| || |
The Acupuncture Now Foundation has put together an informative video about the benefits of acupuncture for treating lower back pain.
The study referenced in this video found that acupuncture was twice as effective and safer than conventional medical trreatment for treating lower back pain.
In Australia it is recommended that you check to see if your acupuncturist is registered with the Chinese Medicine Board
Sprains and strains are one of the many reasons people will approach Coburg Chinese Medicine to seek acupuncture. We recommend acupuncture for the treatment and management of pain disorders. Below is a list of some very simple and common sense things that you can do assist with the management of your pain and aid its recovery in between appointments.
1. Use heat packs and warmth to aid your recovery.
There is evidence to support the use of heat for the management of pain and to aid recovery. Although ice can be useful in the treatment of injuries in the beginning, we would not recommend ice beyond the first few hours because it can interfere with the body being able to self heal. Instead we recommend the application of heat to the affected area after the application of relevant first aid. There are lots of different ways to achieve this i.e. hot water bottle and heat bag. For those more difficult areas such as the shoulder and mid back, we recommend using an adhesive heat patch such as Hotteeze or Flexeeze
2. Apply a topical liniment.
Topical liniments such as deep heat, tiger balm, po sum on oil and our own in house special liniment should be applied every 3-4 hours to the affected area. This will help not only with the pain but can also help the healing process. The three main ingredients typically found in most liniments are Menthol, Camphor and Wintergreen oil. Both the Menthol and Camphor can help reduce muscular pain, with menthol providing a cooling sensation and camphor a warming sensation . Wintergreen oil is often included for its local anti-inflammatory action.Remember to wash your hands thoroughly after applying liniments.
3. Rest the affected area
Resting the affected limb or area can be a very useful strategy to ensure the affected area is not re injured and to give it time to repair. Gentle stretches and exercises such as those given by your treating health professional can often be useful to help strengthen and maintain movement. Continuing with activities that aggravate the condition is likely to slow down your recovery.
The advice above is general and readers are encouraged to check with their treating health practitioners to see if it is appropriate for them.
Based in Melbourne, the Coburg Acupuncture clinic is located in the heart of Coburg on Sydney Rd and provides Acupuncture, Chinese herbal medicine, massage and cupping services. The Coburg Clinic services people from Coburg and surrounding Northern suburbs such as Brunswick, Pascoe Vale, Preston, Fawkner, Thornbury, Northcote.
To book an appointment or see if acupuncture is right for you call (03) 9041 6569.
Trigeminal neuralgia can be a horribly debilitating illness, where even the act of eating or wind brushing on the cheek can cause excruciating pain. A recent study published in the Clinical Journal of Chinese Medicine, found that acupuncture was as effective, if not slightly more so, than the use of Tegretol (Carbamazepine). This 80 participant study showed that acupuncture was a promising alternative to pharmaceutics. 70% of the acupuncture only group reported a cure according to the researchers. More rigorous research needs to be undertaken in this area, but this is a promising start
Shin Splints also known as Tibial stress syndrome (MTSS) or Tibial periostitis or shin splints is a common injury that affects athletes who engage in running sports or physical activity. This condition is characterized by pain in the lower part of the leg between the knee and the ankle. Research of the efficacy of acupuncture in treating shin splints was published in the Journal of Chinese Medicine in 2002. The Abstract can be found below.
Acupuncture & tibial stress syndrome (shin splints)
Method: Forty athletes, ages 18-45 with tibial stress syndrome (shin splints), were analyzed using subjective questioning based on a ten point Likert-type pain scale that was used to assess pain level. The scale ranged from None (1) to Distressing (5) to Unbearable (10). The athletes were divided into three treatment groups: Sports Medicine (N=17), Acupuncture (N=12) and a combination group of Sports Medicine and Acupuncture (N=11). The treating practitioners were certified and student athletic trainers at University of California, San Diego RIMAC Athletic Training Center along with acupuncture interns supervised by the author from Pacific College of Oriental Medicine, San Diego. The study took place over a 3 week period, with each participant filling out an initial questionnaire (Intake) prior to the first week of treatment. Follow- up questionnaires were utilized at the beginning of each week of treatment for the remaining 2 weeks (Follow-up 1 and Follow-up 2). Participants answered questions concerning intensity and duration of pain during and between activities, in addition to dosages taken of anti-inflammatory medications (NSAID). Participants in all groups received a mini- mum of 2 treatments per week.
Results: The three treatment groups were compared to each other: Sports Medicine (S), Acupuncture (A) and Acupuncture and Sports Medicine combination (AS). All athletes reported an increase in effectiveness of treatment from Intake to Follow-up 2, regardless of the treatment group they were in. Athletes in the A and AS Groups received the most pain relief, were least hindered by pain during sporting and non-sporting activities, and felt overall that the treatments were more effective than those reporting in the S Group. The perception of pain, pain relief, and effectiveness was not significantly improved for athletes in the S Group. Athletes taking anti-inflammatory medications in the AS and A Treatment Groups took significantly fewer doses during the course of the study than athletes in the S Group.
Acupuncture has been found to be useful to treat joint pain which is a common side effect of breast cancer treatments known as Aromatase inhibitors. Published in the European Journal of Cancer, the researchers found that the use of acupuncture produced clinically important and durable improvement for this with symptoms of arthralgia (joint pain) - from taking aromatase inhibitors.
A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use
Jun J. Mao, Sharon X. Xie, John T. Farrar, Carrie T. Stricker, Marjorie A. Bowman, Deborah Bruner, Angela DeMichele.
Background: Arthralgia is a common and debilitating side-effect experienced by breast cancer patients receiving aromatase inhibitors (AIs) and often results in premature drug discontinuation.
Methods: We conducted a randomised controlled trial of electro-acupuncture (EA) as compared to waitlist control (WLC) and sham acupuncture (SA) in postmenopausal women with breast cancer who self-reported arthralgia attributable to AIs. Acupuncturists performed 10 EA/SA treatments over 8weeks using a manualised protocol with 2Hz electro-stimulation delivered by a TENS unit. Acupuncturists administered SA using Streitberger (non-penetrating) needles at non-traditional acupuncture points without electro-stimulation. The primary end-point was pain severity by Brief Pain Inventory (BPI) between EA and WLC at Week 8; durability of response at Week 12 and comparison of EA to SA were secondary aims.
Findings: Of the 67 randomly assigned patients, mean reduction in pain severity was greater in the EA group than in the WLC group at Week 8 (−2.2 versus −0.2, p=0.0004) and at Week 12 (−2.4 versus −0.2, p<0.0001). Pain-related interference measured by BPI also improved in the EA group compared to the WLC group at both Week 8 (−2.0 versus 0.2, p=0.0006) and Week 12 (−2.1 versus −0.1, p=0.0034). SA produced a magnitude of change in pain severity and pain-related interference at Week 8 (−2.3, −1.5 respectively) and Week 12 (−1.7, −1.3 respectively) similar to that of EA. Participants in both EA and SA groups reported few minor adverse events.
Interpretations: Compared to usual care, EA produced clinically important and durable improvement in arthralgia related to AIs in breast cancer patients, and SA had a similar effect. Both EA and SA were safe.
A Cochrane Review is considered the gold standard of research meta-analysis. The following abstract shows that Acupuncture may be useful in the treatment of chronic neck pain.
A B S T R A C T
Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are the perceptions of benefits. Acupuncture has been used as an alternative to more traditional treatments for musculoskeletal pain. This review summarizes the most current scientific evidence on the effectiveness of acupuncture for acute, subacute and chronic neck pain.
Objectives: To determine the effects of acupuncture for individuals with neck pain.
Search strategy: We searched CENTRAL (2006, issue 1) and MEDLINE, EMBASE, MANTIS, CINAHL from their beginning to February 2006. We searched reference lists and the acupuncture database TCMLARS in China.
Selection criteria: Any published trial using randomized (RCT) or quasi-randomized (quasi-RCT) assignment to the intervention groups, either in full text or abstract form, were included.
Data collection and analysis: Two reviewers made independent decisions for each step of the review: article inclusion, data abstraction and assessment of trial methodological quality. Study quality was assessed using the Jadad criteria. Consensus was used to resolve disagreements. When clinical heterogeneity was absent, we combined studies using random-effects meta-analysis models.
Main results: We did not find any trials that examined the effects of acupuncture for acute or subacute pain, but we found 10 trials that examined acupuncture treatments for chronic neck pain. Overall, methodological quality had a mean of 2.3/5 on the Jadad Scale. For chronic mechanical neck disorders, there was moderate evidence that acupuncture was more effective for pain relief than some types of sham controls, measured immediately post-treatment. There was moderate evidence that acupuncture was more effective than inactive, sham treatments measured immediately post-treatment and at short-term follow-up (pooled standardized mean difference (SMD) -0.37, 95% confidence interval (CI) -0.61 to -0.12). There was limited evidence that acupuncture was more effective than massage at short-term follow-up. For chronic neck disorders with radicular symptoms, there was moderate evidence that acupunctur was more effective than a wait-list control at short-term follow-up.
Authors’ conclusions: There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment.There is moderate evidence that those who received acupuncture reported less pain at short term follow-up than those on a waiting list. There is also moderate evidence that acupuncture is more effective than inactive treatments for relieving pain post-treatment and this is maintained at short-term follow-up.
Source: Cochrane Library
Acupuncture for the alleviation of lateral epicondyle pain: a systematic review
Objectives: Lateral epicondyle pain is a common complaint in North America. In the past 10 yr acupuncture has become increasingly recognized as an alternative treatment for pain, including epicondyle pain. This review evaluates the effectiveness of acupuncture as a treatment for lateral epicondylitis using the appropriate analysis.
Methods: Online bibliographic database searches in any language from Medline, PsychINFO, CINAHL, Healthstar, PMID, CAM, EMBASE, Cochrane Database of Systematic Review (3rd quarter 2003), articles listed in reference lists of key articles and the author's personal files were performed. Randomized and quasi-randomized controlled trials examining the effects of acupuncture on lateral epicondyle pain were selected. From the six studies that met inclusion criteria, the first author, year of publication, population studied, dropout rate, treatment plan, assessment scale and outcome measures were extracted. Study quality was determined by using the Jadad scale, in which all studies were rated as high quality. A best evidence synthesis approach was used to analyse the data presented in the six studies.
Results: All the studies suggested that acupuncture was effective in the short-term relief of lateral epicondyle pain. Five of six studies indicated that acupuncture treatment was more effective compared to a control treatment.
Conclusions: There is strong evidence suggesting that acupuncture is effective in the short-term relief of lateral epicondyle pain.
Source: Rheumatology Journal
STUDY ANALYSIS SHOWS ACUPUNCTURE EFFECTIVE FOR TREATING CHRONIC LOW BACK PAIN
Millions of people suffer with low back pain in the UK, and it is one of the top reasons people seek medical treatment. Back problems are also, by far, the primary reason for appointments with acupuncturists. But does acupuncture really help these patients? Researchers from the University of Maryland School of Medicine and the Peninsula Medical School, Plymouth, U.K., analyzed dozens of studies from around the world on acupuncture for low back pain. The study results will be published in the April 19 issue of the Annals of Internal Medicine.
“For people with chronic low back pain, this analysis shows that acupuncture is clearly effective in providing considerable pain relief,” says Eric Manheimer, study author and director of database and evaluation for the University of Maryland Center for Integrative Medicine. “The research also showed that acupuncture provided true pain relief. The benefit was not just due to the placebo effect.”
The reviewers scoured the medical literature for all studies involving acupuncture for treating low back pain. To minimize bias, the American and British teams developed explicit criteria for evaluating the studies and did the evaluations independently. Their analysis included only randomized controlled trials, the gold standard study design for evaluating medical procedures.
Thirty-three studies covering more than 2,100 patients met the criteria for review. In the end, the researchers used 22 of these studies for their analysis. All 22 evaluated Chinese-style acupuncture for chronic low back pain, defined as pain that has been on-going for more than three months. The other 11 studies were excluded because they either only reported data that could not be combined statistically, they only included patients with acute back pain or pregnancy-related back pain or they involved forms of acupuncture other than traditional Chinese acupuncture.
Manheimer says, “We wanted the studies for the analysis to meet the highest scientific standards. As a way to account for a possible placebo effect, we looked at many studies that used ‘sham acupuncture’ as a control group, where acupuncture needles were inserted only superficially or in the wrong place.”
The sham acupuncture studies were double-blinded, meaning neither the researchers nor the participants knew who was receiving the real or the sham treatment. When looking at those studies, the reviewers found the differences in pain ratings showed a significant difference between the real acupuncture and the sham acupuncture groups, indicating that the benefit was not just due to the placebo effect.
“From our analysis, the message for people with chronic low back pain is that acupuncture is a truly effective therapy that provides significant pain relief,” says Manheimer. “Patients with low back pain have many options for treatment including medication, chiropractic care, physical therapy and back exercises. However, these treatments do not always help, and scientific evidence indicates that they have only modest effectiveness.”
The researchers evaluated the effects of acupuncture both in the short-term (defined as three weeks after the last acupuncture treatment) as well as in the longer term. They found acupuncture provided definite pain relief in the short-term, and this relief appeared to be sustained over the longer term. However, they say it’s too early to be certain of longer term effects, and more studies are underway.
For patients with acute back pain (defined as lasting less than three months), the reviewers found the data to be sparse and inconclusive. The evidence comparing acupuncture to other therapies was also inconclusive.
Previous attempts to synthesize information on acupuncture and chronic low back pain provided mixed results. But since 1999, the publication of five high quality, large-scale studies has added new evidence for the analysis. The current analysis includes these newer studies as well as earlier research not included in previous reviews.
In all, this analysis contains more than twice as many studies as earlier reviews and includes reports in English, Chinese, Japanese, Korean as well as Germanic and Romance languages. For this study, the reviewers received funding from the National Center for Complementary and Alternative Medicine, a part of the National Institutes of Health.
Source: University of Maryland Press release
Background: Low back pain limits activity and is the second most frequent reason for physician visits. Previous research shows widespread use of acupuncture for low back pain.
Purpose: To assess acupuncture's effectiveness for treating low back pain.
Data Sources: Randomized, controlled trials were identified through searches of MEDLINE, Cochrane Central, EMBASE, AMED, CINAHL, CISCOM, and GERA databases through August 2004. Additional data sources included previous reviews and personal contacts with colleagues.
Study Selection: Randomized, controlled trials comparing needle acupuncture with sham acupuncture, other sham treatments, no additional treatment, or another active treatment for patients with low back pain.
Data Extraction: Data were dually extracted for the outcomes of pain, functional status, overall improvement, return to work, and analgesic consumption. In addition, study quality was assessed.
Data Synthesis: The 33 randomized, controlled trials that met inclusion criteria were subgrouped according to acute or chronic pain, style of acupuncture, and type of control group used. The principal measure of effect size was the standardized mean difference, since the trials assessed the same outcome but measured it in various ways. For the primary outcome of short-term relief of chronic pain, the meta-analyses showed that acupuncture is significantly more effective than sham treatment (standardized mean difference, 0.54 [95% CI, 0.35 to 0.73]; 7 trials) and no additional treatment (standardized mean difference, 0.69 [CI, 0.40 to 0.98]; 8 trials). For patients with acute low back pain, data are sparse and inconclusive. Data are also insufficient for drawing conclusions about acupuncture's short-term effectiveness compared with most other therapies.
Limitations: The quantity and quality of the included trials varied.
Conclusions: Acupuncture effectively relieves chronic low back pain. No evidence suggests that acupuncture is more effective than other active therapies.
Source: Annals of Internal Medicine April 2005
ACUPUNCTURE PROVIDES ADDED BENEFIT FOR PEOPLE WITH OSTEOARTHRITIS OF THE KNEE
Study by University of Maryland doctors is one of the largest ever for acupuncture
Researchers at the University of Maryland School of Medicine have found that traditional Chinese acupuncture significantly reduces pain and improves function for patients with osteoarthritis of the knee who have moderate or more severe pain despite taking pain medication. Those are the results of a four-year study published in the December 21 issue of the Annals of Internal Medicine.
"Our study shows that acupuncture can be a safe and effective complementary therapy for people with osteoarthritis of the knee," explains Brian Berman, M.D., the principal investigator who is director of the University of Maryland Center for Integrative Medicine and a professor of family medicine at the University of Maryland School of Medicine. "Before taking part in our study, many of the patients were taking anti-inflammatory medicine but they still experienced a lot of pain. When we added acupuncture to their treatment, the majority reported significant improvement."
"Osteoarthritis is the most common form of arthritis, affecting more than 20 million Americans," says Marc Hochberg, M.D., M.P.H., a co-investigator of the study. Dr. Hochberg is a professor of medicine and head of the Division of Rheumatology at the University of Maryland School of Medicine and head of rheumatology at the University of Maryland Medical Center.
According to Dr. Hochberg, "Many people with osteoarthritis live with debilitating pain, which forces them to limit their activities. This research shows that acupuncture, when used along with medication, can help to relieve symptoms and improve people's ability to participate in their usual activities."
The Phase III randomized controlled trial followed 570 participants – the largest group ever for an acupuncture study. Researchers divided participants into three groups. One group received education about arthritis, another group received traditional Chinese acupuncture and the third received sham acupuncture, where practitioners tapped the needles on the skin but they did not go through. The stainless steel needles are about the width of a human hair and are not painful when inserted correctly.
"The participants really couldn't tell whether they were receiving the real or the sham acupuncture," explains Lixing Lao, M.D., Ph.D., a licensed acupuncturist and a study investigator who is an associate professor of family medicine at the University of Maryland School of Medicine. "We chose specific places for the needles to be inserted based on traditional Chinese medicine. Those who received the sham acupuncture may have felt the edge of the guide tube, but the actual needle did not go in."
The acupuncturists placed a screen over the participants' stomachs so they did not know whether they were receiving the true acupuncture. Also, when electrical stimulation was supposed to be used, people receiving the sham acupuncture saw machines with flashing lights even though there was no electricity going through.
Patients in the acupuncture and sham acupuncture groups received 24 "treatments" over a 26-week period. At first, the treatments were given twice a week and they were gradually reduced to once a month. People in the education group took a 12-week self-help course involving two-hour group sessions. Researchers assessed the participants at the beginning of the study and then at four weeks, eight weeks, 14 weeks and 26 weeks.
"At the end of the 26 weeks, patients receiving traditional Chinese acupuncture had more improvement in both pain relief and function when compared to the sham acupuncture and the education groups," says Dr. Berman.
But the benefits were not evident right away. Among those who received real acupuncture, their pain was not significantly reduced compared to the sham acupuncture group until week 14. On the function score, researchers saw a difference after eight weeks of real acupuncture compared to the sham acupuncture.
Overall, patients receiving the true acupuncture reported a 40 percent improvement in both pain and function from their baseline scores. Participants rated their pain and function using a standard arthritis measurement: the Western-Ontario McMaster (WOMAC) Index.
Dr. Hochberg adds, "Study participants were allowed to continue whatever drug and non-drug therapies they were already using. With the addition of the acupuncture therapy, the participants did not report any significant side effects. So it proved to be a safe and effective treatment."
During the trial, seven acupuncturists treated participants at three sites: The University of Maryland Center for Integrative Medicine at Kernan Hospital in Baltimore, the Innovative Medical Research Center in Towson, Maryland, and the Hospital for Special Surgery in New York City. Participants had to be at least 50 years old with a diagnosis of osteoarthritis and had to experience at least moderate knee pain on most days of the prior month. They could not have had any previous experience with acupuncture.
"For the first time, a clinical trial with sufficient rigor, size and duration has shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee," says Stephen E. Straus, M.D., director of the National Center for Complementary and Alternative Medicine.
The National Center for Complementary and Alternative Medicine and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, both components of the National Institutes of Health, provided funding for the study.
Source: University of Maryland Press Release
Some recent studies show that acupuncture can be an efficacious intervention in treating shoulder pain.
German Randomized Acupuncture Trial for chronic shoulder pain (GRASP) - a pragmatic, controlled, patient-blinded, multi-centre trial in an outpatient care environment.
Pain, October 2010, Volume 151, Issue 1, pages 146-154
The German Randomized Acupuncture Trial for chronic shoulder pain (GRASP) comprised 424 outpatients with chronic shoulder pain (CSP) > or =6 weeks and an average pain score of VAS > or =50 mm, who were randomly assigned to receive Chinese acupuncture (verum), sham acupuncture (sham) or conventional conservative orthopaedic treatment (COT). The patients were blinded to the type of acupuncture and treated by 31 office-based orthopaedists trained in acupuncture; all received 15 treatments over 6 weeks. The 50% responder rate for pain was measured on a VAS 3 months after the end of treatment (primary endpoint) and directly after the end of the treatment (secondary endpoint).
RESULTS: In the ITT (n=424) analysis, percentages of responders for the primary endpoint were verum 65% (95% CI 56-74%) (n=100), sham 24% (95% CI 9-39%) (n=32), and COT 37% (95% CI 24-50%) (n=50); secondary endpoint: verum 68% (95% CI 58-77%) (n=92), sham 40% (95% CI 27-53%) (n=53), and COT 28% (95% CI 14-42%) (n=38). The results are significant for verum over sham and verum over COT (p<0.01) for both the primary and secondary endpoints. The PPP analysis of the primary (n=308) and secondary endpoints (n=360) yields similar responder results for verum over sham and verum over COT (p<0.01). Descriptive statistics showed greater improvement of shoulder mobility (abduction and arm-above-head test) for the verum group versus the control group immediately after treatment and after 3 months.
The trial indicates that Chinese acupuncture is an effective alternative to conventional orthopaedic treatment for CSP.
Efficacy of Acupuncture as a Treatment for Chronic Shoulder Pain
Journal of Alternative and Complementary Medicine; Volume 15, Issue 6, pages 613-618.
OBJECTIVES: The aim of this study was to evaluate the efficacy of acupuncture as a treatment for chronic shoulder pain and to compare the efficacy of individualized acupuncture to fixed, standard point acupuncture treatment. DESIGN: The study was a single-blind randomized, controlled trial.
SETTINGS/LOCATION: The study was conducted in an outpatient rheumatology clinic at the VA Medical Center of Philadelphia.
SUBJECTS: The participants were adults with shoulder pain for at least 8 weeks with a diagnosis of osteoarthritis or rotator cuff tendonitis and a total Shoulder Pain and Disability Index (SPADI) score of > or =30.
INTERVENTIONS: Thirty-one (31) subjects were randomized to one of three treatment groups: individualized acupuncture points according to the approaches of Traditional Chinese Medicine; fixed, standard acupuncture points conventionally used for shoulder pain; and sham nonpenetrating acupuncture. Subjects received 12 treatments over 6 weeks and were reassessed using the SPADI at the end of the 6 weeks.
OUTCOME MEASURES: The primary outcome evaluated was the mean change in total SPADI score in each group from baseline to 6 weeks.
RESULTS: After 6 weeks of treatment, the mean total SPADI score improved in all three groups, but the change was clinically significant (> or =10 points) only in groups 1 and 2 (-20.3 and -20.4, respectively, versus -6.5 in group 3). The treatment effects of groups 1 and 2 compared to the sham acupuncture group were -13.8 (95% confidence interval: -2.2 to -25.4, p < 0.015) and -13.9 (-2.0 to -25.8, p < 0.013), respectively. There was no difference between the individualized acupuncture and standardized acupuncture treatments.
CONCLUSIONS: Acupuncture may be an effective treatment for chronic shoulder pain.
Chinese Medicine Blog
This blog contains information and research about Acupuncture and Chinese Medicine