Acupuncture and Yoga
by Hans R. Larsen, MSc ChE
Acupuncture may relieve pelvic pain in pregnancy
GOTHENBURG, SWEDEN. Pelvic girdle pain is common among pregnant women, with one in three affected suffering severe pain. It is thought to be caused by hormones affecting the flexibility of ligaments and muscles in preparation for labour.
A research team from Gothenburg's Institute for the Health of Women and Children investigated the effectiveness of acupuncture to relieve this condition. They compared standard treatment (a home exercise routine), standard treatment plus acupuncture, and standard treatment plus stabilising exercises aimed at improving mobility and strength, each treatment given for six weeks. Participants were 386 women seen at 27 Swedish maternity care centers. They were between 12 and 31 weeks of gestation and experiencing pelvic girdle pain. The women given acupuncture had significantly less pain than the other two groups. This applied to both self-reported pain using a recognized scale and pain assessed by an independent examiner in the morning and in the evening. The stabilising exercise group had more pain than the acupuncture group but less pain than the standard treatment group.
The researchers conclude that treatment with acupuncture and stabilising exercises offers clear advantages
and can be seen as a useful addition to standard treatment for pelvic girdle pain during pregnancy. This
finding is supported by previous evidence of a beneficial effect of stabilising exercises adapted for
pregnancy as well as evidence that acupuncture can have a pain-relieving effect for patients with low back
pain. Although acupuncture may well prove helpful in this condition, there was no 'sham acupuncture'
group, so the placebo effect may be a factor. Further trials are necessary to rule out the placebo effect, and
to establish the ideal method of acupuncture if it is shown to be beneficial.
Acupuncture effective in treatment of osteoarthritis of knee
Because medications can cause serious side effects, alternative therapies, such as acupuncture, are receiving attention. While results of various trials suggest that acupuncture may be beneficial in treating the pain associated with knee osteoarthritis, its role is still controversial.
Two recently published studies demonstrate that patients with knee osteoarthritis who receive acupuncture as a complementary (adjunctive) therapy experience better results than those who receive patient education or drug treatment alone.
In one study, researchers at the University of Maryland School of Medicine evaluated 570 elderly patients with knee osteoarthritis to determine whether acupuncture provides greater pain relief and improved function compared with "fake" acupuncture or patient education only. The patients were randomly assigned to either a treatment group that received a total of 23 true acupuncture sessions over 26 weeks, or a control group that received 6 two-hour education sessions over 12 weeks or 23 fake acupuncture sessions over 26 weeks.
Similarly, Spanish researchers evaluated the effectiveness of a 12-week series of acupuncture treatments as a complementary therapy in 97 patients with knee osteoarthritis who were being treated with diclofenac. Like the first study, patients were randomly assigned to receive acupuncture (treatment group) or "fake" acupuncture (control group).
Measurements taken during both studies used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to quantify the pain level and functional disability experienced by the participants. The Maryland researchers found that patients in the acupuncture group, at the end of the study (after 26 weeks), had experienced a 42% reduction in WOMAC pain score as compared to a 19% reduction in the control group. Similarly, a 40% improvement in function score was observed among acupuncture participants versus a 22% improvement in the control group. A global health assessment of the study participants indicated a 15% improvement for acupuncture patients compared to a 7% improvement in the control group. The Spanish researchers found an 82% improvement in WOMAC function score in the patients treated with true acupuncture (and diclofenac) as compared to a 40% improvement in patients treated with sham acupuncture (and diclofenac). Pain scores decreased by 86% in the true acupuncture group versus a decrease of 47% in the sham group. Patients in the true acupuncture group also reported a greater improvement in psychological functioning and consumed 39% less diclofenac tablets than the sham group (85 tablets, on average, versus 139 tablets) over the 12-week trial period.
These results suggest that acupuncture is more effective than drug therapy or patient education therapy
alone, and the Maryland researchers conclude that acupuncture may have an important future role in a
multidisciplinary approach to knee osteoarthritis treatment. The Spanish researchers recommend additional
research to establish the duration of improvement after acupuncture and to establish treatment
Acupuncture acts directly on the brain
CHARLESTOWN, MASSACHUSETTS. Although acupuncture has been successfully used for thousands of years in China it is still viewed with considerable skepticism by many Western medical practitioners. One of the main stumbling blocks to greater acceptance is the lack of understanding of how it works. This may all change now with the publication of a seminal report by researchers at the Harvard Medical School. The researchers used functional magnetic resonance imaging (fMRI) to investigate how acupuncture affects brain activity in normal subjects. Thirteen healthy volunteers (ages 27 to 52 years) were involved in the study. They were seated in the MRI scanner and after relaxing had an acupuncture needle inserted in the LI 4 or Hegu point (located on the hand between the thumb and forefinger). The needle was left at rest for two minutes followed by two periods of manipulation (twirling) with a four-minute rest period in between. The researchers noted a highly significant correlation between brain activity and needle manipulation. Needle manipulation caused a pronounced calming of activity (decreased signal intensity) in the deep structures (amygdala, hippocampus, hypothalamus, etc.) of the brain accompanied by an increased signal intensity in the somatosensory cortex. They conclude that "modulation of this neuronal network could constitute the initiating steps by which acupuncture regulates multiple physiological systems and achieves diverse therapeutic effect". [62 references]
Hui, Kathleen, K.S., et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Human Brain Mapping, Vol. 9, 2000, pp. 13-25
Complementary medicine in Australia
Another survey involving 161 oncologists (cancer specialists) found that
almost a quarter of them had considerable knowledge about the use of
meditation, relaxation, visual imagery, antioxidant therapy, high-dose vitamin
C therapy, and microwave/Tronado therapy in the treatment of cancer. Very few
knew anything about cellular therapy, magnetotherapy, and psychic surgery.
Most oncologists (69-82 per cent) thought that meditation, relaxation, and
visual imagery would be helpful in both curative and palliative (symptom
relief) treatment of cancer. Acupuncture and hypnotherapy were also deemed
helpful whereas coffee enemas, diet therapy (Gerson/macrobiotic),
Iscador/mistletoe therapy, ozone therapy, and psychic surgery were considered
to be ineffective and often harmful. The oncologists often over-estimated
their patients' use of complementary therapies. For example, only 0.5 per
cent of cancer patients in a recent survey reported using aromatherapy while
the oncologists estimated that 15 per cent used this therapy. The use of
herbal therapies and shark cartilage was also vastly over-estimated at 45 per
cent and 15 per cent respectively versus an actual use of 10 per cent and 4
per cent respectively.
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