Acupuncture is effective for diabetic peripheral neuropathy
Diabetic neuropathy is that the nerves in the patients with diabetes were damaged which is caused by high blood sugar levels and decreased blood flow. In a high blood sugar environment nerve cells as well as repair mechanisms are more likely to be damaged. About 50% of patients with diabetes will develop nerve damage many years later after they have been diagnosed diabetes. Many nerves could be affected including cranial nerves (nerves in the skull), autonomic nerves (nerves for internal organs such as heart, stomach etc) and of course peripheral nerves (for instance, nerves for arms and legs). Symptoms may vary depending on which nerves are injured
If peripheral nerves (nerves for the arms and legs) are damaged, this is called peripheral neuropathy which occurs in 50% of the diabetes 2 patients. The early sign of peripheral nerve damage is abnormal sensation such as pain and numbness often started in the toes and feet. The symptoms tingling and burning pain and numbness could be present in the arms and legs. Some pain could be very severe. The nerve conduction became slow. Foot ulcer may occur because of poor blood supply to the skin. The symptoms are worsening with times and age.
The treatment for diabetic peripheral neuropathy included two aspects: first is to keep blood sugar controlled in a normal level to prevent further nerve damage; second is to reduce symptoms. Many medicines are available to relive pain symptoms. Long term use of these medicines could cause kidney damage. Recently there are many studies supporting using acupuncture for the treatment of peripheral neuropathy.
Recent research by Chinese clinicians showed that acupuncture helps improving symptoms of peripheral neuropathy. Chen etc (2009) and Ji XQ (2010) used randomized controlled trials to study effect of acupuncture on nerve conduction velocity in patients with diabetic peripheral neuropathy. They found that acupuncture significantly increased nerve conduction speed. Tong Y (2010) etc compared the effect of acupuncture in patients with diabetic peripheral neuropathy with that of sham acupuncture using randomised trials. After 15 sessions of acupuncture treatment, acupuncture significantly improved nerve conduction speed; acupuncture also significantly improved numbness, pain and rigidity in the arms and legs; vibration and temperature sensations were improved after acupuncture treatment. As we already know that acupuncture has analgesic effect and also acupuncture improves local blood flow, these could contribute to the effectiveness of the treatment.
Positive result of acupuncture in the treatment of diabetic painful neuropathy from Manchester
Role of acupuncture in the management of diabetic painful neuropathy (DPN) was studied by Garrow AP et al in Tameside Hospital NHS foundation Trust, Diabetes Center in greater Manchester UK. In this study, there were 45 patients involved and allocated to two groups real acupuncture group and sham acupuncture group which is a control group. A 10 week course acupuncture was offered to these patients and five standardised acupuncture points on the lower limb of each leg were used in the study: LR3, KI3, SP6, SP10 and ST36. Assessment was done before and after acupuncture treatments. Over the 10-week treatment period, small improvements were seen in Visual Analogue Scale which was used to assess lower limb pain, Measure Yourself Medical Outcome Profile and resting diastolic blood pressure in the true acupuncture group and little changes were in sham acupuncture group. They demonstrated the potential practicality and feasibility of acupuncture as an additional treatment for people with DPN. Acupuncture treatment was well tolerated with little side effects.
Peripheral nerve injury with acupuncture treatment
Peripheral nerve injury can occur through various traumas and it became increasingly common condition. Injury to motor nerves may produce symptoms including muscle weakness, atrophy, twitching and paralysis. Injury to sensory nerve may produce symptoms including continuous burning pain, sensitivity, numbness, tingling or pricking and problems with positional awareness. A first degree injury or neuraplaxia will recover quickly within a few months. The recovery will be completed with no lasting muscle or sensory problem. More severe injuries may take longer to recover completely or may not be fully recovered. The recovery depends on the severity of the injury and the time to get the treatment. Nerve injuries should be treated as early as possible. Apart from surgical treatment, nonsurgical treatments for nerve injuries include medication, massage therapy, orthotics, physical therapy and acupuncture. Studies showed that acupuncture has significantly better effect for nerve injuries than those without acupuncture treatment. Acupuncture provided immediate symptom relief for patients with peripheral nerve injuries. Acupuncture has effect to reduce pain sensation. Acupuncture also improves motor nerve recovery. In addition acupuncture improves nerve conduction over the period of treatment and has been shown effective for nerve repair. This indicates that acupuncture may help nerves regeneration. Acupuncture is a promising approach for nonsurgical treatment of peripheral nerve injuries.
Acupuncture helps with peripheral neuropathy
Peripheral neuropathy is a condition affecting nerves causing impaired sensation, movement, or other organ dysfunction. There are many factors causing the condition, such as diabetes, vitamin deficiency, medication, injury or infection etc. If the cause is unknown, this is called idiopathic neuropathy. The symptoms depend on which nerves are affected. For example, if motor nerves are affected, it could present painful cramps, muscle twitching, muscle weekness, muscle loss, bone degeneration, impaired balance and coordination. If sensory nerves are affected, it may present numbness, loss of sensation, poor balance and coordination, tingling, burning pain etc. If autonomic nerves are affected, it may present poor bladder control, abnormal blood pressure and heart rate, sweat changes abnormally.
Acupuncture can help with peripheral neuropathy, by improving blood supply to the nerves, reducing inflammation and increasing nerve conductivity.
Acupuncture helps motor nerve injury recovering
Recent research from China reported the effectiveness of acupuncture for peripheral nerve injury. Xiao GR et al did a control trial study which investigated and compared the effects of acupuncture on peripheral nerve injury with that of function training and no treatment. They recruited 90 patients and allocated them into three groups: acupuncture group, function training group and control group with each group of 30 patients. After three months of treatments basic function, practical function, EMG, nerve conduction velocity were compared among the 3 groups. They found that the acupuncture group achieved the best recovery; the function training group is the second. They suggested that acupuncture plus function training can accelerate nerve repair, promote functional recovery of the muscles.
Another case report was from Millea PJ in Medical College of Wisconsin USA. A 41-year old female with a 1 week history of inability to write or extend the right wrist received 1 session of acupuncture treatment. Wrist motion returned strait away after the treatment. After acupuncture treatment wrist splint was then used. On the same day, the patient reported increasing strength in wrist and finger extension. On the next day, the patient cancelled the second session of acupuncture treatment, because of her hand recovered. 4 month followup found all wrist and finger extension, sensation and return of the brachioradialis reflex were normal. 1 year followup showed fully recovery to normal. Acupuncture potentially facilitates recovery and may accelerate peripheral motor nerve injury recovery. Although evidence that acupuncture is effective for any type of motor nerve injury is limited to case reports and case series, these findings are beneficial.
Common peroneal nerve palsy, acupuncture can help.
Common peroneal nerve palsy is damage to the peroneal nerve which is a branch of the sciatic nerve and supplies movement and sensation to the lower leg, foot and toes. Common peroneal nerve palsy is a type of peripheral neuropathy. This condition can affect people of any age. The peroneal nerve palsy leads to loss of movement or sensation in the foot and leg. There is a loss of feeling, muscle control, muscle tone, and eventual loss of muscle mass because the nerves aren't stimulating the muscles.
The causes include Trauma or injury to the knee, fracture of the fibula (a bone of the lower leg), use of a tight plaster cast (or other long-term constriction) of the lower leg, crossing the legs regularly, regularly wearing high boots, pressure to the knee from positions during deep sleep injury during knee surgery or from being placed in an awkward position during anesthesia, or unknown reasons. People who have diabetes or exposed certain toxins are in high risk.
The symptoms include decreased sensation, numbness, or tingling in the top of the foot or outer part of the upper or lower leg, foot drops, walking problems including slapping gait and toes drag while walking, weakness of the ankles or feet. Examination shows Loss of muscle control in the lower legs and feet, atrophy of the foot or leg muscles, difficulty lifting up the foot and toes and making toe out movements. Nerve conduction tests show reduced conduction velocity.
Treatments including surgery, physiotherapy etc are aimed for improving mobility and independence. Acupuncture helps improve recovery of peroneal nerve function and increase nerve conductivity. Acupuncture can also reduce pain caused to nerve injury.
Chen YL Journal of Chinese integrative medicine (2009), 7:273
Ji XQ Zhen ci yan jiu (2010), 35; 443-7
Tong Y J Acupunct Meridian Stud. (2010) 3:95-103.
Millea PJ J Altern Complement Med (2005) 11: 167-9
King JC. Peroneal neuropathy. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal disorders, pain and rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 66.
Yao ZH et al J Tradit Chin Med (1984) 4:97-100
Xiao GR et al Zhongguo Zhen Jiu (2007) 27:329-32
Garrow AP et al Acupunct Med (2014) Mar 21. doi: 10.1136/acupmed-2013-010495
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