Acupuncture for Pain

This study published in Complementary Therapies in Medicine aimed to determine the efficacy of wet-cupping therapy for treating persistent nonspecific low back pain. Wet-cupping therapy is an ancient medical technique that involves applying a glass cup to the skin, creating a partial vacuum inside the cup, and inducing bloodletting through superficial incisions in the skin. The study was a randomized controlled trial with two parallel groups, one receiving wet-cupping treatment and the other receiving usual care.

Participants were 98 patients aged 17-68 years with nonspecific low back pain. The experimental group underwent three wet-cupping treatments at three-day intervals, while the control group received usual care from their general practitioner. The outcomes were assessed at baseline and three months after the intervention, focusing on pain intensity (McGill Present Pain Index), pain-related disability (Oswestry Pain Disability Index), and medication use (Medication Quantification Scale).

Results showed that wet-cupping therapy was associated with significant improvements in pain intensity, pain-related disability, and medication use at the three-month follow-up compared to the control group. After controlling for age, gender, and duration of lower back pain, the differences remained significant. The study concluded that traditional wet-cupping therapy was safe and acceptable for patients with nonspecific low back pain and more effective in reducing pain than usual care at a three-month follow-up.

This research review analyzed 64 studies on cupping therapy and was published in The Journal of Traditional and Complementary Medicine, aimed to understand cupping therapy’s mechanisms of action and therapeutic effects.

Their key findings:

• Cupping therapy may have neural, hematological, and immunological effects, with possible mechanisms of action including metabolic hypothesis, vasodilatation, edema and toxin elimination, and immune system modulation.
• Cupping therapy has been reported to induce comfort, relaxation, pain control, increased blood circulation, removal of toxins and waste, and immune system modulation. It may be effective in treating certain conditions such as herpes zoster, acne, facial paralysis, cervical spondylosis, musculoskeletal pain, and low back pain, among others.
• Six main hypotheses (pain-gate theory, release of nitrous oxide theory, blood detoxification theory, activation of immune system theory, diffuse noxious inhibitory controls, and reflex zone theory) have been proposed to explain the mechanism of pain reduction by cupping therapy.
  • Pain-Gate Theory (PGT) – explains how pain signals are transmitted and processed in the brain. Large nerve fiber activity (touch, pressure, vibration) inhibits transmission cell activity, reducing pain sensation. Cupping stimulates pain receptors, increasing impulse frequency and closing the “pain gates,” which leads to pain reduction.
  • Diffuse Noxious Inhibitory Controls (DNICs) – suggest that pain can inhibit pain, with one strong, spatially remote noxious stimulus reducing the perception of another pain. Cupping may cause local skin and capillary vessel damage, creating a nociceptive stimulus that activates DNICs and reduces pain through a “pain inhibits pain” mechanism.
  • Reflex Zone Theory (RZT) proposes that treating areas segmentally related to a nerve can alleviate pain in the corresponding region, as one part of the body can be linked to another through nerve, muscle, and chemical pathways. Cupping therapy applied to areas segmentally related to a nerve can improve blood circulation and blood supply to the skin and internal organs, potentially alleviating pain in the corresponding region.
  • Release of Nitrous Oxide Theory (RNOT) Nitric Oxide (NO) is a signaling gas molecule that plays a crucial role in several physiological functions, such as blood pressure regulation, immune responses, and neurotransmission. The release of nitric oxide theory suggests that cupping therapy could cause the release of NO from endothelial cells, inducing beneficial biological change. Cupping dilates topical capillaries and increases dermal blood flow, which has been proven by numerous studies. Higher activity of myeloperoxidase, lower activity of superoxide dismutase, and higher levels of malondialdehyde and nitric oxide were found in cupping blood compared to venous blood
  • Activation of Immune System Theory (AIST) – Cupping therapy has been shown to have various immunological effects, including regulating immunoglobulins and hemoglobin. It is likely to affect the immune system via three pathways:
    • • Irritating the immune system by creating an artificial local inflammation.
      • Activating the complementary system.
      • Increasing the level of immune products such as interferon and tumor necrotizing factor
      • Cupping therapy was found to improve immunologic functions in patients with chronic obstructive pulmonary disease during stable stage.
      • Cupping therapy reduced laboratory markers of rheumatoid arthritis activity and modulated the immune cellular conditions.
      • A study showed that cupping can upregulate oxyhemoglobin and deoxyhemoglobin, which play a role in immune function
  • Blood Detoxification Theory (BDT) – The blood detoxification theory addresses the removal of toxic substances from the affected area where the cups are applied. According to this theory, cupping therapy is responsible for several hematological adjustments, including a decrease in uric acid, HDL, LDL, and molecular structure and function of hemoglobin
    • • Cupping can affect the molecular structure and function of human hemoglobin and reduce the side effects of diabetes on Hb molecule.
      • A study found that removing heavy metals such as aluminum, mercury, silver, and lead, which were significantly higher in cupping blood compared to venous blood, would support the detoxification mechanisms of action

This randomized controlled trial published in the Journal of the American Medical Association, aimed to investigate the effectiveness of acupuncture in patients with migraine. The study involved 302 patients who were divided into three groups: acupuncture, sham acupuncture, and waiting list control. The primary outcome measure was the difference in headache days of moderate or severe intensity between the 4 weeks before and weeks 9 to 12 after randomization.

The results showed that both acupuncture and sham acupuncture groups experienced a reduction in the number of days with moderate or severe headaches compared to the waiting list group. However, there was no significant difference between the acupuncture and sham acupuncture groups. The proportion of responders (reduction in headache days by at least 50%) was 51% in the acupuncture group, 53% in the sham acupuncture group, and 15% in the waiting list group. The study concluded that acupuncture was not more effective than sham acupuncture in reducing migraine headaches, although both interventions were more effective than a waiting list control.

Note on sham acupuncture in this study: 

In the sham acupuncture group, the number of sessions, their length, and how often they occurred were the same as in the traditional acupuncture group. In each session, at least 5 out of 10 pre-selected non-acupuncture points were used for the treatment, with needles placed on both sides of the body (totaling at least 10 needles). The needles were inserted only slightly into the skin, and manual stimulation of the needles was avoided.

What the results mean in regard to sham acupuncture:

In regard to the study findings with sham acupuncture being just as effective as traditional acupuncture, it means that an acupuncturist can choose the “incorrect” points or miss the traditional points and get significant relief for patients with migraines.

This study published in Acupuncture in Medicne, aimed to evaluate the effectiveness of acupuncture in managing trigeminal neuralgia, a severe facial pain condition, in comparison to the first-line drug treatment (carbamazepine) and a common surgery (microvascular decompression). The research analyzed data related to efficacy, side effects, and cost from medical databases.

The results showed that acupuncture was not significantly more effective than the control group, but it had the highest effectiveness (86.5%) compared to surgery (79.3%) and drug treatment (71.7%). Acupuncture also had fewer side effects (22.7%) than surgery (25.3%) and drug treatment (88.8%).

Regarding costs, acupuncture was found to be the least expensive option. After five years, acupuncture’s cost was approximately $1005 (converted from £750), compared to $2020 for carbamazepine (converted from £1507.73) and $6543 for surgery (converted from £4878.42). Acupuncture was also found to be the least stressful treatment for patients, with a score of 53 points on the Social Readjustment Rating Scale, while surgery scored 153 points and drug treatment scored 217 points.

In conclusion, acupuncture appears to be more effective, safer, and less expensive than drug therapy or surgery for treating trigeminal neuralgia. The study suggests further research to explore these findings and the availability of acupuncture in healthcare systems like the UK’s National Health Service.

This study published in the journal Complementary Therapies in Medicine investigated the effectiveness of traditional acupuncture for chronic neck pain in a two-arm, randomized, sham-controlled, single-blinded clinical trial. Participants with neck pain, stiffness, and symptoms lasting for six months or more were included. The intervention consisted of six 30-minute treatments over three weeks. The study group received traditional acupuncture, while the control group received placebo acupuncture. Primary outcome measures were the Northwick Park Neck Pain Questionnaire (NPQ) for neck disability and a visual analog scale (VAS) for pain intensity, with the SF-36 questionnaire as a secondary outcome for quality of life assessment.

A total of 190 participants were recruited, with 178 completing the intervention and follow-up assessment. Physician assessments revealed significantly better healing, effectiveness, and improvement rates in the study group compared to the control group. Questionnaire assessments (NPQ, VAS, and SF-36) demonstrated that the study group experienced greater pain relief and improved quality of life after the intervention and at the 3-month follow-up. Adverse events during treatment were generally short-lived and manageable. Both patient-reported outcomes (PRO) and clinical-reported outcomes (CRO) were used to measure effectiveness, indicating that acupuncture can be an effective treatment for chronic neck pain.

This study published in the British Journal of Obstetrics and Gynecology aimed to determine the effectiveness of acupuncture in treating primary dysmenorrhoea (painful periods) by reviewing randomized controlled trials (RCTs). Researchers searched 19 electronic databases for relevant RCTs up until July 2008, with no language restrictions. The review included all RCTs that compared acupuncture with control groups, but excluded studies focusing on moxibustion or body acupressure.

Out of 27 RCTs that were systematically reviewed, only nine clearly described their randomization methods and none mentioned allocation concealment methods. The results showed that acupuncture was associated with a significant reduction in pain when compared to pharmacological treatment or herbal medicine. Three studies reported reduced pain within groups from baseline.

This study published in the journal Complementary Therapies in Medicine aimed to compare acupuncture and analgesics (pain-relieving drugs) in terms of effectiveness, safety, and durability for treating sciatica, a condition resulting from damage to the sciatic nerve in the lower back or buttock region. The review followed the Cochrane Handbook for Systematic Reviews of Interventions and searched four databases.

The results from 28 randomized controlled trials (RCTs) with 2,707 participants showed that the acupuncture group had a significantly higher total effective rate (TER) than the analgesic group. Additionally, the acupuncture group had a significantly lower visual analog scale (VAS) score, which measures pain intensity, and a higher pain threshold, meaning they were better able to tolerate pain. The acupuncture group also had fewer adverse effects (AEs) and lower relapse rates compared to the analgesic group.

In conclusion, acupuncture was found to be more effective and safe compared to analgesics for treating sciatica. However, more rigorous studies are needed to further validate these findings.

This study published in the Journal of Acupuncture and Meridian Studies aimed to investigate the effectiveness of acupuncture in reducing acute dental pain. The main outcome measure was pain intensity, measured using the Visual Analog Scale (VAS). Participants were divided into three groups based on the number of acupuncture points used for treatment.

120 patients participated in the study, with ages ranging from 18 to 71 years. Acupuncture significantly decreased pain intensity (from a mean baseline of 6.558 to 0.963 after intervention). The study found that the LI4 acupuncture point had the most significant analgesic effect, followed by CV23 and ST44.

The study concluded that acupuncture reduced pain intensity in 72.5% of patients with acute dental pain, with the LI4 point showing the most significant analgesic effect. Most patients (99.17%) would recommend acupuncture for dental pain relief. The study suggests that acupuncture could be a useful supplementary technique for pain control in patients with acute dental pain, but further research is needed to better understand its effects.

The number of treatments that it takes to treat any given condition is based on a great number of factors. Some of these factors can include: how long you have had said condition, age, dietary and lifestyle factors, willingness to perform self care at home, etc. It would also be safe to say that this medicine isn’t magic and no condition will be fully resolved after one treatment. However with that being said, many patients often leave the office with less pain than they started with and feeling more relaxed. 

At The Subtle Point, we offer a variety of services that can run from 5 minutes to as long as an hour. Initial appointments, however, are one hour long. During that appointment we will go over your health intake form, go over the estimated amount of treatments that will get you to your optimal health, go over the treatment methods that will be utilized, herbal medicine, dietary and lifestyle advice, and more. 

For the most part, no you don’t. I typically try and utilize points below the elbows and knees, sometimes around the belly, and sometimes on the back. Because of this I highly recommend that you come in wearing loose, comfortable clothing to allow easy access to these areas. 

To schedule an appointment you can call, send us an email, or book online by clicking on the “Book Now” button in the upper right portion of the screen. 

We accept cash, check, and credit card (Visa, Mastercard, American Express, and Discover). 

At this time I am not accepting insurance, but I can give you an invoice/superbill to give to your insurance company for reimbursement.