Tag Archives: acupuncture

Research: Reflexology and Other CAM Therapies Reduce Pain in Hospital Patients

Non-traditional therapies relieve pain among a wide range of hospitalized patients as much as 50 percent, according to a first-of-a-kind study in the Journal of Patient Safety.

The study shows that an inpatient integrative medicine program can have a significant impact on pain in an environment where pain management continues to be a major challenge, and traditional medications can have negative consequences.

“Roughly 80 percent of patients report moderate to severe pain levels after surgery,” says Gregory Plotnikoff, M.D., one of the study’s authors and medical director of the Penny George Institute for Health and Healing at Abbott Northwestern Hospital.

“We struggle to provide effective pain control while trying to avoid the adverse effects of opioid medications, such as respiratory depression, nausea, constipation, dizziness and falls.”

The study included 1,837 cardiovascular, medical, surgical, orthopedics, spine, rehabilitation, oncology, and women’s health patients at Abbott Northwestern between January 1, 2008, and June 30, 2009. They scored their pain verbally on a zero-to-ten scale before and after treatments.

The treatments included non-pharmaceutical services and mind body therapies to elicit the relaxation response including:

  • acupuncture
  • acupressure
  • massage therapy
  • healing touch
  • music therapy
  • aromatherapy
  • reflexology.

The study, “The Impact of Integrative Medicine on Pain Management in a Tertiary Care Hospital” was published March 5 in the Journal of Patient Safety.

“Earlier studies narrowly focused on whether specific integrative therapies manage pain in either cancer or surgical patients,” says Jeffery A. Dusek, Ph.D., research director for the George Institute.

“Our real-world study broadly shows that these therapies effectively reduce pain by over 50 percent across numerous patient populations. Furthermore, they can be clinically implemented in real time, across, and under the operational and financial constraints within an acute care hospital.”

Dusek says future research will focus on defining appropriate intervention doses, duration of pain relief, and developing profiles of which patients are most likely to respond to nonpharmacologic treatments. Reductions in total hospitalization costs, medication use and adverse events will be quantified in future prospective research using the electronic medical record.

“I think we will find that integrative approaches to pain management during the hospital stay will improve patient satisfaction and outcomes, and we will see cost savings from patients using fewer drugs and experiencing fewer adverse events,” said Lori Knutson, RN, BSN, HN-BC, executive director of the George Institute.

Homeopathy and Acupuncture Beneficial

Homeopathy, acupuncture and reflexology are among a range of complementary and alternative therapies a new trial concludes should be provided on the NHS.

The major new Government-funded study found there would be a range of benefits to patients in providing access to complementary and alternative medicine, and that the treatments could even save the health service money.

As many as 81% of patients receiving the treatments on referral from their GP reported improvements in their physical health, and 79% in their mental health. (article continues, here)

Key Findings
• 81% of patients reported improvement in their physical health, 79% in their mental health.
• 84% of patients directly linked improvements in their health and wellbeing to the complementary treatment.
• 62% of patients were suffering less pain, with 55% said they had been able to reduce their use of painkillers.
• 64% of patients in employment said they took less time off work after treatment.
• Half of GPs reported prescribing less medication for chronic or acute patients during the trial.
• In 65% of cases, GPs reported a health improvement.

Source: Evaluation of Government-funded pilot project in Northern Ireland, carried out by Social & Market Research (SMR)

Helping Soldiers Heal: Quick Acupuncture Pain Relief

Battlefield Acupuncture Introduced
Air Force Print News | March 14, 2008

LANDSTUHL REGIONAL MEDICAL CENTER, Germany – A medical procedure dating back thousands of years was introduced to patients and medical staff for one week in March at Landstuhl Regional Medical Center.

A limited form of acupuncture, called battlefield acupuncture, was introduced to LRMC doctors who applied the procedure to war-wounded servicemembers and local patients for pain relief, and often with significant results.

Major (Dr.) Conner Nguyen was exposed to acupuncture as both a patient and physician and was equally impressed in both roles. As a patient, Major Nguyen experienced 25 percent increased range of motion and a 50 percent reduction in pain for chronic shoulders and upper back pain he endured for several years.

As a pain physician specialist at LRMC, Major Nguyen recruited his most challenging patients with whom traditional pain treatment offered limited relief. Within minutes of the short golden studs inserted on their ears, many said they enjoyed a pain reduction of up to 75 percent.

A reduction of 25 percent would be considered a success with traditional pain medications, Major Nguyen said. In one case, a patient broke into tears when the severe pain he had been suffering from for more than a year subsided within moments.

When the military acupuncturists who introduced battlefield acupuncture return to conduct the follow-up certification training required to practice ancient form of medicine, Major Nguyen will be among the list of LRMC physicians desiring to add acupuncture as another tool in their medical kit.

“It allows a provider like me to confidently complete a treatment and expect a good result within minutes,” Major Nguyen said. Other advantages he noted are virtually no significant complications, patients are subjected to little or no discomfort, and immediate results that can be “quite spectacular sometimes.”

Major Nguyen received his interim hands-on training during the weeklong visit by Col. (Dr.) Stephen Burns and Col. (Dr.) Richard Niemtzow, two of the 40 Department of Defense doctors trained as a licensed acupuncturist.

Colonel Niemtzow developed and named the battlefield acupuncture technique in 2001. It is a radical departure from classical Chinese, French and German ear acupuncture. He said he realized its possible military value and the events of the World Trade Center influenced him to name it battlefield acupuncture.

As an Air Force acupuncturist, Colonel Niemtzow has trained hundreds of his military counterparts. Battlefield acupuncture focuses on locations on the ear that he said have been known for hundreds of years as effective areas for pain control. The ear is also practical because it can be readily accessed whether on the battlefield or in a hospital bed.

Acupuncture can also be a practical means for treating pain in the military, he said, in instances such as a Soldier who develops a migraine headache at the onset of a mission. Where pain medication could cloud the mind and compromise the mission, acupuncture could offer long-lasting relief within minutes.

Introducing acupuncture to doctors trained in traditional Western medicine often meets with raised eyebrows, but the reception is warming.

“In the beginning, many people were skeptical, but after seeing it demonstrated on patients and the benefits achieved — especially in the area of pain — the majority of physicians embraced it and learned how to use it in their practice as an adjunctive therapy,” said Colonel Niemtzow, who is the consultant for alternative and complimentary medicine to the Air Force surgeon general.

The ancient form of medicine was readily received at LRMC, said Col. (Dr.) Stephen Princiotta, the deputy commander for clinical services here.

“The doctors who saw it in action and heard about it have been very excited about the opportunity to add acupuncture as an adjunctive therapy to what we already have been able to accomplish with western medicine,” Colonel Princiotta said.
One LRMC doctor previously trained under Colonel Niemtzow as well as well attending the Helms Medical Institute at the University of California in Los Angeles for an additional 300 hours of acupuncture training. Maj. (Dr.) Teri Simpson is an anesthesiologist by trade, but uses acupuncture one day a week at the LRMC pain clinic with great success.

“I love it,” Major Simpson said. “It can be life-changing when the patient responds immediately and looks at you like you’re a magician.”

Major Simpson said she tells them she doesn’t completely understand how it works but is always happy to see a patient break into a smile who was in misery only minutes before.

In addition to using the small studs that resemble a small pierced earring, Major Simpson uses the longer needles more commonly associated with acupuncture. The frequency of application and the duration of relief vary with each patient, but treatment can progress from about two times a week to as little as once a month or longer. In some cases, further acupuncture treatment may not be required.

Acupuncture doesn’t work for all of her patients; however. About 15 percent do not respond to acupuncture, Major Simpson said, but of the patients that do, their pain reduction often averages about 75 percent.

One of those patients was Army Spc. Bradley Phillips, an Army scout whose back pain while deployed to Iraq increased to the point where he required treatment at LRMC. Specialist Phillips, a 21 year old with the 3rd Armored Cavalry Regiment out of Fort Hood, Texas, had successfully received acupuncture treatment before by an Army medic and enthusiastically agreed to for the opportunity to be a part of the battle acupuncture program.

Specialist Phillips said he preferred acupuncture because it allowed him to avoid taking pain medications and their side effects. As Major Simpson applied two studs in his left ear and five in his right, as well as a few probes into his lower back with a longer needle, Specialist Phillips’ pain slowly eased away.

“While I’m just standing here I feel a lot better,” he said. In addition, the young Soldier edged the closest he’d been to touching his toes in six months.

For Senior Airman Jillian Sandbothe, traditional pain medication could never ease the headaches and upper back pain resulting from whiplash caused by a rear-end collision last April.

“It was amazing,” she said of her initial acupuncture treatment that provided total relief from her headache. “I couldn’t believe it the first time it happened. I could almost function like a normal person again.”
Studs used for battlefield acupuncture barely penetrate the skin and fall out in about three days. When that occurred, her headaches returned and Airman Sandbothe arrived at the LRMC pain clinic for follow-up treatment. As before, the pain diminished as Simpson plied her acupuncture craft.

“I don’t know how it works and I don’t really care as long it keeps working,” said Airman Sandbothe, who is assigned to the 52nd Component Maintenance Squadron at Spangdahlem Air Base, Germany.

Copyright 2009 Air Force Print News.

Research: Fibromyalgia and Alternative Health Approaches

Scand J Rheumatol.
Vegan diet alleviates fibromyalgia symptoms.

Department of Physiology, University of Kuopio, Finland.

The effect of a strict, low-salt, uncooked vegan diet rich in lactobacteria on symptoms in 18 fibromyalgia patients during and after a 3-month intervention period in an open, non-randomized controlled study was evaluated. As control 15 patients continued their omnivorous diet. The groups did not differ significantly from each other in the beginning of the study in any other parameters except in pain and urine sodium. The results revealed significant improvements in Visual analogue scale of pain (VAS), joint stiffness , quality of sleep, Health assessment questionnaire (HAQ), General health questionnaire (GHQ) , and a rheumatologist’s own questionnaire.

The majority of patients were overweight to some extent at the beginning of the study and shifting to a vegan food caused a significant reduction in body mass index (BMI) (p=0.0001). Total serum cholesterol showed a statistically significant lowering. Urine sodium dropped to 1/3 of the beginning values indicating good diet compliance.

It can be concluded that vegan diet had beneficial effects on fibromyalgia symptoms at least in the short run.

Acupuncture
Mayo Clinic study

Acupuncture Relieves Symptoms of Fibromyalgia, Mayo Clinic Study

Schmerz. 2008 Jun;22(3):324-33.
Alternative and complementary therapies in fibromyalgia syndrome

[Article in German]
Langhorst J, Häuser W, Irnich D, Speeck N, Felde E, Winkelmann A, Lucius H, Michalsen A, Musial F.

INTRODUCTION: Interdisciplinary S3 level guidelines were devised in cooperation with 8 medical, 2 psychological and 2 patient support groups. Results were elaborated in a multilevel group process. METHODS: On the bases of the “Cochrane Library” (1993-2006), “Medline” (1980-2006), “PsychInfo” (2006) and “Scopus” (2006) controlled studies and meta-analyses of controlled studies were analyzed.

RESULTS: Only few controlled studies were found supporting in part the effectiveness of CAM therapies in the treatment of fibromyalgia syndrome. Due to the lack of information on long term efficacy and cost-effectiveness, only limited recommendations for CAM therapies can be given.

CONCLUSION: Within a multicomponent therapy setting, selective CAM therapies (acupuncture, vegetarian diet, homeopathy, Tai Chi, Qi Gong, music-oriented and body-oriented therapies) can be recommended for a limited period of time.

Curr Pharm Des. 2006;12(1):47-57
Complementary and alternative medical therapies in fibromyalgia.
Sarac AJ, Gur A.

Department of Physical Medicine and Rehabilitation, Medical Faculty, Dicle University, 21280 Diyarbakir, Turkey.

This article describes the studies that have been performed evaluating complementary or alternative medical (CAM) therapies for efficacy and some adverse events fibromyalgia (FM). There is no permanent cure for FM; therefore, adequate symptom control should be goal of treatment. Clinicians can choose from a variety of pharmacologic and nonpharmacologic modalities. Unfortunately, controlled studies of most current treatments have failed to demonstrate sustained, clinically significant responses. CAM has gained increasing popularity, particularly among individuals with FM for which traditional medicine has generally been ineffective. Some herbal and nutritional supplements (magnesium, S- adenosylmethionine) and massage therapy have the best evidence for effectiveness with FM. Other CAM therapies such as chlorella, biofeedback, relaxation have either been evaluated in only one randomised controlled trials (RCT) with positive results, in multiple RCTs with mixed results (magnet therapies) or have positive results from studies with methodological flaws (homeopathy, botanical oils, balneotherapy, anthocyanidins and dietary modifications). Another CAM therapy such as chiropractic care has neither well-designed studies nor positive results and is not currently recommended for FM treatment. Once CAM therapies have been better evaluated for safety and long-term efficacy in randomised, placebo-controlled trials, they may prove to be beneficial in treatments for FM. It would then be important to assess studies assessing cost-benefit analyses comparing conventional therapies and CAM.

Rheumatology (Oxford), 2004 May;43(5):577-82. Epub 2004 Jan 20
Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo.

Department of Psychiatry, Mel and Enid Zuckerman Arizona College of Public Health at the University of Arizona, Tucson, USA.

OBJECTIVE: To assess the efficacy of individualized classical homeopathy in the treatment of fibromyalgia.
METHODS: This study was a double-blind, randomized, parallel-group, placebo-controlled trial of homeopathy. Community-recruited persons (N = 62) with physician-confirmed fibromyalgia (mean age 49 yr, s.d. 10 yr, 94% women) were treated in a homeopathic private practice setting. Participants were randomized to receive oral daily liquid LM (1/50,000) potencies with an individually chosen homeopathic remedy or an indistinguishable placebo. Homeopathic visits involved joint interviews and concurrence on remedy selection by two experienced homeopaths, at baseline, 2 months and 4 months (prior to a subsequent optional crossover phase of the study which is reported elsewhere). Tender point count and tender point pain on examination by a medical assessor uninvolved in providing care, self-rating scales on fibromyalgia-related quality of life, pain, mood and global health at baseline and 3 months, were the primary clinical outcome measures for this report. RESULTS: Fifty-three people completed the treatment protocol. Participants on active treatment showed significantly greater improvements in tender point count and tender point pain, quality of life, global health and a trend toward less depression compared with those on placebo.

CONCLUSIONS: This study replicates and extends a previous 1-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy. Using a broad selection of remedies and the flexible LM dose (1/50,000 dilution factor) series, the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia.

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Acupuncture Reduces Side Effects of Breast Cancer Treatment

BOSTON – Acupuncture is as effective and longer-lasting in managing the common debilitating side effects of hot flashes, night sweats, and excessive sweating (vasomotor symptoms) associated with breast cancer treatment and has no treatment side effects compared to conventional drug therapy, according to a first-of-its-kind study to be presented Wednesday, Sept. 24 at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston.

Findings also show there were additional benefits to acupuncture treatment for breast cancer patients, such as an increased sense of well being, more energy, and in some cases, a higher sex drive, that were not experienced in those patients who underwent drug treatment for their hot flashes.

“Our study shows that physicians and patients have an additional therapy for something that affects the majority of breast cancer survivors and actually has benefits, as opposed to more side effects. The effect is more durable than a drug commonly used to treat these vasomotor symptoms and, ultimately, is more cost-effective for insurance companies,” Eleanor Walker, M.D., lead author of the study and a radiation oncologist at the Henry Ford Hospital Department of Radiation Oncology in Detroit, said.

The reduction in hot flashes lasted longer for those breast cancer patients after completing their acupuncture treatment, compared to patients after stopping their drug therapy plan.

Eighty percent of women treated for breast cancer suffer from hot flashes after being treated with chemotherapy and/or anti-estrogen hormones, such as Tamoxifen and Arimidex. Although hormone replacement therapy is typically used to relieve these symptoms, breast cancer patients cannot use this therapy because it may increase the risk of the cancer coming back. As a treatment alternative, patients are generally treated with steroids and/or antidepressant drugs.

These drugs, however, have additional side effects, such as weight gain, nausea, constipation and fatigue. The antidepressant, venlafaxine (Effexor), a selective serotonin reuptake inhibitor, is one of the most common drugs used to treat these hot flashes. However, many women decide against this treatment choice because of potential side effects, including decreased libido, insomnia, dizziness and nausea, or because they simply do not want to take any more medications.

The randomized clinical trial compared acupuncture treatment to venlafixine for 12 weeks to find out if acupuncture reduced vasomotor symptoms in breast cancer patients receiving hormonal therapy and produced fewer side effects than venlafaxine. The study involved 47 breast cancer patients who received either Tamoxifen or Arimidex and had at least 14 hot flashes per week. Results show that acupuncture reduces hot flashes as effectively as venlafaxine, with no side effects, and also provides additional health benefits to patients.