Welcome to my blog

Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief.
Based at Kensington Central London.Qualified as a medical doctor in Western medicine over 20 years ago in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences

Doctor who is passionate about acupuncture

I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out.
This blog is to introduce latest development and research of acupuncture and offer a chance of awareness of more treatment options for your condition. The blog is for information purpose only.

About Me

My photo

My specialised areas include fertility for women and men, facial rejuvenation, acne, various pain conditions, chronic fatigue and hormone regulation with acupuncture treatment.

Practice contact for appointments and addresses 

Kensington: for appointments at Anamaya center Kensington please call at 02030110355 or email at info@anamaya.co.uk
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground station

Harley Street: for appointments  at Harley Street please call ALO clinic at 02076368845 or email at info@aloclinic.com
Address
Suite 3 Harmont House
20 Harley Street, London W1G 9PH
5 min walk from Oxford Circus underground station

My background: I became a qualified medical doctor in Western medicine 20 years ago in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Also I was trained with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. I am dedicated to treat patients with acupuncture and am recognized as one of the world leading acupuncture specialists.

I obtained a PhD degree in the University of Leeds in the UK.

I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.

I had frequently presented my research findings in the top international conferences in the field.

I have many publications including ebooks and articles.

I have many year clinical experiences. Over the years of practicing, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, neck pain, headache, migraine, shoulder pain, back pain, fatigue, hot flushes, Parkison's disease etc to achieve best treatment results. My devotion and skills are highly praised by my patients. 


Wednesday, 16 November 2016

Acupuncture is effective for prostatitis/chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is urologic pain or discomfort in the pelvic region lasting for at least 3 months during the preceding 6 months that is associated with urinary symptoms, and not accompanied by a urinary tract bacterial infection. CP/CPPS can impair both the physical and psychological function of patients and frequently diminishes their quality of life. There is lack of effective treatment for CP/CPPS, though a wide range of therapies have been routinely used to treat this condition; alpha-blockers and antibiotics are most commonly used in the clinic. Acupuncture is suggested to be effective for CP/CPPS. Recently an efficiency of acupuncture, alpha-blockers and antibiotics was compared. The results have shown that these treatments were better than placebo effect. Acupuncture has no side effect for the treatment.

Wednesday, 9 November 2016

Can the effect of acupuncture stay?

People who have acupuncture treatment always like to know that how long the effect of acupuncture stays. A new research has shown that this effect can last very long time. This research used a large individual patient dataset from high quality randomised trials of acupuncture for chronic pain. The available individual patient dataset included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck and shoulder), osteoarthritis of the knee and headache/migraine. In trials comparing a course of acupuncture to no acupuncture control (wait-list, usual care, etc), the result suggests that about 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. The effects of a course of acupuncture treatment for patients with chronic pain do not appear to decrease importantly over 12 months. Longer term outcomes of acupuncture need further research to measure.

References
MacPherson H et al (2016) Pain Oct 17 Epub ahead of print

Tuesday, 18 October 2016

Acupuncture is effective for acid reflux

Gastro-oesophageal reflux disease (GORD) or acid reflux disease is a common condition, where acid produced by the stomach leaks up into the oesophagus. At the entrance to the stomach, there is a lower oesophageal sphincter which is a ring muscle that closes the stomach as soon as food passes through into the stomach. If this sphincter becomes loos or opens too often the acid produced in the stomach and go back up to the oesophagus causing acid reflux disease. The symptoms mainly include heart burn and sore throat. Heart burn is a burning sensation in the chest just below the breastbone and it sometimes can spread to the throat. The burning sensation is worse after eating, or lying down or bending over. Sore throat is that acid produced in the stomach is brought back up into the throat and mouth which make you constantly clear the throat (persistent coughing) and sour taste at the throat or at the back of the mouth. Other symptoms include bad breath, bloating, feeling sick, pain when swallowing, difficulty swallowing, tooth decay and gum disease. Certain food and drinks can make acid reflux worse such as citrus, tomato, chocolate, mint, garlic, onions and spicy or fatty foods; alcohol, carbonated drinks, coffee or tea etc. There are some complications with acid reflux such as oesophageal ulcers, scarred and narrow oesophagus, barrett’s oesophagus and oesophageal cancer.

Do you know acupuncture can help reducing acid reflux?

Recently much research has been done to investigate the effectiveness of acupuncture on acid reflux. For example, a study compared the effect of acupuncture with that of Omeprazole capsules. They showed that the effect of acupuncture is much superior to this medication to improve acid reflux symptoms. Another study has shown that acupuncture improved functional state of esophagus, neurohumoral regulation of lower esophageal sphincter, decrease of acid producing function of stomach. A review analyzed current status of acupuncture on acid reflux. They suggested that acupuncture inhibits acid production, increases gastric and oesophageal motility, improves esophageal peristalsis, limits lower esophageal sphincter relaxation and decreases pain perception.

References
Gao &Bai (2016) Zhen Ci yan Jiu 41:150-3
Efendieva (2013) Eksp Klin Gastroenterol 5:49-52
Patrick (2011) Altern Med Rev 16:116-33

How your face changes with aging and how facial acupuncture helps to rejuvenate

How the skin changes with aging?

Skin is an organ which protects us from the environment, controls our body temperature and prevents our body from losing fluid and electrolyte balance.

Skin can be generally divided into three main parts:

The outer part (epidermis) contains skin cells, pigment, and proteins.

The middle part (dermis) contains blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis.

The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat. Each layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength.

There is a network of blood vessels in the two layers of the skin which provides oxygen and nutrients to the skin and takes away the waste from the skin.

Facial skin and facial skin aging

Human body is covered by the skin including face. However facial skin is different from body skin. The skin on the face is thinner than the skin on the body; fat layer is thinner as well. There are more hair follicles, sweat and oil glands on the facial skin. The skin cells on the face are generally smaller than skin cells on the rest of the body. Water is lost from the face more quickly than from the body. Pigmentation, fine lines and outbreaks can be seen on neglected skin. Degradation of collagen leads to dry skin, folds and wrinkles.

How your face changes with aging?

Environmental factors can speed up aging process: such as hormonal imbalance, sun exposure, smoking, stress, diet, diseases etc. This makes people look older than their age.

Face changes when people grow older. This change starts as early as in 30’s year old. The most prominent characteristics by which skin aging is recognized are facial wrinkles and sagging. A study suggested that the average age at which distinct wrinkles occur at the corners of the eyes is 36.5 years old. Wrinkles appear to develop early and rapidly at the corners of the eyes compared with other facial sites. Wrinkles rapidly increase in depth and width in women 40 years or older and reach a plateau at the age of 60 years. The strongest age dependent decline in skin elasticity has been seen at the corners of the eyes. A comparison of wrinkle depth with skin elasticity in the same corners of the eyes revealed that wrinkle severity occurs in proportion to the reduced elasticity of human facial skin. Sun exposure can accelerate facial skin aging and create wrinkles and skin sagging.

With aging, various spots and pigmentation are easily seen. These are not only changes in the aging skin. Also with aging, outer skin layer becomes thinner. Spots including age spot, liver spots etc may appear especially in sun-exposed areas. Skin’s strength and elasticity are reduced with the changes in the connective tissue. The blood vessels of the dermis become more fragile leading to bruising, bleeding under the skin. Skin becomes dry and itching because of less oil produced. The fat layer becomes thinner which reduces skin insulation and padding and one feels more difficult to keep warm in cold weather. The sweat glands produce less sweat which makes it harder to keep cool. Skin tags and warts are common with aging.

Aging change not only happens on the surface of the skin, but also underneath the skin surface such as fat muscle and bone etc. Loss fat volume and muscle mass on the face makes the face loss its fullness. Fat pulls downwards and the skin becomes loose and sagging due to gravity and muscle force. Bone also losses its mass and muscles are shortened and straightened. Corners of the eyes and mouth drop, tip of the nose drops as well and ears become longer.

Facial rejuvenation

Rejuvenation is the reversal of aging. This could be done by repairing or replacing damaged tissues. When people grow older, they want to delay the aging process. Can they? Facial rejuvenation is a cosmetic treatment which helps bring back youthful look. This can be achieved through surgical or non-surgical procedure. Facial rejuvenation procedure is more popular than ever. In 2013, over133,000 facelifts and nearly 216,000 eyelid surgeries were performed in the USA which was 6% increase from 2012. The current trend of facial rejuvenation is towards less invasive procedures. For example, facial rejuvenation procedures experienced the most growth is botulinum toxin type A injections; in 2013, it reached 6.3 million injections in USA, which increased 6% from previous year. Non surgical procedure is preferred because of less invasive, less expensive and quick recovery from the procedure.

What is cosmetic acupuncture, how does it work?

Facial acupuncture can help reducing wrinkles. Thin acupuncture needles are inserted in acupuncture points on the face. This is a natural way to relax facial muscles and reduce wrinkles. Also skin is better nourished by increased facial blood flow and becomes healthier. There is no side effects for acupuncture treatments apart from a small chance of little bruising which would disappear in a few days time.

Recently, cosmetic acupuncture has been introduced as an intervention for skin rejuvenation. It is a natural and healthy way to look and feel years younger. Why acupuncture can play a role in cosmetic purpose? Treatment benefits include elimination of some wrinkles and decrease in length and depth of others, decrease of facial edema, decrease of acne, improvement of facial muscle tone, improving skin texture with tighter pores, and decrease of sagging around the eyes, cheeks, chin, and neck, lifting of droopy eyelids, clearing or fading of age spots. Skin becomes more delicate and fair and at the same time overall appearance and health enhanced.

Acupuncture increases blood circulation leading to homogonous distribution of oxygen and nutrients as well as cellular regeneration. Facial mimetic muscles gradually straighten and shorten with age as a result of increased resting muscle tone and acupuncture can improve the muscle tone. Acupuncture helps regeneration of healthy skin cells, increase nutrition to the skin's surface, improves the quality of the skin and enhances a healthy glow, stimulates normal breathing of the skin and makes skin healthy and stronger to prevent infections and clogged pores. Good skin circulation takes waste and reduces grease accumulation resulting in deep cleaning of the skin. Acupuncture stimulates the production of collagen and elastin in the skin. Recently a research suggested that wrinkles were improved significantly after facial acupuncture treatment and facial elasticity was also improved in women aged 40 and 59 years.

Is there side effect of facial acupuncture? A study has shown that the most commonly reported adverse event that was clearly attributable to FCA treatment was mild bruising (20/140 treatment sessions; 14.28%) at the needle site. No adverse events of scarring, nerve damage, or lengthy recovery periods were observed.

Research shows that acupuncture improves blood circulation

Skin blood flow significantly decreased with increase in age. Skin blood flow is 40% less at age 65 than at age 25. This is because skin blood flow decreases with decreased pumping blood from heart; skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure; less blood is redirected to the skin from other part of the body; blood vessel movement is impaired with aging and blood vessels are not relaxed to increase the blood flow.

Many research data suggested that acupuncture improves blood perfusion. For example, there was a study of acupuncture on 140 healthy volunteers. In this study, acupuncture was applied in LI4’ skin blood flow was measured using a Moor full-field laser perfusion imager before and after acupuncture stimulation. Recently study has shown that stimulating LI4 also increased facial blood flow and hand blood flow. After acupuncture of the right LI4 acupuncture the change ratio of mean blood flux in the left LI4 was increased significantly compared with the control group 60 minutes after acupuncture stimulation. Another study has shown that acupuncture at LI4 and LI11 increased blood circulation along the meridian. Study at ST36 point also has suggested increased skin blood perfusion around the acupuncture point in healthy subjects. In 22 healthy volunteers acupuncture at PC6 point increased microcirculation blood perfusion units along the meridian. Increased blood circulation was also seen at the back acupuncture point study. This also demonstrated in some conditions For example, in a study patients with dysmenorrhea were treated with acupuncture. After 10 sessions of acupuncture treatment, microcirculation was increased and the symptom scores, pain index, and visual analog scale decreased significantly in treatment group.

Reduce wrinkles by botox injection

Botox is a neuro toxin. It has been used to treat various medical conditions. Recently it was approved for using in cosmetic purpose to reduce wrinkles on the face. This is because botox paralyses facial muscles. Botox injection is a procedure in which botox is injected into the desired area using injected needles. Following the treatments visible result can be seen within days or a couple of weeks. They tend to last for up to three or four months. Botox does not actually erase lines but relaxes them which means that deeper lines will become less deep and superficial lines will nearly disappear. Bleeding, bruising , swelling or redness at the site of injection is short term side effects. Other risks include headache, pain, and flu-like illness. In rare cases, there may be inappropriate facial expression, a drooping lid or eyebrow area, or double or blurred vision, dry mouth, fatigue and allergic reactions. If the toxin could travel back to the central nervous system, this would cause long-term damage.

References

http://www.netdoctor.co.uk/brain-and-nervous-system/medicines/botox.html

Yun et al Evid Based Complement Alternat Med (2013) 2013:424313

Barrett Aesthet Surg J (2005) 25:419-24

Imokawa G and Ishida K Int Mol Sci (2015) 16:7753-75

Tsuchida Y J Dermatol Sci (1993) 5:175-81

Guanjun W et al J Altern Complement Med (2012) 18:784-8

Huang H et al Evid Based Complement Alternat Med (2012) 2012:604590

Wang SY et al Zhen Ci Yan Jiu (2012) 37:482-7

Li X et al Evid Based Complement Alternat Med (2013) 2013:452697

Min Set al J Altern Complement Med (2014) Oct 29

Zheng SX et al BMC Complement Altern Med (2014) 14:323

An Y et al Med Devices (Auckl) (2014) 7:17-21

Xu QY et al Zhen Ci Yan Jiu (2013) 38:52-6

Huang T et al J Tradit Chin Med (2013) 33:757-60

Facial Aging, Facial Rejuvenation Acupuncture by [Ju, Dr Maggie]

Thursday, 13 October 2016

The nuchal ligament and neck pain

The nuchal ligament is a ligament at the midline of the neck which extends from the bottom of the skull to the spinous process of the seventh cervical vertibrae which is the lowest cervical vertebrae on the neck. It forms a septum between the muscles on the either side of the neck. There are four muscles including trapezius, splenius capitis, rhomboid minor and serratus posterior superior attached the nuchal ligament. The nuchal ligament limits flexion of the neck, stabilizes the neck and affects muscular activity in the neck. Trauma and overuse of nuchal ligament can result in ossification of the ligament which causes neck stiffness and pain, progressive cervical spine instability and malalignment and nerve route irritation. Acupuncture can help release neck stiffness and neck pain.

Tuesday, 4 October 2016

Muscles related to shoulder pain, acupuncture releases shoulder pain

Muscles related to shoulder pain

Trapezius muscle

Trapezius muscle is a broad triangular muscle at neck and upper back, one of the largest superficial muscles at the back. It attaches to the base of the skull and extends down to the neck, the upper back until mid back; laterally it inserts to the shoulder blades. There are three functional regions to the muscle: the Upper, middle, and lower trapezius, and each region has its own function: upper region moves the shoulder blades and support the arms; the middle region retracts the shoulder blades and the lower region rotates and depresses the shoulder blades.

Pain caused from this muscle may be on the top of the shoulder, neck, mid back and/or upper shoulder pain; pain at the back of the shoulder blade which could go down the inside of the arm to the ring and little fingers.

Latissimus dorsi

Latissimus dorsi is the largest flat muscle at the back. This muscle is involved in adducting the arms, extending the shoulders and rotating shoulder joints medially. It also plays a role in extension and lateral flexion of the lumbar spine. The latissimus dorsi originated from the lumbodorsal fascia of the lower back, arising from the inferior thoracic and lumbar vertebrae, sacrum, iliac crest, and the four most inferior ribs, it runs laterally up through the back, inferior part of shoulder blades and insert on the humerus at the upper front of the upper arm. Tight latissimus dorsi and the trigger points on the muscles could be one of the causes of chronic mid back pain, shoulder pain, forearm pain, pain between shoulder blades, shoulder blades and pain in front of shoulder. The characteristic of pain is at lower shoulder blade and mid back and also the pain can go down the backside of the arm or the inner side of the arm and reach the hand and 4th and 5th fingers. Pain can be present at the front of the shoulder and to the side of the body just above the hip.

Rotator cuff

Rotator cuff comprises four muscles which are supraspinatus muscle, the infraspinatus muscle, teres minor muscle, and the subscapularis muscle. They all originate from the scapula and insert into humerus. They connect scapula to the head to humerus , stabilize shoulder joint and contribute to shoulder joint movement including abduction, internal rotation, and external rotation of the shoulder.

Rotator cuff disorder is one of the problems that cause shoulder pain. The main symptoms are pain around the shoulder and reduced shoulder joint movement. Acupuncture can help reduce the pain.

Teres major muscle

Teres major muscle is the muscle that connects shoulder blades to the upper arms. It starts from lower angle of the shoulder blade and ends at the upper arm in the front of the shoulder. The teres major muscle adducts the arm, extends the shoulder and rotates it inwardly. It also helps stabilize the humeral head. The pain caused in the teres major trigger is the back of your shoulder and also this pain can radiate to the front and side of the shoulder and down the backside of the arm. The trigger points for this muscle can be found at the lower angle of shoulder blades. Acupuncture can help release the pain.

How many muscles connect the humerus (upper arm) to the scapula (shoulder blade)?

There are muscles that connect the upper arm to the shoulder blades and help the movement of the shoulder. Do you know how many of them? There are seven muscles that connect the upper arm to the shoulder blades. They are coracobrachialis muscle, four rotator cuff muscles including infraspinatus, subscapularis, supraspinatus and teres minor muscles, teres major muscle and deltoid muscle. Overuse or injury to these muscles can cause shoulder and arm pain. Acupuncture can help release the pain.

Deltoid muscles

The deltoid muscle is the big muscle on the shoulder which forms the rounded contour of the shoulder. It has three parts; the front or anterior, middle and back or posterior. The anterior fibers are involved in flexing the shoulder and internally rotating the arm. The posterior fibers are involved in extending the shoulder and externally rotating the arm. The lateral fibers are involved in shoulder abduction. Deltoid muscle strain is less common than rotator cuff muscles strain.

Pectoralis major and minor muscles and shoulder pain

The perctoralis major muscle is a muscle located at the chest. Underneath the pectoralis major is the pectoralis minor muscle- a small triangular muscle.

The pectoralis muscle originated from inner half of the clavicular bone, sternum as well as the cartilage of the sixth or seventh rib and the aponeurosis of the abdominal muscle. The muscle run laterally and insert into the upper humerus. It adducts the arm and rotates the shoulder inwardly, pull down the shoulder joint and elevated the arm in front of you. The muscle trigger points contribute to the shoulder pain and upper and inner side of the forearm.

Pectoralis minor originates from the third, fourth and fifth ribs and it runs upward and laterally and inserts to the surface of the coracoids process of the scapula. It pulls the shoulder blade downward, forward and inward towards the ribs, stabilizes the shoulder, prevents the shoulder blade from being pushed backwards. The trigger point of themuscle contributes to the pain in front of the shoulder, that could radiate to your chest and all the way down the inner arm.

Biceps and the shoulder, arm and elbow pain

In the upper arm, there is a muscle called biceps brachii or biceps. This muscle is two headed lies on the upper arm between the shoulder and the elbow. The two heads start from the scapular of the shoulder and join together to one muscle on the upper arm (humarus) and attach to the bones radius and ulnar in the front of the elbow. The biceps turn the arm outward, turn the palm upward, flex the elbow and flex the shoulder (bring the shoulder forward and upwards). The biceps can contribute to the pain on the front of the arm, the elbow and the shoulder. Also it contributes to the medial rotation of the shoulder.

Triceps

The triceps brachii muscle or three headed muscle of the arm is the large muscle on the back of the upper limb. The three heads include long head, medial head and lateral head. The long head originates from the top of the scapula (the infraglenoid tubercle of the scapula). The medial head originates from the upper part of the limb (the groove of the radial nerve, the dorsal surface of the humerus, the medial intermuscular septum and the lateral intermuscular septum). The lateral head originates from the back of the upper limb (the dorsal surface of the humerus, lateral and proximal to the groove of the radial nerve, the greater tubercle down to the region of the lateral intermuscular septum. The three heads join together, form a tendon and attach to the elbow (the olecranon process of the ulna). The triceps extend the elbow and shoulder joint to straighten the elbow and move the arm backwards and also pull the arm towards the body. If the triceps contain trigger points, you can experience pain on the shoulder, arm, elbow or the pain can radiate to the forearm.

Shoulder pain is very common: about 3 in 10 adults are affected by them at any one time. Frozen shoulder and rotator cuff disorders are most common in middle-aged and older people.

Frozen shoulder

Frozen shoulder is a painful condition in the shoulder. The medical term for frozen shoulder is adhesive capsulitis. It presents a painful persistent stiffness of the shoulder joint that it is difficult to carry out everyday tasks such as dressing, driving and sleeping comfortably. Some people are unable to move their shoulder at all. This is caused when the capsule surrounds the shoulder joint becomes inflamed. The capsule that surrounds your shoulder joint becomes swollen, thickened and tightened This leaves less space for your upper arm bone in the shoulder joint, and makes the movement stiff and painful. The symptoms of frozen shoulder can vary greatly, but tend to get worse slowly over the time. They are usually felt in three stages spread over a number of months or years. This is a common condition affecting about 2% of adults.

The most common symptoms are pain and stiffness in the shoulder. Also the amount of movement in affected shoulder joint is reduced. In severe cases, the shoulder may not be moved at all. Though it is a common condition, the treatment remains challenging. Jain and Sharma from University of Kansas Medical Center USA reviewed current best evidence for the use of physical therapy intervention for frozen shoulder. Therapeutic exercises and mobilization are strongly recommended for reducing pain, improving range of motion and function in patients with stage 2 and 3 of frozen shoulder. Low level laser therapy is strongly suggested for pain relief and moderately suggested for improving function but not recommended for improving range of motion. Corticosteroid injections can be used for stage 1 frozen shoulder. Acupuncture is an option of treatment. Acupuncture with therapeutic exercises is moderately recommended for pain relief, improving range of motion and function.

Many case reports were published showing effectiveness of acupuncture in reducing pain on frozen shoulder. For example, Wang XH et al observed 60 cases with frozen shoulder. These patients were divided into two groups for acupuncture or acupuncture plus moxibustion treatments. The acupuncture points selected were Jianyu (LI15), Jianliao (TE14) and Jianzhen (SI9). Tender points were also selected in acupuncture-moxibustion group. They found that acupuncture alone or acupuncture plus moxibustion were effective for frozen shoulder. Acupuncture combined with moxibustion may have better cured rate, but the effective rate has no significant difference. Some clinical trials suggest that acupuncture may improve recovery in patients with a frozen shoulder, either when used alone or in combination with physiotherapy. Acupuncture has effect of frozen shoulder in reducing pain, inflammation muscle and joint stiffness. This is because acupuncture stimulates nerve ends releasing analgesic substances such as endorphins; it reduces inflammation and improves local blood flow. The meridians involved in treating frozen shoulders are muscle meridian of Hand-Yangming, Hand-Shaoyang, Hand-Taiyang, and three yin meridians of hand appeared at proximal points of shoulder joint.

Rotator cuff disorders

The rotator cuff is a group of tendons and muscles in the shoulder, connecting the upper arm to the shoulder blade. The rotator cuff tendons provide stability to the shoulder; the muscles allow the shoulder to rotate. The rotator cuff keeps the joint in the correct position, allowing it to move in a controlled way. It keeps the upper arm bone in the shoulder socket and it raises and twists the arm. If it is irritated or damaged, rotator cuff disorders occur. Rotator cuff disorders include inflammation of the tendons or a bursa; impingement in which a tendone is squeezed and rubs against bone, calcium buildingup in the tendons, tears of the tendons. Rotator cuff disorders are common cause of shoulder pain. Most rotator cuff disorders are caused by a combination of normal wear and tear and overuse. Using the shoulder for many years slowly damages the rotator cuff. As ageing, everyday activities can lead to changes in the rotator cuff, such as thinning and fraying of the tendons and reduced blood supply. Activities in which you use your arms above your head a lot-such as tennis, swimming, or house painting-can lead to rotator cuff problems. Even normal motions made often over a long period can stress or injure the rotator cuff. A simple movement like lifting a suitcase can cause a rotator cuff tear in an older adult or someone whose shoulder is already damaged. Symptoms of a rotator cuff disorder include pain and weakness in the shoulder. Most often, the pain is on the side and front of the upper arm and shoulder. It may hurt or be impossible to do everyday things, such as comb hair, tuck in shirt, or reach for something. You may have pain during the night and trouble sleep. It is important to treat a rotator cuff problem. Without treatment, it may get weaker and lifting up your arm could be a problem. Acupuncture is very effective to treat rotator cuff disorder and helps reducing the inflammation and pain, relaxing rotator cuff muscles and improving blood supply.

New research shows that acupuncture is effective for shoulder pain

Shoulder impingement syndrome which is the common cause of shoulder pain presents pain and weakness in the shoulder especially when you raise your arm. This will limit the movement of the shoulder making daily life difficult. This syndrome involves the rotator cuff tendon which connects the muscles in the shoulder to the top of the arm. You may experience a constant aching in the shoulder and pain at night. It can start suddenly after an injury or it can come on gradually without any obvious causes. The pain tends to be worse when you raise your arm over the head.

Recently a report has shown the effectiveness of acupuncture for shoulder impingement syndrome. In this report the effect of acupuncture in decreasing the intensity of short- and mid-term pain in the injured shoulder was studied. 68 participants with a mean age of 33.4 years were divided into two groups: one group received true acupuncture and the other received acupuncture at sham points. The treatment was carried out over 4 weeks, with the participants receiving a session every week. The result has shown significant difference in pain reduction between two groups both after treatment and 3 months after treatments. No side effects were reported.


Acupuncture is effective for shoulder pain. Shoulder pain is a common reason for patients to visit an acupuncturist. If you have had acupuncture for this, do you know the effect of acupuncture for shoulder pain is closely related to the acupuncture points chosen? Wang et al has analysed some clinical trial to study the acupuncture points for shoulder pain and they assessed the effectiveness of Ashi points stimulation on response rate compared with conventional acupuncture. They have found that there was a significantly greater recovery rate in group of Ashi points stimulation. The conclusion was Ashi points stimulation might be superior to conventional acupuncture, drug therapy and no treatment forshoulder pain. Another study compared the effect of trigger point acupuncture (TrP), with that of sham (SH)acupuncture treatments, on pain and shoulder function in patients with chronic shoulder pain. After treatment, pain intensity between pretreatment and 5 weeks after TrP decreased significantly. Shoulder function also increased significantly between pretreatment and 5 weeks after TrP. Compared with SH acupuncture therapy, TrP therapy appears more effective for chronic shoulder pain.

References
Wang XH Zhongguo Zhen Jiu (2010) 30:364-6
Jain TK and Sharma NK J Back Musculoskelet Rehabil (2013) Nov 27
You Z et al Zhongguo Zhen Jiu (2014) 34:565-8
Wang et al Chin Integr Med (2015) Jun 30
Itoh K et l J Acupunct Meridian Stud (2014) 7:59-64
Rueda Garrido JC et al Complement Ther Med (2016) 25:92-7

Tuesday, 13 September 2016

Which muscle can cause you headache, neck and shoulder pain

Trapezius muscle

You may experience headache, neck and shoulder pain and feel aching and burning from the base of your skull to between your shoulder blades. One of the first muscles to cause this pain is trapezius. This is a broad triangular muscle at neck and upper back, one of the largest superficial muscles at the back. It attaches to the base of the skull and extends down to the neck, the upper back until mid back; laterally it inserts to the shoulder blades. There are three functional regions to the muscle: the Upper, middle, and lower trapezius, and each region has its own function: upper region moves the shoulder blades and support the arms; the middle region retracts the shoulder blades and the lower region rotates and depresses the shoulder blades.

Pain caused from the upper trapezius includes headaches on the temples, facial, temple or jaw pain, pain behind the eye, dizziness, neck pain, stiff neck, limited movement, intolerance to weight on the shoulders. Pain caused by middle trapezius includes headache at the base of the skull, mid back burning pain or aching along the spine or to the top of the shoulder. Pain caused from the lower trapezius includes headache at the base of the skull, aching on the top of the shoulder, neck, mid back and/or upper shoulder pain; pain at the back of the shoulder blade which could go down the inside of the arm to the ring and little fingers.

Acupuncture effectively releases neck and shoulder pain from the trapezius muscles.

Tuesday, 23 August 2016

It is time for facial acupuncture

In summer time people are rushing to get away to go under the sun. Sun light makes one feel good and sun tan makes one look good. However exposure to the sun causes most of wrinkles and age spots on the face and skin color obtained from being in the sun speeds up skin aging. Sun exposure damages collagen and elastin fibers in the skin. When these fibers break down, the skin begins to sag, stretch, and lose its ability to go back into place after stretching.

Facial rejuvenation acupuncture

Is there any way to make up to the damage caused by sun exposure? Facial acupuncture is an efficient way to do so. Does it work? Acupuncture on the face stimulates collagen and elastin synthesis and improves blood circulation to help skin repairing. As a result, skin becomes delicate and free of wrinkles again.

There is always doubt for those who never tried. A paper by Barrett JB was published in Aesthet Surg. In this paper the benefit of facial acupuncture included include elimination of some wrinkles and decrease in length and depth of others, decrease of facial edema, decrease of acne, improvement of facial muscle tone, improved skin texture with tighter pores, and decrease of sagging around the eyes, cheeks, chin, and neck.

References
Barrett JB Aesthet Surg J (2005) Jul-Aug 25:419-24
Facial Aging, Facial Rejuvenation Acupuncture by [Ju, Dr Maggie]

Wednesday, 10 August 2016

Acupuncture improves chronic pelvic pain

Chronic pelvic pain which is continuous or episodic pain in the lower abdomen or pelvis lasting at least six months is one of the most common pain conditions experienced by women. It has great negative impact on women’s quality of life including constant physical and psychological aspects. It depends on what causes the pain and various treatments are available including surgical and non surgical approaches such as hormonal therapy. Improving day-to-day pain management, functioning, and quality of life through multidisciplinary and holistic approaches are also recommended care to women with chronic pelvic pain. The use of complementary health approaches is common for pain conditions. An estimated 35-52% of patients with chronic pain use therapies such as vitamins and mineral supplements, massage therapy or acupuncture for their symptoms. This is applied to chronic pelvic pain. A survey showed that 60% of perimenopausal women with self-reported pelvic pain, and 84% of women with interstitial cystitis used some form of complementary medicine. Recently a study from the US has shown that most women who used acupuncture (91%) had at least some improvement in symptoms based on self-report.

References
Chao et al Pain Med (2015) 16:328-40

Thursday, 28 July 2016

Acupuncture helps IVF success in women with declined ovarian reserve

Recently there was a study about acupuncture on IVF/ICSI involved in 63 women with declined ovarian reserve. They were divided into two groups: acupuncture group and control group. In acupuncture group acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The patients in the control group were treated with IVF-ET but no acupuncture. The ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the acupuncture group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups. Their result has shown that Compared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in acupuncture group. Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in acupuncture group. Also, the implantation rate, the clinical pregnancy rate were improved and cycle cancellation rate was reduced.

References
Zhou L et al Zhongguo Zhen Jiu (2016) 36:25-8

Tuesday, 26 July 2016

Acupuncture is for hot flashes

Hot flashes are one of the menopausal symptoms in women. They can be associated with anxiety, nausea, tachycardia, and tachypnea, as well as pressure in the head and chest. Night sweats can be severe enough to cause sleep disturbance. The physiology of hot flashes is not clear in detail, but probably involves the core body temperature, neuromodulators, and peripheral vasculature and sweat glands. Women with hot flashes have an increased core temperature and a reduced thermoneutral zone compared with women without flashes. Decrease in estrogen production during the menopausal transition is related with vasomotor symptoms. Decreased endogenous estrogen concentrations also decrease hypothalamic β-endorphins and serotonin that lead to an instability in the hypothalamic thermoregulatory centre. When the set point in the thermoregulatory center is suddenly lowered, reactions are initiated that decrease body temperature, acting in the same way as when the upper limit of the thermoneutral zone is exceeded. The reduced β-endorphin and serotonin concentrations increase the release of noradrenaline, and this may in turn cause sudden drops in the set point in the thermoregulatory centre in the hypothalamus and elicit inappropriate heat loss. According to this hypothesis, any intervention that increases estrogen, β-endorphin, or serotonin concentrations or decreases noradrenalin levels may be expected to reduce hot flashes.

Acupuncture is effective in reducing the intensity and frequency of hot flashes in women and it has been found to decrease the number of hot flashes by at least 50% The physiological processes involved in acupuncture treatment are not fully known, however acupuncture increases central β-endorphin activity and also affects serotonin and noradrenalin activity in the central nervous system and thus has the potential to influence the thermoregulatory centre, making it more stable and decrease vasomotor symptoms. Other factors of importance may include changes in autonomic nerve functioning and may affect hormones such as cortisol, oxytocin, neuropeptides as β-endorphin, serotonin, and cytokines and alterations in collagen network communication. Acupuncture may also have peripheral effects and cause the release of substance P, vasoactive intestinal peptide, and CGRP.

Some studies have shown a decreased activity, measured by fMRI, in the amygdala and hypothalamus, when acupuncture is given. It seems possible that during an incident of hot flashes there is a high neuronal activity in the hypothalamus and that acupuncture may reduce this activity, perhaps mediated by increased β-endorphin release and decreased noradrenalin activity.

Thursday, 21 July 2016

One of the mechanisms of acupuncture effect is increasing blood circulation

Acupuncture is originated from China 2500 thousands years ago and is a part of traditional Chinese medicine. It spread to the Far East and Europe, then to America during the 19th century. Its theory is based on energy (Qi) flow through the body. Qi flow freely through body is fundamental for health. Interruption of this Qi flow is responsible for diseases. Acupuncture needles are inserted into the skin at particular points on the body to unblocks the blockage and restore balances of Qi flow in the body. As a result it achieves therapeutic effects.

The theory is based on the meridians. Scientific research on acupuncture provided evidence of the mechanisms of acupuncture. In 1950s Chinese government began to invest in research on acupuncture. The interest in acupuncture is increased not only for medical professionals all over the world, but also for researchers. They would like to know how the needles work. Since 70’s, acupuncture becomes more and more popular in US and European countries. In 1971, a report in the New York Times inspired American doctors to China to study analgesia effect of acupuncture. In 1990s there was a remarkable increase in acupuncture research. The publications of acupuncture research continue to increase. Acupuncture has received an enormous boost in the last few years. In 50 years the achievements of acupuncture research is extraordinary. The National Institute of Health consensus conference in 1997 recognised acupuncture (and by extension Traditional Chinese Medicine) as a legitimate branch of scientific medicine. Acupuncture seems very likely to be accepted and incorporated into Western medicine. Acupuncture becomes popular than ever.

Acupuncture increases local blood flow.

Regulating blood flow both centrally and peripherally are important in contributing mechanism of acupuncture.

Recently a study investigated the changes of local blood flow in response to acupuncture stimulation. In this study eight random controlled trials involved 205 participants were included. In most of the selected studies, acupuncture was performed at points located distal to the elbows and knees such as LI4, ST36, and PC6, whereas one study simultaneously used several acupoints on the extremities. In one study the GB21 acupoint on the posterior region of the shoulder was stimulated with an acupuncture needle. All eight studies selected for the present review observed acupuncture-induced changes in blood flow in the skin, whereas three studies observed changes in blood flow in the muscle. Four reported significant increases in blood flow following acupuncture compared with control, whereas one other study observed reductions in microcirculation immediately after acupuncture needling. The studies that assessed patients with either fibromyalgia or trapezius myalgia found significant increases in blood flow in the skin and muscle. Additionally, the degree and duration of increases in microcirculation varied depending on the condition of the subjects and the manipulation technique.

Another study about effect of acupuncture in peripheral tissue perfusion has been done on two healthy subjects. Acupuncture was performed on two acupoints (LI4 and SI3) which are in the hands three treatments within 1 week. Local blood perfusion on the hands was measured before and after acupuncture treatments. The result has shown that the blood perfusion rates of the hands were noticeably increased immediately after acupuncture at the first treatment in both cases. At the third treatment the increased blood perfusion was seen in one case, not the other one.

Hsiu H et al studied the microcirculatory blood flow response following acupuncture stimulation using beat to beat laser Doppler flowmetry (LDF) which could provides important information on the circulatory regulatory activities. Changes in the arterial pulse transmission or the opening condition of arteriolar opening might change the fluctuation pattern of the microcirculatory blood supply. They measured LDF signals to study the microcirculatory blood flow response at the needled site particularly at Hegu LI4 acupuncture point) after acupuncture stimulation. They selected 29 male healthy volunteers to measure microcirculatory blood flow after acupuncture stimulation. The measurements were at three times: before acupuncture stimulation, immediately after acupuncture stimulation and about 1 hour after acupuncture stimulation. They found that acupuncture not only improves local blood supply and but also regulates microciculatory blood flow by altering microcirculatory blood supply parameters. Their findings could help to identify the mechanism underlying the effects of acupuncture stimulation.

Acupuncture increases blood perfusion around the acupoints.

Researchers are using modern techniques to study the mechanisms of acupuncture to explain the phenomenon from modern science aspect. Li XM et al studied influence of different acupuncture manipulations at Zusanli (ST36) on skin microcirculation blood perfusion in healthy subjects. They measured local blood perfusion at ST 36 acupuncture points after acupuncture stimulation at 1min, 5 min, 10, 15min, 20 min, 25 min and 30 min. They also compared blood perfusion levels of microcirculation around the acupoints among the different manipulation techniques. They found that microcirculation around the selected acupoint was significantly increased from 1-10 min following simple needle insertion, from 5 -30 min after uniform reinforcing-reducing manipulation, from 1-30 min after reinforcing manipulation, and from 1-25 min following reducing manipulation respectively. The reinforcing manipulation was superior to other techniques. From this study we can see acupuncture increases local blood perfusion in normal subjects. The reinforcing manipulation had better effect.

What is happening in the tissue around the tip of acupuncture needle?

When acupuncture needles are inserted into skin, biochemical reaction is occurring at the acupuncture points selected. Some research showed that histamine and adenosine which are effective biomolecules of acupuncture were produced at the acupuncture points. During the needling manipulation process, the needle is being wrapped by connective tissue which activates certain biomolecule changes at the specific points. These changes are greater at acupoint than at non acupoint leading to greater therapeutic effect at acupuncture points. For example, experiment showed that the analgesic effect at ST36 acupuncture point is greater than at non acupuncture point. The density of Mast cells is higher at acupoint for instance ST36 than non acupoint. Degranulation of Mast cells at acupoint occurs after acupuncture which linked to analgesia effect and inflammatory response. This local effect activates immune system and spreads the local effect to entire body.

Current scientific research in animal and human demonstrates that acupuncture can cause many biological responses. These responses happen locally which is closed to the acupuncture points and remotely in the brain mediated by sensory neurons. For example, Acupuncture analgesia and anesthesia the mechanism of endorphin release is clarified. The acupuncture‘s analgesia effect is widely accepted. Research on acupuncture analgesia has shown a substantial basis for acupuncture and promoted the development of neurophysiology. Acupuncture stimulation may also activate the hypothalamus and the pituitary gland altering the secretion of the neurotransmitters and neurohormones which are important in endocrine system regulating hormone balance in the body.

Recent research suggested that local molecular and cellular changes occur at and around the location of the needled acupoint. For example, the activities of adenosine, which is a neuromodulator with antinociceptive properties, and the extracellular signal-regulated kinase (ERK) pathway, which is involved in the local mechanisms associated with acupuncture, are altered following treatment and might mediate the varied effects of acupuncture, including analgesia. Additionally, it has also been suggested that the morphological changes induced by acupuncture in connective tissue and fibroblasts are involved in this process.

The body fluids carries acupuncture effective biomolecules

Morden research showed that body fluids carries acupuncture effective biomolecules.Cerebraospinal fluids (CSF) is a clear colorless bodily fluid found in the brain and spine. After electroacupuncture endorphins were increased in the CSF. This is correlated with acupuncture analgesia effects. Different frequencies of stimulation can affect the release of different neuropeptides. For example, low frequency electroacupuncture increases the contents of beta-endorphin and met-enkephalin in the CSF, whereas high frequency accelerated the release of dynorphin. Serum includes all of the proteins not used in blood clotting and all the electrolytes, antibodies, antigens, hormones, and any exogenous substances (such as drugs and microorganisms). Serum was also recognized as carrier of acupuncture effective biomolecules. For example acupuncture stimulation may produce many types of components of antiasthma in the serum.

A new research from China studied mechanism of acupuncture from biochemical aspect. High-throughput metabolomics which is the new techinique used for assessing endogenous metabolite within a biological system was applied in this study. In this study, one of the most commonly used acupuncture point ST36 (zusanli). ST-36 is a point of stomach meridian and often used to treat many conditions such as gastrointestinal disorders including stomach ache, abdominal pain and distension, constipation, diarrhea, vomiting, dysentery, indigestion etc. Acupuncture use performed bilateral ST36 for 30 min, once a day for 14 days. Urine samples before acupuncture treatment and 14 days after acupuncture were analysed and compared. 53 specific metabolites relevant to ST36 were identified. These metabolites were significantly changed (3 decreased and 20 increased) after 14 days acupuncture treatment. Also five unique metabolic pathways were altered by acupuncture treatment. From this study, it can be seen that the mechanism of acupuncture in treating disorders could be involved in altering biochemical pathways.

Acupuncture stimulates brain network

There was a study about acupuncture stimulating brain functional network. This study was based on sample entropy of electroencephalograph (EEG) under magnetic stimulation at PC6 acupoint which is on your forearm and near your wrist. Magnetic stimulation at acupuncture point is a new method for studying the theory of acupuncture. It helps to investigate brain network and understand how brain works. This study was trying to provide evidence for the mechanism of acupuncture which is a part of traditional Chinese medicine. The magnetic stimulation of PC6 acupoint was performed and EEG signals were recorded. By analysing the results they found the brain network topology was changed after acupuncture at PC6 acupoint, the connection of the network is increased, the efficiency of information transmission is improved and the small-world proper is strengthened through stimulation the PC6 acupoint.

Acupuncture at different acupoints may alter brain activities in different area.

Recent acupuncture research study the effect of acupuncture on brain activity using functional magnetic resonance imaging (MRI). Wang W et al used electro-acupuncture to stimulate the cerebral activated areas. They compared the altered activation areas of the acupuncture point LI4 on the right hand with some non acupuncture points on the face. There were 6 people in the LI4 group and 5 in the facial nonacupoint group. MRI ws performed before and after acupuncture. They found that activation or deactivation was found the multiple cerebral areas in both groups. In the LI4 group, activation was found in the areas including medline nuclear group thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; deactivation areas include bilateral hippocampus, parahippocampal gyrus, amygdale body area, rostral side/audal side of ingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, the activation and deactivation areas were different from LI4. They concluded that the deactivation area by LI4 was a similar area distribution of pain area in the brain and closely related to the anatomic structure of limbic system which is possibly related to pain relief. Activation of left anterior gyrus by LI4 represents the movement of facial muscles and activation of cerebellum is possibly related to effect of LI4 in treating facial palsy and facial muscle spasm.

Fang JL et al compared the effects of electroacupuncture at acupoints ST36 and CV4 using MRI in 21 healthy volunteers. The similar deactivation effects in the anterior cingulated and medial prefrontal cortices were induced by acupuncture at ST36 or CV4 acupoint. The functional brain network was significantly changed after acupuncture. The instant postacupuncture effects were mainly found in the ventral medial prefrontal cortex and ventral anterior cingulated cortex in the limbic-paralimbic-neocortical network and the effects were stronger at ST36 than that CV4.

References
Kim S et al Evid Based Complement Alternat Med (2016) 9874207. doi: 10.1155/2016/9874207. Epub 2016 Jun 14.
Li XM et al Zhen Ci Yan Jiu (2013) 38:297-300
Wang W et al Chin J Integr Med (2007) 13:10-6
Fang JL et al Zhen Ci Yan Jiu (2012) 37:46-52
Yan G et al Evid Based Complement Alternat Med 2013: 2013:429703
Guo L et al Biomed Mater Eng. 2013 23(0):S1115-S1121
Hsiu H et al Microvasc Res (2013) Jun 24
An Y et al Med Devices (Aucl) (2014) 7:17-21

Friday, 15 July 2016

Acne has great impact on quality of life, stress makes acne worse, acupuncture can help

Acne has great impact on quality of life

Acne is a very common disease in adolescents. Acne has great impact on quality of life. A study involved in 600 high school students investigated this aspect. There were 303 girls and 260 boys aged between 13 and 19. 83% of them was self reported acne. 40% was mild, 36% was moderate and 6.5% severe. This was correlated with dermatologist’s assessment. Acne was more prevalent and severe in boys than girls. There was a direct link between subjective, severety of acne and symptoms of anxiety, depression and lower self-esteem.

Stress makes acne worse

Psychological stress has also been identified amongst factors that worsen acne. Recently a study involved in 160 students was carried out to investigate the association between acne severity and stress levels as well as the mechanism for this. They demonstrated a statistically significant positive correlation between increased self-reported stress and increased severity of acne; there was no correlation between increased stress and sebum levels. They explained that increased acne severity may result not from increased sebum secretion and excretion but from changes in neuropeptide secretion and sebum lipid composition. Other studies have shown that stress may affect the production of inflammatory mediators and specific lipids involved in inflammation by the sebaceous glands rather than the quantity of sebum. Acupuncture reduces inflammation and is used to treat acne effectively. Have you tried acupuncture?

Acupuncture is effective and efficient to treat acne

Acne is a common chronic inflammatory disorder in hair follicles. Treatments can take months to have some effects. Acupuncture is used to treat acne efficiently. There was a study using acupuncture to treat acne. In this study the criteria of participant selection is that they (older than 13 year old) had more than 10 papules and less than 10 nodules on the face and had acne for more than 3 months (chronic stage). They did not use retinoids, antibodies or herbal medicine for acne before. They did not have chemical peeling, intense pulsed light or laser treatment within the past month. After 6 week treatments, there was a significant reduction in the inflammatory acne lesion counts.

They suggested that acupuncture treatment of moderate acne vulgaris was associated with reduction of inflammatory lesions and improvement of the quality of life. The significant effects can be obtained in 6 weeks.

Acupuncture has better effect for treating acne than oxycycline

A study has compared the efficacy differences between acupuncture and oxycycline tablets for the treatment of moderate to severe acne vulgaris. Sixty cases of moderate to severe acne vulgaris were involved in this study and they were divided into acupuncture group and medication group with oxycycline treatment). The treatment duration was 20 days. The fading time of skin damage, including papule, pustule, nodule and cyst in the two groups was recorded and clinical efficacy was compared. After the treatment, two-month follow-up was performed to observe the recurrence rate in the two groups. The results have shown that the curative rate was 69.0% (20/29) in the acupuncture group, which was significantly higher than 40.0% (12/30) in the medication group. The fading time of each type of skin damage in the acupuncture group was shorter than that in the medication group. Recurrence rate was similar between two groups.

Vitamin D deficiency is related to acne

Vitamin D is suggested to play a role in acne development in vitro study. Recently Vitamin D level is compared between acne patients and healthy control. It was found that the prevalence of vitamin D deficiency was significantly higher in patients with acne compared to healthy controls. There was a negative link between level of vitamin D deficiency and severity of acne. There was also a possible link between the extent of vitamin D deficiency and the degree of acne inflammation.

First, people might think that acne is caused by a poor diet. This is not true and no food was found to cause acne.

Second, there is an opinion that acne is caused by dirty skin and poor hygiene and it can be washed away. Acne occurs underneath the skin, not on the surface of the skin, so the dirty skin does not cause acne and acne cannot be washed away.

Third, squeezing the spots can get rid of acne. Spots cannot be get rid of by squeezing, on the contrary it can make spots worse causing infection and scarring.

Fourth, sun exposure can help with the symptoms of acne. There is no research evidence showing that sun exposure improves acne.

Fifth acne is infectious. This is not true. Acne cannot pass from person to person. It is not infection disorder.

What foods promote acne?

Foods that are related to promote acne are three classes 1) hyperglycemic carbohydrates, 2) milk and dairy products, 3) saturated fats including trans-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs). Foods with a high glycemic index, such as sugar, white bread, and white rice, are rapidly absorbed, leading to higher serum glucose levels and corresponding elevated levels of insulin. Insulin and IGF-1 have been shown to increase sebum production, stimulate adrenal androgen synthesis, and increase androgen bioavailability, all of which play a role in the pathogenesis of acne. Here are some examples. A 10-week low glycemic load diet resulted in improvement of acne, with histopathological examination of skin samples revealing decreased inflammation and reduced size of sebaceous glands. A 12-week low glycemic load diet resulted in improvement of acne, with a corresponding improvement in insulin sensitivity, a reduction in testosterone bioavailability, and a decrease in adrenal androgens.

Researchers have demonstrated an association between dairy consumption and acne. Some studies have noted a stronger connection with skim milk versus other types of dairy. One suggested mechanism relates to hormones. As milk is meant to increase the growth of calves, it naturally contains growth hormones and anabolic steroids. Another suggested mechanism relates to the carbohydrate content of dairy products, with related effects on serum insulin and insulin-like growth factor-1 (IGF-1). Finally, many dairy cows in the United States are treated with bovine growth hormone to increase their milk supply, and milk from these cows has been shown to contain higher levels of IGF-1.

Study has shown that increased intake of saturated fat aggravates acne whereas a higher intake of fish, a nutrient source enriched in ω3-fatty acids, exhibited an acne-protective effect.

Eating chocolate may make acne worse

Chocolate has become one of the most popular food types and flavors in the world. What happens, if you have acne? Does chocolate make the acne worse or better? A study has assessed the effect of chocolate on acne in males between the ages of 18 and 35 with a history of acne. This is a double-blind, placebo-controlled, randomized, controlled trial. They found that there was significant increase in the mean number of total acneiform lesions including comedones, papules, pustules, nodules. There was a link between the amount of chocolate each subject consumed and the number of lesions each subject developed. They suggested that the consumption of chocolate worsens acne.

Inflammation occurs during acne lesion formation

Acne affects about 80% of adolescents and it often continues to adulthood. Acne is most common on the face particularly on the cheek, forehead and chin. Apart from hormones imbalanced, inflammation plays a key role in acne lesion formation. Acne lesions develop in the oil gland follicles. Increased oil production and accumulation combined abnormal inner lining cells growth cause the formation of pimples. Bacteria colonize in the follicles and trigger immune response causing inflammation which contributes to the acne lesion formation. Inflammation occurs in the early stage of lesion development and is present throughout the whole process of development of acne lesions until the later stage.

Due to the critical role of inflammation during the acne lesion formation and its connection with bacteria in the follicles, anti inflammatory agents are applied to effectively treat acne and antimicrobials are also used to kill the bacteria to treat acne.

Acne patients used antibiotics too long

Acne is not a life threatening condition, however it affects patients quality of life so much. The spots take their happiness away. Women cannot go out without covering the spots up first. They often use over-the-counter creams, prescription gels, and finally: oral antibiotics. Antibiotics was used too long and increased the antibiotic resistance makes antibiotics loss their effects. A research study at a dermatology practice in an academic medical center has shown that the average duration of antibiotic use was 331.3 days. In all, 21 patients (15.3%) were prescribed antibiotics for 3 months or less, 88 patients (64.2%) for 6 months or more, and 46 patients (33.6%) for 1 year or longer. Patients treated only at the study site had a mean duration of antibiotic treatment of 283.1 days whereas patients who also received antibiotics from another institution had a mean duration of 380.2 days.

References
Gil Yosipovitch et al Acta Derm Venereol 2007; 87: 135–139.
Jiang M et al Zhongguo Zhen Jiu (2014) 34:663-6
Bodo C Melnik, Clinical, Cosmetic and Investigational Dermatology 2015:8 371–388
Caperton et al J Clin Aesthet Dermatol (2014) 7:19-23
Naqler AR et al J Am Acad Dermatol (2015) Oct 29. pii: S0190-9622(15)02254-9. doi: 10.1016/j.jaad.2015.09.046
Son et al Acupunct Med (2010) 28:126-9

Tuesday, 12 July 2016

Acupuncture points and low back pain

Acupuncture points used in the treatment re very important. Recently a study compared two different acupuncture methods with different acupuncture points to treat sacroiliac joint injury which presents low back pain. In one group, 9 Ashi points were used and in another group as a control Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc were used. Treatment durations and frequencies are the same. Two course with each course containing 10 treatments were given. After the two course of treatments, the pain scale and function recovery were found in the both groups, but the group with Ashi points had better effects. From this example, we can see acupuncture points selected are very important to achieve the best treatment results.

Piriformis syndrome is an uncommon neuromuscular disorder. In this condition the sciatic nerve is compressed by piriformis muscle which is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement and it is used in almost every motion of the hips and legs. Through the piriformis muscle sciatic nerve passes and goes down the back of the thigh and leg. The spasm of the piriformis muscle can compress the nerve to cause some symptoms which include pain, tingling, or numbness in the buttocks. The pain can be sever and spread down to the leg and foot. The pain can be triggered by sitting for long periods of time, climbing stairs and running.

Management of piriformis syndrome include avoiding positions that trigger pain. Rest, ice and heat may help reduce symptoms. Exercises and stretches may help reduce sciatic nerve compression reducing symptoms. Pain killers, muscle relaxants or local injection with corticosteroid or anesthetic may help with reduction of pain.

Acupuncture can be helpful. There were case reports showing effectiveness of acupuncture for priformis syndrome. For example, Liu JM et al observed 80 patients with piriformis syndrome. They found that after a course of acupuncture treatments, the pain threshold values were improved significantly. Another study by Chen RN and Chen YB has shown similar results that acupuncture reduced pain instantly in patients with piriformis syndrome. Shu also reported a case study. In this study there were 39 males and 36 females, at the age of 22-85; they suffered piriformis syndrome for from 3 days to 10 years. After acupuncture treatments, symptoms and signs of pain in the hip and thigh disappeared and the patient can move freely in 55 patients. Symptoms were obviously reduced, and signs were partially improved with basically normal walking and movement, but there was still pressure pain on piriformis in 24 patients. There was no effect in 2 patients. Here was a typical case in this study: A 71 year old lady had pain on her back for 10 months and the pain spread to her hip and thigh. The pain severity changed from mild to severe. There was tender point on the piriformis muscle. After 3 sessions of acupuncture treatments, the pain was reduced significnalty. Followed another 5 sessions of acupuncture, the pain was completely disappeared.

References
Kuang J et al Zhongguo Zhen Jiu (2016) 36:359-63
Liu JM et al Zhongguo Zhen Jiu (2013) 33:422-5
Chen RN and Chen YB Zhongguo Zhen Jiu (2009) 29:550-2
Shu H J Tradit Chin Med (2003) 23:38-9

Sunday, 10 July 2016

Acupuncture points used for trigeminal neuralgia

The acupuncture that you get could be very different, if you see different acupuncturists. For example, a study analysed acupuncture points used for trigeminal neuralgia. In this study 180 papers were included and in these papers 148 acupuncture points were used and were distributed in 14 meridians. The most frequent used points are Hegu (LI 4), Xiaguan (ST 7), Fengchi (GB 20) and trigger points. Other points included crossing points, yuan-primary points and five-shu points. They were widely used, accounting for 65. 9%. As for the branch of trigeminal nerve, the top-3 selected acupoints were Yangbai (GB 14), Yuyao (EX-HN 4), Cuanzhu (BL 2) in the first branch, Sibai (ST 2), Quanlian (SI 18), Yingxiang (LI 20) in the second branch, Jiache (ST 6), Xiaguan (ST 7), Dicang (ST 4) in the third branch. It can be seen that right points need to be chosen to get best effects.

References
Tao S et al Zhongguo Zhen Jiu (2016) 36:207-11

Wednesday, 6 July 2016

Acupuncture accelerates the time for conceiving

There is new evidence that acupuncture improves women’s fertility. This new study asked whether providing a multiphasic fertility acupuncture protocol to women with infertility would increase their awareness of fertility and achieve normalisation of their menstrual cycle compared with a lifestyle control. women with infertility were offered an intervention of acupuncture and lifestyle modification or lifestyle modification only. There was a statistically significant increase in fertility awareness in the acupuncture group (86.4%, 19) compared to 40% (n = 8) of the lifestyle only participants. There was no statistical difference in the pregnancy rate with seven women achieving pregnancy during the course of the study intervention however those receiving the acupuncture conceived within an average of 5.5 weeks compared to 10.67 weeks for the lifestyle only group. In acupuncture group women’s fertility awareness and wellbeing increased, and those who conceived did so in half the time.

References
Cochrane S et al Evid Based Complement Alternat Med 2016;2016:3587569. doi: 10.1155/2016/3587569. Epub 2016 May 3.

Thursday, 19 May 2016

Acupuncture is effective for lateral elbow pain

Lateral elbow pain is a common painful condition. Acupuncture is used to treat the pain. Recently a study evaluated the effect of acupuncture for lateral elbow pain. Pateints were evaluated at baseline, before fourth, seventh, and ninth treatment, and at a two-week follow-up after treatment. The treatment group received unilateral acupuncture at LI 10 and LI 11 at the affected side with manual needle manipulation. Control group received sham acupuncture. disabilities of the arm, shoulder, and hand were improved which was seen from fourth week treatment onwards; pain-free grip strength, and a visual analogue scale (VAS) for pain which were used to assess the effect of the treatment was improved at 9th treatment.

References
Liu et al Evid Based Complement Alternat Med 2016;2016:8182071. doi: 10.1155/2016/8182071. Epub 2016 Feb 24.

Tuesday, 17 May 2016

Study has shown that acupuncture improves diminished ovarian reserve

Diminished ovarian reserve is a sign of ovarian ageing. Women with low ovarian reserve have less chance of achieving pregnancy. Acupuncture was suggested modulates female hormone levels, improves menstrual disorders, alleviates depression and improves pregnancy rates. Recently there was a study about acupuncture on diminished ovarian reserve. In this study, twenty-one patients with diminished ovarian reserve were received 12 weeks acupuncture treatment. Mean FSH levels fell from 19.33±9.47 mIU/mL at baseline to 10.58±6.34 mIU/mL at week 12 and 11.25±6.68 mIU/mL at week 24. Change in mean FSH from baseline was -8.75±11.13 mIU/mL at week 12 (p=0.002) and -8.08±9.56 mIU/mL at week 24 (p=0.001). Mean E2 and LH levels, FSH/LH ratios and irritability scores were improved at weeks 12 and/or 24. Approximately 30% patients reported subjective increases in menstrual volume after treatment.

References
Wang Y et al Acupunct Med (2016) May 13. pii: acupmed-2015-011014. doi: 10.1136/acupmed-2015-011014.

Thursday, 5 May 2016

Acupuncture in research

Acupuncture is originated from China thousands years ago. Can the effect of acupuncture be proved by science? Is it recognised by modern science? What is the status of acupuncture in research? More AO analysed the scientific publications from 2000 to 2014. What is the result?

In the past 15 years 15275 documents were published worldwide including acupuncture-related documents (ARDs) and the title filter for acupuncture-specific documents (ASDs).

Which countries have more publications related to acupuncture? The United States is the most productive country, with 2503 ARD publications; China is the second place with 2143 and South Korea with 925 is in the third. Norway is in the first position for the ARD citation rank, with 25.77 citations per document; Switzerland is in the first position for the ASD citation rank, with 26.66. Brazil has 4.19 citations per document, which corresponds to the 20th position in the ASD citation rankings.

The leading journals are Evidence-Based Complementary Medicine, Acupuncture in Medicine, and The Journal of Alternative and Complementary Medicine. Global numbers of ARDs and ASDs and citations have constantly increased from 2000 to 2014.


References
More AO et al J Altern Complement Med (2016) May 2[Epub ahead of print]

Thursday, 28 January 2016

Acupuncture for chronic pain relief

Acupuncture for chronic pain relief

Pain that lasts longer than six months is chronic pain. Chronic pain can be mild or severe, episodic or continuous. Pain signals constantly stimulate nervous system for months or years. This can make great impact on a person’s physically and emotionally. The most common chronic pain is from headaches, joint pain, back pain, shoulder pain, pelvic pain, neck pain and pain from any injuries. The symptoms of chronic pain mainly are pain from mild to severe that does not go away. It can be shooting, burning, aching or electrical; or feeling discomfort, soreness, tightness or stiffness.
Chronic pain is closely related to emotions. Anxiety, stress, depression, anger and fatigue make the pain worse. These negative feelings may increase the level of substances that amplify sensations of pain, causing a vicious cycle of pain. The pain can suppress the immune system causing other symptoms.
Apart from the pain, there could be other symptoms including fatigue, sleeplessness, frequently having cold, changes in mood such as depression irritated anxiety and stress. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and energy.
Pain is a very personal and subjective experience. There is no test that can measure and locate pain with precision. Finding tender points can help locate the source of the pain.
Acupuncture is an effective treatment method for chronic pain. Acupuncture is a treatment derived from ancient Chinese medicine, it becomes popular worldwide. In the UK it is used in many NHS general practices, as well as the majority of pain clinics and hospices. The application of acupuncture in Western medicine is based on proper medical diagnosis and scientific evidence. The theory is that acupuncture can stimulate nerves under the skin and in muscle tissue. This results in the body producing pain-relieving substances, such as endorphins. It is likely these substances are responsible for any beneficial effects seen with acupuncture.
Acupuncture is recommended by the National Institute for Health and Care Excellence (NICE) as a treatment option for chronic lower back pain, chronic tension-type headaches and migraines. This recommendation by NICE is on the basis of scientific evidence. Acupuncture treatment for neck pain is also recognised as effective one.

References
http://www.nhs.uk/conditions/Acupuncture/Pages/Introduction.aspx

Tuesday, 26 January 2016

Knee pain, acupuncture can help

Thanks to the knee joint, one can move around freely and go wherever we want without any difficulties. Knee is the largest joint in the body which can bend and straighten bringing one about. It bears most of the body weight and pressure loads. It supports 1.5 times the body weight when one walks and 3-4 times the body weight when one climbs stairs. Knee is vulnerable which can be injured and can suffer from some diseases causing pain, swelling, stiffness, locking etc. The symptoms may vary depending on the type of injury. Pain may occur when you bend or straighten the knee. There could be swelling; difficulty bearing weight on the knee and trouble with knee motion. Some of the most common reasons for knee pain are sprained ligaments, meniscus (cartilage) tears, tendonitis. Other conditions that cause knee pain include as follows:

Bursitis: A bursa is connective tissue below the skin over the knee. Overuse, a fall, or repeated bending and kneeling can irritate the bursa overlying the knee cap (patella), causing pain and swelling.

Illiotibial band syndrome: The iliotibial band is a piece of tough tissue that runs from your hip down to the outer part of your knee. If it's irritated by overuse or other problems, it can become inflamed and cause pain on the outer side of the knee.

Overuse during repetitive motions as are found during certain exercises (jogging, skiing) or work conditions (long periods of kneeling) can cause breakdown of cartilage and lead to pain.

Others Include osteoarthritis, dislocated kneecap, patellofemoral pain syndrome and patellar tendonitis, a condition caused by inflammation of the tendons around the knee etc.

Acupuncture can help release the pain by reducing the inflammation and improving circulation. Get right exercises level, that you feel no pain in your knee when you bend or straighten it; you feel no pain in your knee when you bend or straighten it; you feel no pain in your knee when you walk, jog, sprint, or jump; your knee feels as strong as your uninjured knee. If you start using your knee before it's healed, you could cause further injury.

Tuesday, 19 January 2016

Iliotibial band syndrome, acupuncture can help

The iliotibial band (IT band) is a thick band of fibers on the outside part of the thigh. It starts from the border of the most prominent bone of the pelvis and ends into the tibia bone, to which the gluteal muscles and tensor fscia latae muscle attached. IT band coordinates muscle function and stabilize the knee during running. This band is one of the most common overused among the runners causing Iliotibial Band Syndrome (ITBS). ITBS is caused by inflamed of IT band. When it happens, knee pain is the most common symptom and can be mild to severe. Pain is most severe with the heel strike of walking or running and may radiate from the knee up the leg to the hip. Pain may also be felt with knee flexing, especially going up or down steps. Swelling on the outside of the knee can be seen in some cases. Tightness of IT band is very common. MRI can show a partial thickening of the IT band, which results from inflammation. When the IT comes near the knee, it becomes narrow, and rubbing can occur between the band and the bone. This causes inflammation. ITBS is more common in women, possibly because some women's hips tilt in a way that causes their knees to turn in. Tenderness over the site of the iliotibial band insertion at the knee joint, and specific tender points may be found over the lateral femoral condyle.

Initial treatment for most overuse injuries remains the same: rest, ice, elevation and antiinflammatory medications. If the pain prolonged, it can become chronic. Physical therapy is often used to treat ITBS. Acupuncture is effective to treat acute and chronic ITBS. It releases the pain and inflammation; reduces tightness of IT band; improves circulation and improves scarring.

Sunday, 10 January 2016

Fruits and vegetables with high pesticides cause lower sperm counts

We all know that fresh fruits and vegetables are good for your fertility. However one needs to be aware what types of fruits and vegetables that you eat. A new research found out that men who ate fruits and vegetables with higher levels of pesticide residues — such as strawberries, spinach, and peppers — had lower sperm counts and lower percentages of normal sperm than those who ate produce with lower residue levels, according to a new study by researchers at Harward TH Chan School of public health. Pesticides are known to have negative impacts on fertility. Numerous studies had shown that consuming conventionally grown fruits and vegetables resulted in measurable pesticide levels in urine. Other studies had uncovered associations between occupational and environmental exposure to pesticides and lower semen quality. The main exposure route to pesticides for most people is from consuming products with pesticides which are into the products and cannot be washed off. This is the first study to report the link between consumption of pesticide residues in fruits and vegetables and semen quality.

In this study 155 men were involved with 338 semen samples provided between 2007 and 2012.

The results showed that men who ate greater amounts of fruits and vegetables with higher levels of pesticide residue — more than 1.5 servings per day — had 49 percent lower sperm count and 32 percent lower percentage of normal sperm than men who ate the least (less than 0.5 serving per day). They also had a lower sperm counts, lower ejaculate volumes, and lower percentages of normal sperm.

The men who ate the most fruits and vegetables with low-to-moderate levels of pesticide residue had higher percentages of normal sperm than those who ate less fruits and vegetables with low-to-moderate levels.

The finding was that consuming more fruits and vegetables with low pesticide residues was beneficial.

References
http://news.harvard.edu/gazette/story/2015/03/pesticides-result-in-lower-sperm-counts/

Tuesday, 5 January 2016

Acupuncture is effective for headaches

Acupuncture is beneficial in treating tension headache

A tension headache is the most common type of primary headache accounting for about 90% of all headaches. The pain is bilateral and the head is like being squeezed. A tension headache can be episodic or chronic. Some antidepressants may be effective to reduce the pain.

More recently Granato et al analysed the current data about the effectiveness of acupuncture on tension-type headache. There were 11 trials involved in 2317 patients. Two trials compared acupuncture wit routine care only or treatment of acute headache only with a 3 month follow-up. Both studies measured responder rate, headache frequency, pain intensity and pain killer intake. They suggested that effect of acupuncture was better controls. There were five trials compared effect of acupuncture with that of sham acupuncture. Four trials had 6 month follow-up and one trial had 12 months follow-up. Numbers of headache days were significantly decreased in acupuncture group. Headache intensity and frequency of taking pain killers was significantly reduced in acupuncture group compared with sham acupuncture group. Three of the four trials compared the effect of acupuncture with physiotherapy, relaxation. Their conclusion is that there was short term benefit by adding acupuncture to routine care and acupuncture could be a nonpharmacological tool for treating patients with tension-type headache.

Schieapparelli P et al also support the effectiveness of acupuncture in treating primary headache particular tension-type headache and migraine. They suggested that acupuncture is an effective and valuable option for patients suffering from frequent tension-type headache and migraine; also acupuncture is cost-effective treatment.

Hao XA et al analysed five high quality trials. They found that the electro-acupuncture might bemore efficacious; needle retention with 30 minutes was better than no needle retention; twice a week treatment was better than once a week treatment. They suggested that acupuncture stimulation mode, needle retention and treatment frequency could be important factors contributing to the outcome of acupuncture for tension-type headache.

Four meridians involved in headache are Shaoyang (the channel on the temporal sides of the head); Taiyang (at the back of the head), Yangming (at the forehead) and Jueyin. Acupuncture points selected could also contribute to the outcome of acupuncture.

Acupuncture is effective in patients with migraine

Migraine is a very painful headache. It is recurrent and it affects sufferer’s quality of life. It occurs in more than 10% of the world's population, afflicting more women than men by a ratio 3:1, and inflicts significant personal and socioeconomic costs. It was ranked eighth worldwide by the World Health Organization among the leading causes of disability in 2010. The exact causes are unknown, but it has genetic factor and change in the brain.

Migraine is featured as moderate or severe pulsating pain only on one side of the head which is deliberated by physical activity. It is recurring headache with duration 4-72 hours. It could accompany other symptoms including nausea, vomiting and increased sensitivity to light or noise. The diagnosis is based on clinical history and exclusion of other kind of headache, because there is no specific test for migraine. The cause of migraine is not fully understood. The current accepted theory of migraine is that the brain chemical called serotonin level is changing; this leads to blood vessels in brain contracting and then dilating, as a result, it causes symptoms of migraine. Migraine attach could be triggered by many factors, such as stress, tension, depression, not sleep well, tiredness, poor posture, neck or shoulder tension, hunger, caffeine products (coffee, tea), bright light , loud noise etc. Apart from headache, there could be other symptoms present, such as nausea, vomiting, fatigue, dizziness, blurred vision etc. Pain killers and anti-inflammatory drugs are mainly used to treat migraine attacks. Beta-blockers (e.g., propranolol, originally developed to treat high blood pressure), anti-seizure drugs (e.g., topiramate), or tricyclic antidepressants (e.g., amitriptyline), in combination with behavioral therapy or lifestyle adjustments are used to prevent migraine attack. Mauskop A from New York Headache Center USA summarised therapies proven (to various degrees) to be effective for migraine. These include aerobic exercise; other forms of relaxation training; dognitive therapies; acupuncture; and supplementation with magnesium, CoQ10, riboflavin, butterbur, feverfew and cyanocobalamin with folate and pyridoxine.

Recent research showed that acupuncture has effect to treat migraine. For example, Wang et al studied the effect of acupuncture in patients with migraine. This was a randomized controlled trial involving in 150 patients with migraine. They found that acupuncture has significantly better effect in relieving pain and reducing acute migraine attack than sham acupuncture. They also conducted another trial in 140 patients in 5 hospitals in China. They compared the effect of acupuncture with that of flunarizine, a drug used for migraine treatment. They found that acupuncture is more efficient in decreasing days of migraine attacks than flunarizine; acupuncture has similar effect as flunarizine in reducing pain and improving patient’s quality of life.

There are a few types of acupuncture and many acupuncture points applied for the treatments. Which points are more commonly used and which type of acupuncture is more effective? Wang JJ et al studied the optimized schemes for acupuncture treatment of migraine attack. They studied five types of acupuncture: manual acupuncture, electroacupuncture, auricular acupuncture and bloodletting therapies for migraine patients. There were 76 patients with migraine participated the study. Three groups of acupuncture points include group 1: local points including Sizhukong (TE23), Shuaigu (GB8), Taiyang (EX-HN 5), group2: local points plus distal points including Hegu L4 and Taichong LR3, and group3: local points plus distal points plus symptom points including Ganshu (BL18), Yanglingquan (GB34), Qiuxu (GB40) and Taixi (KI3). Different acupuncture types were type 1 no acupuncture stimulation, type 2 manual acupuncture stimulation, type 3 manual plus electroacupuncture, type 4auricular acupuncture, type 5 otopoint manual acupuncture, type 6 otopoint electroacupuncdture, type 7bloodletting. Within 24 hours after the treatment, the headache relief effects from greater to smaller were body-acupoints combination> manual acupuncture or electroacupuncture> bloodletting >auricular acupuncture. The pain relief effects were most stable in the manual acupuncture group with local acupoints plus distal acupoints. Manual acupuncture stimulation of the local plus distal body acupoints combined otopoint-EA and bloodletting at Taiyang (EX-HN 5) plus Ashi points is potentially the best option for relieving migraine during attack.

Why acupuncture is effective to migraine?

Acupuncture is recognised as effective treatment for migraine. It is as effective as drug treatments. Why can acupuncture treat migraine? It became commonly knowledge that acupuncture stimulates body releasing endogenous pain relief substances such as beta-endorphin. Recent research has shown that acupuncture can change response of the blood vessels in the brain. In migraine patients, their artery blood flow in the brain is increased excessively during migraine attack. After acupuncture treatments, the artery blood flow in the brain became normal. The reduction of blood flow reflexes the intensity of the headache.

Here are examples of acupuncture for headache and migraine

There was a case report that acupuncture together with spinal manipulation was used to treat a patient with a chronic tension-type headache and episodic migraines. That was a 32 year old woman with headaches for 5 months. She also had a history of episodic migraine that started in her teens. She was diagnosed with mixed headaches: migraine and tension type. Her migraine had been controlled with medication. But she had severe gastrointestinal symptoms including vomiting, nausea and stomach cramping after a period of medication and she had to stop taking the medication. After stopping taking the medicines her headaches got worse and happened on a daily basis. To reduce the headache she started acupuncture treatment first. The points that were used for acupuncture were GB1, Tai Yang (M-HN-9), ST36, K3, K7, BL18 and BL19. After first acupuncture treatment, she had headache free for 2 hours and headache intensity was reduced; after the second treatment, her headache intensity was reduced about 90%. She received 5 treatments over 2 weeks: the first two treatments were acupuncture only and the following 3 treatments were acupuncture combined with chiropractic spinal manipulation treatments. After the 5 treatments, her headache had disappeared. Further four treatments were continued for 11 weeks. After 1 year follow-up, there was no recurrence of the headaches. This case report suggested that patient with headache could choose combined treatment methods in order to achieve best results.

Recent research has suggested that acupuncture is effective for tension-type headache

Acupuncture is used to treat tension-type headache and many people who used this treatment have benefit from it. However its effectiveness is questioned by other people. Recently research from Germany has shown the updated data.

In this review, at least eight weeks of observation period is required and twelve trials are included. There were 2349 participants. In two large high quality trials with 1265 and 207 participants, acupuncture was compared with routine care or treatment of acute headaches. Results have shown that the proportion of participants experiencing at least 50% reduction of headache frequency was much higher in groups receiving acupuncture than in control groups. In seven good quality trials acupuncture group had high reduction of headache frequency compared with sham acupuncture. Withdrawals were low: 1 of 420 participants receiving acupuncture dropped out due to adverse effects.

The conclusion from the data suggested that acupuncture is effective for treating frequent episodic or chronic tension-type headaches, but further trials - particularly comparing acupuncture with other treatment options - are needed.

Acupuncture is for migraine

Acupuncture is used for migraine prevention. The effectiveness has been reviewed recently. Twenty-two trials including 4985 participants were analysed. Migraine frequency (migraine days, attacks or headache days if migraine days not measured/reported) was measured before and after treatment and at follow-up. The response (at least 50% frequency reduction) was also measured. Comparison with no acupuncture, acupuncture was associated with a moderate reduction of headache frequency over no acupuncture after treatment. After treatment headache frequency at least halved was found in 41% of participants receiving acupuncture comparing to 17% with no acupuncture. There is one trial with post-treatment follow-up found a small but significant benefit 12 months after treatment. Comparison with prophylactic drug treatment, acupuncture reduced migraine frequency significantly more than drug prophylaxis after treatment. Trial participants receiving acupuncture were less likely to drop out due to adverse effects than participants receiving prophylactic drugs. The conclusion from this study is that the available evidence suggests that adding acupuncture to symptomatic treatment of attacks reduces the frequency of headaches. The available trials also suggest that acupuncture may be at least similarly effective as treatment with prophylactic drugs. Acupuncture can be considered a treatment option for patients willing to undergo this treatment.

Acupuncture is effective for the treatment or prevention of migraine, tension-type headache

Recently a study summarizes the current evidence that evaluates the effectiveness of acupuncture for the treatment or prevention of migraine, tension-type headache, and chronic headache disorders. It demonstrate that acupuncture is associated with improved clinical outcomes compared to routine care only, medical management, and sham acupuncture 2 months after randomization. Cost effectiveness analyses conducted in the United Kingdom and Germany suggested that acupuncture is a cost-effective treatment option in those countries.

References
Granato A et al Neuroepidemiology (2010) 35:160-2
Schiapparelli P et al Neurol Sci (2011) 32 Suppl 1:S15-8
Hao XA et al J Alterm Complement Med (2012)
Wang LP et al (2012) Pain Med 13:623-630
Wang LP et al (2011) Pain 152:1864-71
Mauskop A Continuum (Minneap Minn) (2012) 18: 796-806
Wang JJ, et al Zhen Ci Yan Jiu (2013) 38:234-40.
Lo MY et al J Tradit Complement Med (2013) 3:213-220
Ohlsen BA J Chiropr Med (2012) 11:192-201
Linde K et al Cochrane Database Syst Rev 2016 Apr 19;4:CD007587. [Epub ahead of print]
Linde K et al Cochrane Database Syst Rev (2016) Jun 28;6:CD001218. doi: 10.1002/14651858.CD001218.pub3
Coeytaux RR & Befus D (2016) 56:1238-40