovery and has the highest mortality rate of any psychiatric disorder. The neuro basis of anorexia is alteration of part of brain activity, abnormal brain circuit and reduced blood flow. From biochemical point of view, low serotonin level is present in patients with anorexia. The evidence for existing psychological and pharmacological interventions to treat anorexia nervosa is not strong. Use of complementary therapy to treat the condition could improve mental health outcomes for these patients. There was a pilot study for a further trial on acupuncture and acupressure and massage health outcomes for patients with anorexia nervosa. This study was by Smith C et al from Australia. There were 26 patients with anorexia revosia. Their conditions were stable and had treatments as usual. The intervention was given twice a week for the first 3 weeks, and then the interventions was on weekly basis for three weeks. Acupuncture group received acupuncture at the points hegu (LI4), zusanli (ST36), neiguan (PC6), taichong (LR3), yanglingquan (GB34) and additional points which were based on the Traditional Chinese Medicine diagnosis. The control group received acupressure and massage. The clinic outcomes which measure body-mass index (BMI) and eating disorder psychopathology, anxiety and depression, were assessed at baseline and at the 6 weeks following completion of the intervention. Participants described both interventions including acupuncture, acupressure and massage positively and experienced a sense of calmness and relaxation. This study shows positive effect of acupuncture and acupressure and massage on patients with anorexia nervosa, which leads to further research on this issue. The potential mechanism could be that acupuncture changes brain activity, increases brain blood flow and increases serotonin level.

How patients with anorexia nervosa view acupuncture therapy?

There was a study to collect the view of patients with anorexia nervosa who received acupuncture treatments. 26 patients with anorexia nervosa received six weeks acupuncture treatments. These patients highly valued the acupuncture treatments in particular the characteristics of empathy, positive regard, acceptance, non judgemental responses and trust. Having someone to talk to, being less stressed and contact, with study staff were also perceived to be important.

References,

Fogarly S et al Complement Ther Med (2013) 21:675-81

Smith C et al J Altern Complement Med 2013 Oct 8

Potential benefit of acupuncture for eating disorders

Students with eating disorders are at risk of dropping out of University. A survey of just over 200 students with eating disorders found that 32% were diagnosed eating disorders after starting their coursed. 18% said that their condition had forced them to drop out of their degree course. 39% had to take a break from their studies.

Do you know that acupuncture can help in the treatment of eating disorders? There was a pilot study from Victoria University of Melbourne Australia. They studied the effect of acupuncture in the treatment of eating disorders in female patients. 9 women (5 with anorexia Nervosa, 4 with bulimia nervosa) with mean age 23.7 year old participated in this study. The result showed that acupuncture improved the participants’ quality of life as measured by the physical/congnitive and psychological components. There was also evidence of decreases in anxiety and perfectionism. There was a potential benefit of acupuncture as an adjunct therapy in the treatment of eating disorders particularly in the improvement of quality of life.

References

http://www.bbc.co.uk/news/education-24622909

Fogarty S et al Complement Ther Med (2010) 18:233-40

Heel pain, tried acupuncture?

 Plantar fasciitis is the most common injury of the plantar fascia and is the most common cause of heel pain. It is associated with long standing. The main symptom is sharp heel pain which is worsen by bearing weight on the heel after long periods of rest for example after getting out of bed or after prolonged periods of sitting. After continuing walk, the pain symptoms is improved. There may be other symptoms accompanied the pain such as numbnesss, tingling, swelling or radiating pain.

Acupuncture is effective to treat plantar fasciitis and realse the pain. There are some clinical evidences by recent research on this aspect. There is a study which investigated the efficacy of electro-acupuncture coupled with conventional treatments and compared it with the efficacy of conventional treatments alone in patients with chronic plantar fasciitis. Subjects in the control group received five weeks of conventional treatments, including stretching exercise, shoe modification and rescue analgesics. Subjects in the acupuncture group received the same treatments plus ten sessions of electro-acupuncture twice weekly. At the end of treatment, pain score decreased significantly in the acupuncture group compared with and control group. At the sixth week follow-up, subjects in the acupuncture group showed a better foot function index and success rate for pain during the day than those in the control group. Electro-acupuncture coupled with conventional treatments provided a success rate of 80% in chronic planar fasciitis which was more effective than conventional treatments alone. The effects lasted for at least six weeks. Another study also compared the effect of acupuncture with that of conventional treatment including treatment with ice, non-steroidal anti-inflammatory medication, and a stretching and a strengthening program. They also found acupuncture had better effects than those conventional treatment and they suggested that acupuncture should be considered as a major therapeutic instrument for the decrease of heel pain, combined with traditional medical approaches.There was a study compared effect of miniscalpel-needle (MSN) ( a special type of acupuncture) with steroid injection for the treatment for plantar fasciitis. Their results showed that visual analog scale scores for morning pain, active pain, and overall heel pain all were decreased significantly in the MSN group from 1 to 12 months after treatment. In contrast, treatment with steroid injection showed a significant effect only at the 1-month follow-up but not at 6 or 12 months after treatment. Moreover, the MSN group achieved more rapid and sustained improvements than the steroid group throughout the duration of this study. No severe side effects were observed with MSN treatment. Their data suggest that the MSN release treatment is safe and has a significant benefit for plantar fasciitis compared to steroid injection. 

Reference 
Kemnerddee W and Pattapong N Am J Chin Med (2012) 40:1167-76 
Karagounis et al PFoot Ankle Spec (2011) 4:226-34 
Li S et al Evid Based Complement Alternat Med (2014) 2014:164714

Pain from slipped disks, acupuncture can help

 There are discs sitting between the bones of the spine (the vertebrae). The inner portion of the disk can protrude through the outer ring due to injury or weakness. This is known as slipped disk, herniated, or prolapsed disk. Lumber disks are the common site to slip. This causes pain and discomfort at the low back. If the slipped disk compresses the nerves, pain and numbness may occur along the route of the nerve. The pain can happen on the back or neck depending on which disks are slipped. The pain is often beginning in the lower back and over time it spreads to other parts of the body. Sometime there is no symptom. This is because the slipped part of the disc is small which will not affect nerves or spinal cord. If sciatic nerve is affected the pain could travel from the low back, through the buttocks and down the legs to the feet. It could be also accompanied with numbness, tingling sensation in legs.

Acupuncture does not send slipped the disk back, but acupuncture treatment can help to release the pain and other symptoms. There are many studies about acupuncture on slipped disk. Here are some examples of the research. 

A recent study has shown that acupuncture had better effects than that of Fugui Gutong capsule and ibuprofen for slipped disc. The scores of clincial symptoms and therapeutic effect were observed before and after treatment. Results In the electroacupuncture group, the effective rate was 84.4% (38/45), which was superior to that of 65.0% (26/40) in the medication group. After treatment, the scores of symptoms significantly decreased in the two groups, and the reduction of scores in electroacupuncture group was superior to that in medication group. Recent study involved in 30 patients with slipped disk has shown that acupuncture releases the pain caused by slipped disk. 

Which acupuncture points are used to treat slipped discs? A study analysed data from recent 10 years. They found 49 main acupuncture points  from 173 studies. there were 10 most common used acupoints on Bladder Meridian [Geshu (BL 17), Xiaochangshu (BL 27), Shenshu (BL 23), Dachangshu (BL 25), Pangguangshu (BL 28), Guanyuanshu (BL 26), Weizbong (BL 40), Zhibian (BL 54), Chengshan (BL 57), Kunlun (BL 60)], 2 on Gallbladder Meridian [Huantiao (GB 30), Yanglingquan (GB 34)], 2 on Governor Vessel [Yaoyangguan (GV 3), Shuigou (GV 26)], 2 on Stomach Meridian [Zusanli (ST 36), Juliao (ST 3)], 2 on Spleen Meridian [Sanyinjiao (SP 6), Xuehai (SP 10)], and the rest were extra points (Huatuo Jiaji) and Ashi points, so a conclusion could be drawn that the most common used acupoints were Bladder Meridian acupoints and supplemented by Gallbladder Meridian, Governor Vessel, Stomach Meridian, Spleen Meridian, extra points and Ashi points. The selected acupoints were most located on the lumbosacral region, leg and fewer located on the face, back and local part.

A recent review evaluate evidence for the effectiveness of acupuncture in the treatment of slipped lumbar disk. 3503 participants were included in the study. Acupuncture has more pain reduction. The result has shown that acupuncture has better effect than other treatments including lumbar traction, ibuprofen, diclofenac sodium, meloxicam, mannitol plus dexamethasone and mecobalamin, fugui gutong capsule plus ibuprofen, mannitol plus dexamethasone, loxoprofen and huoxue zhitong decoction.

References

Grgic V Lijec Viesn (2012) 134:49-55

Gataullin IG and Samitov Osh Khirurgiia (Mosk) (1989) 2:64-6

Jordan J et al Clin Evid (Online) (2011) pii:118

Shan YL Zhongguo Zhen Jiu (2011) 31:987-90

Qiu L et al Zhen Ci Yan Jiu (2016) 41:447-50

Tang S1 et al Acupunct Med. 2018 Apr;36(2):62-70. doi: 10.1136/acupmed-2016-011332. Epub 2018 Mar 1.