Post Herpetic Neuralgia, Shingles and Chinese Medicine

Any individual who has suffered through shingles (herpes zoster) can attest that the experience can be counted as among the worst that a human being can suffer. Usually shingles manifests as an agonizing, burning pain following one or more nerve paths from the spine outwards, and is accompanied by a fluid-filled rash which gradually evolves into painful scabs.

Cruelly, the visual signs of shingles may vanish after several weeks, but leaving searing nerve pain where it had been yet with little or no outward signs. This pain is termed, post-herpetic neuralgia.

While we often treat acute shingles at the Northside Holistic Center with good effect, it is even more common that people are directed to us by their physician or a peer who has been treated at the clinic for post-herpetic neuralgia. This is because living with the neuralgia is often almost intolerable and acupuncture and Chinese medicine are so effective at alleviating the problem.

Articles and Research

• A recent article compared the effectiveness of acupuncture and Chinese medicine to conventional medical care for shingles and found that the effectiveness was the same and was, ultimately, cheaper. The article, reprinted below:

Acupuncture Cost-Effective For Herpes Zoster Care - New Research

12 APRIL 2012

New research published in the Journal of Traditional Chinese Medicine finds acupuncture as effective as pharmacological drugs for the treatment of herpes zoster. The study also notes that acupuncture is more cost-effective as a treatment modality for this ailment. Herpes zoster, also known as shingles, is a viral infection that causes painful skin rashes with blisters. This is the same virus that causes chickenpox. Adults who have had chickenpox earlier in life have a 50 percent chance of contracting a herpes zoster outbreak later in life, however, herpes zoster can attack at any age.

A total of 500 patients with herpes zoster were part of this randomized clinical trial. They were divided into 5 treatment groups to compare Chinese medicine with anti-viral drug therapy. Group 1 received acupuncture and electroacupuncture. Group 2 received moxibustion. Group 3 received red-hot needle treatment. Group 4 received tapping needle technique plus cupping and group 5 received drug therapy. The researchers found no statistical difference between the treatment groups for the “curative effect.” Given the same clinical effects between the treatment groups, the researchers then compared the cost of care and concluded that acupuncture is a more cost-effective modality for the treatment of herpes zoster.

Reference:

Journal of Chinese Medicine. 1-2012. Economic Evaluation of Treating Herpes Zoster with Various Methods of Acupuncture and Moxibustion.

• An Italian study, which can read about here, found that,

...acupuncture is as effective as standard drug treatment for acute pain in patients with herpes zoster (HZ).

• A Yale School of Medicine case report, abstract viewable here, found that with a patient whose post herpetic neuralgia was unresponsive to a variety of Western medical treatments responded well to acupuncture, 

A comprehensive pain treatment regimen, consisting of a stellate ganglia block, medications, transcutaneous electrical nerve stimulation and hypnosis, was administered, but the patient did not gain any incremental pain relief.
The acupuncture service was consulted . . . after acupuncture treatment over a 2-month period, the patient's nausea disappeared. Her left facial pain continued to decline from a maximum of 10 to 0 . . .

[their] conclusions, "Acupuncture and its related techniques may be an effective adjunctive treatment for symptoms associated with post herpetic neuralgia and deserve further study."

A research project comparing several different means of using acupuncture and Chinese medicine to treat shingles (which can be read here) found that, 

Acupuncture plus encircled needling and acupuncture plus encircled needling combined with cotton-moxibustion, or with fire needle stimulation, or with tapping and cupping are effective in the treatment of herpes zoster at the acute stage, being comparable to the medication in the clinical curative effect and improvement of blisters, and better than medication in pain relief. 

Treating Neuropathy with Acupuncture and Chinese Medicine

Because of the association that many people and their physicians make between acupuncture and nerve functioning, it is common for many patients to seek out an acupuncturist immediately upon being diagnosed with any type of neuropathy. For good reason, it turns out: acupuncture and, frequently herbal therapy, can be exceptionally useful in treating neuropathies originating from many disease processes.In broad terms, neuropathy is the manifestation of any disease which affects the peripheral nervous system leading to one or a combination of pain, tingling, 'pins and needles' sensation, numbness, or weakness in the hands and/or feet. Neuropathy can be caused by a large number of triggers ranging from diseases such as cancer, diabetes, or AIDS; nutritional deficiencies; or toxic overloading the body with either environmental poisons or prescription drugs. A large number of neuropathy cases  are termed, 'idiopathic', meaning that western medicine can not determine a specific cause of the problem.

An acupuncturist evaluates each person's case of neuropathy differently weighing the health history of the patient; the location of the problem; the drugs or environmental chemical exposure and, from this, weaves together a treatment plan that most effectively restores nerve function. Neuropathies tend to respond incredibly well to acupuncture and, occasionally additional herbal intervention, depending on the cause of the nerve issue. 

Research and Articles

 A study done by the Cancer Treatment Centers of America, and which can be read about here, found that acupuncture was extemely useful for treating chemotherapy related neuropathy, noting 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.

A British study recently confirmed that acupuncture can be useful in treating chemotherapy induced neuropathy, finding that 82% of the patients in the study received benefit. In a small related study, from Germany, 83% of the subjects enrolled in the study found sustantial benefit from acupuncture. Both can be read about here. In addition the patients found that,

. . . some patients derived additional benefits from the treatment including a reduction in analgesic use and improved sleeping patterns. 

In 2011 the University of Arizona examined acupuncture for HIV-related neuropathies, as well as mortality from that disease and found that:

Acupuncture was clearly effective in reducing attrition and mortality in this sample, especially when health status was taken into account . . . Moreover, these results replicated most of the findings that did not involve the  presence of amitriptyline from the initial independent study in this research project.  

The University Medical Center in Hamburg, Germany examining acupuncture for chemotherapy induced peripheral neuropathy (CIPN) found that,

The data suggest that acupuncture has a positive effect on CIPN. 

A Chinese study entitled, Fifteen-Day Acupuncture Treatment Relieves Diabetic Peripheral Neuropathy, evaluated the use of acupuncture in a diabetic population suffering from both sensory and motor nerve damage. It found,

... evidence that acupuncture may be clinically useful for the radical treatment of diabetic neurapathy.

The study compared:

 ... forty-two cases treated with acupuncture with 21 cases exposed to sham acupuncture and observed the effects on nerve conduction velocity and a variety of subjective symptoms associated with diabetic peripheral neuropathy.

Three of the six measures of motor nerves, and two measures of sensory function, demonstrated significant improvement (p < 0.05) over the 15-day treatment period in the acupuncture group, while no motor or sensory function significantly improved in the sham acupuncture group. There were also significant differences in vibration perception threshold between the groups (p < 0.05) and when compared to the baseline levels (p < 0.01) in the acupuncture group. Acupuncture was significantly more effective than sham for treatment of numbness of the lower extremities, spontaneous pain in the lower extremities, rigidity in the upper extremities and alterations in temperature perception in the lower extremities after therapy.