A complication of acupuncture therapy – pneumothorax

Acupuncture has been used to effectively treat a wide range of disorders and it is a safe modality with only minor side effects when it is performed in the hands of experienced practitioners. Complications of acupuncture treatment such as pneumothorax and severe infections etc may occur if the rules of acupuncture practice are not followed.

Pneumothorax refers to a collection of air in the pleural cavity (between the lung and the chest wall) and ranks the top of major complications arising from acupuncture. It is caused by too deep insertion or wrong anger of needle insertion due to lack of anatomical knowledge or carelessness performance.

Recently Dr. Demir and colleagues in Turkey reported a case of pneumothorax following acupuncture treatment. A 24-year-old female patient with severe chest pain was admitted into the emergency room of hospital. She had a chronic neck pain caused by cervical hernia and received medical treatment for three years but did not respond well to the treatment. Then acupuncture treatment was given with needles applied on her suprascapular region by a physical therapy specialist. She started to suffer severe pain shortly after acupuncture. Chest X-ray showed a reduced density in the right upper zone of periphery. Thoracic computed tomography showed evidence of a small pneumothorax covering almost 15% of the right hemithorax. The progression of pneumothorax was monitored by means of daily X-ray. The size of pneumothorax reached 20% on third day and a chest tube was placed in pleural space. Air leakage disappeared and tube was removed on the seventh day in hospital. Then patient was discharged from the hospital.

The report suggests that acupuncturists should be well-trained and be familiar with anatomy of treatment region for avoidance of potential complications.

Reference:

Demir M et al., A rare complication of acupuncture: pneumothorax. Tuberk Toraks. 2014 Dec;62(4):316-318.    http://www.tuberktoraks.org/managete/fu_folder/2014-04/2014-62-04-316-318.pdf

Different combination of acupoints exerts different therapeutic effect on cystitis-prone women

Utilizing acupuncture as a prophylactic treatment to cystitis-prone women, it was found that different combination of acupoints had different effects on the recurrence rate of cystitis, according to a clinical study published in the Chinese Journal of Integrated Medicine.

Cystitis means the infection of bladder. Recurrent cystitis commonly occurs in women in their late 20s and in women aged over 55. It is believed that a light variation in body’s defence system or kidney problems may tip the balance in favour of bacteria to cause infection. Although antibiotics are normally effective in control the infection, long term use of antibiotics has many side effects.

Acupuncture is effective in treating cystitis. Recently researchers in Norway performed a clinical study to assess the correlation between individual acupoints used and the recurrent rate of cystitis in cystitis-prone women receiving acupuncture as a prophylactic treatment. Fifty-eight cystitis women were recruited for the study and were given acupuncture twice a week for 4 weeks. Residual urine was measured at the baseline, 2, 4 and 6 months following the treatment and a number of cystitis episodes were counted during 6 month observation.

It was reported that the combination of BL23 and KI3 used in 16 women and 13 of 16 (80%) women reported a significant reduction in symptomatic episodes. However, when 42 women treated with acupuncture without combination of BL23 and KI3, on 14 of 42 (33%) women reported a markedly reduction in symptomatic episodes. BL23 application correlated to a significant reduction in residual urine measured a few days after treatment.

Authors suggests that although acupoint SP6 is normally regarded as a primary selection for the treatment of cystitis-prone women, for those with residual urine problem, the better acupoint selection could be BL23 and KI3 acupoints.

Refenece:

Alraek T et al., Acupuncture points used in the prophylaxis against recurrent uncomplicated cystitis, patterns identified and their possible relationship to physiological measurements. Chin J Integr Med. 2014 Dec 9.
http://www.ncbi.nlm.nih.gov/pubmed/25491541

Manual acupuncture produced stronger analgesic effect on lateral epicondylalgia than laser acupuncture

Lateral epicondylalgia is a challenging condition to treat. Laser acupuncture has been recently used to this condition. A meta-analysis to compare the analgesic effect of laser acupuncture and manual acupuncture found that manual acupuncture exerted better pain relief effect than laser acupuncture. The study was recently published in the American Journal of Chinese Medicine.

Lateral epicondylalgia has been recognized for a long time. The typical signs and symptoms include pain and tenderness over the outer part of elbow. It is an acute or chronic inflammation of the tendons that joins the forearm muscles on the outside of elbow (lateral epicondyle). Lateral epicondylalgia is regarded as an overuse injury that is difficult to treat, prone to recurrent bout and may last up to 2 years.

Laser acupuncture is used recently to treat pain-related conditions. Compared with manual acupuncture, laser applied to acupoint has many advantages such as painless, aseptic, safe and dosage adjustable. It is believed that the pain relief achieved by laser acupuncture is related to the metabolism of adenosine triphosphate because it encourages the myofascial trigger point to absorb energy and thereby cause local hypoxia to increase blood circulation, which subsequently decrease the pain caused by lateral epicondylalgia.

By inserting needle into the acupoint manual acupuncture activates biosignals surrounding acupoints. On the one hand the signals are sent to certain brain region, leading to the increased release of endorphin, relieving pain. On the other hand, manual acupuncture stimulation induced an increase in local levels of adenosine, a neuromodulators with analgesic property, which will enhance pain relief.

Researchers in Taiwan conducted a systematic review and meta-analysis to compare the analgesic effect of laser acupuncture and manual acupuncture to treating lateral epicondylalgia. They collected the relevant data from many databases from 1980 to 2013. The review study included 9 randomized study articles, of 6 examined manual acupuncture and others focused on laser acupuncture. They found that manual acupuncture immediately relieved the pain of lateral epicondylalgia, but its long-term analgesic effect is unremarkable. Applying it at a suitable acupuncture point and to an optimal acupuncture depth can effectively treat lateral epicondylalgia.

The study indicates that manual acupuncture applied to lateral epicondylalgia produces stronger evidence of pain relief than the laser acupuncture does.

Reference:

Chang WD et al., Analgesic effect of manual acupuncture and laser acupuncture for lateral epicondylalgia: a systematic review and meta-analysis. Am J Chin Med. 2014;42(6):1301-14. doi: 10.1142/S0192415X14500815.    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1725258/

Acupuncture helps reduce muscle hypertonicity, relieve muscle tension, pain and discomfort in children with cerebral palsy

In the United States, clinical studies of acupuncture treatment for children with cerebral palsy were performed by researchers at the University of Arizona.

In a randomized controlled study to assess effect of acupuncture on motor function of children, aged 12 to 72 months, with cerebral palsy spasticity was performed by the Health Sciences Centre. Following 16 weeks of acupuncture treatment, children with cerebral palsy spasticity displayed marked improvement in their gross motor function compared with control group. The improvement in acupuncture treated children exceeded researcher’s expectations. The study suggested that acupuncture could help children improve their ability to function physically.

Another study was performed by the Paediatrics Department. The study involved in several children and was to assess what extent of muscle hypertonicity can be relieved by auricular acupuncture. It was found that auricular treatment has particular therapeutic effect on one child. After just a few treatments it was noted that his muscles were not as hard as they were before treatment. By the end of 16 treatments with the ear probe, the child’s limb thrusting was reduced by 50 percent, a significant improvement.

There studies suggest that acupuncture is promising to improve symptoms of cerebral palsy.  

Reference:

Downer J, Acupuncture for cerebral palsy. Acupuncture, January 2014.  
http://www.stratfordacupuncture.com/acupuncture-cerebral-palsy/

Acupuncture helps improving bladder dysfunction in Parkinson’s patients

Acupuncture in combination with lower dose of tolterodine not only significantly improved urinary function but the motor functions of Parkinson’s disease (PD) patients with overactive bladder syndrome. According to a report published in the journal of Chinese Acupuncture & Moxibustion.

Many PD patients developed some non-motor symptoms including bladder dysfunction such as overactive bladder syndrome – urinary frequency, urgency, and leakage which could be very severe and significantly impacted on patient’s quality of life. Conventional treatment for urinary dysfunction such as tolterodine can temporarily improve bladder function but has many unpleasant side effects.

Dr Chen Yi-Liang and colleagues in China carried out a clinical study to assess the therapeutic effect of acupuncture plus lower dosage of tolterodine on PD patients with overactive bladder syndrome. PD patients with overactive bladder syndrome were divided into two groups. Combination group (n=30) were treated with electroacupuncture (once a day, 6 time a week for 6 weeks), plus tolterodine 1mg, twice a day for 6 weeks. Drug group (n=30) was given tolterodine 2mg, twice a day for 6 weeks. Urinary functions and UPDRSIII scores were assessed before and after completion of treatment.

At the end of study although both groups showed significant improvement in urinary function, the improvement was greater in combination group. Moreover patients in combination group experienced better motor functions jugged by significant changes in UPDRSIII scores. The occurrence of side effects was also markedly less in combination group than those of drug only group.

The study showed that acupuncture indeed is a treatment for multi targets not only improve non-motor symptoms but motor symptoms as wells.

Reference:

Chen YL et al., [Parkinson's disease combined with overactive bladder syndrome treated with acupuncture and medication]. Zhongguo Zhen Jiu. 2012 Mar;32(3):215-8.     http://www.ncbi.nlm.nih.gov/pubmed/22471132