Acupuncture Effective for Hypertension

From:
Acupuncture Today
August, 2007, Vol. 08, Issue 08

By Tina Beychok, Associate Editor

Significant short-term reductions in BP after six weeks of treatment.


Practitioners and other devotees of Oriental medicine are well-aware of acupuncture's many health benefits – the profession has literally thousands of years of clinical success stories. The challenge in today's evidence-based health care culture is the lack of solid, well-designed research to scientifically support these success stories, particularly for certain conditions.



A randomized, double-blind study, published online for the June 4, 2007 issue of Circulation, suggests regular acupuncture treatments can help with an all-too-common condition: high blood pressure. Researchers found that patients with hypertension achieved significant short-term reductions in systolic and diastolic blood pressure following the administration of acupuncture.



Researchers from the University of Erlangen in Germany and Nanjing University of Traditional Chinese Medicine in China randomized 160 hypertensive patients to six weeks of either active acupuncture or sham acupuncture (22 sessions for 30 minutes each), to determine if active acupuncture could reduce systolic and diastolic blood pressure. Blood pressure measurements were taken before treatment and after each session.



Needling points were chosen according to the Chinese type of hypertension and conformed to typical prescriptions for the disorder. Sham needling was done on locations not relevant for lowering blood pressure. In looking at the blood pressure readings for the subjects, the researchers found:



"There was a significant (P<0.001) difference in posttreatment blood pressures adjusted for baseline values between the active and sham acupuncture groups at the end of treatment. For the primary outcome, the difference between treatment groups amounted to 6.4 mm Hg (95% CI, 3.5 to 9.2) and 3.7 mm Hg (95% CI, 1.6 to 5.8) for 24-hour systolic and diastolic blood pressures, respectively. In the active acupuncture group, mean 24-hour ambulatory systolic and diastolic blood pressures decreased significantly after treatment by 5.4 mm Hg (95% CI, 3.2 to 7.6) and 3.0 mm Hg (95% CI, 1.5 to 4.6), respectively."



For example, before treatment, the mean 24-hour systolic/diastolic reading was 131/81 for the active group and 129/80 for the sham group. By the end of the six weeks of treatment, the active group mean systolic/diastolic was 125/78 and the sham group was 130/80. The active group daytime systolic/diastolic scores before and during treatment were 136/84 and 128/80, respectively. The daytime sham group scores were 133/82 and 134/82, respectively. The nighttime scores for the active group, before and during treatment were 120/73 and 117/72. The sham group's nighttime scores were 120/73 before treatment and 120/74 during treatment. Blood pressure changes during peak bicycle stress-testing were also measured, but the changes were not significant.



It's important to note that these results were short-term. When the researchers measured blood pressure again at both three- and six-month follow up, they found: "Mean systolic and diastolic blood pressures [had] returned to pretreatment levels in the active treatment group." This outcome suggests that reductions in blood pressure are based on receiving regular acupuncture treatment.



In conclusion, the researchers recommended: "As shown in the present study, acupuncture may offer an alternative antihypertensive therapeutic option. Acupuncture effectively lowered systolic and diastolic blood pressures during the treatment period with no or minimal side effects. Patients with mild or moderate hypertension who want to avoid drug therapy or are attracted to the spiritual foundations of acupuncture may therefore be candidates for such a therapy. This modality might also serve as an additional option together with drug therapy."

Qi Sensation: East and West

In China, the intent with acupuncture is to elicit a "qi sensation". The qi sensation is the heavy, achy, dull feeling patients may experience from the insertion of the acupuncture needle. The Chinese believe that this is a vital indicator as to the effectiveness of the treatment(s). Therefore Chinese practitioners often use large gauge needles and may do a lot of manipulation with those needles to get that sensation.Japanese acupuncture tends to favor the use of much smaller, finer needles and the qi sensations are much less obvious.

In the West, patients are often fearful of needles. Most patients do not want to "feel" anything. Any sensation at all is considered "pain". This is a cultural difference. Chinese patients usually do not consider the strong qi sensations from acupuncture to be "painful". They understand that as qi, because it is a part of their cultural tradition and they are familiar with it.

At American Acupuncture Center we have a wide range of needling styles. It really depends on the patient. Some people benefit from strong qi sensation and some do not. Some patients ONLY want strong and obvious qi sensation and don't feel the treatment is effective without it. Others simply can not relax with too much stimulation. After a few treatments, you will be able to recognize the sensation of "qi" as opposed to "pain".

To be honest, patients benefit from all styles; it's really a case-by-case basis.Also, the acupuncturist will know when the needle is at the correct depth and location by the "feel" of the needle in the fingers. This ability simply comes from treating a lot of people. You can not learn it from a book...

Does Acupuncture Hurt?

It shouldn't.

If the practioner inserts an acupuncture needle correctly, the patient will often feel a heavy, dull ache at the spot of insertion. This feeling may travel up or down one's leg/arm back or torso. Some patients describe it as a "weight" or a "mini toothache". It is not referred to as "pain", though.This heaviness is positive, and desirable. It is often referred to as a "qi sensation". This means that the needle has encountered a substantial amount of qi at that point. This is a very good therapeutic indication.

Not all points are the same and patients will not feel the exact same sensation on each point. Some points are characterized by potentially strong qi reactions and some are considered quite benign. The key, especially for new patients, is communication between patient and practitioner.

At American Acupuncture Center, I try to stay in contact with what the patient is experiencing during treatment. This makes the patient feel "safe", helps guide my technique and renders a better result and experience.

Mayo Clinic Study Confirms Acupuncture helps Fibromyalgia

A new study from the world-renowned mayo Clinic confirms what we at American Acupuncture Center have known for a while-- that acupuncture helps those suffering from fibromyalgia. Read the article from their website here.

Kristen Featured on San Diego Television Show

Kristen Burris was featured on "Inside San Diego", a San Diego news magazine show on Oct. 11. Kristen was interviewed by the host Sandra Moss regarding a recent study supporting the efficacy of acupuncture for the relief of menopausal hot flashes. One of our patients from American Acupuncture Center served as a model so acupuncture needling could be demonstrated to the television audience. Congratulations, Kristen! You are a wonderful ambassador for the medicine and our center. "Inside San Diego" airs weekdays at 10 a.m. on KUSI-TV Channel 51. Visit their website here.

Acupuncture Relieves Low Back Pain Over Long-Term, Study Says

Low back pain is probably the most common reason patients seek treatment at American Acupuncture Center. If it's not the primary reason it is often a nagging, secondary problem. The unfortunate truth is that most of us will suffer some degree of low back pain in our lives. The lumbar spine is very flexible and allows us a lot of movement. It sacrifices strength and stability in order to achieve flexibility which makes it prone to injury. Our intervertebral disks, the "cushions" between our spinal vertebrae, tend to deteriorate beginning in the 30's. This combination is a recipe for low back pain. Acupuncture can be very effective in treating this condition and, in fact, is often the only thing that works for many people. Read the latest scietific study regarding acupuncture and low back pain:

By Patricia Reaney
REUTERS
11:33 a.m. September 14, 2006

LONDON – Acupuncture can be effective in treating patients with low back pain and the benefits seem to improve with time, according to research published on Friday.
The ancient Chinese treatment, which involves inserting fine needles at specific meridians of the body, is a popular complementary therapy for a variety of ailments.

Hugh MacPherson and scientists at the University of York in England said the benefits of a short course of acupuncture were evident in their study of 241 back pain sufferers.

'If you offer acupuncture to someone with back pain on average it is expected you are likely to benefit, not just in the short term but particularly in the longer-term of 12 and especially 24 months,' he said in an interview.

'That's a remarkable finding in that normally you would expect the benefit of the treatment to wear off,' MacPherson added.

Low back pain is one of the most common medical complaints. It affects ten of millions of people and is a leading cause of sick days.

The researchers compared the impact of adding 10 acupuncture sessions over three months to the normal treatment for back pain, which includes medication, physiotherapy and exercises.
Patient satisfaction and pain levels were measured and recorded during the two-year study. After three months there was not too much difference between the acupuncture group and patients who had the standard therapy.

Weak evidence of improvement in the acupuncture group was found at 12 months, according to the study published in the British Medical Journal.
By 24 months the difference between the two groups increased.

'This is the first study to show this growing gap up to the two-year point. It is quite unique in that sense,' MacPherson added.


In a separate study in which they looked at the cost of acupuncture, the researchers found that the additional money spent on the acupuncture treatment appeared cost effective. The cost of treating each patient in the acupuncture group was 460 pounds ($863) during the study, compared to 345 pounds ($647) for patients who received just the standard care.

Kristen Featured on Pregnancy Podcast

Kristen is featured on a 50 minute pregnancy podcast on the website Pregtastic.com. Pregtastic.com is a website that features weekly podcasts addressing issues women face during pregnancy. A regular panel of 4 women bring in an expert in the field of women's health to discuss pregnancy issues. Well, this week it was Kristen who discussed how acupuncture and Chinese medicine can help with things like morning sickness and back pain.

For those of you not familiar with podcasts, it is an audio file you can listen to on your computer. It's like listening to the radio.

To hear Kristen's podcast, click here and click "Listen now". Enjoy!

Are There Different Styles of Acupuncture?

Yes, there are many different types and styles of acupuncture. There are different techniques of needling and different ways of viewing the body and how to heal it. Let's look at some of them.

Acupuncture originated in China a milennia or more ago. The "bible" of Chinese acupuncture is known as the Yellow Emperor's Classic of Internal Medicine, or Nei Jing. Named after the legendary Yellow Emperor Huang Ti, this book outlines the major principles of practice. Of course, China was a massive country in geographical size and population, so, like the martial arts, the practice of acupuncture varied slightly from province to province, village to village and family to family. It's well-known that many families developed their own style or version of kung-fu and tai chi and this was true for acupuncture as well. While the general, underlying intention was common, the methods often differed according to the preference of the family style. Taoism also had a profound effect on acupuncture and several esoteric methods such as the "8 Magic Turtle" style were influenced heavily by the Taoist belief system.

In the 1950s, Mao Tse-Tung helped to change the face of modern acupuncture. He realized he had a large, impoverished nation that severely lacked enough medical personnel, especially in rural areas. He decided to use one of China's great cultural treasures, acupuncture and herbology, as a means to spread healthcare to the people. In order to do this most efficiently, much of the theory from these family styles was codified into one system, so that a practitioner in Beijing would be on the same page as a rural doctor in Chengdu. In keeping with Communist ideology, much of the theory that was considered too spiritual, religious, archaic or superstitious was deleted. Mao wanted it based on a more Western model. This system is known as Traditional Chinese Medicine (TCM). This is by far the most common style practiced in the world today. What's ironic is that prior to Mao's dilemma in the 1950s, he was a staunch opponent of traditional medicine, even though he had been cured of Bell's Palsy with acupuncture during his campaign against Chang Kai-Shek.


Japan and Korea had been exposed to acupuncture by the 5th century. Japanese acupuncture is really just basic Chinese meridien acupuncture with much less emphasis on use of herbs. Japanese acupuncture is often characterized by very light needle technique, which many patients find appealing.

Five element acupuncture is based on the traditional Chinese philosophy that natural phenomena, including our own being, can be classified into Five Elements (Chinese: 五行; pinyin: wu xíng): wood, fire, earth, metal, and water (木, 火, 土, 金, 水). Five phases is actually the more appropriate way of translating wu xíng — literally, "five goings". Health concerns arise when these elements are not in balance, and needling points based on their elemental catagory can re-establish this balance. Herbal use in this school is also limited.

Ear acupuncture, or auricular acupuncture has roots in China but was actually developed in France in the 1950s by a man named Nogier. The concept is that the ear is a micro-system of the entire body, and that every part of the body, internally and externally, is represented by points on the ear.

Chinese acupuncture is often characterized by strong needling. This is because Chinese practitioners place such a heavy emphasis on achieving a qi sensation with each needle. Qi sensation is that heavy, dull, achy feeling that arises from a needle insertion. Japanese acupuncture relies less on qi sensation and more on choosing the appropriate points. This is a generalization, of course.

More modern techniques include target tissue needling, a technique popular in sports acupuncture. This involves stimulating the motor points of muscles in order to achieve a fasciculation that will re-set the muscle length. This is a very effective technique for soft-tissue pain relief, but requires good technique and anatomical training as some of thepoints require very deep insertion. Very similar is trigger point (TrP) needling, developed by Dr. Janet Travell, a pioneer in pain medicine. She uncovered how muscles developed trigger points, or painful nodules within the tissue. These nodules could be relieved by needling. Dr. Travell used a hypodermic needle, but the concept is the same.

Of course, most practitioners use an amalgam of these styles and techniques. At American Acupuncture Center, I practice mainly TCM/target tissue/TrP style, but use ear and Five Element as compliments. I can needle very heavy or very lightly, depending upon the patient. It's important to have a several tools in the toolbox. Remember; if all you have is a hammer, all your problems look like nails...