Fibromyalgia as Treated by TCM

Acupuncturists are often called upon to treat fibromyalgia, a complex of symptoms that frequently include muscle and joint pain; sensitivity to pressure; symptoms of the nervous system, such as numbness and tingling; fatigue; and bowel and bladder problems.  

Image copied from http://commons.wikimedia.org/wiki/File:Symptoms_of_fibromyalgia.png

Using a combination of acupuncture and highly tailored herbal approaches we can almost always remedy this problem for our patients.

From a UK acupuncturist's website comes these western research stubs:

(1) A new study has been carried out to assess the effectiveness of acupuncture in treating pain levels and decreasing the number of tender points in fibromylagia patients. Twenty nine patients with at least a six year history of fibromylagia were given acupuncture and tested by using a pain scale and by dolorimetry (a method of measuring pain perception in degrees ranging from unpleasant to unbearable by using heat applied to the skin). No other pain medication was taken. Pain levels were found to decrease from 64.0 to 34.5 after acupuncture, with a decrease in the number of tender points from 16.0 to 11.8. Results also showed an increase in certain blood chemicals (serotonin and substance P) which help to regulate pain. (Pain treatment of fibromyalgia by acupuncture. Sprott H, Franke S, Kluge H, Hein G. Rheumatol Int 1998;18(1):35- 36).

(2) A recent review of the literature on the treatment of fibromyalgia using acupuncture showed improvements in the myalgic index, in the number of trigger points, and in quality of life for the patients. (Current Pain Headache Report 2002;6(5):379-83).

The well regarded Cochrane Report reviewed much of the quality research on fibromyalgia and acupuncture and created a consensus report, which can be viewed here and suggests a strongly positive therapeutic role for acupuncture and Chinese medicine in treating this disorder.

Largest Study Ever Concludes that Acupuncture 'Very Effective in Treating Pain'

From the Annals of Internal Medicine comes the results of the largest study ever on acupuncture and pain management. Business Insider reported on this study and quotes it as saying, 

Data compiled from 29 studies of almost 18,000 people found that acupuncture was better at relieving pain than not having the treatment at all or undergoing a sham procedure, according to research reported in the Archives of Internal Medicine today.

While this finding is hardly surprising to acupuncturists or the millions of clients who have experienced the benefits of acupuncture treatments for their pain issues, it is reassuring to have such a prestigious journal publish such uniformly positive results.

Chronic Pain Responds to Acupuncture, Says Major Study

An enormous and well designed National Institutes of Health (NIH) funded study concluded that acupuncture definitively worked to successfully treat pain in a variety of conditions ranging from migraines, chronic back pain, shoulder pain as well as various types of arthritis.

According to the New York Times,

The findings provide strong scientific support for an age-old therapy used by an estimated three million Americans each year. 

“This has been a controversial subject for a long time,” said Dr. Andrew J. Vickers, attending research methodologist at Memorial Sloan-Kettering Cancer Center in New York and the lead author of the study. “But when you try to answer the question the right way, as we did, you get very clear answers.

“We think there’s firm evidence supporting acupuncture for the treatment of chronic pain.”“This has been a controversial subject for a long time,” said Dr. Andrew J. Vickers, attending research methodologist at Memorial Sloan-Kettering Cancer Center in New York and the lead author of the study. “But when you try to answer the question the right way, as we did, you get very clear answers. 

The study, which was published in the Journal of the American Medical Association (JAMA), and which can be read here, does not surprise those of us who treat chronic pain every day. However, it is deeply satisfying to witness such mainstays of western medical research find such benefits and tout them so widely.

Episiotomy Pain Successfully Treated with Acupuncture

An abstract reprinted here:

Italian clinicians have successfully used acupuncture to relieve perineal pain after episiotomy. Forty-two women who had an episiotomy during childbirth were enrolled in a pilot study. Women in the acupuncture group were significantly less likely to experience pain; 38.1% of women in the acupuncture group asked for analgesics, while all women in the control group requested oral analgesics because of perineal pain. Wrist-ankle acupuncture as perianal pain relief after medio-lateral episiotomy: a pilot study. Journal of Alternative and Complement Med. 2011 Mar;17(3):239-41.

Pregnancy and Acupuncture

While a large part of my practice involves the treatment of infertiliy, once the client has conceived she may opt to continue therapy. There are many reasons that clients who have used Chinese medicine to conceive will continue to work with us through the beginning of their pregnancy, to seek treatment toward the end of term, or use us to help them throughout the entire gestation. In the beginning of the pregnancy, usually through the first trimester, acupuncture can be very useful to minimize the chances of miscarriage due to uterine insufficiency. For women who have had previous miscarriages or who worry that they may carry a risk of such an occurrence may opt for this careful approach by using Chinese medicine. Additionally, acupuncture may be used to minimize or eliminate uncomfortable effects of pregnancy such as morning sickness, digestive problems, lowered energy and musculoskeletal pain - for which it can be extraordinarily effective.

Some women, by virtue of their age, risk factors or general health may opt to work with an acupuncturist throughout the entire pregnancy to ensure that her body remains as strong as possible and to minimize risk to the baby. The added bonus of this type of ongoing work is that labor and delivery is often quite a bit easier as a result.

Finally, many women will use an acupuncturist's services in the last month of pregnancy in order to help with a breach presentation of the baby, induce labor if the child is past term and the mother wants to avoid using chemical means of inducement or Caesarian section; or simply to ease the delivery.

All of these strategies can be very useful for a pregnant woman. Below I've included a few western medical studies demonstrate that the scientific community is beginning to recognize these benefits:

Research:

From the journal, Pain and Symptom Management, and summarized in Acupuncture Today, comes a study which demonstrates dramatic reduction in morning sickness in women receiving acupuncture versus placebo. 

The Journal of Complementary Medicine, 2009 published a study in which it was showed that women who used acupuncture during their pregnancy and labor had much lower rates of Caesarian section and a subjectively higher rate of comfort during the actual labor process.

From the US Pharmacists journal comes a compendium of many other studies demonstrating the utillity of acupuncture for morning sickness.

From the  Scandinavian journal, Acta Obstetricia et Gynecologica Scandinavica comes a study evaluating the treatment of pelvic and low back pain with acupuncture, during preganancy. Not only did the study conclude that acupuncture was very effective at treating this type of pregnancy related pain, but it also found that it obtained a superior result to using physical therapy as the sole treatment for this type of discomfort.

Using acupuncture to treat pregancy and/or post-partum related depression often yields powerful results. And we see this quite often in our clinic. In The Journal of Affective Disorders, there is a study which demonstrates this positive effect.

In the Journal Obstetric and Gynecologic Investigation, a rat model is used to investigate the potential chemical basis for acupuncture's effect in preventing one type of miscarriage.

From an Austrian Obstetrics journal, Wien Klin Wochenschr, comes a study on the effectiveness of using acupuncture to induce labor and ripen the cervix.

A small study in the journal, Acupuncture Medicine, demonstrates the effectiveness of using acupuncture to treat the insomnia which can be connected to pregnancy in many women.

From Science comes this French study on the successful management of  pelvic pain in pregnant women.