Acupuncture Soothes Cervical Spinal Nerves, Reduces Pain

Researchers find acupuncture effective for the relief of cervical spinal syndrome. This condition involves irritation of the spinal nerves located in the neck. Spinal nerves transmit sensory, motor, and autonomic nervous system signals between the spinal cord and the body. Inflammation and impingement present in cervical spinal syndrome results in head, neck, chest, shoulder, or arm pain and dysfunction. The results of the research demonstrates that acupuncture plus moxibustion yields a high total recovery rate. In addition, nearly every patient receiving acupuncture plus moxibustion demonstrated significant improvements.

Researchers from the Hubei Hongan Traditional Chinese Medicine Hospital examined 200 cervical syndrome patients in a controlled investigation. The research team discovered that targeted acupuncture treatments produce an extremely high total effective rate and a high complete recovery rate. Targeting involved the application of a primary acupuncture point prescription for all patients plus an additional set of secondary acupuncture points based upon diagnostic variations in clinical presentations. Using this semi-protocolized targeted approach to patient care, the research team achieved a 97% total effective rate across all tiers of improvement. The breakdown into levels of efficaciousness produced surprising results. The total recovery rate was 64%, the significant improvement rate was 17%, the minimal improvement rate was 16%, and 3% had no improvement.

Dr. Ruth Jackson, MD, notes, “The nerve roots leave the spinal cord at an angle which approximates a right angle, and they fill fairly snugly the foramina through which they pass. This makes them very vulnerable to irritation from any mechanical derangement of the cervical spine.” Cervical syndrome is often triggered by a small event, such as leaning over a sink while brushing teeth or turning the head. However, the initial cause may have been prior, including whiplash injuries, mechanical deformities, or other chronic irritations. The tight spacing of the intervertebral foramina (IVF) through which the nerves pass is easily encroached by both chronic and acute conditions that produce inflammation and morphological changes.

A primary set of acupoints was administered to all patients in this acupuncture continuing education study. A total of 3 – 4 acupoints from the primary set were applied during each acupuncture session. Each acupoint, including customized secondary acupoints, were needled with standard manual acupuncture protocols for insertion and manipulation. Total needle retention time during each acupuncture session was 20 minutes. One acupuncture session was applied daily for a total of 10 days, followed by a two day break and then another 10 days of acupuncture therapy. For moxibustion, a moxa cigar was used to warm the cervical Jiaji acupoints for 30 minutes per day. One 30 minute moxibustion treatment was conducted daily for 10 consecutive days. The next treatment cycle of an additional 10 days of moxibustion care commenced after a 2 day break from treatment. The primary acupoints were selected from the following selection:

Fengchi (GB20)
Dazhui (GV14)
Jianjing (GB21)
Tianzong (SI11)
Lieque (LU7)
Zhongzhu (TB3)
Houxi (SI3)
Ashi (located beside spinous processes)
Secondary acupoints were selected based on the type of cervical syndrome presentation for each patient. For nerve root compression cervical syndrome affecting the shoulders and arms, the following points were applied:

Jianyu (LI15)
Tianzong (SI11)
Binao (LI14)
Yanglao (SI6)
For vertebral artery related cervical syndrome, the following acupoints were applied:

Taiyang (MHN9)
Touwei (ST8)
Baihui (GV20)
Sishencong (MHN1)
Neiguan (PC6)
Sanyinjiao (SP6)
Taichong (LV3)
Zusanli (ST36)
For sympathicus cervical syndrome involving excess stimulation of the sympathetic division of the autonomic nervous system, the following acupoints were applied:

Taiyang (MHN9)
Jingming (BL1)
Qiuhou (MHN8)
Yifeng (TB17)
Neiguan (PC6)
Zusanli (ST36)
Sanyinjiao (SP6)
Jiaoxin (KD8)
Yinjiao (CV7)
Patients were evaluated before and after the treatment course of care. The treatment efficacy for each patient was categorized into 1 of 4 tiers:

Recovery: Complete recovery of neck function. Complete absence of clinical symptoms.
Significantly effective: Alleviation of localized pain. Clinical symptoms largely absent.
Effective: Localized pain present. Basic physiological function achieved. Main clinical symptoms absent.
Not effective: No improvement.
The total treatment effective rate was derived as the percentage of patients who achieved at least an effective tier. The data shows that acupuncture combined with moxibustion benefits nearly every cervical syndrome patient to some degree, with a 97% total effective rate across all tiers of improvement. The 64% complete recovery rate is equally important.

The researchers gave a Traditional Chinese Medicine (TCM) background to the treatment of cervical syndrome, often manifesting as cervical spondylosis. According to TCM, cervical syndrome is common starting in middle-aged individuals and older. Often, cervical nerve impingement is due to osteoarthritis and cervical disc protrusions or extrusions. Radiculitis is common in all cases. According to TCM principles, left untreated, cervical syndrome is a degenerative disorder. Calcification of related ligaments due to chronic strain and inflammation may lead to oppression of the cervical vertebrae, nerve roots, and blood vessels. There may also be pressure onto the spinal cord in more serious cases. These conditions lead to cervical dysfunction and pain.

In TCM, cervical syndrome is often categorized in the class of Bi Zheng. External pernicious influences giving rise to cervical syndrome include external injury, exhaustion, wind, cold, and dampness. Zang-Fu and deficiency related conditions include deficiency of the liver and kidneys or tendon and bone malnutrition. The aforementioned conditions result in poor qi and blood circulation in the Taiyang meridians and imbalances of the Ying and Wei. Symptoms such as severe neck pain, shoulder pain, numbness, headache, dizziness, and nausea ensue as a result of the condition. The results of the research demonstrates that acupuncture combined with moxibustion is effective for the relief of cervical syndrome.

Contact Affinity Acupuncture today for Nashville Acupuncture treatments and appointments!

References:
Li HX & Zhao L. (2013). Efficacy observation on treating 200 cases of cervical syndrome with acupuncture and moxibustion. Clinical Journal of Chinese Medicine. 5(3).

Jackson, Ruth. “The Classic: The Cervical Syndrome.” Clinical Orthopaedics and Related Research. 468, no. 7 (2010): 1739-1745.

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Report Finds Acupuncture Reverses Lower Back Pain

Report Finds Acupuncture Reverses Lower Back Pain

Qi-guiding acupuncture relieves disc herniation pain and a special intensive silver acupuncture needle protocol relieves chronic lower back myofascial pain.

Researchers find acupuncture effective for the treatment of lower back pain disorders. In a protocolized study from the Shanghai Jiaotong University Sixth People’s Hospital, researchers determined that a special type of manual acupuncture therapy, known as qi-guiding acupuncture, produces significant positive patient outcomes for lumbar intervertebral disc herniation patients. In related research from Xinping Hospital of Traditional Chinese Medicine, investigators find acupuncture combined with moxibustion effective for the alleviation of lower back pain due to lumbodorsal myofascial pain syndrome. A special application of silver acupuncture needles produced superior patient outcomes. Let’s start with a look at the Shanghai Jiaotang University research and then we’ll see how the silver needle protocol boosts treatment efficacy for the treatment of lower back pain.

Acupuncture is effective for the treatment of lumbar intervertebral disc herniations. Wu et al. (Shanghai Jiaotong University Sixth People’s Hospital) investigated the treatment results of qi-guiding acupuncture with meridian differentiated acupoint selections and determined that it produces significant positive treatment outcomes for lumbar intervertebral disc herniation patients. Wu et al. also find electroacupuncture with meridian differentiated acupoint selections effective; however, qi-guiding acupuncture had a slightly higher rate of producing positive patient outcomes. Qi-guiding acupuncture had an 87.5% total treatment effective rate and electroacupuncture achieved an 86.6% total treatment effective rate. Qi-guiding acupuncture also had better outcomes for increases in nerve conduction velocity. The results are definitive given the large sample size of 549 patients with lumbar disc herniations evaluated in this study. 

Lumbar disc herniation patients experience lower back pain and radiculopathy (radiating pain and numbness) as a result of anulus fibrosis damage, IVF encroachment, and other issues associated with disc damage (Hu et al.). Acupuncture, as one of the most common non-surgical treatment methods for lumbar disc herniation, has a high treatment effective rate and no significant adverse effects (Cheng).

Qi-guiding acupuncture was first documented in ancient literature, including The Systematic Classic of Acupuncture & Moxibustion by Huang-fu Mi. In qi-guiding acupuncture, needle entry and removal is controlled and slow. To direct qi upward, the acupuncture needle is oriented upward; similarly, to direct qi downward, the needle is pointed downward. Subsequently, the needle is frequently rotated, lifted, and thrust to regulate the flow of qi in the body. Additional manipulation techniques may be intermittently applied. In modern use, qi-guiding acupuncture repairs ultramicroscopic structures of damaged nerve roots and accelerates other aspects of nerve repair, thereby increasing nerve conduction.

In this study, lumbar disc herniation patients receiving qi-guiding acupuncture achieved an 87.5% total treatment effective rate. Patients receiving electroacupuncture achieved an 86.6% total treatment effective rate. Both qi-guiding acupuncture and electroacupuncture significantly increased nerve conduction velocity. Qi-guiding acupuncture had a slightly greater improvement in common peroneal nerve conduction velocity and superficial fibular nerve conduction velocity. Common peroneal nerve conduction velocity increased from 38.26 ± 12.8 to 44.75 ± 5.24 after the application of qi-guiding acupuncture, and increased from 39.11 ± 3.64 to 39.86 ± 10.95 after electroacupuncture. Superficial fibular nerve conduction velocity increased from 41.63 ± 4.37 to 42.55 ± 6.43 after the application of qi-guiding acupuncture, and increased from 40.71 ± 9.56 to 40.43 ± 4.01 after electroacupuncture.

A total of 549 patients with lumbar disc herniations were treated and evaluated in this study. These patients were diagnosed with lumbar disc herniations between December 2012 and March 2014. They were randomly divided into a treatment group and a control group, with 280 patients in the treatment group and 269 patients in the control group. The treatment group underwent qi-guiding acupuncture therapy, while the control group received electroacupuncture. Acupoint selection for both groups was based on meridian differentiation. Identical acupoints were selected for both patient groups.

For Taiyang meridian lumbago and leg pain (scelalgia):

Shenshu (BL23) Dachangshu (BL25) Zhibian (BL54) Huantiao (GB30) Juliao (GB29) Yinmen (BL37) Weizhong (BL40) Chengshan (BL57) Kunlun (BL60) For Yangming meridian lumbago and leg pain:

Shenshu (BL23) Dachangshu (BL25) Qichong (ST30) Biguan (ST31) Futu (ST32) Tiaokou (ST38) Zusanli (ST36) For Shaoyang meridian lumbago and leg pain:

Shenshu (BL23) Dachangshu (BL25) Huantiao (GB30) Fengshi (GB31) Yanglingquan (GB34) For qi-guiding acupuncture, the following protocol was administered. Upon disinfection with 75% ethanol, a 0.30 mm x 40 mm filiform acupuncture needle was inserted into each selected acupoint. Huantiao and Juliao were needle to a depth of 2.5 inches. The remaining acupoints were needled to a depth of 1.2 inches. When a deqi sensation was achieved for all acupoints, qi-guiding needling with the Xie (reducing) manipulation technique was applied to Weizhong, Tiaokou, and Yanglingquan to transmit the needling sensation upward and toward the hip or waist. The same technique was applied to Huantiao, Juliao, and Biguan, instead transmitting the needle sensation downward and toward the legs. Subsequently, qi-guiding needling with the Bu (tonification) manipulation technique was applied on Dachangshu to transmit the needle sensation toward the lumbosacral area. The same technique was used on Shenshu until a deqi sensation of soreness or swelling was perceived at the lumbar region. A needle retention time of 20 minutes was observed during which the needles were rotated, lifted, and thrusted every 5 minutes to facilitate the flow of qi. One qi-guiding acupuncture session was conducted every other day for a total of 10 treatments.

Electroacupuncture for the control group was administered with the same aforementioned protocol. Before needle retention, the needles were connected to an electroacupuncture device. The device was then set to a continuous wave at 4 Hz with a 2mA current. A 20 minute needle retention time was subsequently observed. One electroacupuncture session was conducted every other day for a total of 10 treatments. The clinical results the Wu et al. study demonstrate that both qi-guiding acupuncture and electroacupuncture, when combined with meridian-differentiated acupoint selection, are suitable and effective therapies for lumbar disc herniation patients. However, qi-guiding acupuncture produces slightly better treatment outcomes in terms of nerve conduction velocity improvements.

In a related study, Wang H.D. (Xinping Hospital of Traditional Chinese Medicine) finds acupuncture combined with moxibustion therapy effective for the treatment of lumbodorsal myofascial pain syndrome. The study also finds that a silver needle protocol produces preferable treatment outcomes to conventional acupuncture. Lumbodorsal myofascial pain syndrome causes chronic lumbago and commonly occurs in young adults. Intensive acupuncture combined with moxibustion using silver needles was famously used by Professor Xuan Zhe Ren, a renowned Chinese orthopedist.

Acupoints were selected based on the degree of soft tissue damage, area of muscular tissue involved, and size of tendon contracture. In this approach, acupoints are 2 cm apart from each other and are mainly located on the lumbosacral region. Results from Wang’s study demonstrate that lumbodorsal myofascial pain syndrome patients receiving intensive acupuncture combined with moxibustion using silver needles achieved a 90% total treatment effective rate. Conventional acupuncture with moxibustion achieved an 83.3% total treatment effective rate.

Wang’s study involved a total of 60 patients with lumbodorsal myofascial pain syndrome. They were divided into a treatment group and a control group, with 30 patients in each group. The treatment group underwent intensive acupuncture-moxibustion therapy with silver needles. The control group received conventional acupuncture-moxibustion.

Intensive acupuncture-moxibustion with silver needles was applied to the T12 – L4 Jiaji acupoints and the acupoints located at the midpoint between each Jiaji acupoint. In addition, acupoints located 2 cm lateral to the Jiaji acupoints were needled. Finally, moxibustion applied with one Zhuang of 3 cm moxa cigar. One session was conducted daily for a total of 7 days. For conventional acupuncture-moxibustion therapy, the following primary acupoints were selected:

Shenshu (BL23) Mingmen (GV4) Weizhong (BL40) Ashi Additional acupoints were selected based on individual symptoms. For lumbago with chill-dampness:

Yaoyangguan (GV3) For lumbago due to exhaustion:

Yanglingquan (GB34) Sanyinjiao (SP6) For lumbago with kidney deficiency:

Zhishi (BL52) Taixi (KD3) A needle retention time of 30 minutes was observed. Subsequently, moxibustion was applied using either a 4 hole or 6 hole moxa box on the lumbar acupoints. One session was conducted daily for a total of 7 days. The treatment efficacy for each patient was evaluated and categorized into 1 of 3 tiers:

Recovery: Complete elimination of symptoms. Physical movement regained completely. No pain points. Significantly effective: Elimination of symptoms. Physical movement regained. Discomfort reoccurs only under exhaustion or change in weather. No pain or numbness. Effective: Symptoms relieved. Pain or numbness present. Not effective: No improvement in symptoms. The total treatment effective rate for each patient group was derived as the percentage of patients who achieved at least an effective tier of improvement. The intensive acupuncture-moxibustion with silver needles protocol outperformed conventional acupuncture. However, both approaches produced significant positive patient outcomes.

Both aforementioned studies indicate that acupuncture is effective for the alleviation of lower back pain. These studies highlight the differences in therapeutic effects between various forms of acupuncture. As a result, qi-guiding acupuncture and intensive acupuncture-moxibustion with silver needles are found clinically effective for the relief of lower back pain.

 

References: Wu YC, Sun YJ, Zhang JF, Li Y, Zhang YY & Wang CM. (2014). Clinical Study of Qi-guiding Acupuncture at Points Selected According to Meridian Differentiation for Treatment of Lumbar Intervertebral Disc Herniation. Shanghai Journal of Acupuncture and Moxibustion. 33(12).

Cheng XN. (1987). The study of Chinese acupuncture-moxibustion. Volume 1, Beijing: People’s medical publishing house. 192-284.

Hu YG. (1995). Prolapse of lumbar intervertebral disc. Volume 2, Beijing: People’s medical publishing house. 226-228.

Zhu WM, Wu YC, Zhang JF, et al. (2010). Tuina combined with acupoint injection in treating prolapse of lumbar intervertebral disc. Chinese Journal of Sports Medicine. 29(6): 708-709.

Wang HD. (2013). Clinical Observation on Intensive Acupuncture-moxibustion with Silver Needles for Lumbodorsal Myofascial Pain Syndrome. Shanghai J Acu-mox. 32(8).

 

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Music Electroacupuncture Outperforms Antidepressant Drug.

Researchers conclude that music electroacupuncture causes improved behavioral changes and benefits to neuronal structures in the hippocampus. In a laboratory experiment on depressive rats, music electroacupuncture outperformed fluoxetine (Prozac) for regulating monoamine neurotransmitter levels. Based on the findings, researchers (Cao et al.) conclude that music electroacupuncture demonstrates effectiveness for the treatment of depression.

In a separate investigation (Tang et al.), two types of acupuncture are found to successfully regulate behavioral changes. Based on the findings, the researchers note that music electroacupuncture and standard pulsed electroacupuncture, may assist in the prevention of Alzheimer Disease. In a controlled experiment, laboratory rats receiving electroacupuncture had decreased latency times, improved swimming distances, and significant reductions of β-amyloid protein levels. β-amyloid (Aβ) proteins are the main constituents of amyloid plaques occurring in Alzheimer disease patients’ brains. The researchers noted that music electroacupuncture and standard electroacupuncture improved “learning and memorizing abilities.” Overall, music electroacupuncture outperformed standard electroacupuncture. 

Music electroacupuncture differs from standard electroacupuncture by switching frequencies and waveforms in rhythmic patterns instead of a consistent pulse. Choices of electroacupuncture settings are based on five musical notations (Gong, Shang, Jue, Zhi, Yu). Each setting corresponds to Traditional Chinese Medicine principles of the Five Elements (wood, fire, earth, metal, water) and their corresponding organ systems (liver/gallbladder, heart/small intestine, spleen/stomach, lung/large intestine, kidney/bladder). The settings are adjusted for different diagnosis of each patient.

The Healthcare Medicine Institute (HealthCMi) has not had a chance to test the music electroacupuncture device yet however, we recently tested the ITO ES-160 electroacupuncture device and confirmed its efficaciousness for the alleviation of pain using the sweep mode. Sweep mode involves a gradual increase and decrease of pulse frequencies over time. The adding of subtle gradations between frequency changes in sweep mode demonstrated significant clinical advantages for the treatment of several pain conditions. While the ES-160 has standard intermittent modes, it shows the sweep mode is an important addition.

The laboratory research finds that music electroacupuncture and conventional pulsed electroacupuncture are effective in treating depression in rats. Researchers (Tang et al.) from Beijing University of Chinese Medicine determined, through a protocolized investigation, that both types of electroacupuncture produced positive outcomes in depressed rat models, but music electroacupuncture produced the highest rate of positive outcomes across various metrics. Given the prevalence of depression in society, this research includes important subjective and objective findings.

In this laboratory study, rats receiving electroacupuncture (either music or conventional) displayed higher horizontal activity, vertical activity, sugar consumption, body mass, and expression of serotonin (5-HT), dopamine (DA), and norepinephrine (NE) in the frontal lobe and hippocampus. Additionally, rats treated with music electroacupuncture reported having a higher 5-HT expression than those treated with conventional electroacupuncture. Overall, music and conventional pulsed electroacupuncture demonstrated antidepressant effects in rats, however, music electroacupuncture demonstrated a greater regulatory effect on monoamine neurotransmitters than conventional pulsed electroacupuncture and fluoxetine.

The experiment involved several controlled variables. A total of 50 depression model rats were divided into 5 equal groups of 10 as follows:

  • Control group: Rats were grouped together. Unlimited supply of water and food was provided. Did not receive any stimulation.

  • Model group: Rats were isolated. Received 21 days of chronic unpredictable mild stress stimulation.

  • Fluoxetine group: Rats were isolated. Fluoxetine was diluted with saline to a density of 2 mg/ml. For each rat, 10 ml of diluted fluoxetine was administered per kg of body mass. Medication was administered once per day, one hour before chronic unpredictable mild stress stimulation.

  • Standard pulsed electroacupuncture group: Rats were isolated. Treatment was administered one hour prior to chronic unpredictable mild stress stimulation.

  • Music electroacupuncture: Rats were isolated. Treatment was administered one hour prior to chronic unpredictable mild stress stimulation.

The acupuncture point prescription included standard filiform needle stimulation of acupoints Yintang (MHN3) and Baihui (GV20). For each acupoint in the standard pulsed electroacupuncture group, a filiform acupuncture needle was connected to an electroacupuncture device and was inserted horizontally. The tip of the needle was pointed posteriorly for Baihui and downwards for Yintang. The electrical frequency was set to 2/100 Hz and the intensity was set to 1 mA. The needles were retained for 20 minutes. One 20 minute acupuncture session was conducted per day for a total of 21 days.

For the music electroacupuncture group, acupoint selection and treatment of acupoints was identical to that of the pulsed electroacupuncture group. However, instead of a conventional electroacupuncture device, the needles were connected to a music electroacupuncture device. Voltage was set to 2 V and intensity to 1 mA, until the needle tip was vibrating slightly but did not cause the rat to squeak. An antidepressant music electroacupuncture setting was chosen. The needles were retained for 20 minutes while an acupuncture session was conducted per day for a total of 21 days.

The Tang et al. laboratory experiment demonstrated significant improvements in behavioral and objective results, including improvements in serotonin (5-HT), dopamine (DA), and norepinephrine (NE) levels determined by radioimmunoassay in depression model rats. Additional testing with human subjects is required, including large sample size meta-analyses, to determine the overall efficaciousness of music electroacupuncture for the treatment of depression. The Healthcare Medicine Institute plans on taking a closer look at this innovative approach to electroacupuncture.

 

References:
Tang YS, Ji Q, Cao J, Teng JY, Deng XF, Li J, Li ZG. (2014). Influence of Music Electroacupuncture and Pulsed Electroacupuncture on the Different Encephalic Regions of Monoamine Neurotransmitter Chronic Unpredictable Mild Stress Depression Model Rats. Journal of Clinical Acupuncture and Moxibustion. 30(3). 

Cao J, Tang Y, Li Z, Ji Q, Yao H, Mo Y, Wang X, Song L. Effects of Music Electro-Acupuncture on the Expression of Monoamine Neurotransmitter in Different Encephalic Regions in Chronic Unpredictable Mild Stress Depression Model Rats. The Journal of Alternative and Complementary Medicine. 2014 May 1;20(5):A39.

Tang Y, Cao J, Li Z, Chen W, Xu AP, Mo YP, Yao H, Wang X, Liang C. Effects of Music Electro-Acupuncture and Pulsed Electro-Acupuncture on Behavioral Changes and the Serum β-amyloid Protein in SAMP8 (Senescence Accelerated Mouse Prone 8) Mice. The Journal of Alternative and Complementary Medicine. 2014 May 1;20(5):A38.

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