Tag Archives: Fibromyalgia

Acupuncture, Acupuncture Blogs

Acupuncture Top 3 Treatments

Acupuncture news releases received a great deal of attention at HealthCMi this summer. The following are short excerpts taken from the HealthCMi summer top three list. The first in our top three is an article on the topic of acupuncture for the treatment of neck pain due to disc degeneration. 

Neck Pain
Acupuncture is effective for the treatment of cervical spondylosis, a painful disorder caused by intervertebral disc degeneration (due to wear and tear of the discs in the cervical spine). The acupuncture point GV14 (Dazhui) was found effective across multiple studies for the treatment of cervical spondylosis. Based on the data, this acupuncture point is recommended for patients with cervical spondylosis. Shao et al. tested the efficacy of acupuncture using the following acupuncture points:

  • GV14 (Dazhui)
  • SI3 (Houxi)
  • GV20 (Baihui)
  • GB20 (Fengchi)

Acupuncture at Dazhui was perpendicularly inserted and moxa was added. Deqi was elicited at the other acupoints combined with electroacupuncture. Fengchi was connected to Houxi on the afflicted side and Fengchi was connected to Baihui on the healthy side with electrodes. Acupuncture was applied once per day, 5 times per week, for a total of 2 weeks as one course of treatment. The results indicate that 24 out of 25 cases improved significantly for a total effective rate of 96%. [1]

The remainder of this article covered more research finding GV14 effective for the treatment of neck pain due to disc degeneration. The next article garnered a great deal of attention. The research item presented acupuncture for the treatment of fibromyalgia, using both subjective and objective instruments to determine the results.

 Fibromyalgia
Acupuncture is an effective treatment modality for patients with fibromyalgia. Researchers conclude that acupuncture improves two biochemical markers and subjective clinical outcomes for patients with fibromyalgia. Objective measures demonstrate that acupuncture increases serum serotonin levels and reduces Substance P levels. For subjective measurements, the researchers document enduring subjective improvements including less pain, fatigue, and anxiety. [2]

Fibromyalgia is a chronic condition with symptoms including pain, sleep problems, fatigue, and cognitive difficulties. Fibromyalgia frequently presents with depression and anxiety. The exact mechanism of the disease has not been fully identified within allopathic medicine, but it is posited that serotonin and Substance P play a significant role.

Serotonin is a neurotransmitter active with mood, sleep, sexual behavior, and pain regulation. Independent research confirms that fibromyalgia patients have lower serum serotonin levels than healthy individuals. Substance P is a neuropeptide involved in pain, depression, and neurogenic inflammation. [3] Excess Substance P levels may play a role in fibromyalgia pain perception.

The study measures levels of the biochemical markers along with several clinical changes, both before and after treatment with acupuncture. A total of 75 participants were recruited for the study. The patients were randomized into three groups; acupuncture, sham acupuncture, and simulated acupuncture. The following acupuncture points were administered in the study:

  • Hegu (LI4)
  • Quchi (LI11)
  • Shenmen (HT7)
  • Neiguan (PC6)
  • Qihai (CV6)
  • Taichong (LV3)
  • Zusanli (ST36)
  • Sanyinjiao (SP6)
  • Dazhui (GV14)
  • Jianzhongshu (SI15)

The article continues, demonstrating important aspects of acupuncture for the treatment of fibromyalgia. It is not unusual for patients to seek help with this condition from a licensed acupuncturist because it is non-nociceptive (i.e. the pain perception is not due to pain receptor activation). Often, medications cannot fully address the pain and fatigue levels and acupuncture has the ability to address both of these concerns.

The next research article finds acupuncture effective for the alleviation of pain during pregnancy. This is an important finding because the use of pain medications during pregnancy may be deleterious to the fetus. 

Pregnancy Pain
Acupuncture and cupping are both safe and effective for the treatment of lumbopelvic pain during pregnancy. A hospital-based study at a community clinic in New Zealand finds that acupuncture produces important positive patient outcomes, including significant reductions in lumbopelvic pain levels. [4] Lumbopelvic pain is located at the lower torso, lower back, and pelvic girdle. Acupuncture is an important treatment option because a variety of common prescription drugs and over-the-counter analgesics are contraindicated during pregnancy.

A total of 245 pregnant women attended the New Zealand clinic, 144 (56.5%) reported lumbopelvic pain as their primary or secondary complaint. A total of 63 women were excluded from the study because they either did not complete a baseline assessment or did not complete a post-treatment follow-up. Data from 81 pregnant women were included in the results. Forty-five women were nulliparous (55.5%) and the majority of women were in the third trimester of pregnancy (49.3%). A total of 31 were in their second trimester (38.2%) and 10 were in the first trimester (12.3%). Most participants were referred to the clinic by a midwife (72%).

 Treatment Approach
Acupuncture and cupping treatments were provided and points were selected on an individual basis and not all points were used on all of the women. The most commonly used points were Yanglingquan (GB34) and Zulinqi (GB41), which were used in over 50% of study participants. Ashi points on the lower back were used on 25–50% of participants, excluding needling of Ciliao (BL32) and Zhongliao (BL33). Ashi points surrounding Huantiao (GB30) and ashi points on, near, or between Qiuxu (GB40), Shenmai (BL62), and Taichong (LV3) were also used in 25–50% of participants. Ashi points between Neiting (ST44) and Lidui (ST45) and ashi points on, near, or between Chengshan (BL57), Feiyang (BL58), Yintang (MHN3), Baihui (GV20), Kunlun (BL60), Fengshi (GB31), and Waiguan (TB5) were used in fewer than 25% of participants. Cupping to the lower back was provided to over 50% of participants. This is an interesting selection given that cupping is ordinarily contraindicated on the abdomen and lower back during pregnancy.

Upon insertion of the needles, deqi was obtained manually and needles were retained for 20 minutes. Treatment was provided once per week, with each participant receiving a minimum of 3 treatments. The mean number of treatments was 3.85. Ear press needles were also offered to participants to be placed on foot acupoints. They were advised to retain these for 2–3 days and to remove them if they became uncomfortable.

 Results and Discussion
All women taking part in the study completed the Measure Yourself Medical Outcome Profile (MYMOP) questionnaires prior to and after acupuncture treatments. The MYMOP questionnaire allowed the participants to describe and rate symptoms on a scale of 0–6. They were allowed to give additional information on other symptoms, especially those related to functional impairment and well-being.

Of the 81 participants, 18 reported an improvement in symptoms of 1–1.99 points (22.2%), 30 reported an improvement of 2–2.99 points (37.0%), 15 reported an improvement of 3–3.99 points (18.5%), and 9 reported an improvement of 4 or more points (11.1%). A total of 72 participants (88.9%) reported clinically significant improvements following treatments with acupuncture and cupping. The data demonstrates that acupuncture and cupping are effective for the relief of pain during pregnancy.

There’s the summer top three popular research articles, we hope you liked them. If you have questions regarding these topics, contact a local licensed acupuncturist to learn more.

 References:
[1] Shao YX. Clinical study on treatment of vertebral artery type of cervical spondylosis with warm needling Dazhui [D]. Guangzhou: Guangzhou University of Traditional Chinese Medicine, 2008.

[2] Wolfe F. et al Serotonin levels, pain threshold, and fibromyalgia symptoms in the general population. The Journal of Rheumatology [01 Mar 1997, 24(3):555-559].

[3] Harrison S. Geppetti P. Substance P. The International Journal of Biochemistry & Cell Biology Volume 33, Issue 6, June 2001, Pages 555-576.

[4] Soliday E. Betts D. Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand Journal of Acupuncture and Meridian Studies 2018;11(1):25e30.

Acupuncture, Acupuncture Blogs

Acupuncture Fibromyalgia Relief Confirmed

Acupuncture is an effective treatment modality for the alleviation of fibromyalgia. Researchers at the Physical Medicine and Rehabilitation Department of Ataturk University conclude that acupuncture improves two biochemical markers and clinical outcomes for patients with fibromyalgia. Objective measures show that acupuncture increases serum serotonin levels while simultaneously reducing Substance P levels. For subjectives, the researchers document lasting subjective improvements including less pain, fatigue, and anxiety. [i]

Fibromyalgia is a chronic condition with a variety of symptoms including widespread pain, sleep problems, fatigue, and cognitive difficulties. Fibromyalgia is frequently comorbid with depression and anxiety. The exact mechanism of the disease is has not been fully identified within allopathic and hospital medicine, but it is thought that serotonin and Substance P play an important role.

Serotonin is a neurotransmitter involved with mood, sleep, sexual behaviour, and pain regulation. Independent research confirms that fibromyalgia patients have lower serum serotonin levels compared with healthy individuals. Substance P is a neuropeptide involved in pain sensitivity, depression, and peripheral neurogenic inflammation. [ii] Excess levels of Substance P may play a role in the pathology of fibromyalgia, especially since Substance P has an active role in pain perception.

The study measures levels of these two biochemical markers along with several clinical parameters, both before and after treatment with acupuncture. A total of 75 female participants were recruited for the study. Exclusion criteria included usage of non-steroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, tricyclic antidepressants, and other antidepressant drugs within the past 15 days. Those who had smoked tobacco, suffered from bleeding diathesis, or had painful conditions other than fibromyalgia were also excluded.

The patients were randomized into three groups; acupuncture, sham acupuncture, and simulated acupuncture. All three groups were similar in terms of mean age and body mass index. The mean duration of disease was 4.44 years, 3.94 years, and 5.09 years respectively. The following acupuncture points were selected for the study:

  • Dazhui (GV14)
  • Jianzhongshu (SI15)
  • Hegu (LI4)
  • Quchi (LI11)
  • Shenmen (HT7)
  • Neiguan (PC6)
  • Qihai (CV6)
  • Taichong (LV3)
  • Zusanli (ST36)
  • Sanyinjiao (SP6)

The points were needled bilaterally using 0.25 × 25mm sterile stainless steel filiform acupuncture needles. The needles were retained for 30 minutes per acupuncture session, without manual manipulation during needle retention.

The sham acupuncture group was included to act as a control and to identify the physiological effects of inserting needles into the skin at non-acupuncture points. Sham points were selected within an approximate 1–2cm radius of the true acupoints used in the acupuncture study group. These were identified using an electronic acupuncture point detector to find areas with a weaker signal compared with the genuine acupuncture points.

The simulated acupuncture group was included as a control and to identify the psychological effects of acupuncture treatment. Small, round adhesive bandages were applied to the same points as those used in the acupuncture group. Small needles (0.25 × 15mm) were inserted shallowly into the bandages, but were not allowed to penetrate the skin.

The three groups were blinded using a three section folding hospital screen with the bottom of one of the sections detached allowing the screen to be rolled up. A treatment couch was pushed into this space, and with the patient in position, the screen was dropped over the neck area to block their view. The needles at Dazhui and Jianzhongshu were inserted first, with patients in a seated position. Patients were then asked to recline in a supine position, safely resting in the space between the foldable head and body sections of the couch while the remaining needles were inserted. For all three groups, treatment was administered twice weekly for a total of four weeks.

 Results
Serum serotonin and Substance P levels were monitored before and after treatments using a commercial enzyme immunoassay kit, along with several other clinical parameters. A Visual Analogue Scale (VAS) was used to measure widespread pain. The Fibromyalgia Impact Questionnaire (FIQ) was used to measure work status, depression, anxiety, morning tiredness, pain, stiffness, fatigue, and well-being. The Nottingham Health Profile (NHP) was used to measure quality of life including pain, energy, physical mobility, emotional reactions, social isolation, and sleep. Finally, the Beck Depression Inventory (BDI) was used to measure a total of 21 different items including mood, social withdrawal, insomnia, and fatigue. The number of tender points (NTP) for each patient was also taken into account. All parameters were measured at baseline and after treatment. Follow-up visits were performed one month and three months after completion of treatment.

Patients in the acupuncture group experienced significant improvements in VAS (p<0.001), FIQ (p<0.001), BDI (p<0.001), NTP (p<0.001), and some aspects of NHP following treatment. Most of these improvements continued at the three month follow-up. Patients in the sham acupuncture group experienced significant improvements in VAS (p<0.01), FIQ (p<0.05), BDI (p<0.01), and NTP (p=0.001) following treatment. However, only the improvements in FIQ and NTP continued at the three month follow-up. Patients in the simulated acupuncture group experienced significant improvements in VAS (p=0.001), BDI (p<0.01), and NTP (p=0.01), but these improvements discontinued by the three month follow-up.

These findings indicate that sham acupuncture and simulated acupuncture provide a short-term placebo effect but do not provide long-term results. True acupuncture produced greater short-term results and also produced long-term positive patient outcomes. This indicates that the effective action of true acupuncture is not due to the placebo effect.

Serum serotonin levels increased significantly in the acupuncture and sham acupuncture groups (p<0.001 and p<0.01 respectively), with the increase in the acupuncture group being significantly greater than both sham and simulated acupuncture (p<0.01). Serum Substance P levels significantly decreased in the acupuncture group (p=0.001). There were no significant changes in serum Substance P in the sham group, and there was a significant increase (p=0.001) in the simulated group.

This study suggests that acupuncture is an effective treatment for patients with fibromyalgia, with the ability to improve a wide variety of symptoms, increase serum serotonin levels, and reduce serum Substance P levels. Genuine acupuncture treatment is superior to sham or simulated acupuncture, with improvements in symptoms lasting for several months after completion of all treatments. Contact your local licensed acupuncturist to learn more.

 

References:
[i] Wolfe F. et al “Serotonin levels, pain threshold, and fibromyalgia symptoms in the general population.” The Journal of Rheumatology [01 Mar 1997, 24(3):555-559].
[ii] Harrison S. Geppetti P. “Substance P” The International Journal of Biochemistry & Cell Biology Volume 33, Issue 6, June 2001, Pages 555-576.