by William Alexander | Sep 18, 2026 | Acupuncture and Pain Relief, Back Pain
How Many Acupuncture Sessions Do You Need for Lower Back Pain?
Lower back pain can turn ordinary activities into daily negotiations: how long you can sit at your desk, whether you can finish a walk, or how carefully you need to get out of bed. If you are considering acupuncture, you probably want to know more than whether it might help. You want to know what treatment involves and how much time to give it.
There is no single number of acupuncture sessions that works for everyone with lower back pain. A reasonable plan starts with an evaluation, sets goals you can measure, and includes reassessment. Your symptoms, medical history, and response to treatment should guide the next steps.
At Affinity Acupuncture in Brentwood, serving the Nashville area, pain management is a central focus of our practice. Here is what to consider when deciding whether acupuncture belongs in your back-pain treatment plan.
Can acupuncture help lower back pain?
Acupuncture may help some people manage lower back pain and improve daily function. The American College of Physicians includes acupuncture among the initial nondrug options in its 2017 guideline for chronic low back pain. Other options include exercise and multidisciplinary rehabilitation. That guideline addresses nonradicular pain; its findings should not automatically be applied to pain caused by an irritated nerve root. Read the ACP guideline summary.
The National Center for Complementary and Integrative Health reports that acupuncture can help with back pain, while also explaining that benefits are generally larger compared with no treatment than with simulated acupuncture. Results vary, and treatment does not guarantee relief. Read NCCIH’s evidence overview.
For patients, the useful question is whether treatment helps you do more of what matters: sit through dinner, sleep more comfortably, walk farther, or return to an appropriate exercise routine.
What determines how many sessions you may need?
The number of visits should reflect your individual situation rather than a fixed package applied to every patient. Important considerations include:
- How long symptoms have been present. A recent episode and longstanding pain may call for different plans.
- What has already been evaluated. Previous diagnoses, injuries, surgery, and other treatments help inform the approach.
- How pain affects your day. Pain intensity matters, but so do limitations in work, sleep, and movement.
- Your response between appointments. The duration of any improvement matters when deciding whether to continue or adjust care.
Before starting, ask: “When will we reassess, and what would count as meaningful improvement?” You should understand the proposed frequency, expected costs, and reasons for the plan.
How soon should you notice a difference?
An early change in symptoms can be encouraging, but one appointment does not establish how much lasting benefit you will receive. Equally, an open-ended plan without a progress check is not a useful expectation.
Choose two or three everyday activities to track. For example:
- How many minutes can you sit before you need to change positions?
- How often does your back interrupt your sleep?
- Can you put on shoes or get out of the car more comfortably?
These examples are tracking tools, not promised outcomes. Recording a brief note between appointments can help you describe changes more clearly than trying to remember an entire week during your visit.
If symptoms are unchanged, worsening, or improving only very briefly, discuss that with your practitioner. It may be appropriate to modify treatment, coordinate additional care, or reconsider whether acupuncture is helping enough to continue.
What happens at a lower-back-pain appointment?
At Affinity Acupuncture, care begins with a discussion of your symptoms and an evaluation of your presentation. Bring relevant medical information and be ready to describe what makes your pain better or worse. Your treatment plan should take your history and functional goals into account. Learn more about our approach to chronic pain care.
Acupuncture uses thin needles; some treatments may include electrical stimulation through the needles, called electroacupuncture. The approach is individualized. Ask your practitioner to explain the techniques recommended for you and tell them promptly if anything feels uncomfortable. NCCIH explains acupuncture techniques and safety.
Is lower back pain the same as sciatica?
Not necessarily. Lower back pain can remain near the waist and back muscles. Sciatica typically involves symptoms traveling into the leg and may include tingling, numbness, or weakness. These symptoms need assessment because they may change the treatment plan. NCCIH discusses sciatica symptoms.
If leg pain is a major part of your symptoms, our article on acupuncture for sciatic pain covers that topic separately.
Can you combine acupuncture with physical therapy?
Acupuncture can be considered within a broader care plan. Rehabilitation may address strength, movement, and the demands of your work or daily activities. Your providers should know what other care you receive so recommendations fit together.
NIAMS recommends gradually increasing activity as tolerated rather than prolonged bed rest and describes physical therapy as an option for improving strength and mobility. The right exercises depend on your situation; avoid pushing through worsening symptoms simply to complete a routine. Read NIAMS guidance on back-pain treatment.
When should back pain receive medical attention first?
Seek urgent medical evaluation for new difficulty urinating, loss of bowel or bladder control, numbness around the groin, or rapidly worsening leg weakness. Back pain with fever, unexplained weight loss, or a significant injury also needs prompt medical assessment. Acupuncture should not delay evaluation of these symptoms. See NIAMS’ back-pain warning signs.
Acupuncture for lower back pain in Brentwood and Nashville
You do not need to know the right number of visits before asking for help. The first step is understanding whether acupuncture is appropriate for your symptoms and what a reasonable trial of care would look like.
Dr. William Alexander, DAOM, L.Ac., has advanced training in orthopedic and sports medicine acupuncture and has served Nashville-area patients since 2012. Learn more about his background.
To discuss acupuncture for lower back pain, request an appointment at Affinity Acupuncture or call 615-939-2787.
Affinity Acupuncture
750 Old Hickory Blvd, Building 2, Suite 150
Brentwood, TN 37027
by William Alexander | Dec 5, 2025 | About Acupuncture, Acupuncture for Mental & Emotional Health, Acupuncture for Skin and Vitality, Acupuncture for Women's Health, Health Benefits of Acupuncture, Symptoms, Treatments, Uncategorized
Menopause Treatment with Acupuncture: A Science-Based Approach to Hot Flashes, Sleep, and Mood
Menopause is a normal biological transition, but the symptoms can be anything but normal life: hot flashes, night sweats, disrupted sleep, brain fog, mood swings, joint pain, and vaginal dryness can all take a serious toll on quality of life. These changes are driven by fluctuating and then declining estrogen and progesterone levels, which affect the brain’s temperature-regulation centers, neurotransmitters, and the autonomic nervous system.
For many women, hormone therapy is an excellent option. But some can’t take hormones (for example, after hormone-sensitive cancers), and others prefer non-hormonal options. This is where acupuncture can play an important role as part of a comprehensive, evidence-informed menopause care plan.
How Menopause Symptoms Develop – In Plain Medical Terms
During the menopausal transition, falling estrogen levels disrupt how the hypothalamus (the brain’s thermostat) interprets body temperature. Even very small changes in core temperature can trigger a “thermal flush” response: sudden vasodilation of blood vessels in the skin, sweating, and a racing heart – what you feel as a hot flash or night sweat.OUP Academic+1
At the same time:
Serotonin and norepinephrine signaling shift, affecting mood, sleep, and pain perception.
The autonomic nervous system becomes more reactive, increasing heart rate variability and sympathetic (“fight or flight”) activity.
Chronic sleep disruption and stress can heighten pain sensitivity and worsen anxiety and depression.
Effective menopause care, therefore, isn’t just about hormones; it’s about calming this over-reactive neuroendocrine and autonomic system.
How Acupuncture Works for Menopause – Mechanisms
Modern research suggests that acupuncture can influence many of the same systems that drive menopause symptoms:
Modulation of the hypothalamus and thermoregulation
Functional imaging and neurochemical studies show that acupuncture can alter activity in the hypothalamus and limbic system, which are key centers for temperature regulation, stress response, and mood. It appears to narrow the “thermoneutral zone,” so minor core-temperature fluctuations are less likely to trigger a hot flash.
Neurotransmitter balancing
Acupuncture has been shown to increase endogenous opioids (like β-endorphins), and modulate serotonin and norepinephrine levels in the central nervous system. These changes are associated with improved pain control, more stable mood, and better sleep architecture.PubMed+1
Regulation of the autonomic nervous system
Studies demonstrate that acupuncture can shift the autonomic balance toward parasympathetic (“rest and digest”) activity and reduce sympathetic overdrive. This can help with palpitations, anxiety, and the sudden vascular changes that underlie hot flashes and night sweats.PubMed
Anti-inflammatory and analgesic effects
By down-regulating pro-inflammatory cytokines and modulating pain pathways, acupuncture can help ease joint pain, muscle tension, and headaches that often flare during menopause.PubMed+1
What the Research Says About Acupuncture and Menopause
The evidence base is still evolving, and it’s important to be honest: not every study has shown a clear advantage of acupuncture over sophisticated “sham” or minimal-needling controls. Several early randomized controlled trials and systematic reviews concluded that while women improved, acupuncture did not always outperform sham acupuncture, and more rigorous research was needed.PubMed+2PubMed+2
However, more recent and better-designed studies paint a more encouraging picture:
A 2018 review in the Journal of Alternative and Complementary Medicine found that evidence from randomized controlled trials supports acupuncture as an adjunctive or stand-alone treatment for reducing vasomotor symptoms (hot flashes, night sweats) and improving menopause-related quality-of-life scores, while noting that nonspecific effects may contribute.PubMed
A pragmatic randomized trial in BMJ Open showed that women receiving standardized acupuncture experienced clinically meaningful reductions in hot flash frequency and severity, sleep disturbance, and overall menopause symptom scores compared with usual care.BMJ Open
A meta-analysis in PLOS One focusing on breast-cancer survivors (who often cannot use hormone therapy) found that acupuncture significantly alleviated overall menopause symptoms and improved quality of life, even though it did not significantly change hot-flash counts in every study.PLOS
Major menopause organizations, like The Menopause Society (formerly NAMS), still emphasize hormone therapy as the most effective treatment for vasomotor symptoms, but they also acknowledge the growing evidence and patient interest in non-hormonal options, including acupuncture, especially for women who cannot or prefer not to use hormones.PubMed+1
In real-world practice, many women report better sleep, fewer or less intense flashes, improved mood, and less body pain over a course of acupuncture treatments – and the safety profile is very favorable when performed by a properly trained, licensed provider.
What to Expect from Menopause Treatment at Affinity Acupuncture
At Affinity Acupuncture in Nashville, TN, menopause care starts with a detailed assessment of:
Your specific symptom pattern (hot flashes vs. insomnia vs. mood, joint pain, etc.)
Your medical history, including hormone therapy, cancer history, and medications
Lifestyle factors like stress, diet, exercise, and sleep routines
Treatment typically involves:
Regular acupuncture sessions targeting points shown in research and clinical practice to influence thermoregulation, autonomic balance, and sleep.
Adjunctive therapies as appropriate, such as cupping, gentle manual work, or relaxation strategies.
Collaboration with your other providers so acupuncture can safely complement hormone therapy, non-hormonal medications, or oncology care when needed.
Why Consistency Matters
Acupuncture works through neuroplastic and physiological changes that build over time. Most research protocols for menopause use weekly treatments over 6–8 weeks, sometimes followed by a taper to every other week or monthly maintenance.ScienceDirect+1
That means:
You may notice some improvement within the first few sessions,
But best results usually come with consistent, ongoing treatment,
And maintenance sessions may be needed to keep symptoms under control, especially during periods of stress or rapid hormonal change.
We’ll talk with you about realistic timelines and tailor a plan that fits your life and goals.
Ready to Find Relief?
If menopause symptoms are disrupting your sleep, work, relationships, or sense of self, you don’t have to “just live with it.”
👉 Visit us at www.affinityacupuncture.com
👉 Or call 615-939-2787 to set up your consultation and find out whether acupuncture is a good fit for your menopause treatment plan.
#AffinityAcupuncture #MenopauseRelief #AcupunctureForMenopause #HotFlashHelp #SleepBetter #NaturalMenopauseSupport #NashvilleAcupuncture #WomenOver40 #HormoneHealth #IntegrativeMedicine
by William Alexander | Aug 25, 2025 | Acupuncture and Pain Relief, Acupuncture Nashville TN, Health & Wellness, Treatments
Temporomandibular joint dysfunction (TMD)—often colloquially referred to as “TMJ”—encompasses a spectrum of disorders affecting the jaw joint and related muscles, characterized by symptoms such as orofacial pain, restricted mandibular movement, joint clicking, and myofascial trigger points www.elsevier.com+7Cureus+7integrmed.org+7.
Clinical Evidence for Effectiveness
Clinical research, including randomized controlled trials (RCTs) and systematic reviews, supports the efficacy of acupuncture in relieving TMD symptoms:
A comprehensive meta‑analysis of 32 RCTs (471 participants) found acupuncture significantly improved both overall effect rates (relative risk [RR]: 7.00, 95% CI: 1.91–25.62) and pain scores (standardized mean difference: 0.49, 95% CI: 0.24–0.73), when compared to active controls PMC+1PMC+1.
A 2024 RCT demonstrated that acupuncture reduced pain intensity significantly more than sham acupuncture at both 4 weeks (−1.49; 95% CI: −2.32 to −0.65; p < 0.001) and 8 weeks (−1.23; 95% CI: −2.11 to −0.54; p = 0.001), also improving jaw mobility, mood, sleep quality, and functional scales e-jar.org+7PubMed+7Oxford Academic+7.
A 2024 meta‑analysis focused on muscle-origin TMD found both manual and laser acupuncture offered short‑term relief and superior efficacy versus placebo controls BioMed Central+2PMC+2.
Traditional forms such as warm acupuncture and electroacupuncture have shown long‑term benefits, including reduced pain, improved jaw function, and lower recurrence rates integrmed.org+1.
While the evidence base remains evolving, particularly with varying levels of study quality, consensus points to acupuncture as a promising therapeutic adjunct or complementary intervention PMC+15PubMed+15PMC+15.
Medical Mechanisms: Bridging Traditional and Contemporary Understanding
Traditional Chinese Medicine (TCM) posits that TMD arises from stagnation of Qi (energy) and blood, often aggravated by external pathogenic factors such as cold or dampness. Acupuncture, in this paradigm, restores energetic balance and circulation through targeted needle insertion at meridian points integrmed.orgMedCentral.
Biomedically, acupuncture appears to offer:
Neurotransmitter and neuropeptide modulation, including endorphins and enkephalins, inhibiting pain pathways both centrally (e.g., trigeminal nucleus caudalis) and peripherally MedCentral.
Peripheral release of adenosine, which exerts local anti‑nociceptive effects via A₁ receptor activation Lippincott Journals+15en.wikipedia.org+15e-jar.org+15.
Muscle relaxation and reduction of myofascial hypertonicity by interrupting pain‑tension cycles, reducing ischemia and trigger‑point activity PMC+2MedCentral+2.
Improved jaw joint biomechanics, believed to result from decreased muscular tension, enhanced synovial joint function, and reduced inflammatory mediators en.wikipedia.org.
Why Acupuncture Works for TMD
Multimodal action: By targeting both pain perception (via central neurotransmitter modulation) and muscular/joint mechanics, acupuncture addresses multiple contributors to TMD.
Holistic symptom relief: Beyond pain reduction, acupuncture has been shown to improve mood, sleep quality, stress, and functional mobility PMC+2PMC+2.
Low risk profile: When delivered by skilled practitioners using sterile techniques, acupuncture is generally safe and well‑tolerated en.wikipedia.org.
Versatility: Techniques ranging from manual needle stimulation to electroacupuncture and warm acupuncture allow tailored treatment for specific patient needs integrmed.org+2PMC+2.
What to Expect: Consistency Is Key
Success with acupuncture for TMJ isn’t instantaneous nor one-size-fits-all. Consistent treatment—often multiple sessions over several weeks—is essential to:
Sustain neuromodulatory effects,
Promote musculoskeletal adaptation,
Aid cumulative reduction in central sensitization and muscular tension.
Patients typically experience progressive symptom relief; setting realistic expectations and maintaining consistent care yields the most favorable outcomes.
Visit Affinity Acupuncture
Ready to start your journey toward relief? Visit us at www.affinityacupuncture.com or schedule your personalized consultation by calling 615-939-2787. Consistency is key—let us craft a caring, effective acupuncture plan to help you finally find relief from TMJ dysfunction.
by William Alexander | Jul 9, 2025 | Acupuncture and Pain Relief, Acupuncture Nashville TN
What is Peripheral Neuropathy?
Peripheral neuropathy refers to damage or dysfunction of peripheral nerves—sensory, motor, or autonomic—causing symptoms like tingling, burning pain, numbness, weakness, or balance issues, typically in the hands and feet ClinicalTrials.gov+10Wiley Online Library+10ClinicalTrials.gov+10.
Common causes include diabetes, chemotherapy, nutritional deficiencies, and autoimmune conditions .
How Acupuncture Works: Medical Mechanisms Explained
1. Modulation of Ion Channels & Receptors
Neuropathic pain arises from altered ion channels—like TRP and P2X receptors—causing increased neuronal excitability PMC+1Wikipedia+1.
Acupuncture at specific acupoints can down-regulate overactive ion channels and stabilize action potential firing in damaged peripheral nerves Frontiers.
2. Inhibition of Pain Transmission
Needle insertion activates the somatosensory pathways, stimulating Aβ fibers that, via spinal gating mechanisms, inhibit nociceptive (pain) signals from C and Aδ fibers PMC+15PMC+15ClinicalTrials.gov+15. This aligns with the Gate Control Theory that soothing non-painful stimuli can block pain perception.
3. Activation of Descending Pain Control Pathways
Acupuncture evokes release of serotonin (5-HT), norepinephrine (NE), and endogenous opioids in the spinal cord and brainstem, enhancing descending inhibition of pain PMC.
4. Anti-inflammatory & Glial Modulation
Acupuncture can reduce phosphorylation of protein kinases and quell activation of glial cells that release pro-inflammatory cytokines—both drivers of chronic neuropathic pain PMC.
5. Nerve Regeneration & Conduction Improvements
Studies show acupuncture improves sensory and motor nerve conduction velocities (SNCV and MNCV), suggesting it facilitates nerve repair and remyelination PMC+1ScienceDirect+1.
Evidence from Clinical Trials & Meta-Analyses
Diabetic Peripheral Neuropathy (DPN)
A meta-analysis of acupuncture in DPN showed improved pain scores and enhanced nerve conduction parameters Frontiers+15PMC+15Effective Healthcare+15.
Chemotherapy-Induced Peripheral Neuropathy (CIPN)
Clinical trials and observational studies, including RCTs, demonstrate acupuncture’s safety and efficacy in alleviating CIPN symptoms, improving sensory function and nerve conduction Wikipedia+2Wikipedia+2Wikipedia+2.
Neuropathic Pain in General
A 2022 meta-analysis of eight RCTs (338 patients) found moderate pain reduction (SMD –0.59) versus sham or blank controls, with minimal side effects PMC.
Why It’s Especially Effective When Started Early
Peripheral neuropathy often worsens due to nerve hyperexcitability, inflammation, and structural nerve damage. Initiating acupuncture as soon as symptoms begin helps:
Halt maladaptive ion channel changes and spontaneous ectopic firing.
Prevent central sensitization (spinal/brain changes that cement chronic pain) Wikipedia+1PMC+1.
Promote nerve regeneration before irreversible damage occurs.
Delaying treatment allows degenerative and sensitization processes to set in, making recovery more difficult.
Importance of Consistency & Realistic Expectations
Peripheral nerves heal slowly; acupuncture protocols often require 2+ sessions per week over several months to achieve significant results. Many studies follow regimens lasting 8–12 weeks or longer .
Consistency is key—skipping sessions or stopping early can undermine neuroplastic and regenerative benefits. View acupuncture as a long‑term strategy, not a one‑off solution.
Safety & Tolerability
Acupuncture is well-tolerated. Adverse effects are generally mild (e.g., transient local soreness or bruising). This contrasts favorably with systemic side effects of medications like gabapentin or duloxetine .
In Summary
Acupuncture offers a scientifically plausible and clinically supported option for peripheral neuropathy:
Mechanisms: modulates ion channels, inhibits pain pathways, activates descending control, reduces inflammation, supports regeneration.
Evidence: RCTs and meta-analyses show significant pain relief and improved nerve conduction in DPN, CIPN, and generalized neuropathic pain.
Best results: achieved with early intervention and sustained treatment—consistency is crucial.
Safety: mild reversible side effects; few risks compared with pharmaceuticals.
Ready to Take Action?
If you’re experiencing tingling, numbness, burning, or neuropathic pain—even mild symptoms—don’t wait. Starting acupuncture early can halt nerve damage and restore function more effectively.
Visit us at www.affinityacupuncture.com or schedule a consultation by calling—615‑939‑2787.
Our expert practitioners specialize in peripheral neuropathy treatment and tailor protocols to your symptoms, whether diabetic neuropathy, chemotherapy‑induced, or other causes. We emphasize consistency, early treatment, and long‑term follow‑up for the best outcomes.
Hashtags for Social Sharing
#PeripheralNeuropathy #AcupunctureWorks #NeuropathyRelief #EarlyIntervention #ConsistentCare #AffinityAcupuncture
by William Alexander | Sep 6, 2016 | Back Pain
Acupuncture is Leading the Way in Pain Management
Researchers demonstrate excellent clinical results using acupuncture for the treatment of lumbar disc herniations.
Researchers find acupuncture safe and effective for the treatment of lumbar disc herniations across multiple independent clinical trials. A meta-analysis of investigations reveals that Jiaji acupoints yield significant positive patient outcomes when combined with manual and electroacupuncture techniques. Distal and abdominal acupuncture also demonstrated significant positive patient outcomes. This research review covers rare acupuncture points demonstrating clinical efficacy and details a powerful manual acupuncture technique proven effective for relief of lumbar disc herniation symptoms. We’ll start with primary research by Song et al. and then take a close look at a meta-analysis by Wang et al., including specific approaches to clinical care proven to deliver excellent results.
Researchers find both electroacupuncture and manual acupuncture effective for the treatment of lumbar disc herniations. Song et al. conducted a clinical trial at the Xixiang People’s Hospital in Guangdong, China. Electroacupuncture and manual acupuncture significantly reduced patients’ pain levels. Outstanding positive patient outcomes were recorded for the electroacupuncture treatment group. Patients with lumbar disc herniations receiving electroacupuncture had a 91.8% total treatment effective rate. Improvements included pain reductions, increases in range of motion, and improved straight leg lift testing.
A sample size of 123 patients was randomly divided into two groups. In group one, 61 patients received electroacupuncture therapy. In group two, 62 patients received manual acupuncture. For the electroacupuncture patients, the Jiaji acupoints at the specific vertebra corresponding to the herniated lumbar disc, as well as on the two adjacent vertebrae, were selected as the primary acupoints and treated on both sides. Additional secondary acupoints were selected based on individual patient symptoms. For hip pain, the following acupoints were chosen:
Huantiao (GB30)
Chengfu (BL36)
For calf pain:
Weizhong (BL40)
Chengshan (BL57)
For lateral calf pain, the following acupoint were chosen:
Yanglingquan (GB34)
Zusanli (ST36)
Kunlun (BL60)
Xuanzhong (GB39)
Treatment commenced with the patient in a prone position. Upon disinfection, a 0.30 x 40 mm disposable needle was pierced perpendicularly into each acupoint until a deqi sensation was reported. Next, an electroacupuncture device was connected to the needles in the Jiaji acupoints. A continuous waveform was selected at an initial 0.8 Hz frequency. The intensity was then gradually increased until both sides of the lumbar muscle were twitching rhythmically at a tolerable rate for the patient. Subsequently, a 30 minute needle retention time was observed. One electroacupuncture session was conducted once per day for 20 consecutive days with a one day break after the 10th day. For the manual acupuncture patients, the following acupoints were selected according to the affected area:
Ganshu (BL18)
Shenshu (BL23)
Yaoyan (MBW24)
Huantiao (GB30)
Zhibian (BL54)
Chengfu (BL36)
Weizhong (BL40)
Weiyang (BL39)
Yanglingquan (GB34)
Feiyang (BL58)
Guangming (GB37)
Kunlun (BL60)
Tonggu (BL66)
Jinggu (BL64)
Houxi (SI3)
Treatment commenced with the patient in a prone position. Upon disinfection, a 0.30 x 40 mm disposable needle was pierced perpendicularly into each acupoint until a deqi sensation was felt. During the subsequent 30 minute needle retention time, the acupuncture needle was manipulated once every 10 minutes. One acupuncture session was conducted once per day for 20 consecutive days with a one day break after the 10th day. The total treatment efficacy was measured based on the TCM Treatment Efficacy Guidelines issued by the TCM Governing Board. Efficacy was categorized into 1 of 3 possible tiers:
Effective: Waist and leg pain ceased. Straightened leg lift of 70° and above. Normal waist and leg activity regained.
Improvement: Waist and leg pain relieved. Improvement in extent of waist movement.
Not effective: No improvement in symptoms.
The total treatment effective rate was measured as a percentage of patients who achieved at least the “improvement” tier. Electroacupuncture produced a 91.8% total treatment effective rate including pain reductions, increases in range of motion, and improved straight leg lift testing. Song et al. conclude that acupuncture is effective for the treatment of lumbar disc herniations.
The research team prefaced their study with background information. Lumbar disc herniation is a common disease among adults. Pain, numbness, or weakness arises due to damage or compression of the nerve root caused by herniation of the nucleus pulposus. This is the soft inner core of the vertebral disc that helps absorb compression and torsion. A herniation occurs when the soft material from the inner core escapes through the outer rings of the disc. This stubborn disease is usually characterized by an abrupt onset with a prolonged or repetitive course of symptomatic flare-ups. Main symptoms include leg and lumbar region pain, and also lower limb motor dysfunction. Lower limb paralysis is possible in severe cases.
Song et al. note that acupuncture is a relatively non-invasive treatment for disc herniations that dredges meridians, promotes qi circulation, eliminates blood stasis, and expels wind-dampness. Pain is thereby relieved when blood and qi circulation is restored. In modern terms, acupuncture stimulates parasympathetic tone and downregulates excess sympathetic nervous system activity. Resulting decreases in the inflammatory cascade of endogenous biochemicals results from the regulation of the autonomic nervous system.
Song et al. add that acupuncture regulates nerve activity, facilitates muscles relaxation, mitigates muscular spasms, dilates blood vessels, improves blood circulation, and also reduces both edema and inflammation. The Jiaji acupoints, located on the back beside the Du meridian, are used to treat diseases related to the corresponding affected nerve segments. Electroacupuncture utilizes electrical stimulation to facilitate the regeneration of damaged nerves by improving nerve cell metabolism and nerve cell enzyme activity. The basis of this is that electroacupuncture forms a localized, stable, and subtle electric current that boosts the electrophysiological properties of nerve cells (Sun, 1996).
In a related study, Wang et al. conducted a meta-analysis on the efficaciousness of acupuncture for the treatment of lumbar disc herniations. Without exception, the clinical investigations demonstrate that acupuncture is a safe and effective treatment modality for lumbar disc herniation patients. The following are examples of studies included in the meta-analysis.
Liu et al. investigated the efficacy of conventional acupuncture therapy. Conventional acupuncture treatment was administered by first identifying the vertebrae with lumbar disc herniations. Corresponding Du meridian acupoints and the two adjacent Jiaji acupoints were needled. The identified acupoints were treated with the Shao Shan Huo (Setting the Mountain on Fire) needling technique. Patients were treated for 10 consecutive days and achieved a 95% total treatment effective rate.
Shao Shan Huo is a powerful tonification needling technique in Traditional Chinese Medicine (TCM). Needles are inserted and stimulated to elicit the arrival of deqi for purposes of reinforcing qi. When applied properly, the patient feels a warm sensation at the needle region. In addition, the skin will be flush red as a result of enhanced micro-circulation of blood.
Initially, the needle is inserted slowly to superficial depth beneath the skin. During the procedure, lifting and thrusting is applied to three levels of depth beneath the skin, starting with the most superficial level at approximately a 0.5 cun depth. This is followed by lifting and thrusting at the middle level at approximately 1.0 cun and the deep level at approximately 1.5 cun. Depth varies according to patient size and acupoint location.
At each of the three depths of insertion, the needle motion combines quick and forceful thrusting with slow and gentle lifting for a total of nine times. Rotation may also be applied with the same techniques. After stimulation at all three levels is complete, the needle is lifted to the superficial level and the procedure is repeated, often three times, to ensure elicitation of a qi sensation producing heat and redness of the skin. The patient may also sweat in the region of the needle or throughout the body as a result of the heat sensation produced by this tonification method. Liu et al. achieved a 95% total treatment effective rate using the Setting the Mountain on Fire technique using the Du and Jiajia (Huatuojiaji) acupuncture points at correlated regions to lumbar disc herniations. Notably, acupuncture was applied for 10 consecutive days.
Deng and Cai’s investigation also examined application of the Jiaji acupoints for the treatment of lumbar disc herniations. In a different approach to needle stimulation, Deng and Cai applied electroacupuncture stimulation to the needles. They achieved significant levels of positive patient outcomes in their clinical trial. In their investigation, patients were treated every other day. Short-term results and a three month follow-up confirm significant clinical improvements.
He et al. had an entirely different approach to acupuncture therapy for the treatment of lumbar disc herniations. Their approach focused on abdominal acupuncture and anterior acupoints. The clinical investigation yielded significant positive patient outcomes. In their semi-protocolized investigation, a set of primary acupoints were applied plus secondary acupoints were added for specific diagnostic concerns. The primary acupoints for all patients were the following:
Shuifen (CV9)
Qihai (CV6)
Guanyuan (CV4)
Next, secondary acupoints were added based on diagnostic criteria. For acute lumbar disc herniations, the following acupoints were added:
Shuigou (GV26)
Yintang (MHN3)
For prolonged lumbar disc herniation, the following acupuncture point was added:
Qixue (KD13)
For generalized lumbago, the following acupoints were added:
Wailing (ST26)
Qixue (KD13)
Siman (KD14)
For sciatica occurring when sitting, the following acupuncture points were added:
Qipang
Wailing (ST26), affected side only
Xiafengshidian
Xiafengshixiadian
He et al. measured improvement rates after three weeks of acupuncture therapy. Patients achieved significant improvements. The researchers conclude that the protocol is effective for the treatment of lumbar disc herniation symptoms. He et al. used several acupoints termed ‘extra’ points including Xiafengshidian, Xiafengshixiadian, and Qipang. The acupoints demonstrate that the researchers focused on abdominal acupuncture as a means of treating lumbar concerns.
Xia Feng Shi Dian (Xia Feng Shi Dian, Lower Wind-Damp Point) is located 2.5 cun lateral to CV6 and is indicated for the treatment of knee disorders, including postoperative swelling and pain. Xiafengshixiadian (Xia Feng Shi Xia Dian, Below Wind-Damp Point) is located 3 cun lateral to CV5 and is used for leg, ankle, and foot disorders. Qipang (Qi Pang, Beside Qi) is located 0.5 cun lateral to CV6 and is indicated for lower back and leg pain, swelling, and weakness; including postoperative disorders.
The meta-analysis included the clinical research of Zhang et al. Manual acupuncture was applied to acupoints surrounding the afflicted area. All needles were directed towards the center of the afflicted region. Zhang et al. achieved a 97.5% total treatment effective rate.
Overall, the metal-analysis by Wang et al. documents that acupuncture is a safe and effective treatment modality for patients with lumbar disc herniations. Implementation of Jiaji acupoints was common across several studies. Other techniques including abdominal acupuncture and local Ashi acupoint acupuncture also demonstrated clinical effectiveness. Both electroacupuncture and specialized manual acupuncture demonstrated effectiveness as well. As a result of the findings, the researchers conclude that acupuncture is an important treatment option for patients with lumbar disc herniations.
References:
Song YJ, Yu MJ, Li L, Huang WX, Cai ZW, Su DP. (2013). Clinical Observation of Electro-acupuncture in Treatment of Lumbar Disc Herniation. Chinese Manipulation & Rehabilitation Medicne.
Sun ZR. Mechanism of acupuncture in the regeneration of surrounding damaged nerves. 1996(02).
Wang FM, Sun H, Zhang YM. (2014). Advance of Clinical Research in Intervention of Lumbar Disc Herniation（LDH） with Acupuncture Moxibustion. Journal of Clinical Acupuncture and Moxibustion.
30(3).
Deng W & Cai LH. (2011). Electroacupuncture on Jiaji acupoint in treating lumbar disc herniation. Journal of Clinical Acupuncture. (7).
He JX, Lin WR, Chen JQ, Huang Y, Wang SX, Lin HH & Chen HX. Abdominal acupuncture in treating lumbar disc herniation. Shanghai Journal of Acupuncture. 2012. (7).
Liu YZ, Sun XW & Zou W. (2012). Shao Shan Huo acupuncture technique on lumbar Jiaji acupoint in treating lumber disc herniation. Journal of Clinical Acupuncture. (6).
http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1670-acupuncture-found-effective-for-lumbar-disc-herniations
