Acupuncture for Controlling Pain in Multiple Areas
Acupuncture for controlling pain in multiple areas has been utilized by Asian societies for thousands of years. It utilizes thin metallic needles to penetrate the skin which are manipulated by the hands or by applying electric stimulation. Acupuncture demonstrated significant benefit in control of pain in several conditions which include neck pain, low back pain, osteoarthritis, and one study has also been included on pain relief in lithotripsy for kidney stones. Acupuncture for controlling pain in multiple areas may be beneficial for many other disease conditions and different types of pain.
Acupuncture for Neck Pain:
Trinh et al reviewed 10 trials with 661 participants and examined the effects of acupuncture on neck pain for individuals with chronic neck pain (lasting for at least three months, one study lasted 6 weeks). Acupuncture was compared to sham acupuncture, waiting list, other sham treatments (sham laser, sham TENS) or other treatments (mobilization, massage, traction). Individuals with chronic neck pain who received acupuncture reported, on average, better pain relief immediately after treatment and in the short-term than those who received sham treatments. Individuals with chronic neck pain with symptoms radiating to the arms who received acupuncture reported, on average, better pain relief in the short-term than those who were on a waiting list (1).
Acupuncture for Chronic Low Back Pain:
Brinkhaus et al noted acupuncture to be more effective at reducing pain than no acupuncture in a study that included 298 patients (67% female) with chronic low back pain. Individuals were randomly assigned to acupuncture, minimal acupuncture (superficial needling at non- acupuncture points), or a waiting list control. Acupuncture and minimal acupuncture consisted of 12 sessions per patient over 8 weeks. Pain was rated using a scale of 0-100. After 8 weeks, pain intensity had decreased by an average of 28.7 in the acupuncture group, 23.6 in the minimal acupuncture group, and 6.9 in the waiting list group. There was no significant difference in pain intensity between acupuncture and minimal acupuncture at weeks 26 and 52 (2).
Acupuncture for Controlling Pain in Osteoarthritis
Acupuncture and osteoarthritis: Witt et al evaluated acupuncture treatment of osteoarthritis pain. Acupuncture improved osteoarthritis (OA) severity (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) and health-related quality of life (Short Form 36). In this 3-month study, 357 were randomized to the acupuncture group (acupuncture plus standard care) and 355 to the control group (standard care only) and 2,921 were included in the nonrandomized acupuncture group. After 3 months, quality of life greater improvement for the acupuncture group, compared to control group. Additionally, WOMAC had improved an average of 17.6 in the acupuncture group and 0.9 in the control group. The benefits of acupuncture were maintained at 6 months (3).
A meta-analysis of 18 randomized controlled trials found a greater reduction in pain in people with peripheral joint osteoarthritis (OA) treated with acupuncture compared to controls. Additionally, the review found manual acupuncture to be significantly more effective in OA patients compared to sham acupuncture (4). Traditional acupuncture involves needling of fixed points and additional points on the body to a depth of 5 to 40 millimeters, while sham acupuncture involves needling to a depth of 1 to 3 millimeters into the lower back, avoiding known pressure points.
Manheimer evaluated eleven randomized controlled trials (RCTs) and concluded that acupuncture showed clinical benefits in pain and function for the treatment of knee osteoarthritis, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched to January 2007 for relevant publications. RCTs with an observation period of six weeks or more comparing acupuncture treatment with a sham, usual care or waiting list control group in patients with diagnosed osteoarthritis of the knee reporting pain and function were included. Two reviewers independently screened studies for relevance, with disagreements resolved by discussion. Standardized mean difference (SMD) was calculated by using differences in improvements from baseline for each group (5).
Acupuncture for Controlling Pain in Lithotripsy
Extracorporeal shock wave lithotripsy (ESWL) is a treatment for kidney stones using an acoustic pulse to break them up into pieces so they may be able to pass out the urinary tract. In this study by Hodzic et al, 102 patients were randomized into two groups where one group received analgesics (50 mg pethidine and 10 mg diazepam) and other group received acupuncture. Every minute till 21 min after starting the therapy and 10 min after termination, the pain sensation was rated using numeric pain scale. Results showed that analgesic effect of acupuncture was significantly superior to that of standard analgesics. These results were not statistically significant (6).
Acupuncture for Peripheral Neuropathy in Diabetes Patients
Researchers compared IV alpha lipoic acid and alprostadil (a vasodilating medication) to acupuncture for diabetic peripheral neuropathy. Both groups achieved a benefit from the IV medication (62.1% efficacy) and acupuncture (83.5% efficacy). The conclusion was that “acupuncture is superior to medication in improving clinical signs of sensory disorder, reflection disturbance and muscle weakness, nerve conduction and clinical curative effect.”
Conclusion: Acupuncture for Controlling Pain in Multiple Areas
- Acupuncture for controlling pain in multiple areas may be considered for a wide variety of medical conditions. Acupuncture used to treat neck pain, low back pain, osteoarthritis pain, diabetic peripheral neuropathy, and lithotripsy pain all have evidence of benefit in well-designed research studies. Acupuncture may also be beneficial for many other disease conditions and different types of pain.
References: Acupuncture for Controlling Pain in Multiple Areas
1.Trinh K, Graham N, Gross A, Goldsmith C, Wang E, Cameron I, Kay T. Acupuncture for neck disorders. Spine (Phila Pa 1976). 2007 Jan 15;32(2):236-43. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004870.pub3/abstract
2.Brinkhaus B, Witt CM, Jena S, et al. Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med 2006 Feb 27;166(4):450-7. http://www.ncbi.nlm.nih.gov/pubmed/16505266
3.Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN. Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional nonrandomized arm. Arthritis Rheum. 2006 Nov;54(11):3485-93. http://www.ncbi.nlm.nih.gov/pubmed/17075849
4.Kwon YD, Pittler MH, Ernst E. Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2006 Nov;45(11):1331-7. Epub 2006 Aug 27. http://www.ncbi.nlm.nih.gov/pubmed/16936326
5.Manheimer E, Linde K, Lao L, Bouter L M, Berman B M. Meta-analysis: acupuncture for osteoarthritis of the knee. Annals of Internal Medicine 2007; 146(12): 868-877. http://www.ncbi.nlm.nih.gov/pubmed/17577006
6.Hodzic J, Golka K, Selinski S, Pourvali H, Sommerfeld HJ. [Analgesia with acupuncture in extracorporeal shock wave lithotripsy of kidney stones–first results]. Urologe A. 2007 Jul;46(7):740, 742-4, 746-7. http://www.ncbi.nlm.nih.gov/pubmed/17619207
7.Lu M, Li K, Wang J. [Acupuncture for distal symmetric multiple peripheral neuropathy of diabetes mellitus: a randomized controlled trial]. [Article in Chinese] Zhongguo Zhen Jiu. 2016 May;36(5):481-4. https://www.ncbi.nlm.nih.gov/pubmed/27509606