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

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 42 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.

Plantar Fasciitis and Acupuncture, A Solution

Plantar Fasciitis (PF) is a frequent musculoskeletal problem which we treat successfully, almost daily, at the Northside Holistic Center. PF is a painful inflammatory process of the plantar fascia, which is the connective tissue on the sole of the foot beginning at the base of the heel and spreading across the foot toward the toes. It is quite a frequent problem and can mainifest in two distinct populations: athletes who use their feet a lot and heavier people whose feet bear the brunt of the excessive weight. Those who are suffering with PF, and there are as many as 2 million Americans who go through this each year, experience pain in all or part of this region. The pain is often at its worst as they get out of bed in the morning and can often be exacerbated by flexing the muscles in the toes to bring the toes closer to the shin (referred to as 'dorsiflexion').

PF can trigger many other problems including heel spurs caused by the chronic inflammation in the region causing the calcification, as well as knee and back pain caused by gait changes associated with the pain from the feet. When our patients have been suffering for a long time with plantar fasciitis we will often work on these linked issues at the same time as the problem in the plantar fascia, which is at it's source.

Acupuncture is incredibly useful in remedying this problem and can be used alone or in conjunction with other modalities such as stretching, custom orthotics and physical therapy. It tends to perform much better, long term, and with fewer side effects than steroid injections.

 

Research/Articles

A Greek study entitled, Treatment of Plantar Fasciitis in Recreational Athletes: Two Different Therapeutic Protocols, (which can be read about here) found that:

Acupuncture should be considered as a major therapeutic instrument for the decrease of heel pain in plantar fasciitis (PF) . . . Scores for pain and mobility/function were significantly smaller [indicating improvement] in the acupuncture group after two months of treatment.

One treatment protocol for plantar fasciitis involves treating the unaffected side. We tend to use this technique when the affected side is so painful that the patient can not bear to be touched in that region. While on the surface this may appear counterintuitive, it is supported by thousands of years of clinical experience. A recent Japanese study demonstrates how this may work from a Western perspective and can be read about here:

Blood supply to the Achilles tendon can be increased by treating the contralateral [opposite side] tendon with either acupuncture or a heat pack. Japanese scientists used lasers to measure blood volume (THb) and oxygen saturation (StO2) of treated and non-treated tendons during treatment (10 minutes for acupuncture, 20 minutes for heat) and recovery periods (40 minutes). During both treatments, THb and StO2 of the treated tendon increased significantly from the resting level. The increased THb and StO2 of the treated tendon were maintained until the end of the recovery period after removal of the acupuncture needle, but they decreased after removal of the hot pack. Although THb of the non-treated tendon did not change during either acupuncture or heat treatment, it increased gradually after removal of the acupuncture needle or hot pack. The authors suggest that blood circulation to an injured tendon in a plaster cast could be improved by applying acupuncture or heat treatments to the contralateral healthy limb.

A British study, from the Orthopedics Department of a Bedford hospital [read it here], on the effects of acupuncture for non-responsive plantar fasciitis concluded that,

Our study demonstrates that acupuncture is effective in treating patients with chronic heel pain due to plantar fasciitis and that the addition of trigger point acupuncture in poor or non-responders may be useful.  

Alopecia Often Well Treated by Acupuncture and Chinese Medicine

Alopecia is one of the more frustrating disorders for a patient to experience – the loss of patches, broad swatches, or even all the hair on the body [alocepia areata; alopecia totalis; and alopecia univeralis, respectively]. Happily Chinese medicine, using both acupuncture and herbology, can be extraordinarily useful in remedying this problem for most people.

The process of treating this disorder is highly individualized, as is most of what we do in the field of acupuncture and Chinese medicine. The patient is evaluated based, not only on the hair loss pattern, but also on other health history issues and a tailored treatment plan using acupuncture and herbology is created.

Research/Articles

From the Journal of Chinese Medicine, published in Britain comes a well written summary of generally accepted protocol for treating various patterns of alopecia. It can be read here.

From the Journal of Acupuncture Science comes a study comparing a commonly prescribed pharmacetical for alopecia with acupuncture. The article, which can be read here, found that, 

Acupuncture is better than medications in the treatment of alopecia areata.

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

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."

Chinese Medicine Has Potential Treatments for Dementia

This article from the Taiwan News describes research into one of the herbs, Tian Ma that we frequently use in practice. The article, which can be read here, says:

...studies conducted by the Taiwanese institution have shown that tianma can be effective in curbing the effects of diseases ranging from dementia to spino-cerebellar atrophy, Huntington’s Disease and other ailments of the cerebral and nervous system. Research has shown that tianma can slow or reduce the effects of these diseases but so far it has not been established whether it can actually cure the diseases themselves.

http://zorgenvoormijnmoeder.blogspot.com

While it is true that we treat dementia with some moderate success and that Tian Ma may be one of the herbs that would be included in a formula and acupuncture protocol for this type of complaint, it would never be true that we would use one ingredient alone for such a purpose. Still, it for the purpose of research, it is useful to have yet another ingredient in our toolbox validated by Western methods.

Another interesting reductionist, yet interesting, study is one published by Japanese researchers and viewable here, looks at the effect of one acupuncture point that we might choose to treat cognitive issues. Again, this point would not be used on it's own, but only in the larger context of a treatment protocol. The study suggests that acupuncture enhances blood flow to the brain without altering the overal blood pressure in the region, a highly desirable goal.

Scientists measured the effects of acupuncture at [acupoint] DU-20 on blood flow velocities in the middle cerebral artery (MCA) and anterior cerebral artery (ACA), in 10 healthy male subjects. Mean MCA and ACA blood flow velocities at rest increased significantly after DU-20 acupuncture treatment, whereas mean arterial blood pressure and pulse rate at rest did not change significantly.

Another study which looked at the herbal aspect of what acupuncturists do for people with dementia, looks at one of the many formula which we may use for patients who come to us for Alzheimer's disease. This study, published in Neuroscience Letters (and readable here) found that,

Treatment with the Chinese herbal formula Fuzhisan (FZS) may have a positive effect on cognition, behavioral functions, and cerebral glucose metabolism in patients with mild-to-moderate Alzheimer's disease 

Twenty-two subjects were randomly assigned to receive FZS or placebo for 12 weeks. Positron emission tomography (PET) was used to study the regional cerebral metabolic rate of glucose consumption (rCMRglc) at baseline and week 12. Compared with placebo, FZS significantly improved cognitive and behavioural scores at week 12. In addition, FZS treatment favorably improved rCMRglc in the bilateral temporal and parietal cortices, hippocampus and posterior cingulate gyrus.