Am J Chin Med. 2014;42(2):303-14. doi: 10.1142/S0192415X14500207.
Clinical effectiveness of acupuncture for carpal tunnel syndrome.




ABSTRACT

NECK AND BACK PAIN TREATMENT
page16image1632
Treatment Of Chronic Back Pain And Neck Pain Using Scalp Acupuncture: A Case Study Chunbo Cai, MD
Background page16image3784Acupuncture points on the scalp have been considered important points in the history of the practice of acupuncture. However, development of scalp acupuncture as an independent system took place in the last century. Scalp acupuncture was known to be developed as a systemic approach in China in the 1960s and 1970s. It is sophisticated and has branched out into different styles by the pioneers in this field. Among them, Zhu’s style uses the 3-column zone theory to direct formulation of a treatment regimen.
Objective page16image7912To investigate the effectveness of treatment of chronic back pain and neck pain with scalp acupuncture. Methods page16image8960We used Zhu’s style to treat 20 cases of chronic back pain and neck pain at a hospital-based spine center. The technique involved the use of 36-gauge 1.2 acupuncture needles at relevant points based on the 3-column zone theory. Among the 20 cases, there were 15 cases of chronic back pain, 5 cases of neck pain (13 men, 7 women). Ages were 37 to 80, with a mean of 51 years. Eight cases of 15 chronic back pain cases had a history of lumbar laminectomy surgery (53%). Results page16image13088Relief of pain took place within 10 to 20 minutes into treatment. The degree of pain reduction ranged from 40% to 100% at the end of a 30-minute treatment. The mean VAS scores were significantly improved from 6.4/10 to 2/10 (P<.005) in chronic back pain cases, and 5.5/10 to 1/10 (P<.05) in neck pain cases. The mean degrees of the lumbar pain-free range of motion were improved from 49° to 81° in flexion, from 10° to 28° in extension, at the end of a 30-minute treatment. The treatment effect continued to last from 1 to 5 weeks after 1 treatment. Conclusion page16image17688Zhu’s style scalp acupuncture is an effective regimen for treatment of chronic back and neck pain. It is less complex to formulate tactics for treatment of particular symptomatology and yet more efficient compared to the body points approach. Further randomized controlled trials are needed to evaluate this approach.
KEY WORDS
Acupuncture, Chronic Low Back Pain, Chronic Neck Pain, Visual Analog Scale (VAS), Scalp Acupuncture
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INTRODUCTION
Acupuncture points on the scalp are considered important in the history of acupuncture practice. Scalp acupuncture was developed into a complete acupuncture sub-system in China in the 1960s and 1970s.1 The pioneers in this field had different styles in naming the points and treatment zones based on their own experiences and pref- erences. A standard of nomenclature for scalp acupuncture points was developed in the mid 1980s, with the consensus of 14 therapeutic lines or zones based on the combination and summarization of the differ- ent schools of scalp acupuncture.1 However, few practitioners have adop- ted the standard in practice.1-7
Dr Zhu Mingqing is one of the pioneers in the scalp acupuncture arena. Zhu’s style is popular due to its relative simplicity in learning and application. It is based on 3-column zone theory to formulate group- ing of the treatment points.7 In Zhu’s scalp acupuncture, 9 therapeu- tic zones are used, and the manipulation is characterized by forceful, small-amplitude lifting and thrusting of the needle, coupled with physical and breathing exercises. Scalp acupuncture has been reported for its effectiveness in the treatment of neurological conditions such as strokes and spinal cord injury.7-15 In this study, we investigated Zhu’s style scalp acupuncture in treatment of chronic back and neck pain.
METHODS
This descriptive study reported 15 cases of chronic low back pain and 5 cases of chronic neck pain that had failed other conservative treat- ment, including pain medications and physical therapy. Among the 20 cases, there were 13 men and 7 women, ages 37 to 80, with a mean of 51 years. Eight cases of 15 chronic back pain cases had a history of lumbar laminectomy surgery (53%). The patients were treated with scalp acupuncture by a spine physiatrist certified by the American Board of Medical Acupuncture, at the Spine Center of Lahey Clinic Medical Cen- ter in Burlington, Massachusetts.
Consent for acupuncture treatment was obtained from the patients before treatment. The patient was placed in a sitting position in a quiet treatment room. Three Zhu’s scalp-acupuncture needles (12.5 inch 36 gauge, purchased from Zhu’s Acupuncture Medical Neurology Center, Inc.) were placed into the cervical zone or lumbar zone on the scalp (Figure 1). One needle was inserted on the sagittal midline on the scalp, another 2 were placed 1 cm lateral to the midline on either side of the 1st needle. The Lower Jiao zone was also needled if the pulse diagno- sis demonstrated Kidney deficiency (Figure 1) using the same tech- nique. Depth of the needle insertion was 1/2 needle length. The nee- dles were manipulated with a forceful, small-amplitude lifting and thrusting motion for 2 minutes, with patients being instructed to take deep breaths simultaneously. Then, the needles were left in place during the 30-minute treatment. No music, lighting, moxibustion, or electric stimulation were used. The needles were removed with cautions of avoiding bleeding at the end of the treatment. Only 1 treatment was provided for each patient. The longest follow-up was the 5th week after treatment. A
t test was used for statistical analysis. RESULTS
Pain relief occurred within 10-20 minutes into the treatment in all cases. The pain reduction ranged from 40% to 100% at the end of the 30-minute treatment among the 20 cases. Duration of the treatment benefit varied from 1 week to over 5 weeks. There were 2 chronic low back pain (13%), and 2 chronic neck pain cases; (40%) were still pain- free at the 5th week follow-up visits after the treatment.
Back Pain Cases
The mean visual analog scale score was significantly improved from 6.4/10 to 2/10 (P<.005) in chronic back pain cases. The mean degree of the lumbar spine pain-free ROM (range of motion) was improved from 49° to 81° in flexion, from 10° to 28° in extension, at the end of
PAGE 24 | MEDICAL ACUPUNCTURE | VOLUME EIGHTEEN / NUMBER ONE / 2006
NECK AND BACK PAIN TREATMENT
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Top view: treatment zones

Figure 1.
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page17image9616
page17image9776
1
2
3
4
page17image15240
page17image15512
5
6
7
8
9
1– Sacral; 2 – Lumbar; 3 – Thoracic; 4 – Cervical; 5 – Vertex, Perineum, and Foot; 6 – Lower Jiao; 7 – Middle Jiao; 8 – Upper Jiao; 9 – Head and Face

the 30-minute treatment.
Neck Pain Cases
The mean VAS score was sig- nificantly improved from 5.5/10 to 1/10 (P<.05) in the chronic neck pain cases.
DISCUSSION
Many articles report utilizing acupuncture in the treatment of chronic low back and neck pain. The majority of the studies main- ly utilized body acupuncture points. The reported length of the treatment is once or twice a week over 6 to 8 weeks on the aver- age, and pain reduction ranged from 20% to 50% on VAS.16-19 In this study, we demonstrated that a single 30-minute scalp acupunc- ture treatment resulted in sub- stantial improvement of chronic back and neck pain. Yet, the treat- ment benefit lasted from 1 week to over 5 weeks. The case series in this report indicate that the scalp acu- puncture treatment may be more potent and efficient in the treatment of chronic back and neck pain that does not respond to other conven- tional treatment including pain medications, physical therapy, and massage. However, we report a descriptive study with a small number of cases. Further randomized and controlled studies are needed for ad- ditional investigation.
CONCLUSIONS
The results from this report indicate that the Zhu’s style scalp acu- puncture may be an efficient and simpler approach for treatment of chronic back and neck pain. More large-scale clinical trials would be valuable to evaluate this technique.
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J Tradit Chin Med. 1993;13(3):182-184. Chunhui L, Ying W. Observation of curative effect of acupuncture ther- apy plus scalp acupuncture for restoring consciousness and inducing resuscitation in 80 cases of acute apoplexy. J Tradit Chin Med. 1996;16(1): 18-22. Zhijie W, et al. Study on the treatment of hemiplegia with scalp points. Pract J Integrating Chin Mod Med. 1996;9(4):199-200.
14. Yin Z, Jin W. Treatment of post-stroke syndrome by acupuncture. Shanghai J Acupuncture Moxibustion. 1997;16(2):9-10.
15. Yuxin W. Scalp acupuncture applied to treat 9 cases of infantile central apha- sia. Shanghai J Acupuncture Moxibustion. 1997;16(2):20.
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J Orthop Surg Res. 2012 Oct 30;7:36. doi: 10.1186/1749-799X-7-36.
The effectiveness of acupuncture in treating chronic non-specific low back pain: a systematic review of the literature.
Hutchinson AJ, Ball S, Andrews JC, Jones GG.
Source
Department of Physiotherapy, Trauma & Orthopaedics, Charing-Cross Hospital, Imperial College NHS Trust, Fulham Palace Road, London, W6 8RF, UK. ajphutch@hotmail.com
Abstract
BACKGROUND:
Low back pain is a common musculoskeletal disorder defined as pain and soreness, muscle tension, or stiffness in the lumbosacral area of the spine which does not have a specific cause. Low back pain results in high health costs and incapacity to work causing an economic burden to society. The optimal management of non-specific low back pain appears to be undecided. Recently published guidelines support the use of acupuncture for treating non-specific low back pain and it has become a popular alternative treatment modality for patients with low back pain.
METHODS:
A comprehensive systematic literature search was conducted through Medline using Ovid and Medical Subject Headings for randomized controlled trials published in the last 10 years. The outcomes scored were subjective pain scores and functional outcome scores.
RESULTS:
Eighty two randomized studies were identified, of which 7 met our inclusion criteria. Three studies found a significant difference in pain scores when comparing acupuncture, or sham acupuncture, with conventional therapy or no care. Two studies demonstrated a significant difference between acupuncture treatment and no treatment or routine care at 8 weeks and 3 months. Three studies demonstrated no significant difference between acupuncture and minimal/sham acupuncture with no difference in pain relief or function over 6 to 12 months.
CONCLUSIONS:
This review provides some evidence to support acupuncture as more effective than no treatment, but no conclusions can be drawn about its effectiveness over other treatment modalities as the evidence is conflicting.
PMID: 23111099 [PubMed - in process] PMCID: PMC3563482 Free PMC Article




J Orthop Surg Res. 2012 Oct 30;7:36. doi: 10.1186/1749-799X-7-36.
The effectiveness of acupuncture in treating chronic non-specific low back pain: a systematic review of the literature.
Hutchinson AJ, Ball S, Andrews JC, Jones GG.
Source
Department of Physiotherapy, Trauma & Orthopaedics, Charing-Cross Hospital, Imperial College NHS Trust, Fulham Palace Road, London, W6 8RF, UK. ajphutch@hotmail.com
Abstract
BACKGROUND:
Low back pain is a common musculoskeletal disorder defined as pain and soreness, muscle tension, or stiffness in the lumbosacral area of the spine which does not have a specific cause. Low back pain results in high health costs and incapacity to work causing an economic burden to society. The optimal management of non-specific low back pain appears to be undecided. Recently published guidelines support the use of acupuncture for treating non-specific low back pain and it has become a popular alternative treatment modality for patients with low back pain.
METHODS:
A comprehensive systematic literature search was conducted through Medline using Ovid and Medical Subject Headings for randomized controlled trials published in the last 10 years. The outcomes scored were subjective pain scores and functional outcome scores.
RESULTS:
Eighty two randomized studies were identified, of which 7 met our inclusion criteria. Three studies found a significant difference in pain scores when comparing acupuncture, or sham acupuncture, with conventional therapy or no care. Two studies demonstrated a significant difference between acupuncture treatment and no treatment or routine care at 8 weeks and 3 months. Three studies demonstrated no significant difference between acupuncture and minimal/sham acupuncture with no difference in pain relief or function over 6 to 12 months.
CONCLUSIONS:
This review provides some evidence to support acupuncture as more effective than no treatment, but no conclusions can be drawn about its effectiveness over other treatment modalities as the evidence is conflicting.
PMID: 23111099 [PubMed - in process] PMCID: PMC3563482 Free PMC Article


Treatment of temporomandibular myofascial pain with deep dry needling.
Gonzalez-Perez LM, Infante-Cossio P, Granados-Nuñez M, Urresti-Lopez FJ.
Source
Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, 41013-Sevilla, Spain.
Abstract
OBJECTIVES:
The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain.
STUDY DESIGN:
We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6.5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention.
RESULTS:
We found a statistically significant relationship (p<0.01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline.
CONCLUSIONS:
Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle.
PMID: 22549679 [PubMed - indexed for MEDLINE] PMCID: PMC3482522 Free PMC Article


J Orofac Pain. 2010 Winter;24(1):106-12.
Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders.
Fernández-Carnero J, La Touche R, Ortega-Santiago R, Galan-del-Rio F, Pesquera J, Ge HY, Fernández-de-Las-Peñas C.
Source
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Esthesilogy Laboratory of Universidad Rey Juan Carlos, Spain. josue.fernandez@urjc.es
Abstract
AIMS:
To investigate the effects of dry needling over active trigger points (TrPs) in the masseter muscle in patients with temporomandibular disorders (TMD).
METHODS:
Twelve females, aged 20 to 41 years old (mean = 25, standard deviation +/- 6 years) diagnosed with myofascial TMD were recruited. Each patient attended two treatment sessions on two separate days and received one intervention assigned in a random fashion, at each visit: deep dry needling (experimental) or sham dry needling (placebo) at the most painful point on the masseter muscle TrP. Pressure pain threshold (PPT) over the masseter muscle TrP and the mandibular condyle and pain-free active jaw opening were assessed pre- and 5 minutes postintervention by an examiner blinded to the treatment allocation of the subject. A two-way repeated-measures analysis of variance (ANOVA) with intervention as the between-subjects variable and time as the within-subjects variable was used to examine the effects of the intervention.
RESULTS:
The ANOVA detected a significant interaction between intervention and time for PPT levels in the masseter muscle (F = 62.5; P < .001) and condyle (F = 50.4; P < .001), and pain-free active mouth opening (F = 34.9; P < .001). Subjects showed greater improvements in all the outcomes when receiving the deep dry needling compared to the sham dry needling (P < .001).
CONCLUSION:
The application of dry needling into active TrPs in the masseter muscle induced significant increases in PPT levels and maximal jaw opening when compared to the sham dry needling in patients with myofascial TMD.




Osteoarthritis Cartilage. 2013 Sep;21(9):1290-8. doi: 10.1016/j.joca.2013.05.007.
Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis.
Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, Sutton AJ, Macpherson H, Woolacott NF.
Source
University of York, UK. Electronic address: mark.corbett@york.ac.uk.
Abstract
OBJECTIVE:
To compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to knee osteoarthritis.
DESIGN:
Systematic review with network meta-analysis, to allow comparison of treatments within a coherent framework. Comprehensive searches were undertaken up to January 2013 to identify randomised controlled trials in patients with osteoarthritis of the knee, which reported pain.
RESULTS:
Of 156 eligible studies, 114 trials (covering 22 treatments and 9,709 patients) provided data suitable for analysis. Most trials studied short-term effects and many were classed as being of poor quality with high risk of bias, commonly associated with lack of blinding (which was sometimes impossible to achieve). End of treatment results showed that eight interventions: interferential therapy, acupuncture, TENS, pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise produced a statistically significant reduction in pain when compared with standard care. In a sensitivity analysis of satisfactory and good quality studies, most studies were of acupuncture (11 trials) or muscle-strengthening exercise (9 trials); both interventions were statistically significantly better than standard care, with acupuncture being statistically significantly better than muscle-strengthening exercise (standardised mean difference: 0.49, 95% credible interval 0.00-0.98).
CONCLUSIONS:
As a summary of the current available research, the network meta-analysis results indicate that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. However, much of the evidence in this area of research is of poor quality, meaning there is uncertainty about the efficacy of many physical treatments.
Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
KEYWORDS:
Knee, Network meta-analysis, Osteoarthritis, Pain, Physical treatments




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.



J Back Musculoskelet Rehabil. 2014 Nov 5. [Epub ahead of print]
Effective chronic low back pain and knee pain treatment with acupuncture in geriatric patients.
Cevik C1, An I L A2, I┼čeri SO3.
Author information


Abstract
BACKGROUND:
The most common disease of the older age group in Turkey is degenerative articular disease and pain associated with the disease. Analgesics and physical therapy are preferred treatment for geriatric chronic pain but suffering from multiple medical and nutritional problems in old ages can limit treatment options with analgesics due to an increased risk of adverse effects and drug interactions.
OBJECTIVES:
We aim to show the effect of acupuncture on back-pain and knee-pain treatment of elderly people.
METHODS:
The study includes 34 patients, 24 female and 8 male. The mean age was 69.0417 ± 8.95 years for females and 73.12 ± 8.95.24 years for males. Every two days for a total of 10 sessions acupuncture treatment to Yintang, Ht 7 (Shenmen), LI 4 (Hegu), Ki 3 (Taixi) and Ki 6 were found to significantly reduce pain scores of patients.
RESULTS:
Mean back pain scores (8.8696 ± 1.546) and mean knee pain scores (9.1304 ± 1.4239) of patients were reduced significantly to 2.1739 ± 1.466 and 1.455 ± 0.7; p< 0.001 respectively after the acupuncture treatment.
CONCLUSION:
These are important results as they give rationale to use acupuncture treatment widely in chronic low back pain and knee pain in the geriatric group of patients to reduce the side effects of polypharmacy in elderly.




J Orthop Sports Phys Ther. 2014 Apr;44(4):252-60. doi: 10.2519/jospt.2014.5108. Epub 2014 Feb 25.
Short-term changes in neck pain, widespread pressure pain sensitivity, and cervical range of motion after the application of trigger point dry needling in patients with acute mechanical neck pain: a randomized clinical trial.
Mejuto-Vázquez MJ1, Salom-Moreno J, Ortega-Santiago R, Truyols-Domínguez S, Fernández-de-Las-Peñas C.
Author information


Abstract
STUDY DESIGN:
Randomized clinical trial.
OBJECTIVES:
To determine the effects of trigger point dry needling (TrPDN) on neck pain, widespread pressure pain sensitivity, and cervical range of motion in patients with acute mechanical neck pain and active trigger points in the upper trapezius muscle.
BACKGROUND:
TrPDN seems to be effective for decreasing pain in individuals with upper-quadrant pain syndromes. Potential effects of TrPDN for decreasing pain and sensitization in individuals with acute mechanical neck pain are needed. Methods Seventeen patients (53% female) were randomly assigned to 1 of 2 groups: a single session of TrPDN or no intervention (waiting list). Pressure pain thresholds over the C5-6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle; neck pain intensity; and cervical spine range-of-motion data were collected at baseline (pretreatment) and 10 minutes and 1 week after the intervention by an assessor blinded to the treatment allocation of the patient. Mixed-model analyses of variance were used to examine the effects of treatment on each outcome variable.
RESULTS:
Patients treated with 1 session of TrPDN experienced greater decreases in neck pain, greater increases in pressure pain threshold, and higher increases in cervical range of motion than those who did not receive an intervention at both 10 minutes and 1 week after the intervention (P<.01 for all comparisons). Between-group effect sizes were medium to large immediately after the TrPDN session (standardized mean score differences greater than 0.56) and large at the 1-week follow-up (standardized mean score differences greater than 1.34).
CONCLUSION:
The results of the current randomized clinical trial suggest that a single session of TrPDN may decrease neck pain intensity and widespread pressure pain sensitivity, and also increase active cervical range of motion, in patients with acute mechanical neck pain. Changes in pain, pressure pain threshold, and cervical range of motion surpassed their respective minimal detectable change values, supporting clinically relevant treatment effects. Level of Evidence Therapy, level 1b-.



Braz J Phys Ther. 2014 Nov 28;0:0. [Epub ahead of print]
Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial.
Aranha MF1, Müller CE1, Gavião MB2.
Author information


Abstract
BACKGROUND:
Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions.
OBJECTIVE:
The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control.
METHOD:
Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05).
RESULTS:
There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032).
CONCLUSION:
EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly.



J Tradit Chin Med. 2014 Dec;34(6):684-90.
Electroacupuncture inhibits annulus fibrosis cell apoptosis in vivo via TNF-α-TNFR1-caspase-8 and integrin β1/Akt signaling pathways.
Liao J, Zhang L, Zheng J, Yu D, Ke M, Xu T.
Abstract
OBJECTIVE:
To examine whether electroacupuncture (EA) treatment inhibited cell apoptosis of intervertebral annulus fibrosis (AF) via tumor necrosis factor-α (TNF-α)-tumor necrosis factor receptor 1 (TNFR1)-caspase-8 and integrin β1/Akt signaling pathways in a rat model of cervical intervertebral disc degeneration caused by unbalanced dynamic and static forces.
METHODS:
Thirty-two Sprague-Dawley rats were included in this study, of which 24 rats underwent surgery to induce cervical intervertebral disc degeneration, while eight rats received EA treatment at Dazhui (GV 14). Immunohistochemical staining was used to detect TNF-α, TNFR1, and caspase-8. Apoptosis of AF cells was examined with terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining. The mRNA and protein expression levels of integrin β1 and Akt were evaluated with real-time polymerase chain reaction and western blot analysis, respectively.
RESULTS:
Treatment with EA decreased TUNEL-positive AF cells and lowered TNF-α, TNFR1 and caspase-8 positive cells compared with control groups. EA treatment also increased integrin β1 and Akt mRNA and protein levels compared with controls.
CONCLUSION:
Treatment with EA inhibits AF cell apoptosis through suppression of the TNF-α-TNFR1-caspase-8 signal pathway and increases the expression of integrin β1 and Akt. EA may be a good alternative therapy for treating cervical spondylosis.