Acupuncture and neuropathy

Acupuncture for neuropathy relief didn't work for me but it has worked for many people and this article points out that it is a complementary therapy and is best used in conjunction with other forms of neuropathy treatment. If you're feeling frustrated because nothing else seems to work, why not try acupuncture - thousands of years of Chinese medical expertise cannot just be dismissed as 'alternative' and therefore in some way 'less valuable' and the logic behind it is hard to argue against. Recognised acupuncture and acupressure points are now widely used in various Western medicinal treatments in order to deliver targeted medication.

This article and photo are from:
http://painaction.com/

Acupuncture and acupressure for neuropathic pain: An ancient alternative

Written by: Rita Reznikova
Published: January 26, 2010
Reviewed by: Kevin Zacharoff, MD, December 2009

Neuropathic pain is a kind of chronic pain that usually results from damage to or malfunction of the nervous system. This makes it different from the usual type of pain that is a direct result of injury. Successful treatment for neuropathic pain can be difficult; often, the approach is with a combination of medications, physical and psychological methods, and complementary and alternative practices. This article will focus on acupuncture and acupressure.

What you need to know

Acupuncture and acupressure are ancient Chinese medical treatments.
These techniques may complement (be used with) other medical treatments for neuropathic pain.
Researchers believe that acupuncture and acupressure work on “pressure points” throughout the body, in order to improve the flow of energy.

Acupuncture and acupressure are used to treat many different medical problems, including neuropathic pain. If you’ve ever thought about trying them, you are not alone: According to the 2007 National Health Interview Survey, 3.1 million Americans said that they had visited an acupuncturist in the previous year.

Always talk with your health care provider before starting any complementary treatments: You need to make sure that these treatments won’t conflict with your other care, and that there are no medical reasons to avoid using them.

What is acupuncture?

Acupuncture is an ancient Chinese tradition that dates back thousands of years. In Chinese belief, an energy called qi (“chee”) runs throughout the body. When something blocks or slows down the flow of qi, a person may feel pain. An acupuncturist treats this pain by placing thin needles at special points on the body, to make sure that the flow of qi is clear.

Acupressure is a similar type of treatment, but instead of needles, hand pressure is applied to these same points of the body to increase the energy flow.

How do acupuncture and acupressure feel?

You probably know that acupuncture uses needles, and the thought of someone inserting many thin needles into your skin might be scary. While some people may feel a slight twinge when acupuncture needles are placed, many do not. That’s because acupuncture needles are almost as thin as a piece of thread that’s used for sewing; they are much thinner than regular medical needles. In fact, you may feel so deeply relaxed after the needles are placed that you might even fall asleep during the treatment.

Acupressure, on the other hand, feels more like a deep tissue massage. The therapist’s hands press down on certain muscle areas of your body, called trigger points. The goal of the treatment is to create an all-around feeling of relaxation in that area.

How can acupuncture or acupressure help neuropathic pain?

Both acupuncture and acupressure target specific places called pressure points on your body.

Acupuncture, in Chinese tradition, is viewed in the context of the body’s overall energy flow. In order to relieve your pain, an acupuncturist may place needles near the areas where you hurt, as well as in other parts of your body. This may reduce pain by unblocking your flow of energy. In Western medicine, though, experts aren’t looking at “energy flow”; they feel that the placement of acupuncture needles helps to stimulate the nerves and surrounding tissues; this supposedly helps to change the way that the brain understands neuropathic pain signals.

Acupressure has a different approach. An acupressure therapist relaxes pained muscles by pressing directly on your body’s trigger points. This pressure may help to relieve the tingling, burning, or “prickly” feelings in the body that are associated with neuropathic pain. It may also help with other symptoms, like dull pain or stiffness.

There is some evidence that both acupuncture and acupressure may release a type of molecule called opioid peptides in your brain. These molecules have a pain-relieving effect, almost like ‘natural narcotics.’ Other studies even show that acupuncture and acupressure may help your immune system.

While some researchers believe that these treatments may be helpful, other experts aren’t so sure. Providers may use a mix of acupuncture or acupressure techniques, so these therapies may be better for some types of pain than others. Talk to your health care provider to see which treatment might be right for you.

The National Center for Complementary and Alternative Medicine (NCCAM), a division of the National Institutes of Health, is currently helping with a number of studies about the use of acupuncture and acupressure for different types of conditions.

Risks

While experts don’t fully know how acupuncture and acupressure work, these treatments can still be safe and effective for neuropathic pain when they’re done by licensed therapists. Side effects are rare, although they can occur in certain situations: For example, there may be problems if acupuncture needles are not sterile, or if your pain actually worsens as a result of acupuncture or acupressure treatment.

If you decide to try one of these therapies, always speak first with your health care provider. Your provider may also have suggestions on how to find a skilled professional in your area.

Can Acupuncture Help with Neuropathy

Acupuncture is one of those treatments that divides opinion. Most people reason that if it has worked for thousands of years in Chinese medicine, it must be good. That may well be so and we've all seen the TV clips of operations undertaken with acupuncture needles but without anaesthetics but like any other treatment, alternative or otherwise, evidence-based proof is needed that it works when applied to nerve disease. Neuropathy is such a difficult affliction that even experienced Chinese doctor/acupuncturists admit that acupuncture is very much a hit and miss method as regards effectiveness in controlling neuropathic symptoms. Nevertheless, many people have found relief from acupuncture sessions. Today's enlightening post from Natural News.com (see link below) explains how Chinese medicine sees neuropathy and its potential treatment with acupuncture.
Although not normally done on this blog; the footnotes and references are added at the end to show that the article is based on research and not just alternative theory.

Acupuncture Treats Peripheral Neuropathy
Wednesday, May 06, 2009 by: Melissa Sokulski

Neuropathy, or Peripheral Neuropathy, is defined as having numbness, tingling or pain in nerves apart from the spine or brain, often in the hands and feet (1). It is a fairly common symptom, occurring in people with spinal injuries, diabetes, and genetic conditions such as Charcot-Marie-Tooth Syndrome (2,3). Acupuncture can be an effective way to treat these symptoms, bringing energy, life and feeling back into the extremities.

Neuropathy is a serious symptom, which often affects people`s quality of life. When people don`t feel parts of their bodies, they are more prone to injury and infection, as well as finding difficulty in daily tasks such as walking, fine motor work, or gripping. People who have this symptom as part of a genetic disorder also deal with the fears and hopes that go along with having a rare medical disorder(4).

Acupuncture is a powerful tool not only to balance qi - or energy - in the body, but to bring peace, hope and alignment into the mind, emotions and spirit as well.

When there is numbness in the periphery, there is not enough qi reaching these areas, according to traditional Chinese medicine. This can be for a variety of reasons, but mainly either:

1) there is too little energy in that organ system/meridian (energy pathway)

2) something is blocking the energy from reaching the area.

Sometimes there will be a combination of the two, and often multiple organ systems/meridians are involved. There are also different causes for the condition. Each of these things is considered and addressed by the acupuncturist, and a treatment plan which best suits the patient is mapped out.

In general, treatment would involve selecting points that promote circulation of energy in the meridians. If heat or cold is the cause, treatment would include either dissipating heat or warming coldness.(5)

Sometimes, weakness and flaccidity in the extremities is classified as wei syndrome. According to Traditional Chinese Medicine, this results from malnourishment of the tendons due to depletion of body fluids, caused by "excess heat" remaining in the body after illness.(6) Wei syndrome often requires longer periods of treatment.

Acupuncture often brings immediate relief - especially when there is pain - though it will likely take a series of treatments for the feeling and strength to come back completely and for the body to stay in balance, providing lasting effects. How often or how long treatment should proceed will be individual, depending on the cause and the overall constitution and health of the patient. As mentioned above, Wei syndrome can require a long course of treatment.

Acupuncture works by treating the person as a whole, balancing body, mind and spirit and allowing the body to do what it needs to do to heal itself. Acupuncture helps remove blocks, helps the body focus on increasing energy in areas of deficiency, and helps the patient be more present and focused, but ultimately it is our own bodies and energy that are able to heal.

Footnotes:
1) http://en.wikipedia.org/wiki/Neuropathy
2) http://www.medicinenet.com/peripheral_neuropathy/article.htm#1whatis
3) Charcot-Marie-Tooth Disorders (from CMT Facts III, Special Report, p.24):
- CMT is the most common inherited neuropathy, affecting about 125,000 Americans
- CMT is also known as peroneal muscular atrophy and hereditary motor sensory neuropathy
- does not affect life expectancy
- can vary greatly in severity, even within a family
- is the focus of significant genetic research
4) Flapan, Mark, p.10 of CMTA Special Report.
5) Xinnong, p.444
6) Xinnong, p.443

References:

CMTA Special Report: CMT Facts III. Published by Charcot-Marie-Tooth Association. 2700 Chestnut Parkway. Chester, PA. 19013.

Flapan, Mark. Living With A Rare Disorder: Hope and Fear. CMTA Special Report: CMT Facts III. Published by the Charcot-Marie-Tooth Association.

Maciocia, Giovanni. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Second Edition. Churchill Livingstone. 2005.

Xinnong, Cheng. Chinese Acupuncture and Moxibustion. Foreign Languages Press. Beijing. 1990.

http://www.naturalnews.com/026211_acupuncture_neuropathy_energy.html

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Acupuncture Is One Of The More Difficult To Prove Neuropathy Therapies

Today's short post from nevadaappeal.com (see link below) invites you to visit the Facebook page to find out why acupuncture is becoming more and more acceptable in the treatment of neuropathy and why would you not? (This blog avoids Facebook like the plague but accepts that it is a major information source in the medical world of today). Acupuncture, like so many so-called alternative treatments needs all the evidence it can find and produce, if it's to convince cynical neuropathy patients who've heard it all before. However, even more important that word of mouth evidence, is hard fact brought about by success stories across the spectrum. Like all therapies though, it's important that you trust both your practitioner and the basis behind his or her therapies and that requires a certain amount of research to establish some facts. The success of a therapy is often dependent on the fact that you're convinced by the theory, even if it doesn't seem to be working for you. By using the Search button you'll find many more articles on the subject here on the blog.
 

Acupuncture treats peripheral neuropathy
Maureen Lamerdin, O.M.D.

Peripheral neuropathy has become a more prominent complaint by many who suffer from varying conditions such as diabetes, spinal injuries, alcoholism, HIV, vitamin deficiencies and from adverse side-effects of specific drugs, most notably chemotherapy drugs. This debilitating condition can cause such symptoms as feeling like walking on glass, severe burning, numbness and tingling, weakness and flaccidity of the muscles which can lead to further injury.

This neurological disorder is caused by the abnormal functioning of the sensory, motor and/or autonomic nerves. Peripheral neuropathy typically affects the extremities, including the arms, legs, hands and feet. The time of day and one’s activity level can affect the frequency of the symptoms with this neuropathic condition. Some people may experience symptoms throughout the day, but have increased sensations in the evenings. Typically, applying pressure (such as from walking) will significantly aggravate the condition. There are many other factors that can exacerbate this condition such as stress. When treating this condition it’s important to treat the whole body for successful abatement of this disease.

Most people believe once the nerve fibers are damaged they can’t heal and so most people take pain relieving medication or drugs that specifically affect the nerves such as Lyrica or Neurontin. At best these treatments may help manage the pain, however they don’t help the regeneration of the nerves. Research shows the body does indeed have the ability to regenerate nerves. A lizard can regenerate nerves after the loss of an appendage and can actually recreate the extremity. Much of the human skeleton and nerve makeup maintains the ancient segmental pattern present in all vertebrates such as a lizard.

Numerous research has been published on the effectiveness of acupuncture treatment for peripheral neuropathy some of which include the European Journal of Neurology, JAMA, Sloan-Kettering Cancer Center and of course numerous studies in China. A study published in “Experimental and Toxicologic Pathology” showed electro-acupuncture was effective for regenerating nerve cells in rats who had experienced spinal cord injuries. The researchers reported electro-acupuncture restored partial function to paralyzed limbs in the injured rats. In a 10-week study conducted by the European Journal of Neurology patients were treated with acupuncture at determined points as determined by the practitioner. Patients had symptom relief as well as improved nerve conduction over the course of treatment, leading the researchers of the study to speculate acupuncture caused nerves to regenerate.

Peripheral neuropathy is considered a chronic disease which can be perplexing and involve diligent and consistent therapy to help the patient recover. Traditional Chinese medicine can help improve symptoms and offer people with peripheral neuropathy a better quality of life over time. Treatment of neuropathy should be considered as a long-term therapy and not just a short course of 10 sessions, as is usually implied with acupuncture.
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Gluten Free And Electro Acupuncture For Neuropathy Relief

Today's post from ndnr.com (see link below) concerns an interesting case study of a 55 year old man with severe neuropathy, who's symptoms were helped by a gluten free diet and electro-acupuncture. he had tried everything previously to reduce his neuropathy symptoms but nothing had worked until he began a course of electro-acupuncture and reduced gluten in his diet. This sort of article makes everyone more curious as to whether this is a true general conclusion or not but the problem with neuropathy is, that everyone is different; everyone's nerve damage feels unique to themselves and everyone reacts differently to the treatments currently on offer. My feeling is that if you fall into the same category as the man below, it may be worth trying  the treatments that have helped him. However, a gluten-free diet is anything but an easy option and electro-acupuncture can cost a lot of money, It has to be up to the individual and how desperate he or she is but there are certainly enough cases around the world to encourage the adoption of either or both of these treatments. Talk it over with your doctor.

Acupuncture and Gluten Elimination for Peripheral Neuropathy: A Case Study
Lydia Thurton, ND Posted July 4, 2013  By Editor1
Abstract

This study describes the case of a 55-year-old male with painful peripheral neuropathy, which was severely hindering his quality of life. Despite numerous pharmaceutical interventions, his pain was poorly managed. Electroacupuncture and a gluten-free diet were successfully utilized, resulting in pain resolution and a return of patient functionality.

Introduction

Peripheral neuropathy is a poorly understood chronic pain condition resulting from the demyelination and degradation of axonal nerve fibers. Neuropathies can be the result of toxic exposures, metabolic conditions, traumatic injuries, or infections.1 In some instances, the etiology cannot be elucidated. A neuropathy is commonly treated with a variety of medications, eg, non-steroidal antiinflammatory drugs, opioids, anticonvulsants, and antidepressants.2 The success of these pharmacologic interventions varies and complete cure is not expected. Recently, there has been growing concern about the abuse potential of opioid medication. With this growing recognition, a need for alternative solutions for chronic pain, including neuropathic pain types, is particularly relevant. This article will present the case of B.F., a 55-year-old male who presented with a case of peripheral neuropathy that was resolved with dietary gluten elimination and electroacupuncture treatments.

Case Presentation

B.F., a 55-year-old male, presented with classic paraesthesia symptoms of neuropathic pain: burning, tingling, and, as he described it, “biting” sensations in his feet, jaw, and fingers bilaterally. The pain began approximately 2.5 years prior to our first meeting in May, 2012. Tests for vitamin B12 deficiency, blood glucose, inflammation, and HIV were all unremarkable. B.F. did test positive for low serum testosterone, which was treated with intramuscular injections. Physical exam revealed hypesthesia bilaterally that was particularly focused on the medial aspect of the first toes. MRI, ultrasound, and circulatory imaging studies revealed only mild arthritis of the first MCP joint. A neurologist conducted electrophysiological testing, and B.F. was diagnosed with peripheral neuropathy.

B.F. had a history of alcoholism and working with toxic materials in the heating, ventilating, and cooling industry (HVAC). Alcohol abuse is an independent risk factor for peripheral neuropathy.3 B.F. was prescribed varying combinations of medications over a 2-year duration that included: allopurinol, naproxen, colchicine, prednisone, tramadol, gabapentin, morphine, pregabalin, ketorolac, nortriptyline, duloxetine, hydromorphone, and nabilone. B.F. was also obtaining morphine, methadone, marijuana, oxycontin, and occasionally cocaine from street sources to supplement his pain medication. B.F. expressed frustration with the medications, as he often experienced fatigue, dysphoria, impaired cognitive function and withdrawal effects, while his pain continued to increase in intensity.

Management and Care

B.F. commenced weekly acupuncture treatments. Point selection was based on a combination of his Traditional Chinese Medicine diagnosis and areas of maximal pain. Common points used were LI11, SJ5, LR2, SP2, SP6, GB40 and “well points” on the feet, which are the most distal points on each acupuncture channel. When treatment initially commenced, with a frequency of one pulse per second, the current level was at 24 mA (milliamps). After 10 months of treatment, the current level was reduced to 16 mA as his paresthesia began to heal. The frequency remained unchanged. Neuropathic pain was severely hindering B.F.’s activities of daily living. Activities like playing guitar, sustained walking and standing, and working as a HVAC technician were impossible when he first presented to me. His day-to-day functionality was used as a marker for treatment success, as well as his subjective rating of pain intensity.

After 1 month of electroacupuncture treatment, his symptoms, by his account, had improved by 75%. When B.F. started treatment, a folded towel would have to be placed on the floor because it was extremely painful for his feet to make contact with a hard surface. After 4 treatments, this measure was no longer necessary. After 5 months of treatment, B.F. was able to reduce treatments to biweekly.

Dietary change occurred slowly over the course of months, beginning with increasing his intake of plant-based foods, and progressing to elimination of refined sugar and gluten after 2 months. In the case of B.F., he did not manifest gastrointestinal symptoms characteristic of gluten-based enteropathies and he tested negative for anti-gliadin antibodies. However, by his own account, pain symptoms improved by 90% when he eliminated gluten. Currently, when B.F. consumes gluten in any significant quantity, he notes an almost immediate exacerbation of his foot neuropathy.

Medication weaning was done under B.F.’s own initiative and to date he has been able to eliminate all of the aforementioned medications except methadone. Currently he is participating in a methadone harm-reduction program to safely wean him from high-dose opioid medication. He uses marijuana sporadically and is a member of a marijuana compassion center. B.F. has resumed modified work duties and the day-to-day activities he enjoys.
Discussion

Peripheral neuropathy is a poorly understood but common manifestation of gluten sensitivity and celiac disease.4,5 The case of B.F. also suggests that even without the classic serum markers for celiac, adopting a gluten-free diet can assist in nerve pain resolution. Any patient presenting with bilateral sensory peripheral neuropathy should be screened for anti-gliadin antibodies. 
Neuropathy symptoms can precede or exist without gastrointestinal symptoms. While it is common for anti-neuronal antibodies to be present in celiac patients, serum measurements of antibodies do not directly correlate to subjective patient experience of nerve pain.6

Anti-gliadin IgG and IgA antibodies cross-react with synapsin-1, a ubiquitous phosphoprotein present on both central and peripheral nervous cells. Synapsin-1 is largely responsible for forming and regulating synaptic vesicles.7 Autopsy studies of patients with peripheral neuropathy and gluten sensitivity show destruction of the dorsal root ganglia and peripheral spinal cord columns. Malabsorption of micronutrients may also contribute to derangement of the nervous system in the celiac patient population.5 As gluten-free diets have notoriously low patient compliance, it is important that the attending ND provides dietary planning guidelines that support strict adherence and patient success.

Thanks to the research of Bruce Pomeranz, we know that acupuncture needling has the ability to manipulate nociceptors, proprioceptors and autonomic nerve pathways. Pain relief starts with a cascade of enkephalins, dynorphins and endorphins in the spine, midbrain and hypothalamus-pituitary region. In response to these chemicals, serotonin, norepinepherine, monoamines, and endorphins are released, decreasing substance P and the subsequent pain response. Electroacupuncture serves to add additional needle stimulation.8 Cha et al. (2010) found that electroacupuncture reduces nitric oxide synthase, thereby decreasing nerve allodyina.9 There are a number of research studies that support the use of acupuncture and electroacupuncture as a means of treating neuropathic pain of various etiologies. The most commonly studied neuropathies are those that are chemotherapy-induced, HIV-related, and diabetic.10,11,12,13

Conclusion

While case studies do not provide generalizable data, gluten elimination and electroacupuncture each have their own bodies of research to support their use as treatments for peripheral neuropathy. A limitation of this case, from a research perspective, is that dietary improvement and electroacupuncture were initiated simultaneously, making it difficult to isolate the individual effect of each treatment modality. However, B.F. was able to communicate some distinction. He noted that pain management was the best immediately after acupuncture and it would wane until his subsequent appointment. Furthermore, if B.F. was not stringent about his gluten avoidance, he would experience transient pain flare-ups. While this is a limitation in terms of research, in a clinical setting it is positive that NDs have numerous modalities that work synergistically to achieve patient healing.

Lydia Thurton, ND, graduated from the Canadian College of Naturopathic Medicine in 2010. Lydia maintains a general family practice in Pickering, Ontario and is also the naturopathic physician for the AIDS Committee of Durham Region. Her special area of focus is on African-Canadian, and Caribbean patient populations and she is a regular contributor to the Toronto Caribbean News.

References 
 
Peripheral neuropathy. Mayo Clinic Web site. Updated Novemeber 2, 2011. http://www.mayoclinic.com/health/peripheral-neuropathy/DS00131/DSECTION=causes. Accessed May 10, 2013.
Rowbotham MC, Twilling L, Davies PS, et al. Oral opioid therapy for chronic peripheral and central neuropathic pain. N Engl J Med. 2003;348(13):1223-1232.
Ferrari LF, Levine E, Levine JD. Independent contributions of alcohol and stress axis hormones to painful peripheral neuropathy. 2013;228:409-417.
Hadjivassiliou M, Rao DG, Wharton SB, et al. Sensory ganglionopathy due to gluten sensitivity. 2010;;75(11):1003-1008.
Freeman HJ. Neurological disorders in adult celiac disease. Can J Gastroenterol. 2008;22(11):909-911.
Alaedini A, Okamoto H, Briani C, et al. Immune cross-reactivity in celiac disease: anti-gliadin antibodies bind to neuronal synapsin I. J Immunol. 2007;178(10):6590-6595.
Briani C, Zara G, Alaedini A, et al. Neurological complications of celiac disease and autoimmune mechanisms: a prospective study. J Neuroimmunol. 2008;195(1-2):171-175.
Pomeranz B, Stux G, eds. Scientific Bases of Acupuncture. Berlin, Germany: Springer-Verlag; 1989.
Cha MH, Bai SJ, Lee KH, et al. Acute electroacupuncture inhibits nitric oxide synthase expression in the spinal cord of neuropathic rats. Neurol Res. 2010;32 Suppl 1:96-100.
Phillips KD, Skelton WD, Hand GA. Effect of acupuncture administered in a group setting on pain and subjective peripheral neuropathy in persons with human immunodeficiency virus disease. J Altern Complement Med. 2004;10(3):449-455.
Wong R, Sagar S. Acupuncture treatment for chemotherapy-induced peripheral neuropathy–a case series. Acupunct Med. 2006;24(2):87-91.
Schröder S, Liepert J, Remppis A, Greten JH. Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol. 2007;14(3):276-281.
Hwang HS, Yang EJ, Lee SM, et al. Antiallodynic Effects of Electroacupuncture Combined with MK-801 Treatment through the Regulation of p35/p25 in Experimental Diabetic Neuropathy. Exp Neurobiol. 2011;20(3):144–152
 
http://ndnr.com/pain-medicine/acupuncture-and-gluten-elimination-for-peripheral-neuropathy-a-case-study/

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Acupuncture Prevents Neuropathy During Cancer Treatment

Today's interesting post from healthcmi.com (see link below) looks specifically at how acupuncture can prevent neuropathy developing during cancer treatment. It's a startling claim and one that could be extrapolated to apply to other forms of neuropathy if you follow the logic behind it. However, acupuncture is still getting a bad press in some quarters and there's no doubt a little blind faith doesn't do any harm. However, if the science is sound then it could be an important breakthrough. The acupuncture terminology in the article may leave you a bit baffled, so you may need to go to a basic acupuncture site to discover what it all means but there's no harm in talking to your doctor or specialist about it and maybe a qualified medical acupuncturist too (to get a balanced view).
Acupuncture Alleviates Chemotherapy Peripheral Neuropathy No author given on 24 July 2015.

Researchers find acupuncture effective for alleviating chemotherapy induced peripheral neuropathy (CIPN) for patients with colon cancer. Neurotoxicity from chemotherapy may damage nerve fibers and lead to symptoms including pain, burning sensations, tingling, muscle weakness, balance disorders, paresthesia, dysesthesia, cold or heat sensitivity in the hands and feet, and a “glove and stocking” distribution of symptoms. The paresthesia is often experienced as a bilateral pins and needles sensation. Severity ranges from mild to debilitating. The researchers summarize their findings into three main benefits of acupuncture for patients with CIPN: 

Acupuncture administered prior to chemotherapy prevents CIPN.
Use of acupuncture during chemotherapy inhibits the progression of CIPN.
Administration of acupuncture after completion of chemotherapy eliminates or reduces persistent symptoms.

The research was conducted at the Cancer Treatment Centers of America at the Southwestern Regional Medical Center located in Tulsa, Oklahoma. The investigators applied Traditional Chinese Medicine (TCM) style acupuncture to 10 patients with chemotherapy induced peripheral neuropathy. They note that “all of the patients reported or had improvement in their CIPN grades after starting acupuncture.”

The researchers note that using customized acupuncture point prescriptions in the TCM style produces superior patient outcomes when the use of distal acupuncture points are employed. The researchers emphasize the need for customization of the acupoint prescriptions per each patient’s differential diagnostics for maximum clinical efficacy. In addition, they emphasize that distal acupoints “increase blood flow” and therefore have an especially important role in the treatment of CIPN.

The researchers note that CIPN symptoms are “typically dose-dependent”. As a result, CIPN may limit the amount of chemotherapy a patient can tolerate thereby interfering with the efficacy of anticancer therapy. This is particularly prevalent with drugs containing platinum including oxaliplatin, an important drug in the treatment of colorectal cancer.

Platinum based medications often have both acute and chronic adverse CIPN effects because they “produce direct damage to dorsal root ganglion (DRG) neurons.” The researchers add, “Cisplatin, taxanes, and vinca alkaloids have also been shown to exert damage to microtubules resulting in the disruption of axonal transport and thereby signal transduction in these nerve fibers.” The researchers note that “acupuncture for the treatment of CIPN has several advantages.” They note that “side-effects are minimal and it has been shown to be safe and effective in preliminary studies.” An additional benefit to antitumor therapy, they add that studies indicate that acupuncture regulates the immune system. 


Acupuncture Treatment
The researchers note that the data indicates that “TCM-based acupuncture, prescribed frequently and aggressively, and focused on the distal extremities may be effective for preventing and treating CIPN.” They add that an aggressive treatment would, at a minimum, employ the following acupoints:

5 NP (Five Point Ear Acupuncture Protocol)
Ba Feng
Ba Xie
LI4
LR3
GB41
GB34
SP6

Supplementary acupoints include:
Sheng Ba Feng
Sheng Ba Xie
Jing-well acupoints
ST36
LU7
LI10
Yin Tang
LU9
ST40
LR5
KI6
GB41
HT3
KI3
UB62
SP9
UB60
GB20
SP4
GB4
PC6

The researchers note that aggressive acupoint therapy was not always needed to produce clinical results and some patients are too weak to receive aggressive therapy. All acupuncture needles used were between 1/2” to 1” in length and were between 36 - 38 gauge. For this investigation, DongBang brand acupuncture needles were used. For the Ba Feng, Ba Xie, and Jing-well acupoints only guide tube insertion of the needles was employed. Needle retention ranged between 10 - 45 minutes per acupuncture treatment session with an average of 20 minutes per session. Electroacupuncture was not administered.

The research indicates that an integrative medicine approach to chemotherapy for colon cancer patients has several benefits. Patients experience an improvement in the quality of life including better functionality and comfort. In addition, reduction or elimination of CIPN reduces symptomatic interference with the quantity and frequency of chemotherapy treatments. The researchers note, “In the current authors’ treatments, the goal is to combine Eastern and Western practices in order to best provide for the patient.”

Acupuncture Theory
The investigators provide TCM theory as it relates to CIPN. According to TCM principles, CIPN is caused by qi and blood flow abnormalities. They note that blood nourishes tissues and qi moves blood to the tissues. The researchers note, “CIPN results from the body lacking nourishment to the muscles (Blood) and the body not directing the Blood to the limbs (Qi).”

The authors provide TCM theory as it relates to colon cancer. Tumors are often a form of stagnation resulting from disruption of circulation. Heat stagnation is also common with colon cancer patients and is indicated by “an area that feels hot to the patient, red tongue, rapid pulse, dry stool, and constipation.” Toxin stagnation is also common and is often produced by exposure to chemotherapy. Phlegm or damp stagnation is common with fatty tumors and is often concomitant with the following symptoms: mucus in the stool, loose stool, slippery pulse, puffy tongue, a feeling of heaviness. Qi stagnation may occur and is characterized by: flatulence, bloating, irritability, moving pain, purple tongue. Blood stasis is indicated by sharp or stabbing pain, an immovable tumor, dark stools, and difficulty with defecation.

The authors note that their overall clinical impression of cancer patients is that they have a deficient constitution. They note, “the body is not strong enough to move energy to all of the tissues. Therefore, the energy stagnates. This is often the case with CIPN.” They add, “Acupuncture is an effective treatment option for CIPN because acupuncture not only stimulates the body to send blood flow to the site of the needle but also helps strengthen the underlying condition of Deficiency.” The authors note that by applying acupuncture to the extremities “it will act as a local therapy bringing Blood and nourishment to help treat the damage caused by chemotherapy.” Moreover, the authors note that “by strengthening the body against its underlying Deficiency, acupuncture helps restore balance to the body.”

References:
Valentine-Davis, Brandy, and Laurence H. Altshuler. "Acupuncture for Oxaliplatin Chemotherapy–Induced Peripheral Neuropathy in Colon Cancer: A Retrospective Case Series." Medical Acupuncture 27, no. 3 (2015): 216-223.

Tagliaferri M, Cohen I, Tripathy D. Complementary and alternative medicine in early-stage breast cancer. Semin Oncol. 2001;28(1):121–134.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1500-acupuncture-alleviates-chemotherapy-peripheral-neuropathy

Microcurrent Electro Acupuncture for Neuropathy

A combination of electro-acupuncture and so called microlight treatment in today's video. You may be a little distracted by the decor in what could well be a room in their house but it could be decoration to cheer up the practice (including dog!). However, the doctors here give an honest account of what they do and why and many people seem to obtain relief by having various acupuncture, acupressure treatments so it may be well worth a try. Given how desperate patients can become, if you find something that works for you,there's no argument as to its validity.

It's always helpful if you can actually see what's involved in a treatment before you make a decision. The problem may be finding a practitioner in your area.