Acupuncture for Pain

Posted on March 22, 2015 by John & Barbara Connor

by Barbara Connor, M.Ac., L.Ac.

I thought I would share with you today some recent studies that have come out in the last few years on how acupuncture can help with pain relief. I have seen many patients over the years suffering from various types of painful conditions and I get very good results treating these conditions with a combination of acupuncture and craniosacral therapy. By combining acupuncture with craniosacral therapy I am able to effect energetic and physiological mobilization, fluid exchange, improved delivery of nutrients and removal of metabolic waste products in the affected areas which helps your body to heal naturally. Below are the results of 12 recent studies showing how acupuncture helps to relieve pain.

In this study seventy five randomized controlled trials (n = 11077) were included. Almost all of the studies investigated individuals experiencing chronic neck pain or chronic low back pain. The researchers found moderate evidence that acupuncture was more effective than sham-acupuncture in reducing pain immediately post-treatment for chronic neck pain and acute low back pain. (Yuan et al 2015)

The aim of this study was to evaluate the effect of electroacupuncture and acupuncture for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into electroacupuncture and acupuncture and SHAM groups. Electroacupuncture and acupuncture were effective in reducing the pain intensity compared with SHAM. (Aranha et al 2015)

The purpose of this study was to compare acupuncture treatment and medical treatment with antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) on pain control, urinary symptoms, and quality of life of category IIIB chronic prostatitis-chronic pelvic pain syndrome (CP-CPPS). In the acupuncture group, reduction of pain, urinary symptoms, quality of life, and total National Institutes of Health Chronic Prostatitis Symptom Index score was higher compared with the medical group. However the treatment of CP-CPPS is challenging and difficult for the urologists. This clinical study showed that acupuncture treatment is a safe and effective treatment of category IIIB chronic prostatitis-chronic pelvic pain syndrome. ( Kucuk et al 2015)

Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. In this study acupuncture was investigated as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain. Our sample included 2,500 admissions of total hip and total knee replacement patients.  Average short-term pain reduction was 1.91 points (95% CI: 1.83, 1.99), a 45% reduction from the mean prepain score. Forty-one percent of patients reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after acupuncture. Acupuncture may be a viable adjunct to pharmacological approaches for pain management after total hip or total knee replacement. (Crespin et al 2015)

This study showed that acupuncture, core-stability exercises, and treadmill walking exercises were useful in relieving pain, increasing spinal range of movement, and improving the health of a patient with postsurgical lumbar disc herniation. (Ganiyu & Gujba 2015)

Acupuncture points stimulation is increasingly used for pain relief for chronic musculoskeletal pain. Commonly, a combination of local and distant points is used. In this systemic review local and distant point stimulation was more effective than their respective controls in pain reduction immediately after treatment. Subgroup analyses showed that, local tender point stimulation was more effective than local acupuncture points. However, subgroup analyses suggested that local tender points could be important in the treatment of chronic musculoskeletal pain for short-term pain relief. (Wong Lit Wan et al 2015)

This was a randomized, controlled, single-blinded study comparing conventional postoperative analgesic treatment with the same regime plus acupuncture to assess whether postoperative treatment of children aged 3-12 years undergoing tonsillectomy with acupuncture will reduce pain and to examine possible unwanted effects of this treatment. Sixty children were recruited and randomly divided into a study group and a control group. The results indicate that in the study group, there was less pain, less analgesic drug consumption, and higher patient/parent satisfaction with analgesic treatment scores. No adverse effects were recorded. Acupuncture, in addition to conventional analgesic treatment, is an effective treatment for posttonsillectomy pain. Acupuncture is safe and well received by children and their parents. (Gilbey et al 2015)

In this randomized study acupuncture was found effective for reducing posttraumatic stress disorder (PTSD) symptoms. Limitations included small sample size and inability to parse specific treatment mechanisms. Larger multisite trials with longer follow-up, comparisons to standard PTSD treatments, and assessments of treatment acceptability are needed. Acupuncture is a novel therapeutic option that may help to improve population reach of PTSD treatment. (Engel et al 2014)

In this randomized, controlled, double-blind study acupuncture was proven effective in the immediate pain reduction in patients with fibromyalgia, with a quite significant effect size. (Stival et al 2014)

This was a case study of a 78 year old woman suffering from symptoms suspected to be due to Parkinson’s Disease (PD). She was treated with acupuncture based on the Chinese traditional medicine and electroacupuncture five times per week. After the 2-week treatment, the assessment for the symptoms was as follows; visual analogue scale (VAS) score of the leg pain was 16 mm (70 mm, before), Hamilton’s rating scales for depression (HAM-D) score was 9 (18, before), timed 3 m Up and Go took 20 steps in 30 sec (24 steps in 38 sec, before), and the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part 1 score was 13 (21, before). Autonomic symptoms, hot flashes and paroxysmal sweating, were also alleviated. Acupuncture may be a good treatment modality for nonmotor symptoms in Parkinson’s Disease. (Iseki et al 2014)

A prospective, randomised, parallel-group, double-blind, placebo-controlled trial was performed in 80 men and women with acute non-specific low back pain who were randomly assigned to five acupuncture sessions (intervention group, n=40) and to five non-penetrating acupuncture sessions (sham group, n=40). Yamamoto’s new scalp acupuncture was more effective than sham treatment with regard to decrease in pain and anti-inflammatory intake as well as improving functional status and quality of life for patients with acute non-specific low back pain. (Hasegawa et al 2014)

One hundred and forty-three patients were analyzed in this prospective, randomized, controlled trial on the effectiveness and acceptance of acupuncture in patients with chronic low back pain. Acupuncture was highly accepted and had positive effects in patients with chronic low back pain. These results show that acupuncture can be an effective, well-tolerated therapy with no major adverse events. (Weiss et al 2013)

*****

Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-475-1005.

 

Posted in acupuncture, acute conditions, chronic conditions, craniosacral acupuncture, craniosacral therapy, inflammatory conditions, musculoskeletal conditions, neurological conditions, pain | Tagged , , , , , , , , , , , , , , | Leave a comment

Natural Ways to Lower Blood Pressure

Posted on January 29, 2015 by John & Barbara Connor

by John and Barbara Connor, M.Ac., L.Ac.

John & I thought we would write a little bit today about the various ways in which acupuncture, herbs, nutrients, exercise, weight reduction, qigong, yoga, etc. can help in lowering blood pressure.  High blood pressure (hypertension) is when your systolic blood pressure averages 140 mmHg or greater, and/or your diastolic blood pressure averages 90 mmHg or greater. In the United States high blood pressure affects one in three adults. If you or a loved one has high blood pressure we hope you find this article helpful.

Table of Contents

  • Acupuncture for Lowering Blood Pressure
  • Foods, Herbs and Nutrients That May Help to Lower Blood Pressure
  • Avoiding High Salt and High Fructose Intake
  • Smoking and High Blood Pressure
  • Obesity and High Blood Pressure
  • Benefits of Exercise on Cardiovascular Health
  • Stress and High Blood Pressure
  • Qigong, Yoga and Zen Meditation for Lowering Blood Pressure

Acupuncture for Lowering Blood Pressure

Our results are consistent with acupuncture significantly lowering blood pressure in patients taking antihypertensive medications. We did not find that acupuncture without antihypertensive medications significantly improves blood pressure in those hypertensive patients. (Li et al 2014)

A study published in the J Tradit Chin Med 1996;16: 273-4 reported that it was found that acupuncture treatment and nifedipine (an antihypertensive medication) were equally effective in reducing blood pressure in 62 patients with hypertension. These positive results are supported by other controlled trials.

According to a study reported in the Journal of the British Medical Acupuncture Society 05/31 /1994; V.XII N.I; p.63 the clinical picture improved in 96% of those patients with hypertension (high blood pressure) who were treated with acupuncture. Acupuncture decreased pathological symptoms in patients with Stage I and II hypertension by 60% + or -15% on average when compared with the Initial level. This was accompanied by a 75% + or – 3.1% decrease in the use of drugs.

According to a study published in Russian in Ter Arkh 1985:57(10): 42-5 by Anshelevich et al entitled “Serum aldosterone level in patients with hypertension during treatment by acupuncture” it was concluded that acupuncture resulted in a hypoaldosteronemic effect which showed statistically significant correlation with a decrease in the arterial blood pressure. The results obtained made it possible to regard the effect of acupuncture as one of the most significant mechanisms of its therapeutic action in hypertension.

Foods, Herbs and Nutrients That May Help to Lower Blood Pressure

Andrographis paniculata – may cause hypotension in some people. (Yoopan et al 2007)

Antioxidants – vitamin C (500 mg) vitamin E (200 iu), co-enzyme Q10 (60 mg) and selenium (100 mcg)caused significant increases in large arterial elasticity index (LAEI) as well as small arterial elasticity index (SAEI). A significant decline in HbA1C and a significant increase in HDL-cholesterol were also observed. This beneficial vascular effect was associated with an improvement in glucose and lipid metabolism as well as decrease in blood pressure. (Shargorodsky et al 2010) A significant body of epidemiological and clinical trial data suggest that diets known to contain significant concentrations of naturally occurring antioxidants appear to reduce blood pressure and may reduce cardiovascular risk. Data suggest, regardless of etiology, excessive ROS is a common factor in the pathogenesis and morbidity of hypertension.(Kizhakekuttu & Widlansky 2010)

Beetroot juice – lowers blood pressure.  Only 250 ml is necessary to have this effect. (Kapil et al 2010)

Blueberries –  Daily blueberry consumption may reduce blood pressure and arterial stiffness, which may be due, in part, to increased nitric oxide production. (Johnson et al 2015)

Capsaicin (in chili peppers) – can improve blood vessel function and lower blood pressure. (Yang et al 2010)

Coenzyme Q10 – lowers blood pressure. (Burke et al 2001) (Singh et al 1999) A number of trials provide clinical evidence that some patients with high blood pressure may benefit from coenzyme Q10 supplementation. (Wyman 2010) Early data from non-controlled studies in human hypertension demonstrate reductions in blood pressure with CoQ supplementation. Further, small randomized studies using a CoQ dose of 100–120mg daily have demonstrated significant reductions in blood pressure with minimal side effects in patient with Stage II hypertension. Interestingly, a new, mitochondrial-targeted formulation of CoQ has demonstrated anti-hypertensive efficacy in a rat model. (Kizhakekuttu & Widlansky 2010) 

DHA & EPA – The most compelling evidence for the cardiovascular benefit provided by omega-3 fatty acids comes from 3 large controlled trials of 32,000 participants randomized to receive omega-3 fatty acid supplements containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) or to act as controls.These trials showed reductions in cardiovascular events of 19% to 45%. These findings suggest that intake of omega-3 fatty acids, whether from dietary sources or fish oil supplements, should be increased, especially in those with or at risk for coronary artery disease. Patients should consume both DHA and EPA. (Lee et al 2008)

Egg white peptides – exhibited antihypertensive activity in vivo. (Garcia-Redondo et al 2010)

Garlic – has been shown to reduce systolic blood pressure by 5.5% in animal studies. (Tapsell et al 2006) These findings point out the beneficial effects of garlic supplementation in reducing blood pressure and counteracting oxidative stress in humans, and thereby, offering cardioprotection in essential hypertensives. (Dhawan & Jain 2005) The effect of garlic on blood pressure cannot be ascertained. Previous meta-analyses have been based on trials with inadequate study designs, methodological deficiencies and with too little information about blood pressure measurement. In our view, use of garlic cannot be recommended as antihypertensive advice for hypertensive patients in daily practice. (Simons et al 2009)

Ginger (Zingiber officinale Roscoe), a well-known spice plant, has been used traditionally in a wide variety of ailments including hypertension. We report here the cardiovascular effects of ginger under controlled experimental conditions.These data indicate that the blood pressure-lowering effect of ginger is mediated through blockade of voltage-dependent calcium channels. (Ghayur & Gilani 2005)

Hawthorn (Crataegus oxyacantha) – Crataegus exerts mild blood pressure-lowering activity, which appears to be a result of a number of diverse pharmacological effects. It dilates coronary vessels, inhibits ACE, acts as an inotropic agent, and possesses mild diuretic activity. (Rewerski & Lewak 1967) (Uchida et al 1987) (Pepping et al 1995) (Weihmayr & Ernst 1996) This study showed no herb–drug interactions arising from hawthorn administration. Taken concomitantly with prescribed medications, the herb demonstrated a hypotensive effect for patients with type 2 diabetes. (Walker et al 2006) 

Magnesium – intake of 500 mg/d to 1000 mg/d may reduce blood pressure (BP) as much as 5.6/2.8 mm Hg. However, clinical studies have a wide range of BP reduction, with some showing no change in BP. The combination of increased intake of magnesium and potassium coupled with reduced sodium intake is more effective in reducing BP than single mineral intake and is often as effective as one antihypertensive drug in treating hypertension. Reducing intracellular sodium and calcium while increasing intracellular magnesium and potassium improves BP response. Oral magnesium acts as a natural calcium channel blocker, increases nitric oxide, improves endothelial dysfunction, and induces direct and indirect vasodilation. (Houston 2011) Our meta-analysis detected dose-dependent BP reductions from magnesium supplementation. (Jee et al 2002) 

Olive leaf extract – In vitro, oleuropein and its major metabolite, hydroxytyrosol (which are polyphenols contained in olive leaf extract), exhibited a range of pharmacological properties beneficial for the cardiovascular system. These actions included enhanced nitric oxide production by mouse macrophages, antiinflammatory effects, protection against oxidative myocardial injury induced by ischemia and reperfusion, decreased blood pressure, inhibition of platelet aggregation and eicosanoid production, and scavenging of free radicals in addition to inhibition of 5- and 12-lipoxygenases . Oleuropein reduced infarct size, plasma lipid concentrations, and plasma markers of oxidative stress in cholesterol-fed rabbits.  In vivo, olive leaf extract (OLE) lowered blood cholesterol and lipid concentrations in cholesterol-fed rats and lowered blood pressure in nitro-L-arginine methyl ester-induced hypertensive rats as well as in normotensive rats. (Poudyal et al 2010) 

Omega-3 polyunsaturated fatty acids – are found in fish oil and they have been shown to mitigate the risk of cardiovascular disease.  They reduce fatal and nonfatal myocardial infarction, stroke, coronary artery disease, sudden cardiac death, and all-cause mortality. They also have beneficial effects in mortality reduction after a myocardial infarction. Omega-3 fatty acids have also been shown to have beneficial effects on arrhythmias, inflammation, and heart failure. They may also decrease platelet aggregation and induce vasodilation. Omega-3 fatty acids also reduce atherosclerotic plaque formation and stabilize plaques preventing plaque rupture leading to acute coronary syndrome. Moreover, omega-3 fatty acids may have antioxidant properties that improve endothelial function and may contribute to its antiatherosclerotic benefits. (Kar S 2011)

Reserpine (which is in rauwolfia serpentina root) is effective in reducing systolic blood pressure roughly to the same degree as other first-line antihypertensive drugs. (Shamon & Perez 2009)

Resveratrol – improved hypertension, dyslipidemia, hyperinsulinemia in vivo. (Rivera et al 2009) 

Royal Jelly peptides – were effective in lowering blood pressure in vivo. (Tokunaga et al 2004)

Salmon – Salmon consumption three times per week can decrease diastolic blood pressure (DBP) similar to fish oil and significantly more than lean fish during an 8-wk energy restriction in young overweight individuals. A lower DHA content in erythrocyte membrane at baseline, which might indentify infrequent fish eaters, is associated with a greater DBP reduction in the course of an 8-wk dietary intervention providing fatty seafood. (Ramel et al 2010)

Watermelon – can be an effective natural weapon against pre-hypertension.  When 6 gms of the amino acidL-citrulline/L-arginine from watermelon extract was administered daily for 6 weeks there was improved arterial function and consequently lowered aortic blood pressure in all nine of the pre-hypertensive subjects. (Figueroa et al 2010)

Water soluble vitamins – Supplementation of water-soluble vitamins in prehypertension reduces oxidative stress and its progression to hypertension. (Talikoti et al 2015)

Avoiding High Salt and High Fructose Intake

High salt intake is linked to hypertension (high blood pressure) whereas a restriction of dietary salt lowers blood pressure (BP). Substituting potassium and/or magnesium salts for sodium chloride (NaCl) may enhance the feasibility of salt restriction and lower blood pressure beyond the sodium reduction alone. The substitution of Smart Salt [50% sodium chloride and rich in potassium chloride (25%), magnesium ammonium potassium chloride, hydrate (25%)] for Regular salt in subjects with high normal or mildly elevated BP resulted in a significant reduction in their daily sodium intake as well as a reduction in SBP (systolic blood pressure). (Sarkkinen et al 2011)

It has been shown that a high fructose (sugar) diet may contribute to high blood pressure. (Jalal et al 2010)

Smoking and High Blood Pressure

There is overwhelming evidence garnered from a number of sources, including epidemiological, prospective cohort and intervention studies, suggesting that cardiovascular disease (CVD) is largely a disease associated with physical inactivity. A rapidly advancing body of human and animal data confirms an important beneficial role for exercise in the prevention and treatment of CVD. (Leung et al 2008)

We analyzed 13,529 male participants from the Physicians’ Health Study free of baseline hypertension and CVD who provided information about smoking status. This prospective cohort data suggests that cigarette smoking may be a modest but important risk factor for the development of hypertension. (Halperin et al 2007)

In conclusion, smokers have higher blood pressure than non-smokers. (A-Safi, S.A. 2005)

Because smoking and blood pressure have been shown to exert a synergistic adverse effect on the risk of coronary heart disease, it is critical that persons with raised blood pressure are advised to stop smoking. (Primatesta et al 2001)

Obesity and High Blood Pressure

Epidemiological studies indicate that the risk of hypertension increases by being overweight. Modest increases in exercise intensity and frequency have hypotensive effects in sedentary hypertensive patients. (Yung et al 2009)

Although population ageing is regarded as an important contributor to the atrial fibrillation epidemic, obesity and its associated cardiometabolic comorbidities may represent the principal driving factor behind the current and projected atrial fibrillation epidemic. Obesity-related risk factors, such as hypertension, vascular disease, obstructive sleep apnea and pericardial fat, are thought to result in atrial electro-structural dysfunction. (Abed & Wittert 2013)

Obesity affects the development of hypertension and other metabolic risk factors. And the mechanism of development hypertension has been investigated from adipocyte standpoints. Recently, physiology or pathophysiology functions of adipocyte including TNF-alpha or leptin have been elucidated. Leptin makes sympathetic nerve activity by effects of the central nerve system. TNF-alpha induces insulin resistance. These effects cause hypertension. (Saitoh S 2013)

Abdominal obesity is independently associated with hypertension after adjusting for body mass index (BMI). After adjusting for covariables and parameterizing BMI categories and abdominal obesity the new variable showed a progressive increase in the odds of hypertension. Both BMI and waist circumference should be included in models assessing hypertension risks. (Ostechega et al 2012)

Chinese adults over age 40 years with obesity have a significantly higher risk of hypertension and type 2 diabetes. (He et al 2009)

Benefits of Exercise on Cardiovascular Health

Equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly coronary heart disease. (Williams & Thompson 2013)

Sprint interval training (SIT) has been proposed as a time efficient alternative to endurance training (ET) for increasing skeletal muscle oxidative capacity and improving certain cardiovascular functions. In sedentary males SIT and ET are effective in improving muscle microvascular density and eNOS protein content. (Cocks et al 2013)

Exercise regimens  – The American College of Cardiology/American Heart Association recommends at least 30 minutes of moderate (at 50–70% of maximal predicted heart rate) exercise on most days to reduce the risk of cardiovascular events. Patients with hypertension, type 2 diabetes, metabolic syndrome, stable cardiovascular disease, myocardial infarction, and congestive heart failure, all benefit from exercise training compared to those who do not participate in any training. Importantly, an exercise regimen that improves endothelial function in diabetic patients fails to benefit healthy subjects. In healthy individuals, a longer and more intense exercise protocol is needed to induce measureable changes in cardiovascular parameters, while older and sicker subjects can benefit from less intense exercise regimens. (Golbidi & Laher 2012)

Exercise training improved autonomic function, assessed by heart rate recovery, resting heart rate and systolic blood pressure, in the absence of changes in diet or medication. (Ribeiro et al 2012)

Exercise also resulted in an increase in mitochondrial antioxidant enzymes (copper-zinc superoxide dismutase, manganese superoxide dismutase, and glutathione peroxidase) and prevented the ischemia-reperfusion (IR)-induced release of proapoptotic proteins from the mitochondria. Collectively, these novel findings reveal that exercise-induced cardioprotection is mediated, at least in part, through mitochondrial adaptations resulting in a mitochondrial phenotype that resists IR-induced damage. (Lee et al 2012)

Increased fitness – After adjusting for weight change, fitness was independently associated (p < 0.05) with improvements in R(2 )for glucose (+0.7%), HbA1c (+1.1%), high-density lipoprotein (HDL) cholesterol (+0.4%), and triglycerides (+0.2%) in intensive lifestyle intervention (ILI) and diastolic BP (+0.3%), glucose (+0.3%), HbA1c (+0.4%), and triglycerides (+0.1%) in diabetes support and education (DSE). Taken together, weight and fitness changes explained from 0.1-9.3% of the variability in cardiovascular risk factor changes. Conclusion: Increased fitness explained statistically significant but small improvements in several cardiovascular risk factors beyond weight loss. (Gibbs et al 2012)

Stress and High Blood Pressure

Stress has been shown to be important to vascular hypertension (Spruill 2010; Yu et al. 2013), and it may serve as a risk factor, induce blood pressure spikes, or increase an already elevated blood pressure (Lutgendorf et al. 2000; Wenneberg et al. 1997). Moreover, stress has been considered as an important cause of hypertension among other potential risk factors such as low potassium consumption, low physical activity and sleep abnormalities (Heine and Weiss 1987). Our research showed that chronic stress increased the abdominal aortic constriction-induced high blood pressure and made the pressure overload induced cardiac dysfunction worse. (Liu et al 2014)

Qigong, Yoga and Zen Meditation for Lowering Blood Pressure

Compared with no intervention, qigong significantly reduced systolic blood pressure (SBP) (weighted mean difference [WMD] = -17.40 mm Hg, and diastolic blood pressure (DBP) (WMD = -10.15 mm Hg). Compared with antihypertensive drugs, qigong produced a clinically meaningful but not statistically significant reduction in SBP, but appeared to be more effective in lowering DBP. Qigong plus antihypertensive drugs significantly lowered both SBP and DBP compared with antihypertensive drugs alone. No serious adverse events were reported.The meta-analysis suggests that qigong is an effective therapy for hypertension. (Xiong et al 2015)

The current study is the first meta-analysis to examine the effects of yoga on blood pressure among individuals with prehypertension or hypertension. Overall, yoga was associated with a modest but significant reduction in blood pressure (≈4mmHg, systolic and diastolic) in this population. Subgroup analyses demonstrated larger, more clinically significant reductions in blood pressure for (1) interventions incorporating 3 basic elements of yoga practice (postures, meditation, and breathing) (≈8mmHg, systolic; ≈6mmHg, diastolic) but not for more limited yoga interventions; (2) yoga compared to no treatment (≈8mmHg, systolic; 6mmHg, diastolic) but not compared to exercise. These reductions are of clear clinical significance and suggest that yoga may offer an effective intervention for reducing blood pressure among people with prehypertension or hypertension. (Hagins et al 2013)

These results suggest that Zen meditation is an interesting tool as a complementary treatment for hypertension in elderly subjects. (de Fatima Rosas Marchiori M et al 2014)

*****

Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-475-1005

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