Acupuncture needles with direct electrical stimulation helped speed up nerve regeneration and function recovery after forearm ulnar nerve injury – a case report

A male patient with deep cutting wound and total rupture of right proximal forearm ulnar nerve was treated with direct electrical stimulation of acupuncture needles plus daily rehabilitation activities recovered most of function and returned to work around three months of after surgery. A case study reported in journal of Complementary Therapies in Medicine.

A 32-year old male patient, in Taiwan, China, suffered a deep cut from a broken washbasin and total rupture of right proximal forearm ulnar nerve and partial rupture of many associated tendons. The wound immediately underwent irrigation and muscle and ulnar nerve repair surgery. Two weeks after operation, electroacupuncture was applied, using 2 needles inserted in the cubital tunnel along the site of the injured ulnar nerve and 10 needles inserted according to the origins of muscles innervated by the ulnar nerve and affected by the injury, and other 4 needles were inserted along the suture scar line to avoid possible soft tissue contractures. The procedure was executed once a week for 6 months plus daily rehabilitation activities.

The outcome was monitored using the Rosén and Lundborg (R&L) protocol and DASH scores once a month. The results gathered on the first day of intervention were regarded as the baseline.

It was found that pain/discomfort domain was the first to reach stable amelioration after the first month. The motor and sensory and domains reached stable growth in third and fourth months, respectively. The patient returned to work in third month after operation.

Authors suggested that direct electrical stimulation at the proximal site of the injured nerve can augment nerve regeneration by means of acceleration of axon regeneration, earlier target muscle reinnervation, improvements in axonal conduction speeds, and up-regulation and electrophoretic movement of neurotrophic and neurogrowth factors such as BDNF and its trkB receptors.

Reference

Tang YJ et al., Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report. Complementary Therapies in Medicine 24 (2016) 103–107.    http://www.complementarytherapiesinmedicine.com/article/S0965-2299(15)30024-8/abstract

Acupuncture is effective in treating melasma

Melasma (also called Cholasma in pregnant women) is a commonly acquired dermatological condition characterized by hyper-pigmented patches on the sun exposed area of skin, mostly on the face. Acupuncture with facial acupoints alone or plus body acupoints were reported to improve melasma, according to a randomized clinical study published in journal of Complementary Therapies in Clinical Practice.

Melasma is a type of hyper pigmentation. It is caused by the build up of excess melanin, which creates patches of darker skin. It can be a side effect of the contraceptive pill, pregnancy, and hormone replacement medications. The frequent location of melasma on the face makes it a significant cosmetic condition that has a strong emotional impact on the individual, affecting their quality of life to an extent that they frequently seek treatment. Presently, a combination of hydroquinone (HQ) with steroids and tretinoin is considered the first line of treatment for the condition. However, concerns of the safety and side effects associated with long-term use of HQ are raised.

Recently scientists in Thailand conducted a randomized clinical study to assess the effect of facial acupuncture with or without body acupuncture on the melasma. Forty-one patients with melasma were divided into facial acupuncture only group (n=20) and facial acupuncture plus body acupuncture group (n=21). Facial acupuncture was performed with needles inserted at the rims of melasma and at the angle of 15 degree with needle tips towards the lesion centre. Body acupuncture was performed at 11 acupoints. The duration of treatment was 30 min a session, two sessions a week for a total 8 consecutive weeks.  Assessment of the melasma area and darkness of its pigmentation were carried out before and after treatment.

At the end of 8-week treatment it was found that facial acupuncture with or without body acupuncture significantly reduced the melasma area and darkness of its pigmentation compared with the base line. There was no recorded side effect.

This was the first randomized clinical study of effectiveness of facial acupuncture on melasma. Authors suggested that facial acupuncture could be a safe and cost-effective treatment for patients with melasma.

Reference:

L Rerksuppaphol et al., Randomized clinical trial of facial acupuncture with or without body acupuncture for treatment of melasma. Complementary Therapies in Clinical Practice 22 (2016) 1-7.    http://www.sciencedirect.com/science/article/pii/S1744388115300128

What is optimal stimulation frequency of electroacupuncture to decrease blood pressure in human?

Electroacupuncture has been used to treat hypertension due to its modulation on autonomic nervous system. Stimulation frequency at 1 HZ is reported to be the most effective to decrease blood pressure in human subject according to a report published in the journal of Clinical Autonomic Research.

Electroacupuncture is used to treat patient with hypertension, because it is less dependent on practioner’s skill, and the frequency and duration of stimulation can be precisely controlled.  However, there is no study in human subject about the optimal stimulation frequency in reducing blood pressure.

Recently a group of scientist leading by Dr. Hidehiro Nakahara in Japan conducted a clinical study to investigate the effects of varying stimulation frequencies of electroacupuncture on time-dependent changes in blood pressure and heart rate in humans. Twenty healthy human subjects were recruited for the study. Electroacupuncture was performed at acupoint Ximen (PC4) for 6 mins, at an intensity of 1 V, pulse width of 5 ms, using following stimulation frequencies: 0.5, 1, 5 and 10 HZ. The beginning of electroacupuncture was blinded to subject. Blood pressure and heart rate were monitored two mins before acupuncture and during 6 mins electroacupuncture stimulation. 

The data showed that electroacupuncture stimulation at 1 HZ produced the maximal reduction in blood pressure and heart rate compared with other stimulation frequencies. Further, reduction effect became more pronounced with increase in stimulation duration.

The present study provided fundamental data for potential use of electroacupuncture in the treatment of cardiovascular conditions.

Reference:

H Nakahara et al., Electroacupuncture most effectively elicits depressor and bradycardic responses at 1 Hz in humans. Clin Auton Res. 2015 Dec 22.   http://link.springer.com/article/10.1007%2Fs10286-015-0330-x