Low Back Pain


Annals of Internal Medicine April 19, 2005

Meta-analysis: Acupuncture for Low Back Pain

to assess acupuncture
s effectiveness for treating low back pain.

Randomized, controlled trials comparing needle acupuncture with sham acupuncture, other sham treatments, no additional treatments, or another active treatment for patients with low back pain.

561 articles were identified.

33 met the inclusion criteria

Conclusion

Acupuncture effectively relieves chronic low back pain. No evidence suggests that acupuncture is more effective than other active therapies



Spine
July 15, 2003, pages 1490-1502

Chronic Spinal Pain: A Randomized Clinical Trial Comparing Medication, Acupuncture, and Spinal Manipulation.
The results provides, evidence that in patients with chronic spinal pain, manipulation, if not contraindicated, result in greater short-term improvement than acupuncture or medication. However, the data do not strongly supports the use of only manipulation, only acupuncture or only non-steroidal anti-inflammatory drugs for the treatment of chronic spinal pain.



Anesthesiology December 1999 page 1622

Effect of the Duration of Electrical Stimulation on the Analgesic Response in Patients with Low Back Pain

The recommended duration of electrical stimulation with percutaneous electrical nerve stimulation therapy is 30 minutes.

Pain: March 2002 pages 189 -196

Acupuncture Treatment of Chronic Low Back Pain: A Randomized, Blinded, Placebo Controlled Trial with Nine-month Follow-up.

Conclusion

Compared to sham-acupuncture, acupuncture reduced psychological distress (P=0.040) only. At 9-month follow-up, the superiority of acupuncture compared to the control condition became less and acupuncture was not different to sham-acupuncture. We found a significant improvement by traditional acupuncture in chronic LBP compared to routine care (physiotherapy) but not compared to sham-acupuncture. The trial demonstrated a placebo effect of traditional acupuncture in chronic LBP.


We found a significant improvement by traditional acupuncture in chronic low back pain.


Clinical Journal of Pain: May/June 2002 pages 149 -153

Comparison of Superficial and Deep Acupuncture in the Treatment of Myofascial Pain: A Double-blind Randomized Controlled Study.



The aim of this study was to compare the therapeutic effect of the superficial and in-depth insertion of acupuncture needles in the treatment of patients with chronic lumbar myofascial pain.

Conclusion

Clinical results show that deep stimulation has a better analgesic effect when compared with superficial stimulation.




Clinical Journal of Pain December 17, 2001

The authors found a long-term pain relieving effect of needle acupuncture compared with true placebo in some patients with chronic nociceptive of low back pain.

Rheumatology July 30, 2003

Acupuncture for Chronic Low Back Pain in Older Patients: A Randomized, Controlled Trial


Patients were treated 2 /wk with electro acupuncture for 5 weeks.

Bl 23,24,25,28, GV 3 ,Gv 4

Rdx pts added Bl 36,37,54,40,Gb 30, 31

Conclusion

Acupuncture is an effective, safe adjunctive treatment for chronic low back pain in older patients.

The EA group improved directly after last treatment, three months and six months after the last treatment.


Acupunct Med. 2012 Jun;30(2):103-8. doi: 10.1136/acupmed-2011-010122. Epub 2012 Apr 25.
Spinal nerve root electroacupuncture for symptomatic treatment of lumbar spinal canal stenosis unresponsive to standard acupuncture: a prospective case series.
Inoue M1, Nakajima M, Hojo T, Kitakoji H, Itoi M.
Author information


Abstract
OBJECTIVE:
To study the effectiveness of electroacupuncture of the spinal nerve root using a selective spinal nerve block technique for the treatment of lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis.
METHODS:
Subjects were 17 patients with spinal canal stenosis who did not respond to 2 months of general conservative treatment and conventional acupuncture. Under x-ray fluoroscopy, two acupuncture needles were inserted as close as possible to the relevant nerve root, as determined by subjective symptoms and x-ray and MRI findings, and low-frequency electroacupuncture stimulation was performed (10 Hz, 10 min). Patients received 3-5 once-weekly treatments, and were evaluated immediately before and after each treatment and 3 months after completion of treatment.
RESULTS:
After the first nerve root electroacupuncture stimulation, scores for lumbar and lower limb symptoms improved significantly (low back pain, p<0.05; lower limb pain, p<0.05; lower limb dysaesthesia, p<0.01) with some improvement in continuous walking distance. Symptom scores and continuous walking distance showed further improvement before the final treatment (p<0.01), and a significant sustained improvement was observed 3 months after completion of treatment (p<0.01).
CONCLUSION:
Lumbar and lower limb symptoms, for which conventional acupuncture and general conservative treatment had been ineffective, improved significantly during a course of electroacupuncture to the spinal nerve root, showing sustained improvement even 3 months after completion of treatment. The mechanisms of these effects may involve activation of the pain inhibition system and improvement of nerve blood flow.


Zhongguo Zhen Jiu. 2011 Sep;31(9):791-4.
[Clinical observation of lumbar spinal stenosis treated with deep puncture at Jiaji (EX-B 2)].
[Article in Chinese]
Jing HT1, Peng YY, Chen M, Huang YS.
Author information


Abstract
OBJECTIVE:
To explore the clinical efficacy on lumbar spinal stenosis treated with deep puncture at Jiaji (EX-B 2) with round-sharp needle.
METHODS:
One hundred and fifty cases of lumbar spinal stenosis were divided randomly into a deep puncture at Jiaji (EX-B 2) group (deep puncture group) and a conventional needling group, 75 cases in each one. In deep puncture group, the round-sharp needle was used to puncture Jiaji (EX-B 2) deeply to the nerve root in vertebral canal. Additionally, the conventional acupuncture with filiform needle was applied at the acupoints selected according to the symptoms, such as Shenshu (BL 23), Weizhong (BL 40), Zusanli (ST 36) and Zhibian (BL 54), etc. In conventional needling group, acupuncture with filiform needle was adopted at the acupoints as those in deep puncture group. The clinical symptom scores and efficacies of the patients in two groups were observed after 4 weeks treatment and 3 months of follow-up visit separately.
RESULTS:
After treatment and in follow-up visit, the clinical symptom scores all increased apparently for the patients in two groups (all P < 0.01). The result in deep puncture group was superior to that in conventional needling group (both P < 0.01). In deep puncture group, the total effective rates were 100.0% (75/75) and 96.0 (72/75) after treatment and in follow-up visit respectively, which were all superior to 92.0% (69/75) and 84.0% (63/75) in conventional needling group (both P < 0.05).
CONCLUSION:
The deep puncture at Jiaji (EX-B 2) with round-sharp needle achieves superior efficacy as compared with the conventional needling therapy in treatment of lumbar spinal stenosis. The prognosis of it is better and the disease is hardly recurred.



Acupunct Med. 2008 Sep;26(3):140-4.
Pudendal nerve electroacupuncture for lumbar spinal canal stenosis - a case series.
Inoue M1, Hojo T, Nakajima M, Kitakoji H, Itoi M, Katsumi Y.
Author information


Abstract
OBJECTIVE:
To investigate the effectiveness of pudendal nerve electroacupuncture for lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis for whom acupuncture of the lumbar and lower limb muscles had been ineffective.
METHODS:
Nine patients with lumbar spinal canal stenosis for whom conventional acupuncture at the lumbar and lower limb muscles had no effect. Pudendal nerve electroacupuncture was performed eight times (once per week). VAS scores and continuous walking distance were used to evaluate changes in symptoms.
RESULTS:
The following changes in symptoms occurred after pudendal nerve electroacupuncture: low back pain was improved from 45.3+/-17.4mm (mean +/- SD) to 39.2+/-14.0mm, lower limb pain was improved from 61.1+/-5.6mm to 35.4+/-11.9mm, lower limb dysaesthesia was improved from 63.9+/-8.4mm to 46.9+/-16.2mm, and continuous walking distance was improved from 100.0+/-35.4m to 250.0+/-136.9m. Conclusion Pudendal nerve electroacupuncture may be an effective treatment for lumbar and lower limb symptoms due to spinal canal stenosis, and is potentially useful in patients who have not responded to conventional acupuncture.

Acupunct Med. 2012 Jun;30(2):103-8. doi: 10.1136/acupmed-2011-010122. Epub 2012 Apr 25.
Spinal nerve root electroacupuncture for symptomatic treatment of lumbar spinal canal stenosis unresponsive to standard acupuncture: a prospective case series.
Inoue M1, Nakajima M, Hojo T, Kitakoji H, Itoi M.
Author information


Abstract
OBJECTIVE:
To study the effectiveness of electroacupuncture of the spinal nerve root using a selective spinal nerve block technique for the treatment of lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis.
METHODS:
Subjects were 17 patients with spinal canal stenosis who did not respond to 2 months of general conservative treatment and conventional acupuncture. Under x-ray fluoroscopy, two acupuncture needles were inserted as close as possible to the relevant nerve root, as determined by subjective symptoms and x-ray and MRI findings, and low-frequency electroacupuncture stimulation was performed (10 Hz, 10 min). Patients received 3-5 once-weekly treatments, and were evaluated immediately before and after each treatment and 3 months after completion of treatment.
RESULTS:
After the first nerve root electroacupuncture stimulation, scores for lumbar and lower limb symptoms improved significantly (low back pain, p<0.05; lower limb pain, p<0.05; lower limb dysaesthesia, p<0.01) with some improvement in continuous walking distance. Symptom scores and continuous walking distance showed further improvement before the final treatment (p<0.01), and a significant sustained improvement was observed 3 months after completion of treatment (p<0.01).
CONCLUSION:
Lumbar and lower limb symptoms, for which conventional acupuncture and general conservative treatment had been ineffective, improved significantly during a course of electroacupuncture to the spinal nerve root, showing sustained improvement even 3 months after completion of treatment. The mechanisms of these effects may involve activation of the pain inhibition system and improvement of nerve blood flow.



Cervical spine

Zhongguo Zhen Jiu. 2014 May;34(5):499-502.
[Efficacy comparison between needle-knife therapy and acupuncture-cupping for cervical spondylosis of cervical type].
[Article in Chinese]
Cao L, Wang F.
Abstract
OBJECTIVE:
To compare the efficacy differences between needle-knife therapy and acupuncture-cupping for treatment of cervical spondylosis (CS) of cervical type.
METHODS:
Sixty cases of CS were randomly divided into a needle-knife group (30 cases) and an acupuncture-cupping group (30 cases). The needle-knife therapy was applied at points among superior nuchal line of occipital bone, bilateral neck muscle, neck centerline, trapezius and medial border scapula for only once. In the acupuncture-cupping group, acupuncture was applied at Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), Dazhui (GV 14), Jianjing (GB 21), Jiaji (Ex-B2, from C4 to C6), Houxi (SI 3) and Ashi point, followed by cupping on local skin, once every other day for totally six times. The score of neck stiffness and visual analogue scale (VAS) were observed before and after treatment, in follow-up of 1, 3 and 6 months after treatment in the two groups, and the efficacy was compared.
RESULTS:
In the needle-knife group, 9 cases were cured, 12 cases were markedly effective, 8 cases were effective and 1 case was failed; the total effective rate was 96.7% (29/30) and the cured and markedly effective rate was 70.0% (21/30). In the acupuncture-cupping group, 8 cases were cured, 9 cases were markedly effective, 11 cases were effective and 2 cases were failed; the total effective rate was 93.3% (28/30) and the cured and markedly effective rate was 56.7% (17/30). The difference of total effective rate in the two groups was not statistically significant (P > 0.05), but the cured and markedly effective rate of needle-knife group was significantly superior to that of acupuncture-cupping group (P < 0.05). The needle-knife therapy was significantly superior to acupuncture-cupping on improvement of neck stiffness in the follow-up of 1, 3, 6 months after treatment (P < 0.05, P < 0.001); both treatments were effective on relief of neck pain, but the needle-knife group had better effects in the follow-up of 3 and 6 months after treatment compared with acupuncture-cupping group (both P < 0.01).
CONCLUSION:
The needle-knife therapy has better effects on neck stiffness and pain relief than acupuncture-cupping, and it is more treatment time saving.



Spine J. 2013 Oct;13(10):e59-63. doi: 10.1016/j.spinee.2013.06.024. Epub 2013 Oct 2.
Acute spinal subdural hematoma with hemiplegia after acupuncture: a case report and review of the literature.
Park J1, Ahn R, Son D, Kang B, Yang D.
Author information


Abstract
BACKGROUND CONTEXT:
Subdural spinal hematoma (SDH) is a very rare entity; however, it can lead to serious complications resulting from injuries to the spinal cord and roots. Although acupuncture has been a popular method for the management of pain control, we encountered the first case of SDH after acupuncture.
PURPOSE:
The purpose of this case report was to present the first case of subdural hematoma after acupuncture and the reasons for the risks of blind cervical acupuncture.
STUDY DESIGN:
A case report and review of the previous literature are presented.
METHODS:
A 69-year-old man complained of progressive weakness in the right upper and lower extremities 2 hours after acupuncture on the cervical spine and back. The diagnosis was delayed because of unilateral weakness, and the symptom was initially misinterpreted as a transient ischemic attack because of no sensory change and pain and normal findings of two brain magnetic resonance imaging (MRI).
RESULTS:
Cervical MRI 36 hours after onset revealed acute hematoma from the C3-C5 level; hematoma showed an isointensity on T1-weighted image (WI) with the preservation of epidural fat and a hypointensity on T2WI. A decompressive surgery was scheduled to perform within 2 days after the cervical MRI scan because of a previous anticoagulation therapy, but the patient refused it. Finally, 9 days after the onset, surgical decompression and removal of hematoma were performed. Three months postoperatively, the patient had fully recovered demonstrating fine hand movement and good ability to walk up and down the stairs.
CONCLUSIONS:
Our study indicates that it is essential to perform cervical MRI when a patient does not show an improvement in the neurologic deficit and has a negative brain MRI after acupuncture. In addition, blind acupuncture if not correctly practiced may be harmful to the cervical structures.



Hip Pain

Objective

The aim of the study was to evaluate the therapeutic effect of electro-acupuncture and hydrotherapy, both in combination with patient education or with patient education alone, in the treatment of osteoarthritis of the hip.

Treatment

Patients were treated 10 times during five weeks, two times per week. Each treatment lasted for 30 minutes. All treatments were performed by two experienced physiotherapists.

The patient was positioned on the side, lying with their affected side uppermost. The acupuncture needles were placed locally in the most painful areas distally according to segmental innervation of the hip joint.

Locally in the pain area, four of the following points were selected: Bl 54, Bl 36, GB 29, GB 30, GB 31, and St 31.

The distal points were always the same

GB 34 and Bl 60 , both in the same segmental innervation as the hip joint
Stainless steel needles .32 mm in diameter and 30 mm in length and .4 mm diameter with a 50 mm length
The needles were inserted into a depth of 15 to 35 mm.
The needles were then rotated manually to evoke sensation, reflecting activation of muscle nerve afferent ( Delta, and possibly C) fibers and total four times during each treatment.
All needles were attached to an electrical stimulator and stimulated with continuous square wave pulses with alternating polarity. The frequency used was burst frequency of 2 Hz and a burst frequency of 80 Hz. The intensity was sufficient to cause non-painful local muscular contraction and was optimized for each patient in an attempt to activate both segmental pain control systems and the central descending pain inhibitory systems, including Central and segmental systems.

Hydrotherapy

Hydrotherapy was performed in small groups, the program consisted of warming up, mobility, and strengthening exercises for the muscles around the pelvis and stretching exercises.

Patient Education

Patient education consisted of two group meetings of two hours duration each. Participants were taught about the anatomy and the disease process. Instructed and advised about load unload, activity and inactivity, and pain relief as well as information about total hip arthroplasty surgery. They were also recommended a course of 10 exercises aiming to improve the muscle strength, joint stability and range of motion in the hip, they were taught to train once per day with intensity below pain.


Patients were asked to assess pain in three separate circumstances

Pain related to motion and pain on load

During the day

During the night

Results

Pain related to motion and pain on load

Pain related to motion and pain on load were reduced up to three months after the last treatment in the hydrotherapy group
And up to six months in the electro-acupuncture group

Pain During the Day

Pain during the day was significantly improved in both the electro-acupuncture and hydrotherapy groups up to three months after the last treatment.

Pain at Night

Pain during the night in the hydrotherapy group up to three months after last treatment and the in the EA group up to six months after

It also indicates that both electric acupuncture and hydrotherapy induced long-term effects. These effects are in the previous report.

The mechanisms behind the beneficial affects of electro-acupuncture and hydrotherapy is most likely explained by activation of endogenous pain inhibatory mechanism at both central and segmental levels.

Reduced pain will automatically improve functional activities. Many patients experienced changes in mood such as relaxation and improved well-being, which possibly explains the increased quality of life after electro-acupuncture or hydrotherapy treatments. This is probably the result of effects on the central hormonal system, including the release of oxytocin.

Conclusion

Electro-acupuncture and hydrotherapy, both in combination with patient education, induce long-lasting effects demonstrated by reduced pain and ache and by increased functional activity and quality-of-life as shown by differences in the pre-and post-intervention assessments. The pain relief was more long-lasting, up to six months in the electro-acupuncture group. Patient education alone does not improve any variable in the present study.






The EA group improved directly after last treatment, three months and six months after the last treatment.









47 semester credits (705 hours) in Oriental medical theory, diagnosis and treatment techniques in acupuncture and related studies,
• 22 semester credits (660 hours) in clinical training, and
• 30 semester credits (450 hours) in biomedical clinical sciences.
• 6 semester credits (90 hours) in counseling, communication, ethics and practice management.














Zhongguo Zhen Jiu.
2011 Sep;31(9):791-4.
[Clinical observation of lumbar spinal stenosis treated with deep puncture at Jiaji (EX-B 2)].
[Article in Chinese]
Jing HT1, Peng YY, Chen M, Huang YS.
Author information


Abstract
OBJECTIVE:
To explore the clinical efficacy on lumbar spinal stenosis treated with deep puncture at Jiaji (EX-B 2) with round-sharp needle.
METHODS:
One hundred and fifty cases of lumbar spinal stenosis were divided randomly into a deep puncture at Jiaji (EX-B 2) group (deep puncture group) and a conventional needling group, 75 cases in each one. In deep puncture group, the round-sharp needle was used to puncture Jiaji (EX-B 2) deeply to the nerve root in vertebral canal. Additionally, the conventional acupuncture with filiform needle was applied at the acupoints selected according to the symptoms, such as Shenshu (BL 23), Weizhong (BL 40), Zusanli (ST 36) and Zhibian (BL 54), etc. In conventional needling group, acupuncture with filiform needle was adopted at the acupoints as those in deep puncture group. The clinical symptom scores and efficacies of the patients in two groups were observed after 4 weeks treatment and 3 months of follow-up visit separately.
RESULTS:
After treatment and in follow-up visit, the clinical symptom scores all increased apparently for the patients in two groups (all P < 0.01). The result in deep puncture group was superior to that in conventional needling group (both P < 0.01). In deep puncture group, the total effective rates were 100.0% (75/75) and 96.0 (72/75) after treatment and in follow-up visit respectively, which were all superior to 92.0% (69/75) and 84.0% (63/75) in conventional needling group (both P < 0.05).
CONCLUSION:
The deep puncture at Jiaji (EX-B 2) with round-sharp needle achieves superior efficacy as compared with the conventional needling therapy in treatment of lumbar spinal stenosis. The prognosis of it is better and the disease is hardly recurred.






Zhongguo Zhen Jiu.
2014 May;34(5):499-502.
[Efficacy comparison between needle-knife therapy and acupuncture-cupping for cervical spondylosis of cervical type].
[Article in Chinese]
Cao L, Wang F.
Abstract
OBJECTIVE:
To compare the efficacy differences between needle-knife therapy and acupuncture-cupping for treatment of cervical spondylosis (CS) of cervical type.
METHODS:
Sixty cases of CS were randomly divided into a needle-knife group (30 cases) and an acupuncture-cupping group (30 cases). The needle-knife therapy was applied at points among superior nuchal line of occipital bone, bilateral neck muscle, neck centerline, trapezius and medial border scapula for only once. In the acupuncture-cupping group, acupuncture was applied at Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), Dazhui (GV 14), Jianjing (GB 21), Jiaji (Ex-B2, from C4 to C6), Houxi (SI 3) and Ashi point, followed by cupping on local skin, once every other day for totally six times. The score of neck stiffness and visual analogue scale (VAS) were observed before and after treatment, in follow-up of 1, 3 and 6 months after treatment in the two groups, and the efficacy was compared.
RESULTS:
In the needle-knife group, 9 cases were cured, 12 cases were markedly effective, 8 cases were effective and 1 case was failed; the total effective rate was 96.7% (29/30) and the cured and markedly effective rate was 70.0% (21/30). In the acupuncture-cupping group, 8 cases were cured, 9 cases were markedly effective, 11 cases were effective and 2 cases were failed; the total effective rate was 93.3% (28/30) and the cured and markedly effective rate was 56.7% (17/30). The difference of total effective rate in the two groups was not statistically significant (P > 0.05), but the cured and markedly effective rate of needle-knife group was significantly superior to that of acupuncture-cupping group (P < 0.05). The needle-knife therapy was significantly superior to acupuncture-cupping on improvement of neck stiffness in the follow-up of 1, 3, 6 months after treatment (P < 0.05, P < 0.001); both treatments were effective on relief of neck pain, but the needle-knife group had better effects in the follow-up of 3 and 6 months after treatment compared with acupuncture-cupping group (both P < 0.01).
CONCLUSION:
The needle-knife therapy has better effects on neck stiffness and pain relief than acupuncture-cupping, and it is more treatment time saving.



Acupunct Med. 2008 Sep;26(3):140-4.
Pudendal nerve electroacupuncture for lumbar spinal canal stenosis - a case series.
Inoue M1, Hojo T, Nakajima M, Kitakoji H, Itoi M, Katsumi Y.
Author information


Abstract
OBJECTIVE:
To investigate the effectiveness of pudendal nerve electroacupuncture for lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis for whom acupuncture of the lumbar and lower limb muscles had been ineffective.
METHODS:
Nine patients with lumbar spinal canal stenosis for whom conventional acupuncture at the lumbar and lower limb muscles had no effect. Pudendal nerve electroacupuncture was performed eight times (once per week). VAS scores and continuous walking distance were used to evaluate changes in symptoms.
RESULTS:
The following changes in symptoms occurred after pudendal nerve electroacupuncture: low back pain was improved from 45.3+/-17.4mm (mean +/- SD) to 39.2+/-14.0mm, lower limb pain was improved from 61.1+/-5.6mm to 35.4+/-11.9mm, lower limb dysaesthesia was improved from 63.9+/-8.4mm to 46.9+/-16.2mm, and continuous walking distance was improved from 100.0+/-35.4m to 250.0+/-136.9m. Conclusion Pudendal nerve electroacupuncture may be an effective treatment for lumbar and lower limb symptoms due to spinal canal stenosis, and is potentially useful in patients who have not responded to conventional acupuncture.



Evid Based Complement Alternat Med. 2008 Jun;5(2):133-43. doi: 10.1093/ecam/nem050.
Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms-The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow.
Inoue M1, Kitakoji H, Yano T, Ishizaki N, Itoi M, Katsumi Y.
Author information


Abstract
To investigate the clinical efficacy of acupuncture treatment for lumbar spinal canal stenosis and herniated lumbar disc and to clarify the mechanisms in an animal experiment that evaluated acupuncture on sciatic nerve blood flow. In the clinical trial, patients with lumbar spinal canal stenosis or herniated lumbar disc were divided into three treatment groups; (i) Ex-B2 (at the disordered level), (ii) electrical acupuncture (EA) on the pudendal nerve and (iii) EA at the nerve root. Primary outcome measurements were pain and dysesthesia [evaluated with a visual analogue scale (VAS)] and continuous walking distance. In the animal study, sciatic nerve blood flow was measured with laser-Doppler flowmetry at, before and during three kinds of stimulation (manual acupuncture on lumber muscle, electrical stimulation on the pudendal nerve and electrical stimulation on the sciatic nerve) in anesthetized rats. For the clinical trial, approximately half of the patients who received Ex-B2 revealed amelioration of the symptoms. EA on the pudendal nerve was effective for the symptoms which had not improved by Ex-B2. Considerable immediate and sustained relief was observed in patients who received EA at the nerve root. For the animal study, increase in sciatic nerve blood flow was observed in 56.9% of the trial with lumber muscle acupuncture, 100% with pudendal nerve stimulation and 100% with sciatic nerve stimulation. Sciatic nerve stimulation sustained the increase longer than pudendal nerve stimulation. One mechanism of action of acupuncture and electrical acupuncture stimulation could be that, in addition to its influence on the pain inhibitory system, it participates in causing a transient change in sciatic nerve blood blow, including circulation to the cauda equine and nerve root.



http://dx.doi.org/10.1155/2014/212098
Research Article
Effects of Wonli Acupuncture Procedure in Patients with LSS: A Clinical, Retrospective Study
Geon-Mok Lee,1 Eun-Yong Lee,2 Jong-Hyun Han,3 Kyong-Ha Cho,1 Se-Rin Kang,1 and Sang-Hoon Yoon1
1Lee-Geonmok Wonli Korean Medicine Hospital, 196 Dongjak-daero, Seocho-gu, Seoul 137-829, Republic of Korea2Department of Acupuncture and Moxibustion, College of Korean Medicine, Semyung University, 65 Semyeong-ro, Jecheon-si 390-711, Republic of Korea3Department of Pharmacology, College of Korean Medicine, Wonkwang University, 460 Iksan-daero, Iksan-si 570-749, Republic of Korea
Received 6 March 2014; Revised 28 April 2014; Accepted 5 May 2014; Published 22 June 2014
Academic Editor: Alfredo Vannacci

Copyright © 2014 Geon-Mok Lee et al. This is an open access article distributed under the

Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Lumbar spinal stenosis (LSS) is a disease with increasing prevalence due to prolongation of average life span. Despite various treatment methods, many limitations remain unsolved. Objective. We are reporting cases of patients who have been treated with Wonli Acupuncture, a method of treating LSS by directly approaching the intervertebral foramen and interlaminar space with acupuncture needles different from those used in original acupuncture. Methods. A total of 82 patients with LSS were treated with Wonli Acupuncture, and out of those, 47 patients without exclusion criteria were selected for the following research. We compared the pretreatment VAS and ODI scores based on 1-year follow-up measurements. Results. The ODI value dropped by on average (from at the baseline to at the reading) and the average VAS also dropped by (from at baseline to at the reading) . Conclusions. Wonli Acupuncture was found to have clinical efficacy for lumbar spinal stenosis.


Evidence-Based Complementary and Alternative MedicineVolume 2014 (2014), Article ID 212098, 9 pages




The Knee

A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee

July 11, 2002

A total of 180 patients with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement, arthroscopic Lavrge, or placebo surgery.

Patients in the placebo group received skin incisions and underwent a simulated procedure without insertion of the arthroscope.

Patients and assessors of outcome were blinded to the treatment group assignment.

Outcomes were assessed at multiple points over a 24 month period with the use of five self-reported scores – 3 on scales for pain and two on scales for function – and one objective test of walking and stair climbing.
A total of 165 patients completed the trial

results

At no point did either of the intervention group
s report less pain or better function than the placebo group.
Furthermore, the 95% confidence interval for the difference between the placebo group and the intervention group exclude any clinically meaningful difference

Conclusion
In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic Lavarge or arthroscopic débridement were no better than those after a placebo procedure.





Abstract
OBJECTIVE:
To explore the efficacy on knee osteoarthritis (KOA) treated with different acupuncture methods at different stages.
METHODS:
One hundred and eighty cases of KOA were divided into stagnation stage, fascia cramp stage and tendon lesion stage according to the condition of disease, 60 cases in each stage. Each stage was randomized into a staging treatment group and an electroacupuncture (EA) group, 30 cases in each one. In the staging treatment group, acupuncture at the tendon points of meridians and electric thermal needling method were adopted for the cases at the stagnation stage; the small needle-knife therapy and bleeding method were used for the cases at the fascia cramp stage; and the electric thermal therapy with thick silver needles was applied for the cases at the tendon lesion stage. In the EA group, EA was applied for the cases of all the three stages at Liangqiu (ST 34), Xuehai (SP 10), Yanglingquan (GB 34), etc.
RESULTS:
The total effective rate was 96.1% (87/90) in the staging treatment group and was 91.1% (82/90) in the EA group, without significant difference in comparison (P > 0.05). The controlled and remarkably effective rate (88.9%, 80/90) in the staging treatment group was higher apparently than (62.2%, 56/90) in the EA group (P < 0.001). And in the EA group, with the disease progression and the further disease stages, the controlled and remarkably effective rate was reduced. After treatment, the scores of symptoms and signs were decreased in both groups (both P < 0.001), the improvement in the staging treatment group was superior to that in the EA group (P < 0.001).
CONCLUSION:
The different acupuncture methods at the three stages improve obviously the clinical effect and are highly targeted. The mechanism of the three stages on "meridian muscle region pathology" and the treatment based on the disease stages can be the effective approach to KOA.


Annals of Internal Medicine

Effectiveness of Acupuncture as an Adjunctive Therapy in Osteoarthritis of the Knee: A Randomized Controlled Trial.
December 21, 2004

Objective

To determine whether acupuncture provides greater pain relief and improved function compared with sham acupuncture or education in patients with osteoarthritis of the knee.

The researchers tested the hypothesis that an eight week intensive acupuncture treatment regime, followed by an 18 week tapering regime, reduces pain and improves function among patients with knee osteoarthritis as compared with both sham acupuncture and education control groups

A systematic review of the literature revealed the existence of seven small randomized controlled trials published in English.

In five of these studies acupuncture seem to really benefit knee pain and function compared with sham acupuncture controls.
True Acupuncture
Each acupuncture group underwent 26 gradually tapering treatments according to the following schedule: eight weeks of two treatments per week followed by two weeks of one treatment per week, four weeks of one treatment every other week and 12 weeks of one treatment per month.


The acupuncture point selection was based on traditional Chinese medicine meridian therapy to treat knee joint pain known as bi syndrome.

These points consisted of five local points:

GB 34,Sp 9, St36, St 35, extra point xiyan.
And four distal points:
Bl 60, GB39, Sp 6, and K3
Both knees were treated in the event of bilateral symptomatology.


1 ½ inch needles and 1 inch needles were inserted to a conventional depth of approximately .3-1in depending on point location

All the participants in the treatment group achieved the De Qi sensation at these nine points.
Electric stimulation was applied to needle points xiyan at 8 Hz and 80 Hz square biphasic pulse of .5 ms pulse width for 20 minutes.

A sham procedure was used on a second group where acupuncture was simulated with non-inserted needles and guide tubes taped to the patient in the same locations. This procedure was demonstrated to be effective in fooling the patients into believing they received real acupuncture.

A third group was created and treated with patient education. Participants underwent six two hour sessions of education conducted by professionals experienced with osteoarthritis of the knee.

The acupuncture needles used were 1.5 inch for local points and 1 inch for distal points using 32 gauge needles to a conventional depth of approximately .3-1 inch depending on point location


All participants in the treatment group achieved the De Qi sensation Electrical stimulation at points xiyan at low-frequency, 8 Hz with a square biphasic pulse for 20 minutes.


Conclusion

Acupuncture seems to provide improvement in function and pain relief as an adjunct of therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.

Participants in the true acupuncture group experienced a pain reduction of 40% better than their counterparts in the sham group. A similar benefit in functional capacity was also realized

The author States:
It is interesting that the optimal acupuncture effects observed for our primary outcomes took a minimum of eight weeks for function and 14 weeks for pain to manifest.
From a physiologic perspective, this delayed response is not consistent with the most common proposed mechanisms of acupuncture (for example, the release of neuropeptides or gate control theory.)


In the two previous trials where acupuncture failed to show superior benefit then a sham acupuncture in the treatment of osteoarthritis of the knee, the trials consisted of only 20 participants and fewer than 10 acupuncture treatments were administered.
This indicates that these studies may not allow a sufficient course of treatment to produce clinically significant benefits.


The British Medical Journal

Acupuncture as a Complementary Therapy to be Pharmacological Treatment of Osteoarthritis of the Knee: Randomized Controlled Trial

Objective

To analyze the efficacy of acupuncture as a complementary therapy to the pharmacologic treatment of osteoarthritis of the knee, with respect to pain relief, reduction of stiffness, and increased function during treatment; modifications in consumption of diclofenac during treatment and changes in the patients quality of life.


True Acupuncture Group

The standard acupuncture intervention entailed the insertion of sterile, single use, 30 gauge, 45 mm acupuncture needles into the local points GB 34, Sp 9, Lv5, and St36. The distal points used were K 3,
Sp 6 Li 4, and St 40.


The De Qi sensation was experienced by the patient with each needle insertion.

An electrical stimulator was used to stimulate all the needles inserted into the local points electrically in pairs.
The treatment lasted 12 weeks, starting with a visit zero and ending with 11. The doctor carried out the final evaluation at visit 12, one week after treatment had ended.

The placebo procedure utilizing the same points was administered to the control group.

In each group, the patients received a bag with 21 tablets of diclofenac and were instructed to take one every eight hours with the instruction to reduce the dose if the symptoms improved.

Results

Patients in the real acupuncture group exhibited a greater reduction of pain, consumption of medicine, and increased functional activity.

Acupuncture plus diclofenac is more effective than placebo acupuncture plus diclofenac for the symptomatic treatment of osteoarthritis of the knee.



Head Ache

British Medical Journal July 29, 2005

Acupuncture in Patients with Tension Type Headache: Randomized Controlled Trial.

Objective

To Investigate the Effectiveness of Acupuncture Compared with Minimal Acupuncture and with No Acupuncture in Patients with Tension Type Headache.


participants

270 people (74% women, mean age of 43,) history of chronic tension type headache.


Intervention

Acupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or waiting list control.


Acupuncture and minimal acupuncture were administered by specialized physicians and consisted of 12 sessions per patient over eight weeks.


Mean outcome measures

Difference in the number of days with headache between the four weeks before randomization and weeks nine through twelve after randomization, as recorded by participants in headache diaries.

Results

The number of days with headache decreased by 7.2 days in the acupuncture group.

The number of days with headache decreased by 6.6 days in the minimal acupuncture group.

The number of days with headache decreased by 1.5 and the waiting list group.


Conclusion

The acupuncture interventions investigated in this trial was more effective than no treatment but not significantly more effective than minimal acupuncture for the treatment of tension type headache.











Acupunct Med. 2014 Aug 27. pii: acupmed-2014-010612. doi: 10.1136/acupmed-2014-010612. [Epub ahead of print]
Acupuncture decreases matrix metalloproteinase-2 activity in patients with migraine.
Cayir Y1, Ozdemir G2, Celik M3, Aksoy H4, Akturk Z1, Laloglu E4, Akcay F5.
Author information


Abstract
OBJECTIVE:
To evaluate the effect of acupuncture on the serum matrix metalloproteinase-2 (MMP-2) level and activity in patients with migraine.
METHODS:
After baseline testing, eligible patients with migraine according to the criteria of the International Headache Society who volunteered to join the study were included (n=27). The patients received 10 sessions of acupuncture treatment. The points selected were bilateral ST8, ST44, LI4, LI11, LIV3, SP6, GB1, GB14, GB20, GV14, GV20, Yintang, Taiyang and ear Shenmen. Pain was measured using a visual analogue scale (VAS). Short form-36 (SF-36) was used to determine their quality of life. Blood samples were taken before treatment and after the first and last sessions of acupuncture for measurement of MMP-2 concentration and activity.
RESULTS:
The mean VAS was 85.5±16.6 before acupuncture and was significantly decreased to 39.8±20.6 after 10 sessions of acupuncture (p<0.0001). There was a significant increase in all SF-36 scores after acupuncture compared with values before treatment (p<0.0001). No significant differences were found in MMP-2 concentrations before treatment and after the first and last sessions (p>0.05). However, there were significant changes in MMP-2 activity (p<0.0001).
CONCLUSIONS:
The results of this study showed a clinically relevant decrease in MMP-2 activity in patients with migraine treated with acupuncture. The mechanism underlying the effect of acupuncture in alleviating pain may be associated with a decrease in MMP-2 activity.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Zhongguo Zhen Jiu. 2013 Nov;33(11):989-92.
[Clinical observation on cervical headache treated with acupuncture and fire needling technique].
[Article in Chinese]
Zhang XZ1, Wang LL2, Liu YQ2.
Author information


Abstract
OBJECTIVE:
To observe the efficacy in cervical headache of acupuncture combined with fire needling and the simple acupuncture therapy.
METHODS:
One hundred and eighty cases were randomized into an acupuncture plus fire needling group (group A) and an acupuncture group (group B), 90 cases in each one. Baihui (GV 20), Wangu (GB 12), Fengchi (GB 20), Tianzhu (BL 10) and Neck-Jiaji (EX-B 2) were selected in the two groups. In group A, the fire needling technique was applied to all the above points before acupuncture with filiform needles. In group B, the acupuncture therapy was used only. The treatment was given once a day, the efficacy was compared between the two groups after 20 treatments.
RESULTS:
The total effective rate was 95.6% (86/90) in group A and was 84. 4% (76/90) in group B, indicating the significant difference in comparison (P<0.05). VAS were 7.44+/-1.26 and 0.73+/-l. 44 before and after treatment in group A separately, those were 7.56+/-1.07 and 2. 56+/-2. 99 in group B, indicating the significant difference in comparison (P<0.01). The difference in VAS after treatment was significant between the two groups. In group A, the follow-up visit was conducted at 3 months and 6 months after treatment for the cured cases. The total recurrence rate in the patients without bony pathological changes was 14.8% (4/27) and that in the patients with bony pathological changes was 43. 5% (10/23), there was significant difference between them (P<0. 05).
CONCLUSION:
The combined therapy of fire needling technique and filiform needle acupuncture improves the efficacy and sustains the efficacy especially on cervical headache without bony pathological changing.



Zhen Ci Yan Jiu. 2013 Jun;38(3):234-40.
[Optimized schemes for acupuncture treatment of migraine during attack].
[Article in Chinese]
Wang JJ, Wu ZC, Hu J, Jiao Y, Zheng JY, Wang QM.
Source
Institute of Acu-moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China. wjj751@sina.com
Abstract
OBJECTIVE:
To observe the therapeutic effect of manual acupuncture, electroacupuncture (EA), auricular acupuncture and bloodletting therapies combined with orthogonal design for migraine patients, so as to select a better scheme for relieving headache.
METHODS:
total of 76 migraine patients in the stage of attack were recruited in the present study and randomly (stratified random and central random) allocated to 9 groups by means of orthogonal experimental design [L9 (3(4)), 4 factors (F) and three levels (L)] i.e., F1: ody-acupoints combination; F1-L1: regional acupoints [Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), etc.] near the focus, F1-L2:regional +distal acupoints [Hegu (L 4), Taichong (LR 3), etc.] far from the focus, and F1-L3:regional + remote acupoints+ those selected according to syndrome differentiation [for instance, Ganshu (BL 18), Yanglingquan (GB 34), Qiuxu (GB 40) and Taixi (KI 3) for hyperactivity of Liver-yang, etc.]; F2: manual acupuncture or EA of body acupoints; F2-L1:no acupuncture stimulation, F2-L2:manual acupuncture stimulation, and F2-L3:manual + EA stimulation; F3: auricular acupuncture therapy; F3-L1:no acupuncture stimulation, F3-L2: otopoint-manual acupuncture (Shenmen, Jiaogan, etc.), and F3-L3:otopoint-EA; F4: bloodletting; F4-L1 : EX-HN 5 + Ashi point bloodletting, F4-L2:EX-HN5 bloodletting, and F4-L3: no bloodletting. The therapeutic effect of acupuncture was evaluated using Visual Analogue Scale (VAS) and analyzed by investigators who did not participate in the treatment course.
RESULTS:
Within 24 hours after the treatment, the four factors influencing headache relief from bigger to smaller are body-acupoints combination > manual acupuncture or EA stimulation > bloodletting > auricular acupuncture. Among the therapeutic schemes evaluated by orthogonal deduction, the analgesic effect was most stable in the manual acupuncture at regional + distal acupoints group which was recommended to be the ba-sic scheme for migraine. The auricular EA could effectively reduce VAS levels from 10 min to 30 min after stimulation, while bloodletting at Taiyang (EX-HN 5)+ Ashi points was effective in relieving migraine from 4 h to 24 h after the treatment, suggesting a long lasting post-therapeutic analgesic effect.
CONCLUSION:
Manual acupuncture stimulation of the local + distal body acupoints combined with otopoint-EA and bloodletting at Taiyang (EX-HN 5) + Ashi points is the best option for relieving migraine during attack.

Basic points
GB 20

GB 21

Lv 3

Optional points
Mainly frontal headache: LI 4, GV 23, St 44 and Tai yang

Headache mainly in the vertex: GV 20 or GV23 extra points Sishencong

Mainly Neck Pain

Bl 10, 60 or 62, GV 14 or 19, SI 3 or 6


Holocephalic Pain with Fatigue

LI4, GV 14, GB 3,TW 6 and GB 39

Extra point Tai yang, Spleen 6 or spleen nine, stomach 36 or stomach 40, conception vessel 12

Worse with wet or cold weather


LI4, GV 14, GB 3,TW 6 and GB 39.

Modalities to wind, dampness, cold: Li 4, GV14, TW6 and GB 34

Wind Cold

LI 4, Lu 7, TW 5 and GV 15





April, 2004, Vol. 05, Issue 04

Acupuncture Today

 



"As Above, So Below" Acupuncture: Great Loops and Reverse Body Image Points
By Darren Starwynn, OMD, LAc
One of the greatest contributions from acupuncture is the understanding of the interrelatedness of all parts of the body, and the ability to effectively treat using this understanding. It is the use of distal acupoints, energetically related to the afflicted body area, that often brings the most immediate balance and relief.

Many of us use this method without fully knowing the basis for its effectiveness. A valuable model for understanding and selecting highly effective distal treatment points can be found in ancient writings often referred to as Hermetic Law.
The Hermetic Laws originated in ancient Egypt or earlier, and are attributed to the god-man Thoth (pronounced "Toth"). Thoth was called Hermes in ancient Greece, and Mercury in Rome. In the Middle Ages, he was referred to as Hermes Trismegistus, and was considered the originator of 42 books of esoteric knowledge collectively known as the
Hermetica. The Hermetic Laws are a major basis for the Kaballa tree of life and most other metaphysical teachings throughout the ages.1
A brief survey of the Hermetic Laws will quickly reveal that they also explain the basis for all forms of vibrational healing, including many aspects of Chinese medicine and modern quantum physics.
Of the seven best-known Hermetic Laws, the best known principle is "as above, so below," also known as the Law of Correspondance. This principle has been key to such diverse pursuits as astrology, magical practices, quantum physics and traditional acupuncture. Five-element acupuncture is a system especially organized around extensive lists of correspondences between organs, colors, smells, directions, emotions, animals and much more.
A simple way to grasp as above, so below is to examine the similarity between our solar system and the structure of atoms. Both have a central nucleus with bodies orbiting around it in regular patterns. One could also compare the spiral shape of the Milky Way galaxy to spiral snail shells and the DNA double helix within our cells. Such clear correspondences exist on all levels throughout nature and consciousness. The universe is holographic in nature: the whole exists in each part, no matter how minute.
Musical instruments, such as pianos or sitars, demonstrate resonance between octaves. If a note is played in one octave, such as middle C, sympathetic tones are created in other higher or lower octaves of that same note through the principle of as above, so below. It is similar with consciousness and our energy bodies.
We exist on many levels simultaneously, from the most dense and gross (physical) to the most subtle (spirit). Injuries to the physical body can create ongoing interference in the subtle energy bodies, thereby creating stored, self-perpetuating memories of trauma. Held negative impressions on the subtle energy level can also precipitate in the physical as disease and pain. In fact, such interferences can actually attract accidents and other traumatic events to people through the Law of Attraction.
This holographic nature of the body is recognized in the acupuncture classics, paraphrased as follows (assume the opposite is also true after each statement):
"For diseases of the upper body, treat the lower body. For diseases of the right treat the left. For diseases of the front, treat the back. For diseases of the inner, treat the outer."
As Above, So Below Acupuncture Treatment Methods
These time-tested principles can be used for highly effective pain relief and energy balancing treatments in the acupuncture practice. They are clearly manifested through two acupuncture methods: microsystems and great loops distal acupoints.
Microsystems are holographic representations of the entire body projected in a single body part. Most acupuncturists are familiar with and clinically utilize microsystems, which are commonly treated in areas as diverse as the ear, hand, foot, face, abdomen and gastocnemius muscle. Stimulating an appropriate microsystem point can cause a healing or pain-relieving reaction in the corresponding body part. Pain is often relieved more effectively through stimulating a distal holographic micropoint than treating the affected area directly.
2
Two of the most powerful and effective clinical applications of as above, so below I have experienced are treatment of great loops and reverse body image (RBI) points. These are based on the principles mentioned above in the
Nei Jing passage. Microcurrent stimulation through polarized probes is an ideal way to perform these treatments.
starwynn01_3706_1_1_2956
Knee-Elbow
Here are photos of the as above, so below correspondence of the major joints of the body:
The phrase "great loops" literally refers to the six great meridians of
taiyang, yangming, shaoyang, taiyin, jueyin and shaoyin, each of which includes one upper and one lower extremity channel. Treating tender points on the lower extremity channel for pain of the upper extremity channel can be an effective pain controlling method. I am expanding "great loops" here to include all energetically-related meridians on the upper and lower body.
starwynn02_3708_1_1_7346
Ankle-Wrist
As above, so below can also be applied to RBI points on the trunk of the body. For example, the spine is holographically represented on the front of the body, upside-down:
The major joints are also projected on the body in a similar way:
More information about these "reverse body image" points on the trunk can be found in the work of Peter Mandel, ND, originator of the German colorpuncture system.
starwynn03_3710_1_1_7433
Hip-Shoulder
Treating As Above, So Below Points
Great loops treatment is utilized for pain and injury of the extremities, while RBI points are primarily used for disorders on the trunk of the body.
The principle of great loops treatment is simply that, for pain on or around a joint, go to the joint on the opposite quadrant of the body, as shown in the joint correspondence pictures above, and palpate for very tender points. When treated, these distal points will likely be highly effective for relieving pain in the symptomatic area.
Treatment of RBI points is similar. Using the charts above, find the region corresponding to the painful or diseased area. Palpate to find the sorest point upon pressure, and use that for distal treatment.
There are several methods that can be used to treat as above, so below points:
1. Microcurrent probe stimulation. This is my favorite method, because polarized microcurrent probe therapy can correct imbalanced polarity fields in the body rapidly and powerfully. Such treatment creates a gentle electrical circuit between the point of pain and the corresponding point. I also like it because it works much more quickly than acupuncture needling for this purpose, in my experience.
starwynn2_2_1591_3712_1_1_9320
While there is certainly room for customizing settings to individual patients, the following electrical parameters work well:
  • Intensity: 75 µA
  • Frequency: 10 Hz
  • Polarity: negative
  • Waveform: square
  • Timer: 5-6 seconds
  • Modulation: if available, alternate 10 Hz with 5 Hz every 3 seconds to avoid accommodation3
Place the positive probe (counterprobe) on the local point of pain, and the negative probe (trigger probe) on the tender point you found on the opposite aspect of the body. For example, for tennis elbow, place the positive probe on the painful elbow, and the negative probe on the sore point around knee joint on the opposite side of the body. If available, use the device's search function to hone in on the most highly conductive local and distal points.
Look at conductivity reading on the device meter and note. Press the trigger button and treat for 5-6 seconds. After the timer has expired, look at the conductivity reading again. If it has increased, press the trigger again to give another treatment period on the same points. Keep treating in this way in 6-second segments until the conductivity reading stabilizes, and does not rise any more.
4 If the readings significantly increase after 2-3 treatment segments, the patient will most likely report lessened pain and/or increased range of motion.
starwynn3_2_4519__1_1_3570
You can continue to treat in this way by placing the positive probe on other painful points in the same or related areas and palpating for additional distal tender points. The two main reasons for poor results with this method would be incorrect choice of polarity or frequency, or incorrect distal point selection.
2. Color light therapy. Light is also very effective for as above, so below, as it is the prime medium of communication between all the parts of the body, and with the outer environment. Using any good focused color light device, shine an appropriate color onto the tender distal point for 20-30 seconds. Kinesiology (muscle testing) is quite helpful in confirming color selection. For distal pain points, generally use cool colors in the blue and green wavelengths, or use complementary color balancing on bilateral points.5
The following colors are commonly affected for treatment of major joints through RBI points:
  • Neck: green or blue
  • Shoulders: green or blue
  • Sacroiliac joints: red/green (green on the more tender side, red on the other side)
  • Knees: yellow or green
  • Hip joint: red/green (green on the more tender side, red on the other side)
starwynn4_2_1691__1_1_4570
Microcurrent may be combined with color light therapy for treatment with often excellent, synergistic results. I have developed a special combination probe system for this purpose.
3. Needle acupuncture. Needling is also effective for treatment of great loops and RBI points. Find the most tender distal point, and place a needle to a depth that produces an energetic release (teh chi). Leave it in place for 10-20 minutes, periodically manipulating it to maintain stimulation.
Because creation of a circuit between the pain point and the distal point is often superior to stimulation of the distal point alone, I recommend needling both, and connecting them with an ion-pumping cord. In most cases, place the red clip on the pain point and the black clip on the distal point, although this may need to be reversed in some patients. Proper polarity can be confirmed through pulse, patient response or kinesiology.
References
  • There are many good writings about Thoth and the Hermetic Laws available on the Internet, found through any search engine.
  • Maps of auricular, hand, foot, face and other microsystems are readily available in English-language texts. See www.redwingbooks.com or other catalogs for reference books.
  • When using the Acutron Mentor, these settings are produced by selecting probe preset #2.
  • Meter readings while treatment currents are being delivered are not relevant to this method, only the conductivity readings after treatment has ended and the unit is in measuring mode.
  • For principles of complementary color balancing, see my previous article, or the work of Peter Mandel.




J. 2013 Oct;13(10):e59-63. doi: 10.1016/j.spinee.2013.06.024. Epub 2013 Oct 2.
Acute spinal subdural hematoma with hemiplegia after acupuncture: a case report and review of the literature.
Park J1, Ahn R, Son D, Kang B, Yang D.
Author information


Abstract
BACKGROUND CONTEXT:
Subdural spinal hematoma (SDH) is a very rare entity; however, it can lead to serious complications resulting from injuries to the spinal cord and roots. Although acupuncture has been a popular method for the management of pain control, we encountered the first case of SDH after acupuncture.
PURPOSE:
The purpose of this case report was to present the first case of subdural hematoma after acupuncture and the reasons for the risks of blind cervical acupuncture.
STUDY DESIGN:
A case report and review of the previous literature are presented.
METHODS:
A 69-year-old man complained of progressive weakness in the right upper and lower extremities 2 hours after acupuncture on the cervical spine and back. The diagnosis was delayed because of unilateral weakness, and the symptom was initially misinterpreted as a transient ischemic attack because of no sensory change and pain and normal findings of two brain magnetic resonance imaging (MRI).
RESULTS:
Cervical MRI 36 hours after onset revealed acute hematoma from the C3-C5 level; hematoma showed an isointensity on T1-weighted image (WI) with the preservation of epidural fat and a hypointensity on T2WI. A decompressive surgery was scheduled to perform within 2 days after the cervical MRI scan because of a previous anticoagulation therapy, but the patient refused it. Finally, 9 days after the onset, surgical decompression and removal of hematoma were performed. Three months postoperatively, the patient had fully recovered demonstrating fine hand movement and good ability to walk up and down the stairs.
CONCLUSIONS:
Our study indicates that it is essential to perform cervical MRI when a patient does not show an improvement in the neurologic deficit and has a negative brain MRI after acupuncture. In addition, blind acupuncture if not correctly practiced may be harmful to the cervical structures.
Copyright © 2013 Elsevier Inc. All rights reserved.




Spine J. 2013 Jul;13(7):e9-e12. doi: 10.1016/j.spinee.2013.02.012. Epub 2013 Mar 21.
Myositis ossificans in the paraspinal muscles of the neck after acupuncture: a case report.
Lee DG1, Lee SH, Hwang SW, Kim ES, Eoh W.
Author information


Abstract
BACKGROUND CONTEXT:
Although traumatic myositis ossificans (MO) has been reported occasionally, MO of paraspinal muscles has been rarely seen in the cervical spine after minor injury. This is difficult to distinguish from benign and malignant soft lesions in cases of a lack of definite trauma history.
PURPOSE:
We report a case of MO in the cervical paraspinal muscle after acupuncture and describe methods for diagnosis and proper treatment, including classification, etiology, and radiologic and histologic features.
STUDY DESIGN:
Case report.
METHODS:
A 26-year-old woman complained of posterior neck pain that had began 2 months earlier and neck swelling after acupuncture. No abnormal finding existed on the X-ray except soft tissue swelling. Magnetic resonance imaging was evaluated because of constant neck pain. To obtain more accurate assessment, computed tomography-guided biopsy was performed and a diagnosis of MO was made.
RESULTS:
The patient was conservatively treated through rest and analgesics. Posterior neck pain and swelling improved for a several months. The hyperdensity was comparable with the bony density, and the size of the calcified lesion on X-ray diminished until the last follow-up.
CONCLUSIONS:
Myositis ossificans that can occur after acupuncture should be recognized as a possible cause of persistent neck pain and swelling despite no definite trauma after thorough evaluation of the neoplasm and infection.
Copyright © 2013 Elsevier Inc. All rights reserved.


Shoulder Pain


J Shoulder Elbow Surg. 2013 Aug;22(8):1053-62. doi: 10.1016/j.jse.2012.10.045. Epub 2013 Jan 24.
Clinical effectiveness of bee venom acupuncture and physiotherapy in the treatment of adhesive capsulitis: a randomized controlled trial.
Koh PS1, Seo BK, Cho NS, Park HS, Park DS, Baek YH.
Author information


Abstract
BACKGROUND:
Bee venom acupuncture (BVA) has been used in the treatment of adhesive capsulitis (AC) in the clinical field. This study aimed to investigate whether the addition of BVA to physiotherapy (PT) would be more effective in the management of AC, and whether BVA would have a dose-dependent effect.
MATERIALS AND METHODS:
Sixty-eight patients diagnosed with AC were recruited into 3 groups; BV 1 (1:10,000 BVA plus PT), BV 2 (1:30,000 BVA plus PT), and group 3 (normal saline (NS) injection, as a control, plus PT). PT was composed of 15 minutes of transcutaneous electrical nerve stimulation (TENS), transcutaneous infrared thermotherapy (TDP), and manual PT. Treatments were given in 16 sessions within 2 months. Shoulder pain and disability index (SPADI), pain visual analogue scale (VAS), and 3) active/passive range of motion (ROM) were measured before treatment and at 2, 4, 8, and 12 weeks after the treatment.
RESULTS:
All 3 groups showed statistically significant improvements in SPADI, pain VAS scores, and active/passive ROM. The BV 1 group showed significantly better outcomes in SPADI at 8 and 12 weeks, in pain VAS (at rest) at 8 weeks, and in pain VAS (during exercise) at 12 weeks than the NS group. No significant differences were found in active/passive ROM among all the groups.
CONCLUSION:
BVA in combination with PT can be more effective in improving pain and function than PT alone in AC. However, the effectiveness of BVA was not shown in a dose-dependent manner.
Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
KEYWORDS:
Adhesive capsulitis; Level I; Randomized Controlled Trial; Treatment Study; bee venom acupuncture; physiotherapy









Spine

tao sounds
tao sounds 2


The wrist



Evid Based Complement Alternat Med. 2013;2013:795906. doi: 10.1155/2013/795906. Epub 2013 Jun 17.
Acupuncture-evoked response in somatosensory and prefrontal cortices predicts immediate pain reduction in carpal tunnel syndrome.
Maeda Y1, Kettner N, Lee J, Kim J, Cina S, Malatesta C, Gerber J, McManus C, Im J, Libby A, Mezzacappa P, Morse LR, Park K, Audette J, Napadow V.
Author information


Abstract
The linkage between brain response to acupuncture and subsequent analgesia remains poorly understood. Our aim was to evaluate this linkage in chronic pain patients with carpal tunnel syndrome (CTS). Brain response to electroacupuncture (EA) was evaluated with functional MRI. Subjects were randomized to 3 groups: (1) EA applied at local acupoints on the affected wrist (PC-7 to TW-5), (2) EA at distal acupoints (contralateral ankle, SP-6 to LV-4), and (3) sham EA at nonacupoint locations on the affected wrist. Symptom ratings were evaluated prior to and following the scan. Subjects in the local and distal groups reported reduced pain. Verum EA produced greater reduction of paresthesia compared to sham. Compared to sham EA, local EA produced greater activation in insula and S2 and greater deactivation in ipsilateral S1, while distal EA produced greater activation in S2 and deactivation in posterior cingulate cortex. Brain response to distal EA in prefrontal cortex (PFC) and brain response to verum EA in S1, SMA, and PFC were correlated with pain reduction following stimulation. Thus, while greater activation to verum acupuncture in these regions may predict subsequent analgesia, PFC activation may specifically mediate reduced pain when stimulating distal acupoints.




Am J Chin Med. 2014;42(2):303-14. doi: 10.1142/S0192415X14500207.
Clinical effectiveness of acupuncture for carpal tunnel syndrome.
Ho CY1, Lin HC, Lee YC, Chou LW, Kuo TW, Chang HW, Chen YS, Lo SF.
Author information


Abstract
Acupuncture and electroacupuncture treatments of symptomatic carpal tunnel syndrome (CTS) may improve symptoms and aid nerve repair as well as improve sensory and motor functions. However, limited evidence is available regarding the effects of these treatments based on comprehensive evaluation methods. This research completed the treatment and evaluation of 26 patients with confirmed CTS. Participants were divided into two treatment groups based on a modified neurophysiological grading scale. Of the total number of participants, 15 received acupuncture and 11 received electroacupuncture on both upper limbs. Acupoints were PC-7 (Daling) and PC-6 (Neiguan) along the pericardial meridian compatible with the median nerve tract. The treatment program consisted of 24 sessions of 15 min duration over 6 weeks. After electroacupuncture treatments, symptom severity was evaluated using the short clinical questionnaire by Lo and Chiang, which indicated improvements in the respective symptom severity score. After the acupuncture treatment, grip strength in the major symptomatic side in CTS patients could be significantly increased. Electrophysiology evaluation likewise indicated a significant increase in the distal median motor amplitude of the palm-wrist segment. In addition, Tinel's sign significantly decreased in the major symptomatic side. Our findings indicated that electroacupuncture could improve symptomatology, while acupuncture could exert positive therapeutic effects for CTS patients, as evidenced by improved symptomatology, grip strength, electrophysiological function, and physical provocation sign.