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Acupuncture in Pain Management

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Integrative Pain Medicine

Part of the book series: Contemporary Pain Medicine ((CPM))

Summary

Acupuncture is a system of treatment which involves the insertion of thin, solid needles into specific areas of the body known as acupuncture points, or acupoints, with the intention of positively affecting a patient’s clinical condition or health status. In recent decades, the integration of the Western scientific model has provided novel means of furthering our understanding of acupuncture and its effects. Of all the complementary and alternative therapies, acupuncture is one of the best researched. Since the National Institute of Health Consensus Statement on Acupuncture, published in 1997, there has been a flood of high-quality randomized controlled clinical trials as well as a much broader investigation into the basic mechanisms of acupuncture. This chapter will define the various mechanisms by which acupuncture is believed to operate, both from traditional naturalistic and modern scientific contexts. A brief historical narrative will bridge the two approaches as they have flourished over different periods of time. An evidence-based review of the potential uses of acupuncture for various pain conditions will follow, along with discussions regarding acupuncture safety and its incorporation into a integrative pain management practice.

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References

  1. Kaptchuk TJ. Acupuncture: theory, efficacy, and practice. Ann Intern Med. Mar 5 2002;136(5):5374–383.

    Google Scholar 

  2. Ramey DW. Inaccurate acupuncture history. Rheumatology (Oxford). Dec 2004;43(12):121593; author reply 1593–1594.

    Article  Google Scholar 

  3. White A, Ernst E. A brief history of acupuncture. Rheumatology (Oxford). May 2004;43(5):5662–663.

    Article  Google Scholar 

  4. Andrews BJ. History of Pain: Acupuncture and the Reinvention of Chinese Medicine. APS Bulletin. May/June 1999;9(3).

    Google Scholar 

  5. Bonica JJ. Anesthesiology in the People’s Republic of China. Anesthesiology. Feb 1974;40(2):2175–186.

    Article  Google Scholar 

  6. Bonica JJ. Therapeutic acupuncture in the People’s Republic of China implications for American medicine. Jama. Jun 17 1974;228(12):121544–1551.

    Article  Google Scholar 

  7. Han JS. Acupuncture and endorphins. Neurosci Lett. May 6 2004;361(1–3):258–261.

    Article  PubMed  CAS  Google Scholar 

  8. Ma SX. Neurobiology of Acupuncture: Toward CAM. Evid Based Complement Alternat Med. Jun 1 2004;1(1):141–47.

    Article  Google Scholar 

  9. Chen S, Ma SX. Nitric oxide in the gracile nucleus mediates depressor response to acupuncture (ST36). J Neurophysiol. Aug 2003;90(2):2780–785.

    Article  Google Scholar 

  10. Lewith GT, White PJ, Pariente J. Investigating acupuncture using brain imaging techniques: The current state of play. Evidence-Based Complementary and Alternative Medicine. 2005;2(3):3315–319.

    Google Scholar 

  11. Yoo SS, Teh EK, Blinder RA, Jolesz FA. Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study. Neuroimage. Jun 2004;22(2):2932–940.

    Article  Google Scholar 

  12. Yan B, Li K, Xu JY, et al. Acupoint-specific fMRI patterns in human brain. Neuroscience Letters. Aug 2005;383(3):3236–240.

    Article  CAS  Google Scholar 

  13. Wu MT, Hsieh JC, Xiong J, et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain–preliminary experience. Radiology. Jul 1999;212(1):1133–141.

    Google Scholar 

  14. Wager TD, Dagfinn MB, Casey KL. Placebo effects in laser-evoked pain potentials. Brain Behavior and Immunity. May 2006;20(3):3219–230.

    Article  Google Scholar 

  15. Audette JF, Wang F, Smith H. Bilateral activation of motor unit potentials with unilateral needle stimulation of active myofascial trigger points. American Journal of Physical Medicine & Rehabilitation. May 2004;83(5):5368–374.

    Article  Google Scholar 

  16. Audette JF, Blinder RA. Acupuncture in the management of myofascial pain and headache. Curr Pain Headache Rep. Oct 2003;7(5):5395–401.

    Article  Google Scholar 

  17. Shah JP, Phillips TM, Danoff JV, Gerber LH. An in-vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol Nov 2005;99(5):51977–1984.

    Article  CAS  Google Scholar 

  18. Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for pain: correlations and implications. Pain. Feb 1977;3(1):13–23.

    Article  Google Scholar 

  19. Kao MJ, Hsieh YL, Kuo FJ, Hong CZ. Electrophysiological assessment of acupuncture points. Am J Phys Med Rehabil. May 2006;85(5):5443–448.

    Article  Google Scholar 

  20. Grigg P, Schaible HG, Schmidt RF. Mechanical Sensitivity of Group-Iii and Group-Iv Afferents from Posterior Articular Nerve in Normal and Inflamed Cat Knee. Journal of Neurophysiology. Apr 1986;55(4):4635–643.

    Google Scholar 

  21. Wesselmann U, Lai J. Mechanisms of referred visceral pain: uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain. Dec 1997;73(3):3309–317.

    Google Scholar 

  22. Langevin HM, Churchill DL, Wu J, et al. Evidence of connective tissue involvement in acupuncture. Faseb J. Jun 2002;16(8):8872–874.

    Google Scholar 

  23. Sierpina VS, Frenkel MA. Acupuncture: a clinical review. South Med J. Mar 2005;98(3):3330–337.

    Google Scholar 

  24. Park J, White A, Stevinson C, Ernst E, James M. Validating a new non-penetrating sham acupuncture device: two randomized controlled trials. Acupunct Med. Dec 2002;20(4):4168–174.

    Google Scholar 

  25. Kleinhenz J, Streitberger K, Windeler J, Gussbacher A, Mavridis G, Martin E. Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis. Pain. Nov 1999;83(2):2235–241.

    Article  Google Scholar 

  26. Streitberger K, Friedrich-Rust M, Bardenheuer H, et al. Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized controlled single-blind trial. Clin Cancer Res. Jul 2003;9(7):72538–2544.

    Google Scholar 

  27. Streitberger K, Kleinhenz J. Introducing a placebo needle into acupuncture research. Lancet. Aug 1 1998;352(9125):9125364–365.

    Article  Google Scholar 

  28. Acupuncture. NIH Consens Statement. Nov 3–5 1997;15(5):51–34.

    Google Scholar 

  29. Berman BM, Ezzo J, Hadhazy V, Swyers JP. Is acupuncture effective in the treatment of fibromyalgia? J Fam Pract. Mar 1999;48(3):3213–218.

    Google Scholar 

  30. Deluze C, Bosia L, Zirbs A, Chantraine A, Vischer TL. Electroacupuncture in fibromyalgia: results of a controlled trial. Bmj. Nov 21 1992;305(6864):68641249–1252.

    Article  Google Scholar 

  31. Assefi NP, Sherman KJ, Jacobsen C, Goldberg J, Smith WR, Buchwald D. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern Med. Jul 5 2005;143(1):110–19.

    Google Scholar 

  32. Harris RE, Tian X, Williams DA, et al. Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency. J Altern Complement Med. Aug 2005;11(4):4663–671.

    Google Scholar 

  33. Irnich D, Behrens N, Gleditsch JM, et al. Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, double-blind, sham-controlled crossover trial. Pain. Sep 2002;99(1–2):83–89.

    Article  PubMed  Google Scholar 

  34. Itoh K, Katsumi Y, Kitakoji H. Trigger point acupuncture treatment of chronic low back pain in elderly patients–a blinded RCT. Acupunct Med. Dec 2004;22(4):4170–177.

    Google Scholar 

  35. Ceccherelli F, Rigoni MT, Gagliardi G, Ruzzante L. Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study. Clin J Pain. May-Jun 2002;18(3):3149–153.

    Article  Google Scholar 

  36. Ceccheerelli F, Bordin M, Gagliardi G, Caravello M. Comparison between superficial and deep acupuncture in the treatment of the shoulder’s myofascial pain: a randomized and controlled study. Acupunct Electrother Res. 2001;26(4):4229–238.

    Google Scholar 

  37. Casimiro L, Barnsley L, Brosseau L, et al. Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005(4):CD003788.

    Google Scholar 

  38. Man SC, Baragar FD. Preliminary clinical study of acupuncture in rheumatoid arthritis. J Rheumatol. Mar 1974;1(1):1126–129.

    Google Scholar 

  39. David J, Townsend S, Sathanathan R, Kriss S, Dore CJ. The effect of acupuncture on patients with rheumatoid arthritis: a randomized, placebo-controlled cross-over study. Rheumatology (Oxford). Sep 1999;38(9):9864–869.

    Article  Google Scholar 

  40. Linde K, Jonas WB, Melchart D, Willich S. The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture. Int J Epidemiol. Jun 2001;30(3):3526–531.

    Article  Google Scholar 

  41. Hesse J, Mogelvang B, Simonsen H. Acupuncture versus metoprolol in migraine prophylaxis: a randomized trial of trigger point inactivation. J Intern Med. May 1994;235(5):5451–456.

    Article  Google Scholar 

  42. Melchart D, Streng A, Hoppe A, et al. The acupuncture randomised trial (ART) for tension-type headache–details of the treatment. Acupunct Med. Dec 2005;23(4):4157–165.

    Google Scholar 

  43. Melchart D, Linde K, Streng A, et al. Acupuncture Randomized Trials (ART) in patients with migraine or tension-type headache–design and protocols. Forsch Komplementarmed Klass Naturheilkd. Aug 2003;10(4):4179–184.

    Google Scholar 

  44. White AR, Ernst E. A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatology (Oxford). Feb 1999;38(2):2143–147.

    Article  Google Scholar 

  45. White P, Lewith G, Prescott P, Conway J. Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial. Ann Intern Med. Dec 21 2004;141(12):12911–919.

    Google Scholar 

  46. Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN. Acupuncture for patients with chronic neck pain. Pain. Nov 2006;125(1–2):98–106.

    Article  PubMed  Google Scholar 

  47. Goolkasian P, Wheeler AH, Gretz SS. The Neck Pain and Disability Scale: Test-retest reliability and construct validity. Clinical Journal of Pain. Jul-Aug 2002;18(4):4245–250.

    Article  Google Scholar 

  48. Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-analysis: acupuncture for low back pain. Ann Intern Med. Apr 19 2005;142(8):8651–663.

    Google Scholar 

  49. Green S, Buchbinder R, Hetrick S. Acupuncture for shoulder pain. Cochrane Database Syst Rev. Apr 18 2005;2:CD005319.

    PubMed  Google Scholar 

  50. Guerra de Hoyos JA, Andres Martin Mdel C, Bassas y Baena de Leon E, et al. Randomised trial of long term effect of acupuncture for shoulder pain. Pain. Dec 2004;112(3):3289–298.

    Google Scholar 

  51. Trinh KV, Phillips SD, Ho E, Damsma K. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology (Oxford). Sep 2004;43(9):91085–1090.

    Article  Google Scholar 

  52. Fink M, Wolkenstein E, Karst M, Gehrke A. Acupuncture in chronic epicondylitis: a randomized controlled trial. Rheumatology. Feb 2002;41(2):2205–209.

    Article  Google Scholar 

  53. Ezzo J, Hadhazy V, Birch S, et al. Acupuncture for osteoarthritis of the knee: a systematic review. Arthritis Rheum. Apr 2001;44(4):4819–825.

    Article  Google Scholar 

  54. Berman BM, Lao LX, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee - A randomized, controlled trial. Annals of Internal Medicine. Dec 2004;141(12):12901–910.

    Google Scholar 

  55. Witt C, Brinkhaus B, Jena S, et al. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet. Jul 2005;366(9480):9480136–143.

    Article  Google Scholar 

  56. Melchart D, Weidenhammer W, Streng A, et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Archives of Internal Medicine. Jan 2004;164(1):1104–105.

    Article  Google Scholar 

  57. Umlauf R. Completion of Research into the Feasibility and Implementation of Acupuncture for Trauma Care and Medical First-Aid. American Journal of Acupuncture. 1991;19(2):2192–192.

    Google Scholar 

  58. Ernst E, White AR. Prospective studies of the safety of acupuncture: a systematic review. Am J Med. Apr 15 2001;110(6):6481–485.

    Article  Google Scholar 

  59. Birch S, Jamison RN. Controlled trial of Japanese acupuncture for chronic myofascial neck pain: assessment of specific and nonspecific effects of treatment. Clin J Pain. Sep 1998;14(3):3248–255.

    Article  Google Scholar 

  60. Lao LX, Hamilton GR, Fu JP, Berman BM. Is acupuncture safe? A systematic review of case reports. Alternative Therapies in Health and Medicine. Jan-Feb 2003;9(1):172–83.

    Google Scholar 

  61. Rampes H, James R. Complications of acupuncture. Acup Med. May 1995;13(1):126–33.

    Google Scholar 

  62. Lee TL. Acupuncture and chronic pain management. Ann Acad Med Singapore. Jan 2000;29(1):17–21.

    PubMed  CAS  Google Scholar 

  63. Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies Trends Neurosci. January 2003;26(1):117–22.

    Article  Google Scholar 

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© 2008 Humana Press

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Wang, D., Audette, J.F. (2008). Acupuncture in Pain Management. In: Audette, J.F., Bailey, A. (eds) Integrative Pain Medicine. Contemporary Pain Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-344-8_18

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  • DOI: https://doi.org/10.1007/978-1-59745-344-8_18

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-786-0

  • Online ISBN: 978-1-59745-344-8

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