The science-y stuff

Acupuncture Pain relief research

Acupuncture is helpful for pain relief. There is strong scientific evidence for the effectiveness of acupuncture for pain relief for these conditions:

• acupuncture knee pain relief: A 2013 meta-analysis of high quality studies found that acupuncture was better than the usual care physical therapies like exercise, weight-loss and sham acupuncture for providing pain relief in oesteoarthritis of the knee

  [Corbett MS, Rice SJC, Madurasinghe V, et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis and Cartilage 2013;21:1290–8. doi:10.1016/j.joca.2013.05.007]

• Acupuncture for shoulder pain relief: A 2015 network mata-analysis found that exercise plus acupuncture was most effective for pain relief in shoulder impingment syndrome. Acupuncture outperformed other adjunct interventions like steroid injection, NSAIDs (non-steroidal anti-inflammatory medication) and ultrasound therapy

  [Dong W, Goost H, Lin X-B, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore) 2015;94:e510. doi:10.1097/MD.0000000000000510]

• Acupuncture for sciatica pain relief: A 2016 comparison of 20 treatments for sciatica ranked acupuncture as the 2nd most effective treatment for sciatica pain relief. Acupuncture outperformed manipulation, epidural, disc surgery, opiod medication, exercise and radio-frequency denervation.

  [Lewis R, FLCOM NHWPF, PhD AJS, et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. The Spine Journal 2015;15:1461–77. doi:10.1016/j.spinee.2013.08.049]

• Acupuncture chronic pain relief: A 2012 controlled clinical trial using functional MRI (fMRI) investigated how acupuncture for pain relief is produced. This study showed that acupuncture causes important pain relief related changes in the brain functional connectivity for providing pain relief. The condition investigated was sciatica. Acupuncture was shown to be able to:

• reduce the pain intensity, and

• reduce pain frequency experienced in sciatica sufferers

  Acupuncture does this by influencing changes in the activated pain centres of the brain. The fMRI also showed that acupuncture is able to restore pain-free connectivity related activity in the brain, allowing the (pain -free) resting state of the brain to be restored.

During acupuncture, researchers have demonstrated that the body releases its own:

• natural opiod ‘pain killers’

• natural pain-reliving anti-inflammatory substances (eg. adenosine, substance P)

• cells to promote tissue healing in the local area

Following acupuncture treatment, changes in brain activity were observed:

• reduced activity in brain regions associated with pain perception

• increased activity in brain areas that regulation of pain response

[www.healthcmi.com/Acupuncture-Continuing-Education-News/1903-acupuncture-mri-discovery-for-sciatica-relief

Goldman N, Chen M, Fujita T, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci. 2010;13(7):883-888. doi:10.1038/nn.2562.

Staud R, Price DD. Mechanisms of acupuncture analgesia for clinical and experimental pain. Expert Rev Neurother. 2006;6(5):661-667. doi:10.1586/14737175.6.5.661.

Langevin, H. M., Bouffard, N. A., Churchill, D. L., & Badger, G. J. (2007). Connective Tissue Fibroblast Response to Acupuncture: Dose-Dependent Effect of Bidirectional Needle Rotation. The Journal of Alternative and Complementary Medicine, 13(3), 355–360. doi.org/10.1089/acm.2007.6351

Huang W, Pach D, Napadow V, et al. Characterizing acupuncture stimuli using brain imaging with FMRI–a systematic review and meta-analysis of the literature. PLoS ONE. 2012;7(4):e32960. doi:10.1371/journal.pone.0032960.]

Acupuncture for fibromyalgia pain relief: A 2009 study investigating the mechanisms of acupuncture pain relief looked at the brain’s processing of pain via endogenous pain receptors. Background: The human body has its own system of natural pain relief. These natural pain relief chemicals are a natural opiod chemical; when the natural opiod chemical binds to the pain receptor you achieve natural pain relief. Fibromyalgia sufferers have reduced receptors for mu-opiod receptors. Since there are less pain reducing receptors available for the natural pain relief chemicals to adhere/attach to; fibromyalgia suffers are more sensitive to pain.

Findings: Acupuncture was shown to increase the availablities of these receptors to the natural pain relief chemicals, allowing increased binding potential in the short-term and long-term. These same effects were not seen in sham acupuncture.

This means that acupuncture can help

• provide pain relief in fibromyalgia

• help some people maintain or even reduce their dosages of pain medications

  [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757074/pdf/nihms122574.pdf]

Acupuncture pain relief for carpel tunnel syndrome: Acupuncture has neuromodulating effects; that is it is able to rewire the brain, using the brain’s neuroplasticity to improve long term clinical outcomes for carpel tunnel pain relief.

[https://academic.oup.com/brain/article/140/4/914/3058778]

Acupuncture for plantar fasciitis: A systematic review concluded that acupuncture is effective for plantar fasciitis. Acupuncture was found to be as effective as stretching, use of night splints and dexamethasone (a corticosteroid medication) . Acupuncture for plantar fasciitis has shown to have few to no adverse effects, plus a high level of effectiveness.

For plantar fasciitis, Acupuncture is able to:

• reduce/ eliminate pain

• improve function by healing tissue and reducing inflammation

• allowing plantar fasciitis sufferers to get back on their feet.

Clark, R. J., & Tighe, M. (2012). The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupuncture in Medicine: Journal of the British Medical Acupuncture Society, 30(4), 298–306.

Langevin, H. M., Bouffard, N. A., Churchill, D. L., & Badger, G. J. (2007). Connective Tissue Fibroblast Response to Acupuncture: Dose-Dependent Effect of Bidirectional Needle Rotation. The Journal of Alternative and Complementary Medicine, 13(3), 355–360. doi.org/10.1089/acm.2007.6351

Acupuncture for migraine relief and headache relief: (more research info to come)

There is only moderate scientific evidence for the effectiveness of acupuncture for pain relief for the following conditions. (The research looks promising, but more high quality and high level studies are needed. Or there is mixed/inconclusive evidence about the effectiveness of acupuncture and chinese medicine for these conditions)

Acupuncture for heel pain: Acupuncture has a potential positive effect for treating heel pain.

[Clark, R. J., & Tighe, M. (2012). The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupuncture in Medicine: Journal of the British Medical Acupuncture Society, 30(4), 298–306.

Hempel, S., Taylor, S. L., Solloway, M. R., Miake-Lye, I. M., Beroes, J. M., Shanman, R., et al. (2014). Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs. 6. McDonald, J. L., & Janz, S. (2017). The Acupuncture Evidence Project, 1–81. Retrieved from https://www.acupuncture.org.au/OURSERVICES/Publications/ AcupunctureEvidenceProject.aspx 7.

Goldman N, Chen M, Fujita T, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci. 2010;13(7):883-888. doi:10.1038/nn.2562.]

(more conditions to be added)