Acupuncture-like stimulation relieves chronic tension headache

CM NEWS – A group of scientists at the University of Aarhus of Denmark recently published a report of a randomized, double-blinded, placebo-controlled trial on the effect of acupuncture-like electrical stimulation on chronic tension-type headache. They have demonstrated that such practice might provide a safe and potentially analgesic-sparing therapy to tension headache.

What is tension-type headache? A tension headache is the most common headache, and yet it’s not well understood. A tension headache generally produces a diffuse, usually mild to moderate pain over your head. Many people liken the feeling to having a tight band around their head.

A tension headache may also cause pain in the back of your neck at the base of your skull. A tension headache can last from 30 minutes to an entire week. You may experience these headaches occasionally, or nearly all the time. If your headaches occur 15 or more days a month for several months, they’re considered chronic. Unfortunately, chronic tension headaches sometimes persist for years.

A tension headache may cause you to experience a dull, achy pain or sensation of tightness in your forehead or at the sides and back of your head. In its most extensive form, the pain feels like a hooded cape that drapes down over the shoulders. The headache is usually described as mild to moderately intense. The severity of the pain varies from one person to another, and from one headache to another in the same person. Many people report that the pain starts first thing in the morning or late in the day when work stress or conflict at home is anticipated.

In the study, 36 patients (18 men, 18 women) with chronic tension-type headache in accordance with the criteria of International headache Society were investigated. The patients were randomly assigned into 2 groups: a treatment group and a placebo group. Pain duration, pain intensity on a 0 to 10 cm visual analog scale, number of headache attacks, and use of medication were recorded in a diary for 2 weeks before treatment (baseline), early stage of treatment (Treat-1; 2 wk), late stage of treatment (Treat-2; 4 wk), and after the end of treatment (Post-1, Post-2, Post-3 corresponding to 2, 4, and 6-wk follow-up).

The patients also provided an overall evaluation of the treatment effect at each stage. Patients were taught how to use either an acupuncture-like electrical stimulator or a sham stimulator (identical but incapable of delivering an electric current) and then instructed to use the device at home.

Six acupoints, bilateral EX-HN5, GB 20, LI 4, were selected to be stimulated 3 minutes for each point, twice a day.

The results showed that the pain duration was shortened at Treat-1 and pain intensity was decreased at Treat-1 and Treat-2 compared with baseline. The overall evaluation of the 2 treatments indicated improvements in both the treatment and the placebo groups, but with no significant difference between the groups (P>0.061).

Despite the apparent improvement in both the treatment and placebo groups, a decrease in analgesic use was only observed in the treatment group. There was also a significant positive correlation between the reported intensity of the stimulus-evoked sensation and the evaluation of the effect of either active or placebo treatments (P=0.039).

In conclusion, the researchers said that the use of acupuncture-like electrical stimulation was not associated with significant adverse effects. These results indicate that acupuncture-like electrical stimulation is a safe and potentially analgesic-sparing therapy that may be considered as an adjunctive treatment for patients with chronic tension-type headache although the clinical effect on pain seems to be marginal in the present set-up.

[Clin J Pain. 2007 May;23(4):316-322]

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Acupuncture is more effective, cheaper alternative to pain killers for migraines

American Chronicle – A recent study done in Italy and reported in the Journal of Traditional Chinese medicine compared the effect of acupuncture for migraine headaches versus conventional pain killer therapy.

One of the most interesting features of this study is that each patient was given a complete examination prior to the start of the test. This allowed the acupuncture therapy to be tailored to the individual causation of each patient’s condition.

There is no cookie cutter acupuncture treatment that is correct for everyone. When a study is done using the exact same points for the exact same duration, the results are going to be skewed and worthless.

What are the symptoms of migraines? Not all migraines are preceded by preliminarily symptoms, or auras, but if they are, they symptoms associated with an impending migraine usually involve some kind of vision disturbance such as:

* Bright or dark sport (sometimes resembling champagne bubbles)
* Tunnel vision
* Zigzag lines ( called fortification spectra)

The aura is followed by an intense crescendo of a headache, frequently behind one eye or on one side of the head. the pain may be pounding, throbbing, viselike, or stabbing; frequently it feels like the head is going to explode from pressure. Other symptoms that can accompany the headache of a migraine include.

* sensitivity to light
* nausea
* vomiting

The study showed that acupuncture for migraines was generally more effective than a series of pain killing drugs administered to the control group. What was more interesting is that the study looked at other factors beside the pain reduction. It also evaluated such things as the cost of the treatments and the time patients would have been unable to work under both treatments. It was in these areas that even more startling results were found.

The results indicated that acupuncture for migraine was not only a slightly more effective treatment for severe cases, but also resulted in considerable savings when viewed from a socio-economic point of view.

Many in the Western medical establishment give acupuncture a reluctant nod of acceptance as a treatment alternative for pain, but few have been made aware of how much more cost efficient and economically beneficial these treatments can be. There is certainly a need for more studies of this type that treat alternative medicine with a serious attitude and do not design the study to debunk what they already do not accept.

Migraines are one of the leading causes of lost time in the workplace in the United States. It is estimated that the cost of absenteeism from the estimated 157 million lost work days is over US$50b yearly when medical expenses are included. An additional US$4b is spent on pain killers for migraines and other types of headaches.

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250-year-old pill formula proven good at fighting cold

CM NEWS – A popular herbal flu pill used widely among Chinese and Japanese has effective anti-inflammatory and analgesic functions, a study finds.

Liu Shen Wan (六神丸, “Six Spirits Pills“) is a famous traditional Chinese medicine for treatment of upper respiratory tract inflammation. The pills are made from a 250-year-old herbal formula and consist of 6 herbs (thus “Six Spirits Pills”). In a study done at the Department of Complex Prescription of TCM, China Pharmaceutical University in Nanjing, the anti-inflammatory and analgesic functions activities of Liu Shen Wan was evaluated.

It was observed that Liu Shen Wan exerted significant anti-inflammatory and analgesic activities in these models at doses of 30 and 90mg/kg crude drug in vivo.

At doses of 0.5-5mug/ml in vitro, Liu Shen Wan was able to prevent the immune system from over-reacting and hence becoming useless. This is done by targetting the “superantigens”, or super strong pathogens, that cause the infection.

The researchers say that Liu Shen Wan potently inhibited proliferation of human peripheral blood mononuclear cell (PBMC) stimulated by streptococcal pyrogenic exotoxin at doses of 0.5-5mug/ml in vitro.

What is PBMC? A Peripheral Blood Mononuclear Cell (PBMC) is a blood cell having a round nucleus, such as a lymphocyte or a monocyte. These blood cells are a critical component in the immune system to fight infection and adapt to intruders.

Streptococcal pyrogenic exotoxins are a superantigen which can cause a massive immune response by activating up to 20% of the body’s T-cells. Since one of the fundamental strengths of the adaptive immune system is its ability to target antigens with high specificity, superantigens produce an immune response that is effectively useless.

What are T cells? T cells belong to a group of white blood cells known as lymphocytes and play a central role in cell-mediated immunity. Antigen-specific T cells provides the immune system with “memory” against past infections.

What is streptococcal pyrogenic exotoxin? Streptococcus pyogenes (group A streptococcus) is a virulent organism that causes scarlet fever, rheumatic fever and streptococcal toxic shock syndrome (STSS). Streptococcal pyrogenic exotoxin A1 (SpeA1) is a superantigen commonly isolated from streptococcal strains infecting individuals with STSS.

Streptococcus pyogenes is one of the most frequent pathogens of humans. It is estimated that between 5-15% of normal individuals harbour the bacterium, usually in the respiratory tract, without signs of disease. Streptococcus pyogenes can casue infection when body defenses are compromised.

The researchers then separate Liu Shen Wan into fractions to test their individual functions. The pill was partitioned with chloroform, methanol, water and mineral fraction.

The results show that several fractions inhibited inflammation and pain in varying degrees. Among them, chloroform fraction exerted the most remarkable inhibitory effect on human PBMC proliferation.

Methanol and water fractions had more suppressive activities in vascular permeability, leukocyte migration.

These results suggest that Liu Shen Wan has significant anti-inflammatory and analgesic activities. The chloroform fraction is a key fraction of Liu Shen Wan to the overall anti-inflammatory and analgesic effects, while methanol and water fractions also partly contribute to anti-inflammatory activities of Liu Shen Wan.

[J Ethnopharmacol. 2007 Feb 11]

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Massage, acupuncutre ease pain after cancer surgery

UCSF News – Massage and acupuncture are effective in decreasing pain and depression following surgery in cancer patients, according to a UCSF study.

The findings of the randomized controlled clinical trial are reported in the March 2007 issue of the “Journal of Pain and Symptom Management.” Read more

Herbal formula reduces knee arthritis pain by 30%

CM NEWS - A group of Taiwanese researchers were able to demonstrate scientifically that a traditional herbal Duhuo Jisheng Tang (DJT, 獨活寄生湯) can reduce pain of knee arthritis by almost 30%.

Little scientific evidence supports the efficacy of herbal medicines in the treatment of degenerative arthritis of the knee. The purpose of this study is to evaluate both the efficacy and safety of a finished Chinese herbal preparation Duhuo Jisheng Tang in reducing symptoms of degenerative osteoarthritis of the knee.

A prospective follow-up study was carried out in two hospitals in Taipei between April and October 2005. 68 osteoarthritis patients, with symptoms diagnosed by radiologists, received DJT at a rate of 2.5 g, twice daily for four weeks. Baseline scores were measured on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, followed by further measures at the end of weeks 1, 2 and 4.

The World Health Organization Quality of Life (WHOQOL) assessment was undertaken as a secondary outcome, with pattern identification questionnaires being adopted. Regression models were constructed to explore the score differences between the baseline and at weeks 2 and 4 by various determinants including age, gender, body mass index (BMI), severity at baseline, use of rescue medication, aversion to cold and flaccidity of the lower back and knees.

Among the 68 participants, there were statistically significant reductions in the WOMAC index scores for pain, stiffness and physical functioning in the second and fourth weeks, with effects first appearing during week 2.

By week 4, the mean WOMAC index scores had fallen from 22.2 (+/-19.2) to 16.1 (+/-16.2) for pain, from 28.1 (+/-24.9) to 18.5 (+/-20.3) for stiffness, and from 22.6 (+/-18.0) to 18.2 (+/-17.8) for physical functioning, while the global score for pain under the visual analogue scale (VAS) was reduced from 38.7 (+/-21.5) to 27.8 (+/-19.8).The researchers conclude that in the treatment of degenerative osteoarthritis of the knee, a 4-week therapy with the Chinese herbal preparation DJT reduced pain and stiffness and improved physical functioning, but it was less effective in treating flaccidity and aversion to cold.

[Chinese Medicine 2007, 2:4]

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Acupuncture controls chronic prostatitis/chronic pelvic pain

CM NEWS – Researchers have shown in a recent study that acupuncture is effective in alleviating the severity of pain in patients with chronic prostatitis/chronic pelvic pain syndrome.

What is chronic prostatitis or chronic pelvic pain syndrome? CP/CPPS occurs in men and is characterized by persistent discomfort or pain in the pelvic area that lasts several months, often longer. The discomfort is usually at the base of the penis and around the anus and lower back. Sometimes it spreads into the testes. Some patients have pain with ejaculation, and others may have pain or an urgency or hesitancy when they pass urine, as well as a poor urinary stream. The cause of CP/CPPS is not known. Physicians often try various therapies, including antibiotics to treat hidden or persistent infections in the prostate gland and {alpha}-blockers to relax the muscle tissue of the prostate and the outlet of the bladder. Thus far, few research studies have tested whether either of these treatments helps relieve symptoms of CP/CPPS.

The researchers of Columbia University and Cornell Medical College say that the etiology and treatment of chronic prostatitis/chronic pelvic pain syndrome remain poorly understood. Pain, lower urinary tract voiding symptoms and negative impact on quality of life are the most common complaints. Acupuncture, which has been widely used to treat painful and chronic conditions, may be a potential treatment to alleviate the constellation of symptoms experienced by men with chronic prostatitis/chronic pelvic pain syndrome.

In the present study, 10 men diagnosed with category IIIA or IIIB chronic prostatitis/chronic pelvic pain syndrome for over 6 months, refractory to at least 1 conventional therapy (antibiotics, anti-inflammatory agents, 5-alpha reductase inhibitors, alpha-1 blockers). The median age of the subjects was 36 years (range 29-63).

Standardized full body and auricular acupuncture treatment was given twice weekly for 6 weeks. The results show that subjects reported less pain after 3 and 6 weeks of treatment and remained so after an additional 6 weeks of follow-up. There weren’t any adverse events reported.

The researchers thus conclude that these preliminary findings suggest the potential therapeutic role of acupuncture in the treatment of chronic prostatitis/chronic pelvic pain syndrome.

[Chinese Medicine 2007, 2:1 doi:10.1186/1749-8546-2-1]

Acupuncture helps control pain during delivery, study finds

CM NEWS – Acupuncture is able to help first time moms to better endure pain and labour duration during delivery without side effects, according to a recently published study.

In this randomized controlled trial completed in the Department of Obstetrics and , Vali Asr Research Centre for Reproductive Health, Imam Medical Complex, Tehran, Iran, 144 healthy nulliparous women in active phase were randomised into the study and control group, receiving real and minimal acupuncture, respectively. Visual analogue scale was used to assess pain. Objectives were to evaluate acupuncture effect on pain and labour duration and patients’ willingness to receive acupuncture for subsequent pregnancies.

The aim of the trial is to assess the effects of acupuncture on nulliparous women during labour with respect to pain, labour duration and maternal acceptability.

The results showed that visual analogue scale pain score in the study group was lower after two hours. Active phase duration and the oxytocin units administered were lower in the study group. Study group patients had greater willingness to receive acupuncture again. No adverse effects were detected.

The researchers concluded that acupuncture could reduce pain experience, active phase duration and oxytocin units. Patients were satisfied and no adverse effects were noted.

[Aust N Z J Obstet Gynaecol. 2007 Feb;47(1):26-30 ]

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