Category Archives: Musculoskeletal Conditions
Musculoskeletal conditions encompass a very wide array of problems, but for simplicity I shall exclude under this category, both injuries and arthritis; for help with them, please look under their specific headings on my website. Under the musculoskeletal heading, I am going to give you an introduction to how acupuncture approaches conditions as diverse as frozen shoulder, stiff neck, tight shoulders, trapped nerves, carpal tunnel syndrome, knee pain, foot pain and other chronic pain conditions.
In our first consultation, I need to establish when the problem began, whether you feel it was triggered by a particular event, or whether it has crept on gradually. Then there are some other things for you to think about. Do you feel pain all of the time, or only on certain movements? Is your range of movement restricted, and if so, how eg. a frozen shoulder might be preventing you from reaching into a back pocket or brushing your hair? Is the pain sharp or shooting, or does it feel more dull and heavy? Have you found it responds to movement, rest or warmth? Does the pain spread some distance from where you feel the focus of the problem lies eg. pain which radiates from your shoulder to your elbow or beyond?
Next I will gather information on your health and wellbeing more generally, and note any other medical conditions which you have, or have had, in the past. We will move on to a thorough physical examination of the affected area and its surroundings, including assessing your range of movement and checking for tender areas. I can then give you your first treatment, aimed not only at helping the problem directly, but also at assisting with any subtle underlying imbalances which may have been perpetuating it: even stress may be one such factor.
My treatments for musculoskeletal problems are likely to involve a combination of massage and acupuncture, with exercises for you to perform at home. Generally, the longer a condition has persisted, or the more severe it is, the more treatment will be required. Some change is usually experienced after four or five treatments, but fairly recent problems treated early, can respond more quickly. I will usually suggest an initial number of sessions, after which we will review progress.
Do not worry if I have not listed your specific musculoskeletal problem (there exist a great many), or if you have not to date had a clear diagnosis. You are always welcome to telephone to discuss it.
Researchers in Turkey studying acupuncture for fibromyalgia, have found that it may provide better subjective clinical outcomes, plus long-term objective improvements in levels of pain neuromediators. A total of 75 women with the condition were randomised to receive either true acupuncture, sham acupuncture or simulated acupuncture. Treatments were given twice a week for four weeks.
Serum serotonin levels increased after treatment in both the true and sham acupuncture groups, but the increase in the true acupuncture group was significantly greater. Levels of substance P, the main pain neurotransmitter in the central nervous system, decreased in the true acupuncture group, but increased in the simulated acupuncture group. Some short-term improvements in subjective symptom scores occurred in all three groups. However the true acupuncture group showed the most benefit, with significant improvements in almost all clinical outcomes, including pain, number of tender points, disease impact, depression and general health. These changes were still reported three months after the end of treatment.
The authors conclude that acupuncture, rather than sham or placebo acupuncture, may lead to long-term improvements in clinical outcomes and pain neuromediator values. Changes in serum serotonin and substance P levels may be an explanation behind acupuncture’s mechanisms in fibromyalgia treatment.
(Effects of Acupuncture Treatment on Fibromyalgia Symptoms, Serotonin, & Substance P Levels: A Randomized Sham & Placebo-Controlled Trial. Pain Medicine, 6 December 2017.)
An update of the 2012 study by the international Acupuncture Trialists’ Collaboration reinforces the evidence that acupuncture for chronic musculoskeletal pain is an effective intervention. The new meta-analysis included raw data from an additional 13 randomised trials, giving a total dataset of nearly 21 000 patients from 39 trials. Acupuncture was superior to sham and no-acupuncture control for all four chronic pain conditions assessed: back and neck pain, shoulder pain and chronic headache. Patients receiving acupuncture had less pain, and there was clear evidence that the benefits of acupuncture persist over time, with only a 15% decrease in treatment effect after one year.
(Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain, 30 November 2017.)
Researchers at the University Medical School and Research Hospital in Ankara, Turkey have found that acupuncture given to patients with carpal tunnel syndrome, reduces symptom severity as well as swelling of the median nerve. A total of 45 arms belonging to 27 female patients, were randomly allocated to either an acupuncture or control group. All patients used a wrist splint at night. In addition, the acupuncture group received treatment two to three times a week for four weeks, giving ten sessions in total.
Symptom severity, hand function and electromyographic measurements improved in both groups, but the acupuncture group exhibited significantly higher improvements. Further, the cross-sectional area of the median nerve, which can increase due to swelling, significantly decreased in the acupuncture group; there was no change in the control group.
(The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study. Evidence-Based Complementary & Alternative Medicine, 6 June 2017.)
A randomised controlled trial undertaken by researchers at the University Medical Center Hamburg-Eppendorf in Germany, shows that acupuncture at sights distant to the affected area can bring immediate pain relief to patients with frozen shoulder. Its addition to the usual conservative care regime, also results in shorter recovery times.
Sixty patients with the condition were assigned to receive either shallow “press tack” acupuncture or sham treatment. An immediate improvement in pain score of 3.3 points was seen in the treated group, compared with 1.6 points in the sham group. The participants were then offered standard acupuncture and 34 accepted ten treatments over ten weeks, in addition to usual conservative care. A further 13 patients received usual care alone. The acupuncture group exhibited significantly improved pain scores within 15 weeks; the corresponding time for the usual care group was 30 weeks.
(Immediate Pain Relief in Adhesive Capsulitis by Acupuncture – A Randomized Controlled Double-Blinded Study. Pain Medicine, 20 March 2017.)