From webmd, nonetheless!
Acupuncture May Cool Night Hot Flashes
Alternative Medicine Treatment May Ease Menopausal Symptoms
By Jennifer WarnerWebMD Medical News
Sept. 22, 2006 -- Acupuncture may nix nighttime hot flashes caused by menopause, according to a new study.
Researchers found seven weeks of acupuncture treatment reduced the severity of nighttime hot flashes by 28% among menopausal women compared with a 6% decrease among women who had a sham acupuncture treatment.
Hot flashes are a common symptom of menopause and often occur at night, which can significantly disrupt sleep and affect a woman's quality of life.
Until recently, hormone replacement therapy (HRT) was the most popular treatment for hot flashes. But in the wake of studies that suggested HRT use could increase a woman's risk of heart disease or cancer, alternative therapies for hot flashes have received renewed interest
Friday, September 22, 2006
Thursday, September 21, 2006
Celebrity Alert
Not that I am proponent of following Hollywood trends, but everything a celebrity gets press for receiving acupuncture, it raises popular awareness. While I do not think we should look to Hollywood as a guide for healthy living, I am not picky on the manner in which people come to my door.
September 19, 2006
Marcia's Christmas Surprise
Marcia Cross has an extra special Christmas present for her new husband, Tom Mahoney: the sex of their baby. According to the National Enquirer, the "Desperate Housewives" star has asked her doctor to write her baby’s gender on a piece of paper. She plans to keep the paper in an envelope until Tom opens it during the holidays. The envelope is said to read, “Do Not Open Until Christmas.”
Cross’s pregnancy is truly a gift. At 44, she was nervous about her ability to conceive a child and sought out the help of an acupuncturist to increase her chances of fertility. Marcia’s acupuncturist is Dr. Yi Pan, co-founder of The Chinese Healing Institute in Los Angeles. An insider told the Enquirer, “[Marcia] knew at her age her odds of conceiving had diminished, and she hoped acupuncture would help. When she found out she was expecting in July, she personally thanked Dr. Pan."
Marcia and Tom have been married for just over two months. She found out about her pregnancy only about a month after her wedding and the child is due in April.
http://thebosh.com/archives/2006/09/marcias_christmas_surprise.php
Saturday, September 16, 2006
Relief that Lasts
While the majority of research in acupuncture focuses on effects in general, this one takes the long view and examines efficacy after 24 months.
Research Shows Long-Term Benefits Of Acupuncture In Relieving Back Pain
September 15, 2006 4:56 p.m. EST
Shaveta Bansal - All Headline News Staff Writer
London, England (AHN) - Research by scientists at University of York in England, has shown that acupuncture can be effective therapy in treating patients suffering from lower back pain and that the benefits seem to improve with time.
Short-term benefits of acupuncture have been long known but to investigate the long-term effects of the therapy, Dr. Hugh MacPherson and his team studied a group of 241 back pain sufferers who underwent a short course of acupuncture.
Patients were divided into two groups: one group was subjected to take 10 acupuncture sessions over three months and the other group underwent the normal treatment for back pain, which included medication, physiotherapy and exercises. The satisfaction and pain levels of both groups were measured and recorded during the two-year study.
After three months there was not too much difference between the acupuncture group and patients who had the standard therapy.
A weak evidence of improvement in the acupuncture group was found at 12 months, according to the study published in the British Medical Journal.
By 24 months the difference between the two groups increased. "If you offer acupuncture to someone with back pain on average it is expected you are likely to benefit, not just in the short term but particularly in the longer-term of 12 and especially 24 months," MacPherson told Reuters in an interview.
Read More
Research Shows Long-Term Benefits Of Acupuncture In Relieving Back Pain
September 15, 2006 4:56 p.m. EST
Shaveta Bansal - All Headline News Staff Writer
London, England (AHN) - Research by scientists at University of York in England, has shown that acupuncture can be effective therapy in treating patients suffering from lower back pain and that the benefits seem to improve with time.
Short-term benefits of acupuncture have been long known but to investigate the long-term effects of the therapy, Dr. Hugh MacPherson and his team studied a group of 241 back pain sufferers who underwent a short course of acupuncture.
Patients were divided into two groups: one group was subjected to take 10 acupuncture sessions over three months and the other group underwent the normal treatment for back pain, which included medication, physiotherapy and exercises. The satisfaction and pain levels of both groups were measured and recorded during the two-year study.
After three months there was not too much difference between the acupuncture group and patients who had the standard therapy.
A weak evidence of improvement in the acupuncture group was found at 12 months, according to the study published in the British Medical Journal.
By 24 months the difference between the two groups increased. "If you offer acupuncture to someone with back pain on average it is expected you are likely to benefit, not just in the short term but particularly in the longer-term of 12 and especially 24 months," MacPherson told Reuters in an interview.
Read More
Tuesday, September 12, 2006
Doubting the Atom
Every once in a while I feel it is good to read what the skeptics have to say. There is something delightfully quaint about people who demand scientific proof that the reflection in the mirror is that of their own face, rather then trusting their own senses. They talk about scientific proof, but many cannot define basic concepts like statistical significance, independent variables, and random sampling. And the assumptions - wow - I am amazed at the lack of investigation and logic.
Normally, I pay little attention to those who dismiss complementary medicine outright - I prefer to spend my time helping people, not converting them. I know of very few practitioners who shun Western Medicine as of us have a yearly check-up with a regular doctor, and many take prescription medicine. Yes, there are some people who practice complementary therapies (including MDs) without proper training, but this is no different in allopathic medicine. Just because someone is an MD and says they are a plastic surgeon, does not mean they are trained and board certified. Frauds are everywhere, but at least with acupuncture, certification is easy to prove and most people who seek it out have a healthy amount of skepticism that helps them determine subjectively whether it is works for them. Individuals do not need a clinical trial to validate personal efficacy.
The gentlemen who wrote the following article brings up a good point if you can fish it out of the supercilious sarcasm: Medicine is medicine whether it came from the ground of from the factory - you need to know what your are putting into your body and to ensure your health by going to qualified medical professionals.
Of course, my first and last impression is that this guy would have gagged Galileo.
Talk of doctors can push buttons
2006-09-10
Generally speaking, I am slow to anger.
Some may argue differently but most people describe me as generally good-natured.
But when my buttons are pushed oh, my.
Recently, there was a photo in another newspaper that had this person with a number of acupuncture needles sticking into her face. It seems she was undergoing acupuncture because she ``didn't like doctors.''
OK. Let me see here.
She doesn't like the doctor that has been through four years of college, four years of medical school, and 3-7 years of residency training, but she will let someone without a college degree stick needles in her face?
She doesn't trust a trained health care professional yet allows someone to apply unproven and unconventional treatments to her?
I have a friend who states unequivocally ``I don't like to take medicine,'' yet pops four homeopathic pills in her mouth without even asking what is in them. And then wonders why she felt hot flashes all the way home.
Or the one who refuses to take an ibuprofen because he heard that ibuprofen damages the kidneys but knows intimately the dosage on Oxycodone?
Oh yeah my buttons are pushed.
Doesn't ``like doctors?'' To me, that's almost the same as not liking air -- definitely important and pretty unhealthy to do without.
Obviously, I'm firmly entrenched in the ``traditional'' side of medicine. Have been for almost 29 years. My daughter and her husband are both doctors, of the ``M.D.'' variety.
Oh, I'm definitely prejudiced.
Prejudiced because I am at heart a scientist and I want scientific evidence of what I do to or put in my body.
Prejudiced because I having a pretty good working knowledge of what medical training involves.
Prejudiced because I understand the importance of good, traditional medical care.
Don't take this as a complete indictment of non-traditional methods of health care. Oftentimes, we have learned more about how the body works by NOT doing things the way they've always been done.
For example, we have learned a lot about the body by exceeding what we always thought were physical limitations.
We've learned a lot by exploring home remedies and ancient forms of promoting healing.
Not everything must pass the test of a double-blind study for us to know that it works.
But when it comes to health care, I just prefer to rely on the person who has dedicated 11-18 years in formal education in the pursuit of knowledge that makes him or her the absolute best person to help me make decisions about my health.
I want to live to be old but still be healthy and active.
That's why I get a physical examination every single year and have a good working relationship with a specific family practitioner.
Doesn't ``like doctors?''
Your doctor should be one of your favorite people.
Joe Black, PT, SCS, ATC, is a physical therapist and athletic trainer at Appalachian Therapy Center. Write to him at: Joe Black, c/o The Daily Times, P.O. Box 9740, Maryville, TN 37802-9740.
Normally, I pay little attention to those who dismiss complementary medicine outright - I prefer to spend my time helping people, not converting them. I know of very few practitioners who shun Western Medicine as of us have a yearly check-up with a regular doctor, and many take prescription medicine. Yes, there are some people who practice complementary therapies (including MDs) without proper training, but this is no different in allopathic medicine. Just because someone is an MD and says they are a plastic surgeon, does not mean they are trained and board certified. Frauds are everywhere, but at least with acupuncture, certification is easy to prove and most people who seek it out have a healthy amount of skepticism that helps them determine subjectively whether it is works for them. Individuals do not need a clinical trial to validate personal efficacy.
The gentlemen who wrote the following article brings up a good point if you can fish it out of the supercilious sarcasm: Medicine is medicine whether it came from the ground of from the factory - you need to know what your are putting into your body and to ensure your health by going to qualified medical professionals.
Of course, my first and last impression is that this guy would have gagged Galileo.
Talk of doctors can push buttons
2006-09-10
Generally speaking, I am slow to anger.
Some may argue differently but most people describe me as generally good-natured.
But when my buttons are pushed oh, my.
Recently, there was a photo in another newspaper that had this person with a number of acupuncture needles sticking into her face. It seems she was undergoing acupuncture because she ``didn't like doctors.''
OK. Let me see here.
She doesn't like the doctor that has been through four years of college, four years of medical school, and 3-7 years of residency training, but she will let someone without a college degree stick needles in her face?
She doesn't trust a trained health care professional yet allows someone to apply unproven and unconventional treatments to her?
I have a friend who states unequivocally ``I don't like to take medicine,'' yet pops four homeopathic pills in her mouth without even asking what is in them. And then wonders why she felt hot flashes all the way home.
Or the one who refuses to take an ibuprofen because he heard that ibuprofen damages the kidneys but knows intimately the dosage on Oxycodone?
Oh yeah my buttons are pushed.
Doesn't ``like doctors?'' To me, that's almost the same as not liking air -- definitely important and pretty unhealthy to do without.
Obviously, I'm firmly entrenched in the ``traditional'' side of medicine. Have been for almost 29 years. My daughter and her husband are both doctors, of the ``M.D.'' variety.
Oh, I'm definitely prejudiced.
Prejudiced because I am at heart a scientist and I want scientific evidence of what I do to or put in my body.
Prejudiced because I having a pretty good working knowledge of what medical training involves.
Prejudiced because I understand the importance of good, traditional medical care.
Don't take this as a complete indictment of non-traditional methods of health care. Oftentimes, we have learned more about how the body works by NOT doing things the way they've always been done.
For example, we have learned a lot about the body by exceeding what we always thought were physical limitations.
We've learned a lot by exploring home remedies and ancient forms of promoting healing.
Not everything must pass the test of a double-blind study for us to know that it works.
But when it comes to health care, I just prefer to rely on the person who has dedicated 11-18 years in formal education in the pursuit of knowledge that makes him or her the absolute best person to help me make decisions about my health.
I want to live to be old but still be healthy and active.
That's why I get a physical examination every single year and have a good working relationship with a specific family practitioner.
Doesn't ``like doctors?''
Your doctor should be one of your favorite people.
Joe Black, PT, SCS, ATC, is a physical therapist and athletic trainer at Appalachian Therapy Center. Write to him at: Joe Black, c/o The Daily Times, P.O. Box 9740, Maryville, TN 37802-9740.
Friday, September 08, 2006
Making a Difference
It is wonderful to see how giving so many fellow professional acupuncturists can be not only in the midst of tragedy, but in its aftermath.
Healing hands help Katrina victims
By Jillian Fennimore/ Staff WriterFriday, September 8, 2006 - Updated: 09:55 AM EST
Known for their calm nature and healing hands, acupuncturists from across the country brought peace to an area still in chaos and repair one year later. Hurricane Katrina ravaged the Gulf Coast last August with record strength, leaving the people of New Orleans and coastal Mississippi in devastation, some homeless, and most stressed in the wake of its destruction.
Licensed acupuncturist Bella Rosner, whose practice is in Watertown at the Japanese Acupuncture Center, was one of the many who joined the worthy cause of Acupuncturists Without Borders to treat the traumatized with free community acupuncture in Louisiana both last November and February. Last Thursday, Rosner’s treatments were brought back to Watertown in order to help raise money for the organization’s continued success as the needs increase down south. Rosner treated several people throughout the day, with funds going to AWB.
Since last September, AWB has sent rotating teams of acupuncturists to benefit the evacuees, displaced residents, relief workers, emergency responders and others suffering from the devastating effects of hurricanes Rita and Katrina. They hope to continue with much-needed funding.
"We worked with the poorest of the poor, to FEMA workers staying at the Hyatt, and National Guard rescue workers," said Rosner about her two visits this past year to the more distressed areas of Louisiana. "But people were telling me that for the first time [since Hurricane Katrina] they got a good night’s sleep. They wanted us to come back."
Inside the serene treatment office on Watertown Street, a rock fountain flows in the corner and a can for AWB donations sits at a nearby table. Inside of a photo album, pictures of Katrina’s aftermath sit boldly behind their plastic pockets, displaying empty lots where homes used to be and the faces of those happy to help and happy to be alive. Rosner said she and a group of grassroots organizations visited emergency communities of the Lower 9th Ward and St. Bernard’s Parish, along with other venues, treating people with symptoms of acute stress and trauma.
Traveling on a bus to visit a community, Rosner found herself sitting with New Orleans residents driving past their homes and uncovering their neighborhoods for the first time, including a young couple with their newborn baby.
"They would point and say ’look there’s auntie’s house’ or ’that’s grandma’s house’," she said. "Entire communities were torn apart. We just want to give them peace of mind for one day."
Since their efforts on year ago, AWB members have treated more than 6,000 people in the aftermath of the hurricane and their appointment calendars are still full.
Healing hands help Katrina victims
By Jillian Fennimore/ Staff WriterFriday, September 8, 2006 - Updated: 09:55 AM EST
Known for their calm nature and healing hands, acupuncturists from across the country brought peace to an area still in chaos and repair one year later. Hurricane Katrina ravaged the Gulf Coast last August with record strength, leaving the people of New Orleans and coastal Mississippi in devastation, some homeless, and most stressed in the wake of its destruction.
Licensed acupuncturist Bella Rosner, whose practice is in Watertown at the Japanese Acupuncture Center, was one of the many who joined the worthy cause of Acupuncturists Without Borders to treat the traumatized with free community acupuncture in Louisiana both last November and February. Last Thursday, Rosner’s treatments were brought back to Watertown in order to help raise money for the organization’s continued success as the needs increase down south. Rosner treated several people throughout the day, with funds going to AWB.
Since last September, AWB has sent rotating teams of acupuncturists to benefit the evacuees, displaced residents, relief workers, emergency responders and others suffering from the devastating effects of hurricanes Rita and Katrina. They hope to continue with much-needed funding.
"We worked with the poorest of the poor, to FEMA workers staying at the Hyatt, and National Guard rescue workers," said Rosner about her two visits this past year to the more distressed areas of Louisiana. "But people were telling me that for the first time [since Hurricane Katrina] they got a good night’s sleep. They wanted us to come back."
Inside the serene treatment office on Watertown Street, a rock fountain flows in the corner and a can for AWB donations sits at a nearby table. Inside of a photo album, pictures of Katrina’s aftermath sit boldly behind their plastic pockets, displaying empty lots where homes used to be and the faces of those happy to help and happy to be alive. Rosner said she and a group of grassroots organizations visited emergency communities of the Lower 9th Ward and St. Bernard’s Parish, along with other venues, treating people with symptoms of acute stress and trauma.
Traveling on a bus to visit a community, Rosner found herself sitting with New Orleans residents driving past their homes and uncovering their neighborhoods for the first time, including a young couple with their newborn baby.
"They would point and say ’look there’s auntie’s house’ or ’that’s grandma’s house’," she said. "Entire communities were torn apart. We just want to give them peace of mind for one day."
Since their efforts on year ago, AWB members have treated more than 6,000 people in the aftermath of the hurricane and their appointment calendars are still full.
Sunday, September 03, 2006
Blanket Marketing
One of the woes of living in the Midwest is selling people on the success of Acupuncture and Oriental medicine treatment. Unlike the coasts, where acupuncture is an established complementary therapy, many here regard the modality with suspicion and doubt. I have had people say to me flatly, "I don't believe in any of that." I have found that explaining acupuncture is not a belief system but a medical one makes little difference. The blank stare can be most frustrating.
On the up side, the majority of people who seek out treatment here have done their internet research and understand the potential and the limitations of treatment as well as the need to give ample time to allow the medicine to work. Some know very little and come because someone they know recommended it, but are eager to learn as much as they can. There are also those who may want to give it a try but put everything into a western medical context - I say "blood deficiency", they think "anemia." Needless to say, a big part of a practitioner's practice is education. The following article is must-have waiting room reading material.
Alternative Health: Making acupuncture connect
Written by Robert Gluck
Thursday, 31 August 2006
The theory behind the practice of acupuncture continues to confound Western science, but despite the lack of understanding, its popularity is on the up...
This therapy, originating in Asia, is based on the concept that currents of energy called meridians flow through your body. However, no one has ever been able to conclusively demonstrate the existence of these meridians.
Despite the evasiveness of these energy streams, Traditional Chinese Medicine (TCM) holds that alterations in these energy flows can disrupt health and cause pain. Consequently, an acupuncturist punctures your skin with specialised needles to redirect the body's vital energy.
Alleviating Illness
Despite the fact that western scientists have not been able to find satisfactory evidence of the existence of these energetic meridians, studies show that acupuncture works and is especially effective at relieving pain. This therapy has been used to alleviate a variety of conditions including chronic pain, nausea and even mental illness. In addition, some practitioners apply it to those trying to shake off the chains of drug addiction. (More recently, many practitioners now also successfully use acupuncture to relieve physical problems in animals.)
Of course, no matter what your perspective on this therapy, acupuncture's no panacea.
While you might use acupuncture to relieve the discomforts of chemotherapy, you wouldn't use this technique as your primary weapon against a dangerous disease like cancer. Still, this reliable therapy occupies a welcome spot as an adjunct to many mainstream therapies.
Consequently, many mainstream practitioners accept the validity of using acupuncture and many managed care companies reimburse this therapy. Some HMOs even keep a list of approved acupuncturists that they make available to enrolees.
Read More
On the up side, the majority of people who seek out treatment here have done their internet research and understand the potential and the limitations of treatment as well as the need to give ample time to allow the medicine to work. Some know very little and come because someone they know recommended it, but are eager to learn as much as they can. There are also those who may want to give it a try but put everything into a western medical context - I say "blood deficiency", they think "anemia." Needless to say, a big part of a practitioner's practice is education. The following article is must-have waiting room reading material.
Alternative Health: Making acupuncture connect
Written by Robert Gluck
Thursday, 31 August 2006
The theory behind the practice of acupuncture continues to confound Western science, but despite the lack of understanding, its popularity is on the up...
This therapy, originating in Asia, is based on the concept that currents of energy called meridians flow through your body. However, no one has ever been able to conclusively demonstrate the existence of these meridians.
Despite the evasiveness of these energy streams, Traditional Chinese Medicine (TCM) holds that alterations in these energy flows can disrupt health and cause pain. Consequently, an acupuncturist punctures your skin with specialised needles to redirect the body's vital energy.
Alleviating Illness
Despite the fact that western scientists have not been able to find satisfactory evidence of the existence of these energetic meridians, studies show that acupuncture works and is especially effective at relieving pain. This therapy has been used to alleviate a variety of conditions including chronic pain, nausea and even mental illness. In addition, some practitioners apply it to those trying to shake off the chains of drug addiction. (More recently, many practitioners now also successfully use acupuncture to relieve physical problems in animals.)
Of course, no matter what your perspective on this therapy, acupuncture's no panacea.
While you might use acupuncture to relieve the discomforts of chemotherapy, you wouldn't use this technique as your primary weapon against a dangerous disease like cancer. Still, this reliable therapy occupies a welcome spot as an adjunct to many mainstream therapies.
Consequently, many mainstream practitioners accept the validity of using acupuncture and many managed care companies reimburse this therapy. Some HMOs even keep a list of approved acupuncturists that they make available to enrolees.
Sunday, August 27, 2006
For Just a Little Money Down . . .
. . . you can get rid of that pain in the neck. There is nothing like a large sample size to support a point (no pun intended)!
Yes, acupuncture really does have a point, study reveals
By Hannah Devlin from The Times Online
A study has found that acupuncture not only helps to relieve pain but is a cost-effective way of doing so.
More than 3,400 patients suffering from neck pain were studied over a three-month period by scientists based at the Berlin Institute of Social Medicine. About half received acupuncture in addition to routine care.
The researchers, whose study is reported in the journal Pain, found that the extra cost of the acupuncture treatment resulted in health benefits that were great enough to make the treatment cost-effective.
“Acupuncture isn’t controversial any more,” said Claudia Witt, who led the project. “We’ve shown that it works.” She added that it was in no way comparable to other alternative therapies. ”
One in five people in Britain suffers from long-term pain and about half of these have taken time off work because of it. While acupuncture is provided in the majority of pain clinics in Britain, access to the treatment is limited.
Yes, acupuncture really does have a point, study reveals
By Hannah Devlin from The Times Online
A study has found that acupuncture not only helps to relieve pain but is a cost-effective way of doing so.
More than 3,400 patients suffering from neck pain were studied over a three-month period by scientists based at the Berlin Institute of Social Medicine. About half received acupuncture in addition to routine care.
The researchers, whose study is reported in the journal Pain, found that the extra cost of the acupuncture treatment resulted in health benefits that were great enough to make the treatment cost-effective.
“Acupuncture isn’t controversial any more,” said Claudia Witt, who led the project. “We’ve shown that it works.” She added that it was in no way comparable to other alternative therapies. ”
One in five people in Britain suffers from long-term pain and about half of these have taken time off work because of it. While acupuncture is provided in the majority of pain clinics in Britain, access to the treatment is limited.
Wednesday, August 16, 2006
The Woes of Research Grant Money
If one were to believe the bevy of solicitous e-mails, one would surmise that to get a grant, you just need to fill out a few pieces of paperwork and send it off to various organizations that some internet company provides you for the low cost of $59.99. For the past two years, we have been trying to get funding though the government to continue the research started by Dr. Hollifield and Nityamo Lian concerning an acupuncture treatment protocol for PTSD, and the going is rough and frustrating.
We have applied for grants to "further research in several sites with several practitioners of each discipline is needed to confirm these results," but when the concerns on the part of the grant investigators are addressed and answered by our team, the investigators come up with additional concerns. The latest: To sham, or not to sham - that is the question.
A review and analysis of placebo treatments, placebo effects, and placebo controls in trials of medical procedures when sham is not inert.
J Altern Complement Med. 2006 Apr;12(3):303-10.
Birch S.Stichting (Foundation) for the Study of Traditional East Asian Medicine (STEAM), Amsterdam, The Netherlands. sjbirch@gmail.com
Researchers examining the efficacy of medical procedures make assumptions about the nature of placebo. From these assumptions they select the sham interventions to be used in their trials. However, placebo is not well defined. A number of definitions are contradictory and sometimes misleading. This leads to problems in sham-controlled studies of medical procedures and difficulties interpreting their results. The author explores some of the contradictory definitions of placebo and assumptions and consequences of these. Principal among these is the assumption that the placebo is inert when it is not, which introduces bias against the tested medical procedures and devices. To illustrate the problem, the author examines the use of sham procedures in clinical trials of the medical procedures surgery and acupuncture in which the sham was assumed to be inert but was not. Trials of surgery and acupuncture should be re-examined in light of this.
More to come on this in the future. In the meantime, here is the abstract from the Journal of Alternative and Complementary Medicine on the protocol that was used in New Mexico (you need sign-on to access the full article - it has the specifics on the treatment points). If you would like to see some JAMA abstracts of acupuncture research fortunate enough to get funding, check out http://jama.ama-assn.org/cgi/search?fulltext=acupuncture or the Society for Acupuncture research http://www.acupunctureresearch.org/
Journal of Alternative and Complementary Medicine
Developing a Traditional Chinese Medicine Diagnostic Structure for Post-Traumatic Stress Disorder
Jan 2006, Vol. 12, No. 1: 45-57
Nityamo Sinclair-Lian, D.O.M. (N.M.)
University of New Mexico, Department of Family and Community Medicine, Albuquerque, NM.
Behavioral Health Research Center of the Southwest, Albuquerque, NM.
Michael Hollifield, M.D.
University of Louisville, Department of Psychiatry and Behavioral Sciences, Louisville, KY.
Margaret Menache, Ph.D.
University of New Mexico, Department of Family and Community Medicine, Albuquerque, NM.
Teddy Warner, Ph.D.
University of New Mexico, Department of Family and Community Medicine, Albuquerque, NM.
Jenna Viscaya, D.O.M. (N.M.)
International Institute of Chinese Medicine, Sante Fe, NM.
Richard Hammerschlag, Ph.D.
Oregon College of Oriental Medicine, Portland, OR.
Background: Post-traumatic stress disorder (PTSD) is a common, disabling condition with many diverse symptoms including anxiety, depression, insomnia, and body pain. These symptoms are likely to be helped by treatment with Traditional Chinese Medicine (TCM); however, PTSD is not yet a recognized disorder (bing ming) in Chinese medicine. In preparation for a phase II clinical trial comparing TCM and cognitive behavioral therapy (CBT) treatment of PTSD symptoms, a TCM diagnostic pattern framework for persons who meet the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) definition of PTSD was sought.
Methods: Three approaches were used to identify the most likely TCM pattern differentiations for PTSD: an English-language TCM textbook review on the conditions "depression," "anxiety," and "insomnia"; a survey of 20 experienced practitioners of TCM; and TCM assessments of 21 individuals affected by PTSD. Two TCM practitioners synthesized the information into a list of pattern differentiations.
Results: The most likely pattern differentiations for PTSD were Heart Shen disturbance caused by Heat, Fire, or a constitutional deficiency; Liver Qi stagnation; and Kidney deficiency. Secondary patterns identified were outcomes of long-term Liver Qi stagnation—Liver overacting on Spleen/Stomach, Liver Fire, Phlegm Fire, Phlegm-Damp, and Heart Fire—and constitutional deficiencies in the Heart, Kidney, and Spleen organ systems.
Conclusions: The use of extant literature, expert knowledge, and clinical TCM diagnoses contributed to the development of a TCM diagnostic structure for PTSD. The results can inform the clinical practice of TCM. The method can be used to guide research design involving different diagnostic systems.
We have applied for grants to "further research in several sites with several practitioners of each discipline is needed to confirm these results," but when the concerns on the part of the grant investigators are addressed and answered by our team, the investigators come up with additional concerns. The latest: To sham, or not to sham - that is the question.
A review and analysis of placebo treatments, placebo effects, and placebo controls in trials of medical procedures when sham is not inert.
J Altern Complement Med. 2006 Apr;12(3):303-10.
Birch S.Stichting (Foundation) for the Study of Traditional East Asian Medicine (STEAM), Amsterdam, The Netherlands. sjbirch@gmail.com
Researchers examining the efficacy of medical procedures make assumptions about the nature of placebo. From these assumptions they select the sham interventions to be used in their trials. However, placebo is not well defined. A number of definitions are contradictory and sometimes misleading. This leads to problems in sham-controlled studies of medical procedures and difficulties interpreting their results. The author explores some of the contradictory definitions of placebo and assumptions and consequences of these. Principal among these is the assumption that the placebo is inert when it is not, which introduces bias against the tested medical procedures and devices. To illustrate the problem, the author examines the use of sham procedures in clinical trials of the medical procedures surgery and acupuncture in which the sham was assumed to be inert but was not. Trials of surgery and acupuncture should be re-examined in light of this.
More to come on this in the future. In the meantime, here is the abstract from the Journal of Alternative and Complementary Medicine on the protocol that was used in New Mexico (you need sign-on to access the full article - it has the specifics on the treatment points). If you would like to see some JAMA abstracts of acupuncture research fortunate enough to get funding, check out http://jama.ama-assn.org/cgi/search?fulltext=acupuncture or the Society for Acupuncture research http://www.acupunctureresearch.org/
Journal of Alternative and Complementary Medicine
Developing a Traditional Chinese Medicine Diagnostic Structure for Post-Traumatic Stress Disorder
Jan 2006, Vol. 12, No. 1: 45-57
Nityamo Sinclair-Lian, D.O.M. (N.M.)
University of New Mexico, Department of Family and Community Medicine, Albuquerque, NM.
Behavioral Health Research Center of the Southwest, Albuquerque, NM.
Michael Hollifield, M.D.
University of Louisville, Department of Psychiatry and Behavioral Sciences, Louisville, KY.
Margaret Menache, Ph.D.
University of New Mexico, Department of Family and Community Medicine, Albuquerque, NM.
Teddy Warner, Ph.D.
University of New Mexico, Department of Family and Community Medicine, Albuquerque, NM.
Jenna Viscaya, D.O.M. (N.M.)
International Institute of Chinese Medicine, Sante Fe, NM.
Richard Hammerschlag, Ph.D.
Oregon College of Oriental Medicine, Portland, OR.
Background: Post-traumatic stress disorder (PTSD) is a common, disabling condition with many diverse symptoms including anxiety, depression, insomnia, and body pain. These symptoms are likely to be helped by treatment with Traditional Chinese Medicine (TCM); however, PTSD is not yet a recognized disorder (bing ming) in Chinese medicine. In preparation for a phase II clinical trial comparing TCM and cognitive behavioral therapy (CBT) treatment of PTSD symptoms, a TCM diagnostic pattern framework for persons who meet the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) definition of PTSD was sought.
Methods: Three approaches were used to identify the most likely TCM pattern differentiations for PTSD: an English-language TCM textbook review on the conditions "depression," "anxiety," and "insomnia"; a survey of 20 experienced practitioners of TCM; and TCM assessments of 21 individuals affected by PTSD. Two TCM practitioners synthesized the information into a list of pattern differentiations.
Results: The most likely pattern differentiations for PTSD were Heart Shen disturbance caused by Heat, Fire, or a constitutional deficiency; Liver Qi stagnation; and Kidney deficiency. Secondary patterns identified were outcomes of long-term Liver Qi stagnation—Liver overacting on Spleen/Stomach, Liver Fire, Phlegm Fire, Phlegm-Damp, and Heart Fire—and constitutional deficiencies in the Heart, Kidney, and Spleen organ systems.
Conclusions: The use of extant literature, expert knowledge, and clinical TCM diagnoses contributed to the development of a TCM diagnostic structure for PTSD. The results can inform the clinical practice of TCM. The method can be used to guide research design involving different diagnostic systems.
Monday, August 07, 2006
German Survey
Our Teutonic friends have been busy lately in collecting research covering a wide range of acupuncture effects and techniques. From one side of the pond to the other, a lot of great investigation is being done and I have included links to some of my favorites.
Measurement of acupuncture needle grasp at acupuncture points and control points
http://www.akupunktur-aktuell.de/fb0112_1.htm
One of the most controversial aspects of acupuncture is whether the location of acupuncture needling sites is important, ie: does the needling of classically defined acupuncture points have an enhanced therapeutic effect as compared with the needling of any other set of points on the body. Resolving this issue is of fundamental importance, since the specificity of acupuncture points is implied in some of the most basic principles underlying the traditional practice of acupuncture.
These results provide objective evidence that acupuncture points have different biomechanical behavior than control points. Whether this is due to anatomical and/or physiological differences between acupuncture points and surrounding tissues, and what these differences are, remains unknown. Our results also show that needle manipulation strongly influences needle grasp, and does so at control points as well as at acupuncture points. We are planning to use the results of this study as a first step to understand the mechanisms underlying needle grasp, and the therapeutic significance of both de qi and acupuncture points.
As someone trained in TCM, I have always believed if there is no Qi, there is no treatment. Perhaps it is Western programming to believe “no pain, no gain,” but I see better results with patients who report feeling sensation over ones that feel nothing. In my experience, I find the patient will have the Qi sensation a moment after I feel the needle “grab.” For those patients that I know are sensitive, I try to keep the needle positioned at that threshold between the grab and the sensation so that they can reap the maximum benefit with the minimum discomfort. Of course, there are those others that can’t get enough Qi either, or as one of my patients says, “Give me the ju-ju!”
DESCRIPTION AND VALIDATION OF A NON-INVASIVE PLACEBO ACUPUNCTURE PROCEDURE
http://www.akupunktur-aktuell.de/fb0202_1.htm
Objective: To evaluate a simulated acupuncture technique for use in randomized controlled trials assessing the efficacy of acupuncture for low back pain.
Experimental Design: In the first experiment, subjects received six insertions of real needles and six pokes with a toothpick in a guidetube in a two-period crossover design. In the second experiment, subjects were randomized to receive either a complete treatment with real acupuncture needles or a simulated treatment using a toothpick in a guidetube.
Conclusions: The simulated acupuncture procedure evaluated in this study represents a reasonable control treatment for acupuncture-naïve individuals in randomized controlled trials assessing the efficacy of acupuncture for low back pain.
Having sat in on some design planning for a few different research projects, I know the use of sham acupuncture is a controversy. A placebo pill in a drug trial is not analogous to random needling. This sounds like a promising (an somewhat humerous) alternative for those who have research aspirations.
CLINICAL STUDY OF HERPES ZOSTER TREATMENT USING ACUPUNCTURE OF THUMB-JOINT ACUPOINT AND FIRE-TWINKLING METHOD
http://www.akupunktur-aktuell.de/fb0224_1.htm
This paper is the summary of clinical results of using Acupuncture of Thumb-Joint Acupoint and Fire-Twinkling for 27 cases of Herpes Zoster, a virulent skin disease called "Yao Chan Huo Dan" and "She Du Cang" in traditional Chinese medicine. The condition usually results from decreased immune function, emotional depression, dietary disorder, malfunctional spleen and liver, or virus infection. The course of the illness lasts from two to fifteen days. The purpose of using Acupuncture of Thumb-joint Acupoint locally is to stimulate the infected region, improve the overall body immune system, and thus kill the virus using the body’s own immune functionality. Additionally, the Fire-Twinkling method utilizes the flame’s radiating and heating effect to enlarge local blood vessels, accelerate blood circulation and energize body cells.
The outcome of the treatment and observation study showed that Acupuncture of Thumb-Joint Acupoint and Fire-Twinkling was a very effective treatment method for Herpes Zoster: among the 27 cases studied, 24 (88.8%) were completely cured, 2 cases (7.4%) showed evident improvement, and only one case (3.8%) showed no sign of improvement. The overall efficiency of the treatment was 96.8%.
“Fire-Twinkling” - I have always been a sucker for TCM technique descriptions!
Measurement of acupuncture needle grasp at acupuncture points and control points
http://www.akupunktur-aktuell.de/fb0112_1.htm
One of the most controversial aspects of acupuncture is whether the location of acupuncture needling sites is important, ie: does the needling of classically defined acupuncture points have an enhanced therapeutic effect as compared with the needling of any other set of points on the body. Resolving this issue is of fundamental importance, since the specificity of acupuncture points is implied in some of the most basic principles underlying the traditional practice of acupuncture.
These results provide objective evidence that acupuncture points have different biomechanical behavior than control points. Whether this is due to anatomical and/or physiological differences between acupuncture points and surrounding tissues, and what these differences are, remains unknown. Our results also show that needle manipulation strongly influences needle grasp, and does so at control points as well as at acupuncture points. We are planning to use the results of this study as a first step to understand the mechanisms underlying needle grasp, and the therapeutic significance of both de qi and acupuncture points.
As someone trained in TCM, I have always believed if there is no Qi, there is no treatment. Perhaps it is Western programming to believe “no pain, no gain,” but I see better results with patients who report feeling sensation over ones that feel nothing. In my experience, I find the patient will have the Qi sensation a moment after I feel the needle “grab.” For those patients that I know are sensitive, I try to keep the needle positioned at that threshold between the grab and the sensation so that they can reap the maximum benefit with the minimum discomfort. Of course, there are those others that can’t get enough Qi either, or as one of my patients says, “Give me the ju-ju!”
DESCRIPTION AND VALIDATION OF A NON-INVASIVE PLACEBO ACUPUNCTURE PROCEDURE
http://www.akupunktur-aktuell.de/fb0202_1.htm
Objective: To evaluate a simulated acupuncture technique for use in randomized controlled trials assessing the efficacy of acupuncture for low back pain.
Experimental Design: In the first experiment, subjects received six insertions of real needles and six pokes with a toothpick in a guidetube in a two-period crossover design. In the second experiment, subjects were randomized to receive either a complete treatment with real acupuncture needles or a simulated treatment using a toothpick in a guidetube.
Conclusions: The simulated acupuncture procedure evaluated in this study represents a reasonable control treatment for acupuncture-naïve individuals in randomized controlled trials assessing the efficacy of acupuncture for low back pain.
Having sat in on some design planning for a few different research projects, I know the use of sham acupuncture is a controversy. A placebo pill in a drug trial is not analogous to random needling. This sounds like a promising (an somewhat humerous) alternative for those who have research aspirations.
CLINICAL STUDY OF HERPES ZOSTER TREATMENT USING ACUPUNCTURE OF THUMB-JOINT ACUPOINT AND FIRE-TWINKLING METHOD
http://www.akupunktur-aktuell.de/fb0224_1.htm
This paper is the summary of clinical results of using Acupuncture of Thumb-Joint Acupoint and Fire-Twinkling for 27 cases of Herpes Zoster, a virulent skin disease called "Yao Chan Huo Dan" and "She Du Cang" in traditional Chinese medicine. The condition usually results from decreased immune function, emotional depression, dietary disorder, malfunctional spleen and liver, or virus infection. The course of the illness lasts from two to fifteen days. The purpose of using Acupuncture of Thumb-joint Acupoint locally is to stimulate the infected region, improve the overall body immune system, and thus kill the virus using the body’s own immune functionality. Additionally, the Fire-Twinkling method utilizes the flame’s radiating and heating effect to enlarge local blood vessels, accelerate blood circulation and energize body cells.
The outcome of the treatment and observation study showed that Acupuncture of Thumb-Joint Acupoint and Fire-Twinkling was a very effective treatment method for Herpes Zoster: among the 27 cases studied, 24 (88.8%) were completely cured, 2 cases (7.4%) showed evident improvement, and only one case (3.8%) showed no sign of improvement. The overall efficiency of the treatment was 96.8%.
“Fire-Twinkling” - I have always been a sucker for TCM technique descriptions!
Sunday, July 30, 2006
Editorial: What's In A Title
No matter what your opinion of western allopathic medicine, no one can deny that medical school takes a great deal of drive, personal determination, and a large chunk of one’s twenties. Doctors sweat out a large portion of their youth in the troughs of sleep deprivation, condemnation from their superiors, and rigorous study in the hopes of providing a humanitarian service . . . and paying back their student loans. Whether the M.D. becomes a virtuous practitioner, or a money-grubbing autocrat, they all had to earn those initials.
Oriental Medicine training is tough. Most of us come from a western medical background and leaning TCM theories, acupuncture points, herbs, and all of the other modalities does not come easily. Those of us who have gone through the formal, master’s education route and have been nationally certified and licensed through our respective states have had our share of academic trials. While our scholastics are comparable to those of chiropractors and naturopaths, the later professions confer the designation of “doctor” on their graduates, while our titles are bestowed upon us by the state in which we practice. But for a group of complementary medical practitioners, it may seem puzzling as to why so many are eager to take the doctor title, without earning the MD credential.
While I hold a Doctor of Oriental Medicine license in New Mexico, I have never felt comfortable referring to myself as “doctor” – it seems presumptuous and misleading. I feel confident in my training and abilities as an acupuncturist and I do not feel the need to make myself seem more important or alleviate personal insecurities by putting on heirs with a title. Whenever I hear someone refer to a local practitioner as Dr. so-and-so, I cringe; especially when I find out the patient didn’t even realize they were not an MD.
But on the other hand, MDs are not the only people who call themselves “doctor.” The Associated Press states, “use Dr. only for physicians, dentists members of the paramedical professions (osteopaths, optometrists, chiropractors, podiatrists etc.) and clergymen who hold earned or honorary doctorates.” Paramedical profession? Well that “etc.” would include acupuncturists, wouldn’t it? If an RN is an RN, a DC is a DC, and an ND is an ND once they pass their respective boards, why are we a DOM, L.Ac., C.Ac., R.Ac., or OMD, plus whatever NCCAOM Diplomat status we may have earned? I am not advocating one way or another that we should be granted the title of “Acupuncture Doctor” or Doctor of Oriental Medicine,” but why do we not have one degree, with one title like the rest of our fellow healthcare professionals? Take a look at this muddled and unnecessary designation diversity:
Licensed Acupuncturist: Alaska, Arizona, California*, Colorado*, Florida, Georgia, Hawaii (“§436E-3.5 Physicians and osteopaths not exempt.” - nice touch)*, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Minnesota, Missouri, Montana, New Hampshire, New Jersey, New York (“certified” if you are a physician or dentist with 300 hours training), North Carolina, Oregon, South Carolina, Texas, Utah, Vermont, Virginia, Washington, West Virginia (although OMD, DOM, and M.Ac. are used)
Certified Acupuncturist: Kentucky, Louisiana, New Hampshire (2), Ohio*, Tennessee, Wisconsin
Doctor of Oriental Medicine: Arkansas, New Mexico
Registered Acupuncturists: Michigan, Ohio* (2)
Oriental Medicine Doctor: Nevada,
Doctor of Acupuncture: Rhode Island
Note that some states allow dual titles. Those with *s specifically mention in their statutes that only the title bestowed by the state may be used and that the term “doctor” is prohibited unless you have graduated from an applicable or approved medical or PhD program.
I have personally been a Doctor of Oriental Medicine once, a Licensed Acupuncturist twice, and am soon to be a Certified Acupuncturist, yet in all four instances I held the same degrees and practiced the same medicine! To transfer my RN license to another state, I submit current license verification, pay a fee, read up on the particulars of the state’s nurse practice acts, and keep my credentials. This is sensible, reasonable, and adaptable to our profession.
Now that nearly all of the states have enacted or are in the process of enacting legislation for acupuncturists, it makes sense that as legitimate healthcare providers, we have a unanimous and uniform title. Whether that means the CCAOM requires all schools to issue the same degree titles, that the NCCAOM creates something more viable than “diplomat,” or that we empower our own National Organizations for unification, we require a clean, descriptive, professional title that transfers in the same manner as our peers in the healthcare profession.
Oriental Medicine training is tough. Most of us come from a western medical background and leaning TCM theories, acupuncture points, herbs, and all of the other modalities does not come easily. Those of us who have gone through the formal, master’s education route and have been nationally certified and licensed through our respective states have had our share of academic trials. While our scholastics are comparable to those of chiropractors and naturopaths, the later professions confer the designation of “doctor” on their graduates, while our titles are bestowed upon us by the state in which we practice. But for a group of complementary medical practitioners, it may seem puzzling as to why so many are eager to take the doctor title, without earning the MD credential.
While I hold a Doctor of Oriental Medicine license in New Mexico, I have never felt comfortable referring to myself as “doctor” – it seems presumptuous and misleading. I feel confident in my training and abilities as an acupuncturist and I do not feel the need to make myself seem more important or alleviate personal insecurities by putting on heirs with a title. Whenever I hear someone refer to a local practitioner as Dr. so-and-so, I cringe; especially when I find out the patient didn’t even realize they were not an MD.
But on the other hand, MDs are not the only people who call themselves “doctor.” The Associated Press states, “use Dr. only for physicians, dentists members of the paramedical professions (osteopaths, optometrists, chiropractors, podiatrists etc.) and clergymen who hold earned or honorary doctorates.” Paramedical profession? Well that “etc.” would include acupuncturists, wouldn’t it? If an RN is an RN, a DC is a DC, and an ND is an ND once they pass their respective boards, why are we a DOM, L.Ac., C.Ac., R.Ac., or OMD, plus whatever NCCAOM Diplomat status we may have earned? I am not advocating one way or another that we should be granted the title of “Acupuncture Doctor” or Doctor of Oriental Medicine,” but why do we not have one degree, with one title like the rest of our fellow healthcare professionals? Take a look at this muddled and unnecessary designation diversity:
Licensed Acupuncturist: Alaska, Arizona, California*, Colorado*, Florida, Georgia, Hawaii (“§436E-3.5 Physicians and osteopaths not exempt.” - nice touch)*, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Minnesota, Missouri, Montana, New Hampshire, New Jersey, New York (“certified” if you are a physician or dentist with 300 hours training), North Carolina, Oregon, South Carolina, Texas, Utah, Vermont, Virginia, Washington, West Virginia (although OMD, DOM, and M.Ac. are used)
Certified Acupuncturist: Kentucky, Louisiana, New Hampshire (2), Ohio*, Tennessee, Wisconsin
Doctor of Oriental Medicine: Arkansas, New Mexico
Registered Acupuncturists: Michigan, Ohio* (2)
Oriental Medicine Doctor: Nevada,
Doctor of Acupuncture: Rhode Island
Note that some states allow dual titles. Those with *s specifically mention in their statutes that only the title bestowed by the state may be used and that the term “doctor” is prohibited unless you have graduated from an applicable or approved medical or PhD program.
I have personally been a Doctor of Oriental Medicine once, a Licensed Acupuncturist twice, and am soon to be a Certified Acupuncturist, yet in all four instances I held the same degrees and practiced the same medicine! To transfer my RN license to another state, I submit current license verification, pay a fee, read up on the particulars of the state’s nurse practice acts, and keep my credentials. This is sensible, reasonable, and adaptable to our profession.
Now that nearly all of the states have enacted or are in the process of enacting legislation for acupuncturists, it makes sense that as legitimate healthcare providers, we have a unanimous and uniform title. Whether that means the CCAOM requires all schools to issue the same degree titles, that the NCCAOM creates something more viable than “diplomat,” or that we empower our own National Organizations for unification, we require a clean, descriptive, professional title that transfers in the same manner as our peers in the healthcare profession.
Thursday, July 27, 2006
Incongruity
Headlines are supposed to tell you the cut-and-chase of an article in a single phrase. I find the following one amusing because, while the headline implies that acupuncture doesn't work, the text demonstrates that the evidence is merely inconclusive due to the poor organization and follow-through of the cited studies. The headline should have read something like Efficacy of Acupuncture Uncertain in Stroke Patients or Evidence of Acupuncture Effectiveness Inconclusive for Treating Stroke. Of course, the study's intent was to find if acupuncture is the "most effective for improving stroke patients' rehabilitation" yet there was no mention of a control group or what the other "best" methods might be. Curious, no?
Reported July 27, 2006
Acupuncture Lacks Evidence, Say Researchers
(Ivanhoe Newswire) -- An ancient form of treatment is under new inspection.
Acupuncture has been used in China for over a thousand years and more recently in Western countries to treat chronic stroke. Stroke ranks as the third leading cause of death in Western society, and it is the second most common cause of death in China. It is a main reason for disability and dependency in the elderly. New research reveals acupuncture's scientific data fails to provide sufficient evidence it is, in fact, most effective for improving stroke patients' rehabilitation.
Researchers came to this conclusion after a thorough systemic review. Systemic reviews draw evidence-based conclusions about medical practices after considering both the content and quality of existing trials on a topic.
Acupuncture has been used to improve patients' motor skills, sensation, speech and other neurological functions. Lead author of the study, Hongmei Wu, M.D., of the West China Hospital in Si Chuan, was very surprised by the findings. "In China, acupuncture has been well accepted by Chinese patients and is widely used for stroke rehabilitation."
The review's intent was to provide evidence that acupuncture should be routinely used to rehabilitate patients with both subacute and chronic stroke. However, the available research failed to offer sound evidence of the effects of this therapy.
Researchers analyzed trials from 368 patients between ages 24 and 86. The hemorrhagic strokes were classified as either subacute -- less than three months since onset, or chronic -- more than three months since onset.
Researchers admit there was some overall improvement after acupuncture treatment, however they warn the results need to be "interpreted with caution" due to the insufficient number and general poor quality of clinical trials.
Wu states "most studies are poor in methodological quality, so the continued recommendation for acupuncture on stroke rehabilitation is uncertain."
Reported July 27, 2006
Acupuncture Lacks Evidence, Say Researchers
(Ivanhoe Newswire) -- An ancient form of treatment is under new inspection.
Acupuncture has been used in China for over a thousand years and more recently in Western countries to treat chronic stroke. Stroke ranks as the third leading cause of death in Western society, and it is the second most common cause of death in China. It is a main reason for disability and dependency in the elderly. New research reveals acupuncture's scientific data fails to provide sufficient evidence it is, in fact, most effective for improving stroke patients' rehabilitation.
Researchers came to this conclusion after a thorough systemic review. Systemic reviews draw evidence-based conclusions about medical practices after considering both the content and quality of existing trials on a topic.
Acupuncture has been used to improve patients' motor skills, sensation, speech and other neurological functions. Lead author of the study, Hongmei Wu, M.D., of the West China Hospital in Si Chuan, was very surprised by the findings. "In China, acupuncture has been well accepted by Chinese patients and is widely used for stroke rehabilitation."
The review's intent was to provide evidence that acupuncture should be routinely used to rehabilitate patients with both subacute and chronic stroke. However, the available research failed to offer sound evidence of the effects of this therapy.
Researchers analyzed trials from 368 patients between ages 24 and 86. The hemorrhagic strokes were classified as either subacute -- less than three months since onset, or chronic -- more than three months since onset.
Researchers admit there was some overall improvement after acupuncture treatment, however they warn the results need to be "interpreted with caution" due to the insufficient number and general poor quality of clinical trials.
Wu states "most studies are poor in methodological quality, so the continued recommendation for acupuncture on stroke rehabilitation is uncertain."
Sunday, July 23, 2006
Seminar Style: Mary Elizabeth Wakefield Part II
One of the shortcomings of many Traditional Chinese Medicine (TCM) schools is that they are often accused of teaching Traditional “Communist” Medicine. This is because, unlike 5-Element institutions, they tend to overlook the mental, emotional, and spiritual aspects of acupuncture. Whereas in Western Medicine, diabetes is diabetes no matter who your physician is or what school he went to, diagnosis and treatment with acupuncture depends largely on where you studied and the modality you prefer. Although my TCM program did explore 5-element theory in addition to other systems, they were not the emphasis. That is why today’s session was such a pleasure – it was a review made new.
Mary Elizabeth opened with an informative Q&A period that could have gone on all day had she allowed it. She introduced elemental diagnosis using hand and facing reading as well as Hara palpation to determine one’s tendency to wood, fire, earth, metal, or water. There was also instruction on the spiritual uses of Kidney points 23 – 26, scar therapy, and the five element wrinkle patterns. Unlike day one where I was well versed with 8-principle treatment and her needling techniques, I found that these were methods that I had previously had only the barest of introductions. Needless to say, I was eager to give them a try.
The protocol taught can be utilized prior to the facial portion and in conjunction with whatever “you do what you do” style of treatment. From personal experience, I can now testify to this method’s incredible power and immediately noticeable effects.
Mary Elizabeth Wakefield is my kind of instructor: She is passionate and knowledgeable about her craft, genuinely warm and attentive to her students, adaptable and accepting of differing styles of practice, encouraging, and above all patient. This seminar awakened a host of new creative juices in my Jing, and there is no doubt I will be returning for the rest of the series.
A Wrinkle In Rhyme (a ditty to remember the treatment principle):
If deep in the skin, thread it in
If superficially muscular, use Lavier perpendicular
Diagnostic Haiku
When you spread the flesh
Wrinkles fade if in muscle
But stay if in skin
http://www.chiakra.com
Mary Elizabeth opened with an informative Q&A period that could have gone on all day had she allowed it. She introduced elemental diagnosis using hand and facing reading as well as Hara palpation to determine one’s tendency to wood, fire, earth, metal, or water. There was also instruction on the spiritual uses of Kidney points 23 – 26, scar therapy, and the five element wrinkle patterns. Unlike day one where I was well versed with 8-principle treatment and her needling techniques, I found that these were methods that I had previously had only the barest of introductions. Needless to say, I was eager to give them a try.
The protocol taught can be utilized prior to the facial portion and in conjunction with whatever “you do what you do” style of treatment. From personal experience, I can now testify to this method’s incredible power and immediately noticeable effects.
Mary Elizabeth Wakefield is my kind of instructor: She is passionate and knowledgeable about her craft, genuinely warm and attentive to her students, adaptable and accepting of differing styles of practice, encouraging, and above all patient. This seminar awakened a host of new creative juices in my Jing, and there is no doubt I will be returning for the rest of the series.
A Wrinkle In Rhyme (a ditty to remember the treatment principle):
If deep in the skin, thread it in
If superficially muscular, use Lavier perpendicular
Diagnostic Haiku
When you spread the flesh
Wrinkles fade if in muscle
But stay if in skin
http://www.chiakra.com
Saturday, July 22, 2006
Seminar Style: Mary Elizabeth Wakefield Part I
From Eden Park B&B in Takoma Park, MD:
It is going to take a while to assimilate all of the information I have learned in day one of Mary Elizabeth Wakefield's Constitutional Facial Acupuncture Renewal. After meeting a fellow TCM practitioner from California at the airport last night (4 hours later than expected due to monsoon style thunder and lightning), and hoofing it almost 1.5 miles in the heat and humidity to the seminar, I found myself in a room of local Tai Sopheia trained 5-Element practitioners. Needless to say, I felt a little bit out of my "element." However, that quickly changed when Mary Elizabeth introduced herself and began speaking about her acupuncture facial rejuvination techniques.
We spent the morning going over contraindications, benefits, wrinkle analysis, intake and release forms, a review of 8 extraordinary meridians with their opening and balancing pairs, and Jacques Lavier's diagnosis and treatment protocols. The afternoon involved a practical demonstration of a treatment involving constitutional diagnosis with applicable points, facial and motor point needling technique, uses of herbal masks, poultices, and creams, instruction in jade rolling, and a brief introduction to acutonics.
I got to play patient today and I have to admit, although we were just practicing, I had a fantastic treatment by my two partners. I felt an abundance of Qi all through my body during the facial, so much so that one of my partners commented "you look zoned out, I may have to cut you off!" This sensation was intesified by the addition of the acutonic tuning forks placed on specific areas of the body. The herbal tea mask and facial cream were excellent, but the eggwhite herbal mask needed the some essential oil to cover up the scent. The jade rollers were cooling, relaxing, and something that I may add to my daily facial regimen.
Tomorrow is chock full of new information and more practical demonstration and practice and I am looking forward to being on the other side of the table!
It is going to take a while to assimilate all of the information I have learned in day one of Mary Elizabeth Wakefield's Constitutional Facial Acupuncture Renewal. After meeting a fellow TCM practitioner from California at the airport last night (4 hours later than expected due to monsoon style thunder and lightning), and hoofing it almost 1.5 miles in the heat and humidity to the seminar, I found myself in a room of local Tai Sopheia trained 5-Element practitioners. Needless to say, I felt a little bit out of my "element." However, that quickly changed when Mary Elizabeth introduced herself and began speaking about her acupuncture facial rejuvination techniques.
Contrary to popular belief, acupuncture facial rejuvination (and don't you dare call it a facelift) is not limited to the face. It includes all of the ingredients of a typical whole body constitutional treatment that can be done whether you are a 5 Element, 8 Principle, or Zang-Fu practitioner. You perform the facial diagnosis and then, as Mary Elizabeth says "do what you do." Rather than teaching a ridged protocol system, she incorporates different styles of acupuncture allowing for the practitioner to customize the treatment according to their training and comfort level.
We spent the morning going over contraindications, benefits, wrinkle analysis, intake and release forms, a review of 8 extraordinary meridians with their opening and balancing pairs, and Jacques Lavier's diagnosis and treatment protocols. The afternoon involved a practical demonstration of a treatment involving constitutional diagnosis with applicable points, facial and motor point needling technique, uses of herbal masks, poultices, and creams, instruction in jade rolling, and a brief introduction to acutonics.
I got to play patient today and I have to admit, although we were just practicing, I had a fantastic treatment by my two partners. I felt an abundance of Qi all through my body during the facial, so much so that one of my partners commented "you look zoned out, I may have to cut you off!" This sensation was intesified by the addition of the acutonic tuning forks placed on specific areas of the body. The herbal tea mask and facial cream were excellent, but the eggwhite herbal mask needed the some essential oil to cover up the scent. The jade rollers were cooling, relaxing, and something that I may add to my daily facial regimen.
Tomorrow is chock full of new information and more practical demonstration and practice and I am looking forward to being on the other side of the table!
Friday, July 21, 2006
The Future of Hospital Care
Every year, many schools of Traditional Chinese Medicine offer internships to several different hospitals in China where students and practitioners can do intensive study of acupuncture, herbal therapy, Tui Na, or medical Qi Gong and Tai Chi. It is a system designed to allow doctors to find the best treatments for their patients and collaborate closely with other physicians.
Imagine such an intergration in a US hospital, where patients have the option of receiving alternative therapies to augment their allopathic treatment. How useful would this be to so many lying in hospital beds who are suffering from post-of pain, undergoing cancer treatment, detoxing off alcohol or drugs, or simply having trouble going to sleep in an inherently bustling environment? It is beginning to become a reality, albeit in select areas of the country.
Many Western Doctors feel threatened at the notion that medicine can be practiced by those who do not have an MD after their name and, likewise, there are a small pocket of CAM practitioners who are also exclusionists and believe alternative medicine is the only alternative. But by an large, acupuncturists believe in choosing the treatment that is best for their patient, not what is best for their ego or for their pocket. I look forward to the day when there is true collaboration within the healthcare system in this country and to the day acupuncture doctors get to be a part of it.
U.S. Hospitals Offering Alternative Medicine
Thursday, July 20, 2006
By Jennifer Warner
More than one in four U.S. hospitals now offer alternative and complementary therapies, such as acupuncture, homeopathy, and massage therapy.
A new survey of nearly 1,400 U.S. hospitals shows more mainstream medical institutions are providing complementary and alternative therapies to meet growing demand.
"More and more, patients are requesting care beyond what most consider to be traditional health services," say researchers Sita Ananth of Health Forum and William Martin, PsyD, of the College of Commerce at DePaul University in Chicago, in a news release. "And hospitals are responding to the needs of the communities they serve by offering these therapies."
Complementary and alternative medicine (CAM) includes therapies not based on traditional Western medical teachings and may include acupuncture, chiropractic, homeopathy, diet and lifestyle changes, herbal medicine, and massage therapy, among others.
A 2002 CDC survey showed that more than half of Americans thought combining CAM with conventional medicine would be helpful.
The survey, conducted and published by the American Hospital Association every two years, shows the percentage of hospitals offering one or more CAM services increased from 8 percent in 1998 to 27 percent in 2005.
Contrary to popular belief, researchers found that complimentary and alternative medicine offerings were most common in the Midwest (Illinois, Indiana, Michigan, Ohio, and Wisconsin) and less common on the West Coast. The least common areas to offer CAM services were in the South (Alabama, Kentucky, Mississippi, and Tennessee).
The top six complementary and alternative medicine services offered on an outpatient basis among hospitals offering CAM were massage therapy (71 percent); tai chi, yoga, or chi gong (47 percent); relaxation training (43 percent), acupuncture (39 percent); guided imagery (32 percent), and therapeutic touch (30 percent).
Read more
Imagine such an intergration in a US hospital, where patients have the option of receiving alternative therapies to augment their allopathic treatment. How useful would this be to so many lying in hospital beds who are suffering from post-of pain, undergoing cancer treatment, detoxing off alcohol or drugs, or simply having trouble going to sleep in an inherently bustling environment? It is beginning to become a reality, albeit in select areas of the country.
Many Western Doctors feel threatened at the notion that medicine can be practiced by those who do not have an MD after their name and, likewise, there are a small pocket of CAM practitioners who are also exclusionists and believe alternative medicine is the only alternative. But by an large, acupuncturists believe in choosing the treatment that is best for their patient, not what is best for their ego or for their pocket. I look forward to the day when there is true collaboration within the healthcare system in this country and to the day acupuncture doctors get to be a part of it.
U.S. Hospitals Offering Alternative Medicine
Thursday, July 20, 2006
By Jennifer Warner
More than one in four U.S. hospitals now offer alternative and complementary therapies, such as acupuncture, homeopathy, and massage therapy.
A new survey of nearly 1,400 U.S. hospitals shows more mainstream medical institutions are providing complementary and alternative therapies to meet growing demand.
"More and more, patients are requesting care beyond what most consider to be traditional health services," say researchers Sita Ananth of Health Forum and William Martin, PsyD, of the College of Commerce at DePaul University in Chicago, in a news release. "And hospitals are responding to the needs of the communities they serve by offering these therapies."
Complementary and alternative medicine (CAM) includes therapies not based on traditional Western medical teachings and may include acupuncture, chiropractic, homeopathy, diet and lifestyle changes, herbal medicine, and massage therapy, among others.
A 2002 CDC survey showed that more than half of Americans thought combining CAM with conventional medicine would be helpful.
The survey, conducted and published by the American Hospital Association every two years, shows the percentage of hospitals offering one or more CAM services increased from 8 percent in 1998 to 27 percent in 2005.
Contrary to popular belief, researchers found that complimentary and alternative medicine offerings were most common in the Midwest (Illinois, Indiana, Michigan, Ohio, and Wisconsin) and less common on the West Coast. The least common areas to offer CAM services were in the South (Alabama, Kentucky, Mississippi, and Tennessee).
The top six complementary and alternative medicine services offered on an outpatient basis among hospitals offering CAM were massage therapy (71 percent); tai chi, yoga, or chi gong (47 percent); relaxation training (43 percent), acupuncture (39 percent); guided imagery (32 percent), and therapeutic touch (30 percent).
Read more
Wednesday, July 19, 2006
Neck Pain
One of the major limitations with most acupuncture research is the small sample size - so many of the studies just meet the minimum 30 participants to make the study statistically significant. Fortunately, there is no shortage of people suffering with neck pain and willing to volunteer. Here is a quick survey study of recent research findings.
From The Scotsman Wed 19 July 2006
Study proves acupuncture can aid neck pain and stiffness
ACUPUNCTURE is effective in helping people suffering neck pain, a review of evidence has concluded.
Some sceptics have claimed any benefit from using the technique is down to a patient's expectation that the treatment will work - a placebo effect.
Now a group of researchers has analysed ten trials, with a total of 661 patients, which investigated whether acupuncture alleviated neck pain.
It is estimated that between 26 per cent and 71 per cent of adults suffer neck pain or stiffness.
The Canadian researchers said that in many cases, pain could last for months.
The review found that overall, people who received acupuncture reported better pain relief immediately after treatment than those who received dummy treatments, such as laser methods with the machines switched off, or acupuncture with the needles inserted in the wrong places.
From The Scotsman Wed 19 July 2006
Study proves acupuncture can aid neck pain and stiffness
ACUPUNCTURE is effective in helping people suffering neck pain, a review of evidence has concluded.
Some sceptics have claimed any benefit from using the technique is down to a patient's expectation that the treatment will work - a placebo effect.
Now a group of researchers has analysed ten trials, with a total of 661 patients, which investigated whether acupuncture alleviated neck pain.
It is estimated that between 26 per cent and 71 per cent of adults suffer neck pain or stiffness.
The Canadian researchers said that in many cases, pain could last for months.
The review found that overall, people who received acupuncture reported better pain relief immediately after treatment than those who received dummy treatments, such as laser methods with the machines switched off, or acupuncture with the needles inserted in the wrong places.
Saturday, July 15, 2006
Today, Its Official!
I post a lot about this, but I cannot help but be excited over the validation of my profession in this state . . . especially since we, thankfully, are not the last one to pass a regulatory law!
Acupuncture now regulated health care in Kentucky
Associated Press
LEXINGTON, Ky. - Thousands of years after the Chinese invented the procedure and three decades after states first began overseeing its practice, Kentucky is making acupuncture a regulated form of medical care.
Beginning next year acupuncturists in Kentucky who want to practice the art of sticking hairlike needles into various pressure points around the body to relieve pain will have to be certified.
The law - which Gov. Ernie Fletcher signed on April 26 - went into effect on Saturday.
The regulations will require acupuncturists who want to practice in Kentucky to pass a national certification program from the National Certification Commission for Acupuncture and Oriental Medicine. They must also receive 1,800 hours of education from an accredited acupuncture training program.
Non-certified acupuncturists who are already working in the state have until July 1, 2007 to meet the requirements.
For Dr. Maureen Flannery, who runs an acupuncture practice in Berea, the new law validates her belief that the practice is a legitimate form of medicine.
"This was a long time coming," Flannery said. "I think it's important for consumers and practitioners to know who is trained when they're accessing care. Before this, there was no way for people to judge who was well trained."
Nancy Butler of Lexington began receiving acupuncture to recover from a rotator cuff injury and became such a fan that she's allowed her dog to go under the needles. She said the law will open the practice to people who previously may have been reluctant to try it.
"It's just really important for people to have access to something inexpensive that could help them terrifically," she said. "It's a form of healing that for thousands of years has worked."
The Kentucky Board of Medical Licensure - which monitors the practices of medical doctors and physicians' assistants - will oversee the practice of acupuncturists. An eight-member advisory committee will meet with the board regularly to keep it updated.
There are 18 acupuncturists currently working in Kentucky according to the certification commission. However, the new guidelines could lure more practitioners to the state.
"It's becoming more mainstream," said Kathleen Fluhart, a nationally credited acupuncturist. "It makes us be more acknowledged and recognized."
Acupuncture now regulated health care in Kentucky
Associated Press
LEXINGTON, Ky. - Thousands of years after the Chinese invented the procedure and three decades after states first began overseeing its practice, Kentucky is making acupuncture a regulated form of medical care.
Beginning next year acupuncturists in Kentucky who want to practice the art of sticking hairlike needles into various pressure points around the body to relieve pain will have to be certified.
The law - which Gov. Ernie Fletcher signed on April 26 - went into effect on Saturday.
The regulations will require acupuncturists who want to practice in Kentucky to pass a national certification program from the National Certification Commission for Acupuncture and Oriental Medicine. They must also receive 1,800 hours of education from an accredited acupuncture training program.
Non-certified acupuncturists who are already working in the state have until July 1, 2007 to meet the requirements.
For Dr. Maureen Flannery, who runs an acupuncture practice in Berea, the new law validates her belief that the practice is a legitimate form of medicine.
"This was a long time coming," Flannery said. "I think it's important for consumers and practitioners to know who is trained when they're accessing care. Before this, there was no way for people to judge who was well trained."
Nancy Butler of Lexington began receiving acupuncture to recover from a rotator cuff injury and became such a fan that she's allowed her dog to go under the needles. She said the law will open the practice to people who previously may have been reluctant to try it.
"It's just really important for people to have access to something inexpensive that could help them terrifically," she said. "It's a form of healing that for thousands of years has worked."
The Kentucky Board of Medical Licensure - which monitors the practices of medical doctors and physicians' assistants - will oversee the practice of acupuncturists. An eight-member advisory committee will meet with the board regularly to keep it updated.
There are 18 acupuncturists currently working in Kentucky according to the certification commission. However, the new guidelines could lure more practitioners to the state.
"It's becoming more mainstream," said Kathleen Fluhart, a nationally credited acupuncturist. "It makes us be more acknowledged and recognized."
Thursday, July 13, 2006
Verification Optional
I was ordering from an acupuncture supply company today and I was bothered by something during check-out. Unlike many herbal suppliers, such as Crane Herbs or Kan, several distributors of needle, moxabustion, and Electro Therapy products, including Acu-Market and Lhasa OMS, do not require license verification before allowing you to buy. I merely had to check boxes stating that I legally met the criteria to purchase such products, but there was no process to ensure I was who I claimed to be. By making professional products easily available to the public, it can encourage quack practitioners and lead to dangerous experimentation, particularly with those companies that sell herbal formulas. Of course they have the usual "hold-harmless-no-medical-claims-intended-the-herbs-are-just-food-supplements" disclaimers, but the open access still seems odd.
I have to remind myself of all the other "herbal" products on the market that any laymen can self-prescribe while standing in the natural section of their local grocery store, then pick-up a box of lacnets at the pharmacy. I must also admit, however, the side pet peeve is that there is no "practitioner pricing" on these sites and I have to pay the same for Tiger Balm as everyone else. But truly, my concern is more about the right tools in the right hands. I understand that mail-order companies are in the business of making money, but there should be some sort of license verification process before they will ship things like acupuncture needles, plum blossom hammers, and direct moxibustion - it keeps the profession honest.
I have to remind myself of all the other "herbal" products on the market that any laymen can self-prescribe while standing in the natural section of their local grocery store, then pick-up a box of lacnets at the pharmacy. I must also admit, however, the side pet peeve is that there is no "practitioner pricing" on these sites and I have to pay the same for Tiger Balm as everyone else. But truly, my concern is more about the right tools in the right hands. I understand that mail-order companies are in the business of making money, but there should be some sort of license verification process before they will ship things like acupuncture needles, plum blossom hammers, and direct moxibustion - it keeps the profession honest.
Sunday, July 09, 2006
Cupping with Fire
Since my first lesson, I have been a big fan of fire cupping. It is powerful, dramatic, and can leave marks that may have friends lifting eyebrows and inquiring if everything is okay at home. While most of the press dedicated to cupping focuses on it's use for pain management, I have to interject it is a first-rate modality for preventing the progression of a cold. At the first sniffle or scratch in the throat, I reach for the plum-blossom hammer, my fire cups, some Po sum On oil and my jade Gua Sha stone. These tools can knock out a wind-cold invasion before it has a chance to knock the client out. Not to mention, it feels really good. I have found that while they can be cumbersome, glass cupping is the most versatile as you can perform multiple techniques that are impossible with plastic suction and, unlike bamboo styles, you are able to see the strength and effectiveness of the suction during the treatment. It was brought to my attention several years ago that cupping is not exclusive to China and has been practiced in Mexico for centuries as well; the article below also reports its use in the Middle East. Fire away!
Cupping runneth over By LEIGH WOOSLEY
Alternative treatment for pain is drawing attention
Bearing marks on your back bigger than silver dollars may not seem all that healing, but it is for many people who have taken to Chinese fire cupping, an ancient, though somewhat offbeat, practice that supposedly releases toxins that cause aches, pains and irregularity in the body.
It's often an alternative or an addition to traditional acupuncture treatment and commonly is used to treat soreness, stiffness, pain and breathing problems such as bronchitis. It's used for other ailments, as well.
Here's how cupping is done. Glass, bell-shaped cups are heated, usually with an open flame to remove all the oxygen. The flame is swirled around the cup and immediately put on the body.
As the cup cools, it creates a sort of vacuum that sucks the skin into the cup. This suction causes blood vessels to expand and is supposed to release toxins from beneath the skin so they can be excreted from the body.
The cup stays on the skin for five to 15 minutes and leaves behind obvious red marks that can last a couple of weeks.
Read more
Cupping runneth over By LEIGH WOOSLEY
Alternative treatment for pain is drawing attention
Bearing marks on your back bigger than silver dollars may not seem all that healing, but it is for many people who have taken to Chinese fire cupping, an ancient, though somewhat offbeat, practice that supposedly releases toxins that cause aches, pains and irregularity in the body.
It's often an alternative or an addition to traditional acupuncture treatment and commonly is used to treat soreness, stiffness, pain and breathing problems such as bronchitis. It's used for other ailments, as well.
Here's how cupping is done. Glass, bell-shaped cups are heated, usually with an open flame to remove all the oxygen. The flame is swirled around the cup and immediately put on the body.
As the cup cools, it creates a sort of vacuum that sucks the skin into the cup. This suction causes blood vessels to expand and is supposed to release toxins from beneath the skin so they can be excreted from the body.
The cup stays on the skin for five to 15 minutes and leaves behind obvious red marks that can last a couple of weeks.
Read more
Tuesday, July 04, 2006
And the Research Continues
From the Boston Channel
Acupuncture may help knee pain more than taking anti-inflammatory drugs, according to new researchers.
Researchers studied 1,000 patients with osteoarthritis in the knee. Twenty-nine percent of those who had medication and physical therapy for six weeks reported less pain, compared to 53 percent of those who had acupuncture reporting less pain.
Fifty-one percent of those who had a placebo form of acupuncture also said their pain had decreased. It's possible, experts said, that just thinking a treatment may work will actually alleviate pain.
From the Annals of Internal Medicine
What is the problem and what is known about it so far?
Knee osteoarthritis is a common condition in which changes in the knee joints lead to pain. Treatments include drugs to decrease pain and inflammation; weight loss, if needed; physical therapy; and exercise. Unfortunately, these treatments do not always help and some have side effects. Consequently, many people with knee osteoarthritis seek alternative treatments, such as acupuncture. Acupuncture is an ancient Chinese treatment that involves putting special needles into specific points on the body to treat medical conditions. Mainstream medicine is increasingly recognizing acupuncture as an effective treatment for some disorders. Past studies about acupuncture for osteoarthritis have had inconsistent results.
Why did the researchers do this particular study?
To find out whether acupuncture is an effective treatment for knee osteoarthritis.
Who was studied?
1007 patients with osteoarthritis knee pain for at least 6 months.
How was the study done?
The researchers assigned patients to receive either 10 sessions of traditional Chinese acupuncture (TCA), 10 sessions of sham acupuncture, or 10 doctor visits without acupuncture over 6 weeks. Traditional Chinese acupuncture was "real" acupuncture according to Chinese protocols that specify the location and depth of needle placement in the treatment of knee pain. Sham acupuncture was "fake" acupuncture in which the acupuncturist placed the needles at a shallow depth in places other than the TCA points. Patients in all 3 groups could receive 6 physical therapy treatments and could take anti-inflammatory medications as needed up to a certain amount. The researchers compared changes in patients' pain after 26 weeks.
What did the researchers find?
After 26 weeks, patients in the TCA and sham acupuncture groups had greater improvement in pain than those in the no acupuncture group. Surprisingly, the changes in pain were not different in the TCA and sham acupuncture groups. However, patients in the TCA group reported higher satisfaction with treatment than those in the sham acupuncture group, but both acupuncture groups reported higher satisfaction than the no acupuncture group. Of note, patients in both acupuncture groups had more contact with health care providers during the study than did those in the no acupuncture group.
What were the limitations of the study?
Patients knew whether they were getting acupuncture. The researchers did not monitor whether the acupuncturists were following the TCA and sham protocols exactly as the study plan specified.
What are the implications of the study?
Compared with patients with knee osteoarthritis treated with physical therapy and anti-inflammatory drugs alone, patients who also received TCA or sham acupuncture had improvements in pain at 26 weeks. Surprisingly, the researchers found no difference in pain reduction between real and fake acupuncture. Several potential explanations are possible. First, because of psychological effects, patients who know they are getting special types of treatment report feeling better regardless of whether the treatment really works. Second, patients who received acupuncture had more intense contact with health care providers, which could explain why they felt better. Third, sticking needles into the body may have a physical effect on pain, regardless of whether the needles are placed according to TCA principles.
Acupuncture may help knee pain more than taking anti-inflammatory drugs, according to new researchers.
Researchers studied 1,000 patients with osteoarthritis in the knee. Twenty-nine percent of those who had medication and physical therapy for six weeks reported less pain, compared to 53 percent of those who had acupuncture reporting less pain.
Fifty-one percent of those who had a placebo form of acupuncture also said their pain had decreased. It's possible, experts said, that just thinking a treatment may work will actually alleviate pain.
From the Annals of Internal Medicine
What is the problem and what is known about it so far?
Knee osteoarthritis is a common condition in which changes in the knee joints lead to pain. Treatments include drugs to decrease pain and inflammation; weight loss, if needed; physical therapy; and exercise. Unfortunately, these treatments do not always help and some have side effects. Consequently, many people with knee osteoarthritis seek alternative treatments, such as acupuncture. Acupuncture is an ancient Chinese treatment that involves putting special needles into specific points on the body to treat medical conditions. Mainstream medicine is increasingly recognizing acupuncture as an effective treatment for some disorders. Past studies about acupuncture for osteoarthritis have had inconsistent results.
Why did the researchers do this particular study?
To find out whether acupuncture is an effective treatment for knee osteoarthritis.
Who was studied?
1007 patients with osteoarthritis knee pain for at least 6 months.
How was the study done?
The researchers assigned patients to receive either 10 sessions of traditional Chinese acupuncture (TCA), 10 sessions of sham acupuncture, or 10 doctor visits without acupuncture over 6 weeks. Traditional Chinese acupuncture was "real" acupuncture according to Chinese protocols that specify the location and depth of needle placement in the treatment of knee pain. Sham acupuncture was "fake" acupuncture in which the acupuncturist placed the needles at a shallow depth in places other than the TCA points. Patients in all 3 groups could receive 6 physical therapy treatments and could take anti-inflammatory medications as needed up to a certain amount. The researchers compared changes in patients' pain after 26 weeks.
What did the researchers find?
After 26 weeks, patients in the TCA and sham acupuncture groups had greater improvement in pain than those in the no acupuncture group. Surprisingly, the changes in pain were not different in the TCA and sham acupuncture groups. However, patients in the TCA group reported higher satisfaction with treatment than those in the sham acupuncture group, but both acupuncture groups reported higher satisfaction than the no acupuncture group. Of note, patients in both acupuncture groups had more contact with health care providers during the study than did those in the no acupuncture group.
What were the limitations of the study?
Patients knew whether they were getting acupuncture. The researchers did not monitor whether the acupuncturists were following the TCA and sham protocols exactly as the study plan specified.
What are the implications of the study?
Compared with patients with knee osteoarthritis treated with physical therapy and anti-inflammatory drugs alone, patients who also received TCA or sham acupuncture had improvements in pain at 26 weeks. Surprisingly, the researchers found no difference in pain reduction between real and fake acupuncture. Several potential explanations are possible. First, because of psychological effects, patients who know they are getting special types of treatment report feeling better regardless of whether the treatment really works. Second, patients who received acupuncture had more intense contact with health care providers, which could explain why they felt better. Third, sticking needles into the body may have a physical effect on pain, regardless of whether the needles are placed according to TCA principles.
Thursday, June 29, 2006
Data Bits 2
For those that believe if it looks like a duck and quacks like a duck, then it must be a random coincidence, here are some objective findings.
ACUPUNCTURE AND MIGRAINE: A NEW CONCLUSIVE STUDY
Literary search and editing by Francine L. Comtois, sec. trés. of the ACDM
Acupuncture would help to relieve the chronic headaches, migraine in particular. Such are the conclusions of a clinical study, carried out in England and in Wales, which was published in British Medical Journal. The study was made with an aim of evaluating if acupuncture could be rather effective, in the case of the headaches, to be integrated into the free care of the system of public health in England.
For 12 months, the researchers followed 401 patients suffering from chronic headaches, mainly of migraines. These patients had been divided randomly in two groups: one received up to 12 treatments of acupuncture for three months, while the others (which were used as reference group) were treated by a usual medication. The gravity of the headaches among patients of the two groups was measured, after 3 and 12 months; the researchers also evaluated, every three months, the need to take drugs or to consult a doctor.
After 12 months, the results showed that the headaches had decreased more in the group treated by acupuncture (reduction of 34%) that in the group which received a medication (reduction of 16%). The patients, who belonged to the group treated by acupuncture, counted on average 22 days fewer headaches per year. Compared with the reference group, they, during this period, had used 15% less drugs, makes 25% less medical visits and taken 15% less sick leave.
The researchers thus concluded from it that acupuncture produces beneficial and persistent effects among patients suffering from chronic headaches, especially from migraines. These conclusions were however criticized, in particular by famous Dr. Edzard Ernst, of the Laing Pulpit of complementary medicines at the Peninsula Medical School of the university of Exeter in England. According to him, being given the methodology of the study, the waitings of the patients could influence the effects allotted to the treatments of acupuncture.
ACUPUNCTURE AND MIGRAINE: A NEW CONCLUSIVE STUDY
Literary search and editing by Francine L. Comtois, sec. trés. of the ACDM
Acupuncture would help to relieve the chronic headaches, migraine in particular. Such are the conclusions of a clinical study, carried out in England and in Wales, which was published in British Medical Journal. The study was made with an aim of evaluating if acupuncture could be rather effective, in the case of the headaches, to be integrated into the free care of the system of public health in England.
For 12 months, the researchers followed 401 patients suffering from chronic headaches, mainly of migraines. These patients had been divided randomly in two groups: one received up to 12 treatments of acupuncture for three months, while the others (which were used as reference group) were treated by a usual medication. The gravity of the headaches among patients of the two groups was measured, after 3 and 12 months; the researchers also evaluated, every three months, the need to take drugs or to consult a doctor.
After 12 months, the results showed that the headaches had decreased more in the group treated by acupuncture (reduction of 34%) that in the group which received a medication (reduction of 16%). The patients, who belonged to the group treated by acupuncture, counted on average 22 days fewer headaches per year. Compared with the reference group, they, during this period, had used 15% less drugs, makes 25% less medical visits and taken 15% less sick leave.
The researchers thus concluded from it that acupuncture produces beneficial and persistent effects among patients suffering from chronic headaches, especially from migraines. These conclusions were however criticized, in particular by famous Dr. Edzard Ernst, of the Laing Pulpit of complementary medicines at the Peninsula Medical School of the university of Exeter in England. According to him, being given the methodology of the study, the waitings of the patients could influence the effects allotted to the treatments of acupuncture.
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