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    You are here : Home » MS Research News » Complementary Therapies » Acupuncture


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    Acupuncture's molecular effects pinned down

    AcupunctureScientists have taken another important step toward understanding just how sticking needles into the body can ease pain.

    In a paper published online May 30 in Nature Neuroscience, a team at the University of Rochester Medical Center identifies the molecule adenosine as a central player in parlaying some of the effects of acupuncture in the body.

    Building on that knowledge, scientists were able to triple the beneficial effects of acupuncture in mice by adding a medication approved to treat leukemia in people.

    The research focuses on adenosine, a natural compound known for its role in regulating sleep, for its effects on the heart, and for its anti-inflammatory properties. But adenosine also acts as a natural painkiller, becoming active in the skin after an injury to inhibit nerve signals and ease pain in a way similar to lidocaine.

    In the current study, scientists found that the chemical is also very active in deeper tissues affected by acupuncture. The Rochester researchers looked at the effects of acupuncture on the peripheral nervous system - the nerves in our body that aren't part of the brain and spinal cord. The research complements a rich, established body of work showing that in the central nervous system, acupuncture creates signals that cause the brain to churn out natural pain-killing endorphins.

    The new findings add to the scientific heft underlying acupuncture, said neuroscientist Maiken Nedergaard, M.D., D.M.Sc., who led the research. Her team is presenting the work at a scientific meeting, Purines 2010, in Barcelona, Spain.

    "Acupuncture has been a mainstay of medical treatment in certain parts of the world for 4,000 years, but because it has not been understood completely, many people have remained skeptical," said Nedergaard, co-director of the University's Center for Translational Neuromedicine, where the research was conducted.

    "In this work, we provide information about one physical mechanism through which acupuncture reduces pain in the body," she added.

    To do the experiment, the team performed acupuncture treatments on mice that had discomfort in one paw. The mice each received a 30-minute acupuncture treatment at a well known acupuncture point near the knee, with very fine needles rotated gently every five minutes, much as is done in standard acupuncture treatments with people.

    The team made a number of observations regarding adenosine:
    In mice with normal functioning levels of adenosine, acupuncture reduced discomfort by two-thirds.

    In special "adenosine receptor knock-out mice" not equipped with the adenosine receptor, acupuncture had no effect.

    When adenosine was turned on in the tissues, discomfort was reduced even without acupuncture.

    During and immediately after an acupuncture treatment, the level of adenosine in the tissues near the needles was 24 times greater than before the treatment.

    Once scientists recognized adenosine's role, the team explored the effects of a cancer drug called deoxycoformycin, which makes it harder for the tissue to remove adenosine. The compound boosted the effects of acupuncture treatment dramatically, nearly tripling the accumulation of adenosine in the muscles and more than tripling the length of time the treatment was effective.

    "It's clear that acupuncture may activate a number of different mechanisms," said Josephine P. Briggs, M.D., director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health. "This carefully performed study identifies adenosine as a new player in the process. It's an interesting contribution to our growing understanding of the complex intervention which is acupuncture," added Briggs, who is the spouse of co-author Jurgen Schnermann.

    The paper includes three first co-authors: Nanna Goldman, technical associate Michael Chen, and post-doctoral associate Takumi Fujita. Other authors from Rochester include Qiwu Xu; medical student Tina Jensen; former student Wei Liu and former post-doctoral associate Yong Pei; assistant professors Takahiro Takano and Kim Tieu; and research assistant professors Weiguo Peng, Fushun Wang, Xiaoning Han, and Lane Bekar. Also contributing were Jiang-Fan Chen from Boston University and Jürgen Schnermann from the National Institute of Diabetes and Digestive and Kidney Diseases.

    Funding for the work came from the New York State Spinal Cord Injury Program and the National Institutes of Health.

    Source: Medical news Today © 2010 MediLexicon International Ltd (01/06/10)

    Acupuncture goes mainstream as evidence mounts that acupuncture really works, doctors turn to the technique more and more
    The acupuncturist taps a hair-thin needle into the inside of Kathy Kevnick's ankle. He twirls the needle delicately, until her body "grabs" it and achieves something called Da Qi.

    More needles follow on her calves, knees, hands and the top of her head. The needles, he explains, will clear blockages in Kevnick's energy channels and bring her body into balance.

    "The body knows which direction to go, and the acupuncture frees up the body's ability to do that," he says.

    This is not some New Age shaman. The acupuncturist, David Bilstrom, is an M.D. and a specialist in physical rehabilitation. He has decorated his office suite with Burmese tapestries and Oriental art, but it's still not far off from a typical doctor's office. In fact, it's on the campus of Advocate Good Samaritan Hospital in Downers Grove.

    Ninety percent of Bilstrom's patients are referred by other doctors.

    "Not too many years ago, a family doctor would have said acupuncture doesn't work, or it's a lot of hooey," Bilstrom said. "Nowadays, there's enough information out there that physicians have heard good things, they know it's safe."

    Acupuncture has gone mainstream.

    Ancient art

    While acupuncture dates back more than 2,000 years, most Americans had never heard of it until 1971 after Secretary of State Henry Kissinger's trip to China.

    Traveling with the White House staff was New York Times reporter James Reston, who underwent an emergency appendectomy on the trip. Reston was so impressed with acupuncture's ability to relieve his postoperative pain that he wrote about it when he returned to the United States.

    Acupuncture received a nod of approval from mainstream medicine in 1996, when the U.S. Food and Drug Administration approved the use of acupuncture needles as long as they are sterile, nontoxic and disposed of after a single use.

    The following year, the National Institutes of Health issued a statement documenting acupuncture's safety and efficacy for a range of health problems. Even a decade ago, that list was relatively long: postoperative pain, nausea, stroke rehabilitation, back pain, menstrual cramps, tennis elbow, dental pain, fibromyalgia, myofascial pain, osteoarthritis, carpal tunnel syndrome and asthma.

    The popularity of acupuncture has grown since then, and today thousands of acupuncturists, medical doctors, dentists and other health care practitioners who have learned the technique are using acupuncture to treat everything from asthma to infertility.

    More than 8 million Americans have turned to acupuncture at one time or another.

    Kevnick, 41, of Schaumburg sought Bilstrom's help after her multiple sclerosis progressed and left her unable to work. Her right side was so weak she couldn't walk. Steroids no longer worked. Neither did chemotherapy.

    Weekly acupuncture sessions - as well as biweekly massage treatments - have helped Kevnick eliminate 80 percent of her medications and return to work full time as a hospital digital image archives coordinator.

    "It's changed my life," she said. "I had medical bills of $42,000 the year before I started acupuncture. Now my bills are (acupuncture) and massage therapy.

    "I'm walking tall and I'm happy. That says it all."

    Healing energy

    According to theories of traditional Chinese medicine, the body's vital energy, or qi, flows through pathways called meridians. Disruptions in this energy flow cause disease. Placing needles in specific acupuncture points clears blockages in the meridians to restore balance to the body.

    This talk of "energy channels" and meridians initially turned off conventional doctors because they had no correlation in Western medicine. Then our science started to catch up.

    The stainless steel needles used in acupuncture appear to generate a tiny electrical current, Bilstrom said. Placed in the right spots, the needles conduct that current through the path of least resistance through the body along the planes between muscles.

    Researchers have been able to measure the current as it travels from one needle to the next.

    A widely accepted medical explanation of acupuncture is that the needles stimulate the nervous system to release chemicals in the muscles, spinal cord and brain, which either reduce pain or help the body to heal.

    Studies using brain images have shown acupuncture can increase our pain threshold, which may be why it's so effective for long- term pain relief. Studies are also showing how acupuncture stimulates the brain to help heal other diseases. In one study using functional MRI scans, for example, needles placed behind the inner ankle - a point used to heal ear problems - cause parts of the auditory cortex to light up.

    "The research is starting to come along," said Dr. William Rutenberg, a Buffalo Grove pediatrician trained in acupuncture.

    Rutenberg was a skeptic himself until about seven years ago, when his son had acupuncture to ease excruciating pain from a bulging disc in his spine. Rutenberg eventually enrolled in an acupuncture course for physicians, becoming one of a growing number of medical acupuncturists.

    "We apply the best of both worlds, combining elements of traditional Chinese medicine and acupuncture with what we've learned in Western medicine," he said.

    Finding proof

    What helped to persuade Rutenberg was the fact that prestigious universities are both teaching acupuncture and conducting research on its effects, funded in large part by the NIH's Center for Complementary and Alternative Medicine. With NIH funding, research studies on acupuncture have begun appearing in respected medical journals.

    In one oft-quoted study, researchers at the University of Maryland found patients with osteoarthritis of the knee who received acupuncture felt less pain and could walk farther than those who got "sham" treatment, in which acupuncture needles were placed randomly or did not pierce the skin.

    A study at the Mayo Clinic published earlier this year found acupuncture relieved the pain, fatigue and anxiety of fibromyalgia much more so than did simulated acupuncture. Researchers at Memorial Sloan-Kettering Cancer Center in New York found chronic headache sufferers who received acupuncture had a 34 percent reduction in pain, compared to a 16 percent drop in the control group.

    Other studies have found acupuncture effective for chronic low back pain, headache, postoperative nausea, labor pains and neck pain.

    But other research is less clear. Earlier this year, German researchers reported in The Lancet Neurology that 313 migraine patients who received acupuncture fared as well as those who got drugs instead. But the study also produced a surprise; the patients who received sham acupuncture did just as well as the other two groups.

    The researchers concluded the decision to use acupuncture for migraine must rest with individual doctors.

    For some doctors, that's an easy answer. Unlike opioids and other powerful pain medications, acupuncture has few side effects.

    Dr. Mario Rustia of Elgin, an anesthesiologist and pain specialist by training, now performs acupuncture exclusively.

    "Acupuncture works where pain medications fail," he said. "We don't know at present why it does, but for certain things, it works. It doesn't only alleviate the pain, it heals."

    Last resort

    Wallace Williams of Burr Ridge found acupuncture helped ease the pain of shingles after conventional drug therapy failed. Williams, 81, said his pain grew so intense each evening that tears ran down his cheeks.

    "I have never experienced such continuous pain, really nasty pain, in my life," Williams said. "It's like having a very large area of the worst toothache of your life."

    Williams took so many painkillers that at one point he overdosed and had to go to the hospital. Eventually, a friend suggested acupuncture, and he found Bilstrom.

    After a thorough checkup, Bilstrom placed 10 needles in Williams' chest and arm. The doctor then attached clamps to the needles to send a tiny electrical pulses through them, a technique called electroacupuncture.

    The procedure is painless, Williams said. Unlike hypodermic needles, which are sharp and hollow, acupuncture needles are blunted and solid. They don't so much pierce tissue as slip between cells.

    Williams was skeptical, but the treatment worked so well it completely changed his view of acupuncture as something practiced only "in an attic in Chinatown."

    "It took three or four treatments before I realised the pain was dissipating," Williams said. "To me it was almost miraculous."

    For Williams - and many who seek acupuncture for the first time - acupuncture was a last resort. But practitioners say it is even more effective when used early in the course of disease, or as a complementary therapy to traditional medicine.

    "It's easier to help them sooner, and it makes their whole recovery process easier to handle," said Maria Lesniak, a licensed acupuncturist and founder of the North Shore Healing Center in Glenview.

    Acupuncture can't fix everything. As a part of traditional Chinese medicine, it's better suited to maintaining health, Lesniak said. For trauma and acute illnesses, patients are better off seeing a conventional doctor; when patients show up with sky-high blood pressure, for example, she's counseled them to head to the hospital.

    "Eastern medicine takes time to make effects on the body," Lesniak said. "If I broke my leg, I would call a Western medicine doctor and have my leg set, and then I would use acupuncture to help the healing process."

    Source: Daily Herald; Arlington Heights, Ill. (c) 2006 Daily Herald; Arlington Heights, Ill..

    Acupuncture for bladder dysfunction Study

    41 people with MS were divided into four groups, receiving no intervention, conventional treatment, acupuncture, and conventional treatment plus acupuncture, respectively.

    Those receiving either conventional treatment or acupuncture alone benefited most, using an outcome measure of post-void residual volume in the bladder. This suggests that in this instance conventional and alternative therapies may not work well together.

    Brunham 5, et al. A single-blinded, randomised controlled trial of acupuncture for symptomatic therapy of bladder dysfunction in multiple sclerosis.

    Source: Neurology 2003; 60S: A485.

    © Multiple Sclerosis Resource Centre (MSRC)

    Person having Acupuncture
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