Acupuncture is as effective as the corticosteroid, prednisone, for the treatment of carpal tunnel syndrome (CTS), according to a new study.

The randomized, controlled study that was published in the May 2009 issue of the Clinical Journal of Pain, investigated the efficacy of acupuncture compared with steroid treatment in patients with mild-to-moderate carpal tunnel syndrome as measured by both nerve conduction studies and symptom assessment surveys.

Seventy-seven patients were randomly divided into 2 groups. One group received eight acupuncture treatments over four weeks, and the other group received oral doses of prednisone, daily, for four weeks. The results showed that acupuncture was just as effective as the corticosteroid for pain, numbness, tingling and weakness.  For the symptoms of night time awakening and motor function, the acupuncture group had better results.

The researchers concluded that acupuncture is a safe and effective treatment option for CTS for those who experience side effects to oral steroids or for those who do not opt for early surgery.

In our practice we use a variety of treatment techniques for carpal tunnel syndrome including cold laser technique, manual therapies and biopuncture injections, in addition to acupuncture treatment. This integrative medical approach can greatly enhance the results for many patients.

Source: The Clinical Journal of Pain. 25(4):327-333, May 2009.

For more information on Chinese medicine and carpal tunnel  treatment, please click on this link to receive my free ebook “How to Thrive in a Modern World.”  For an article on acupuncture treatment for carpal tunnel syndrome on acufinder.com please click here.

If you would like more information about Dr. Denny’s practices please visit http://www.drscottdenny.com or http://www.multicareclinic.org or http://www.dodaifusion.com. Please call 954-473-8925 for further information.

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Acupuncture Prostatitis Evidence Physical Therapies, Acupuncture Brings Good Treatment News as Alpha Blocker Disappoints at 2008 AUA Meeting

Although news from a major clinical trial was disappointing, the 2008 American Urological Association meeting also brought good news of helpful treatment for men with CP/CPPS from an unexpected quarter-physical and alternative therapies. Some of those were supported with well-designed, controlled, and even sham-controlled studies, a scientific gold standard that few thought could be applied to these therapies.

The disappointing news was from the clinical trial of the alpha blocker alfuzosin from the NIDDK-sponsored Chronic Prostatitis Collaborative Research Network (CPCRN). Good Science Supports Acupuncture for CP/CPPS Pain.

For more information on Chinese medicine and prostate treatment, please click on this link to receive my free ebook “How to Thrive in a Modern World.” 

If you would like more information about Dr. Denny’s practices please visit http://www.drscottdenny.com or http://www.multicareclinic.org. Please call 954-473-8925 for further information 

Here are the references and resources to review if you are a patient who is considering acupuncture treatment for prostate conditions:

www.prostatitis.org

Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. The American journal of medicine 2008 Jan
www.nextbio.com

Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Lee SH, Lee BC. Urology. 2009 May;73(5):1036-41. PMID: 19394499 [PubMed – in process]

Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Lee SW, Liong ML, Yuen KH, Leong WS, Chee C, Cheah PY, Choong WP, Wu Y, Khan N, Choong WL, Yap HW, Krieger JN. Am J Med. 2008 Jan;121(1):79.e1-7. PMID: 18187077 [PubMed – indexed for MEDLINE]

Chronic prostatitis/chronic pelvic pain syndrome and acupuncture–a case report. Rosted P. Acupunct Med. 2007 Dec;25(4):198-9. PMID: 18160930 [PubMed – indexed for MEDLINE]

A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain. Capodice JL, Jin Z, Bemis DL, Samadi D, Stone BA, Kapan S, Katz AE. Chin Med. 2007 Feb 6;2:1. PMID: 17284322 [PubMed]

Complementary and alternative medicine for chronic prostatitis/chronic pelvic pain syndrome. Capodice JL, Bemis DL, Buttyan R, Kaplan SA, Katz AE. Evid Based Complement Alternat Med. 2005 Dec;2(4):495-501. Epub 2005 Oct 10. PMID: 16322807 [PubMed]

Effects of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion: preliminary results. Honjo H, Kamoi K, Naya Y, Ukimura O, Kojima M, Kitakoji H, Miki T. Int J Urol. 2004 Aug;11(8):607-12. PMID: 15285750 [PubMed – indexed for MEDLINE]

Acupuncture for chronic prostatitis/chronic pelvic pain syndrome. Chen RC, Nickel JC. Curr Urol Rep. 2004 Aug;5(4):305-8. PMID: 15260934 [PubMed – indexed for MEDLINE]

Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Antolak SJ Jr. Urology. 2004 Jan;63(1):212. No abstract available. PMID: 14751398 [PubMed – indexed for MEDLINE]

Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Chen R, Nickel JC. Urology. 2003 Jun;61(6):1156-9; discussion 1159. PMID: 12809886 [PubMed – indexed for MEDLINE]

Clinical studies on chronic prostatitis and prostatitis-like syndrome (7). Electric acupuncture therapy for intractable cases of chronic prostatitis-like syndrome. Ikeuchi T, Iguchi H. Hinyokika Kiyo. 1994 Jul;40(7):587-91. Japanese. PMID: 8085519 [PubMed – indexed for MEDLINE]

Acupuncture Found Effective for Back Pain- Study Finds it Superior to Usual Care

From Acupuncture Today, July, 2009, Vol. 10, Issue 07

There seems to be no question that Americans spend a great deal of money dealing with back pain. According to research, we spend at least $37 billion annually on medical care for back pain.1,2 Furthermore, the economy suffers another $19.8 billion in lost worker productivity due to back pain.3

In response to this, there has been extensive research on the use of acupuncture for treating back pain. A 2008 literature review concluded that there was “strong evidence” for the use of acupuncture as an adjunct to conventional therapy for lower back pain.4

Now, a new study published in the May 11, 2009 issue of Archives of Internal Medicine has added even further to the literature on the value of acupuncture in treating back pain.5

Daniel C. Cherkin, PhD, and colleagues examined a group of 638 patients suffering from back pain to determine not only if acupuncture is superior to usual care for treating back pain, but to see if needle insertion at individualized points is the mechanism of action by which acupuncture works best. A total of 10 acupuncture treatments was provided over the course of eight weeks.

Study Design: The researchers started by dividing the patients into four groups:

Individualized acupuncture: This treatment was prescribed by the diagnostician at the beginning of each visit. There were no constraints on number of needles, depth of insertion or needle manipulation. Needles were retained for 18 minutes. Seventy-four distinct points were used.

Standardized acupuncture: This protocol used a standardized acupuncture prescription considered effective for chronic low back pain, including Du 3, Bladder 23 on either side, low back Ashi point, Bladder 40 on ether side and Kidney 3 on either side. All points were needled for 20 minutes, with needle stimulation at 10 minutes and again just prior to removal.

Simulated acupuncture: This technique used a toothpick in a needle guide tube. All acupuncture points were stimulated with toothpicks at 10 minutes and again at 20 minutes, just before they were “removed.” The acupuncturists simulated insertion and removal of needles at the eight acupuncture points used in the standardized treatment.

Usual care: Participants in this group only received the care, if any, they and their physicians chose. This was mainly mostly medications, and primary care, and physical therapy visits. All participants received a self-care book with information on managing flare-ups, exercises and lifestyle modifications.

Results:

At 8-week follow up, all groups of patients showed improvement. However, the “usual care” group only improved by 2.1 points (scored on a disability questionnaire), as opposed to the individualized, standardized and simulated acupuncture groups, which improved by 4.4, 4.5 and 4.4 points, respectively. The greater improvement for the acupuncture groups over usual care continued all the way to 52 weeks, at the end of the study. Of those patients receiving real acupuncture, only 11 reported any side effects.

Interestingly, at the end of the study, there was little difference between the four acupuncture treatment groups in terms of effectiveness. The researchers speculated that this may mean that acupuncture’s actual mechanism of action may not be clear and that further research is warranted.

Nevertheless, they concluded, “Compared with usual care, individualized acupuncture, standardized acupuncture and simulated acupuncture had beneficial and persisting effects on chronic back pain. These treatments resulted in clinically meaningful improvements in function. … For clinicians and patients seeking a relatively safe and effective treatment for a condition for which conventional treatments are often ineffective, various methods of acupuncture point stimulation appear to be reasonable options, even though the mechanism of action remains unclear.

According to Josephine P. Briggs, MD, director of the National Center for Complementary and Alternative Medicine, “The findings of this research show that acupuncture-like treatments, including simulated acupuncture, can elicit positive responses. This adds to the growing body of evidence that there is something meaningful taking place during acupuncture treatments outside of actual needling. Future research is needed to delve deeper into what is evoking these responses.”

Commentary from Dr. Denny: This interesting study compares usual or standard medical care with individualized acupuncture care, standard acupuncture care and simulated acupuncture care. All three types of acupuncture care produced better results than usual medical care. What makes this a fascinating study is the apparent benefit from the simulated acupuncture care. It is described as stimulating the acupuncture points with toothpicks on the skin. For those of you reading who are not familiar with acupuncture, there are many acupuncture techniques. There are also acupuncture techniques which do not involve puncturing the skin, which have been reported in Japanese acupuncture for generations. In fact, the Japanese have developed many devices to accomplish non-needle techniques such as Tei-shin, Yuko-shin and others. Many of these devices are used for the needle-phobic patient as well as in pediatric acupuncture. In addition there is an entire system of Japanese acupuncture where needles are not inserted or only superficially inserted on or over acupuncture points. This is called Toyohari.

In summary, acupuncture has many styles. Simply because needles are not inserted, does not make the treatment a “simulation.” Once again we see how difficult it is to “blind” treatments which actually involve patient participation. This method makes sense when you give someone a placebo sugar pill, but is very difficult to assess the effectiveness of hands-on type of treatments.

For more information on Chinese medicine including the different styles of acupuncture please click on this link to receive my free ebook “How to Thrive in a Modern World.” 

If you would like more information about Dr. Denny’s practices please visit http://www.drscottdenny.com or http://www.multicareclinic.org. Please call 954-473-8925 for further information.

References:

1. Luo X, Pietrobon R, Sun SX, et al. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine. 2004 Jan 1;29(1):79-86.

2. Martin BI, Deyo RA, Mirza SK, et al. Expenditures and health status among adults with back and neck problems. JAMA. 2008 Feb 13;299(6):656-64.

3. Stewart WF, Ricci JA, Chee E, et al. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003 Nov 12;290(18):2443-54.

4. Yuan J, Purepong N, Kerr DP, et al. Effectiveness of acupuncture for low back pain: a systematic review. Spine. 2008 Nov 1;33(23):E887-900.

5. Cherkin DC, Sherman KJ, Avins AL, et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med. 2009 May 11;169(9):858-66.