Does the effect of acupuncture depend on needling sensation and manipulation?

Choi, Yujin; Lee, Jae-Eun; Moon, Woongjoon; Cho, Seung-Hun

doi:10.1016/j.ctim.2012.12.009

Cited by 59 publications

(55 citation statements)

References 29 publications

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“…Also, the degranulation of MCs further emphasizes the importance of needle manipulation. By comparing 3 types of needle manipulation, a deep needling group, a superficial needling group and a group in which the needle was bilaterally rotated, Choi et improvement in pressure pain threshold compared to the two groups in which the needle was simply inserted, regardless of depth [107]. Moreover, there was a significant correlation of needle sensation (de qi) secondary to needle rotation and improvement in pain pressure threshold [107].…”

Section: The Effect Of Dry Needling Mechanotransduction On Mast Cellsmentioning

confidence: 88%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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There are a number of biochemical, biomechanical, endocrinological and neurovascular mechanisms underpinning the anti-nociceptive and anti-inflammatory effects of dry needling (DN). While myofascial trigger points likely play a role in peripheral pain, a diagnostic tool for localizing them has not been validated, and DN studies that have targeted trigger points to elicit localized twitch responses have reported mixed results. Therefore, the mechanism responsible for DN-mediated analgesia may be more complicated. DN activates opioid-based pain reduction, mediated by endogenous cannabinoids and the sympathetic nervous system, and non-opioid pain relief via serotonin and norepinephrine from the brain stem. DN also triggers the hypothalamic-pituitary-adrenal axis centrally and the corticotropin releasing hormone-proopiomelanocortin-corticosteroid axis locally to inhibit cox-2, reducing inflammatory cytokines. Recent studies demonstrate that DN combined with mechanical and/or electrical stimulation may reverse PKC-mediated peripheral hyperalgesic priming by normalizing nociceptive channels, to include TRPV, ASIC, TTX and P2X/Y. Electrical DN (EDN) stimulates immune cells, fibroblasts and keratinocytes to release CGRP and substance-P, altering the stimulation of TTX receptors to reverse hyperalgesia. It also encourages the supraoptic nucleus to release oxytocin to quiet ASIC receptors peripherally and stimulate opioid interneurons spinally. Moreover, EDN inhibits ERK1/2 kinase pathways of inflammation in the spinal cord and stimulates Aδ fibers and N/OFQ to reverse C-fiber mediated central changes. Mechanotransduction of fibroblasts and peripheral nerves via TRPV1 and P2X/Y-mediated intracellular Ca 2+ wave propagation and subsequent activation of the nucleus accumbens inhibits spinal pain transmission via glycinergic and opioidergic interneurons. The increased ATP is metabolized to adenosine, which activates P1 purinergic receptors, events considered key to DN analgesia and rho kinase-based tissue remodeling. Mechanotransduction-mediated release of histamine further explains analgesia secondary to needling points distal to pain. DN-mediated analgesia is dependent on a number of synergistic physiologic events involving biochemical and mechanical processes in neural, connective and muscle tissue.

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Section: The Effect Of Dry Needling Mechanotransduction On Mast Cellsmentioning

confidence: 88%

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Butts¹,

Dunning²

2016

Int J Phys Med Rehabil

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“…26 Methodologically robust experimental studies are starting to provide evidence to support the widely held belief that greater hypoalgesia may be attained using techniques that increase the intensity of needle stimulation including deeper insertion of needles, 13 more vigorous needle manipulation (rotation) 12 and more needles. 9 It is possible that these techniques increase the likelihood of conditioned pain modulation (ie, diffuse noxious inhibitory controls) whereby a noxious stimulus reduces the sensation of pain in a different receptive field.…”

Section: Discussionmentioning

confidence: 99%

“…Benham and Johnson 11 12 found that bidirectional needle rotation of 'deep tissue' increased hypoalgesia with a weak positive correlation between hypoalgesia and the intensity of needle sensations. Choi et al 13 found that the pressure pain threshold increased during deep needling with needle rotation compared with superficial needling (0.3 cm) without rotation and deep needling (2 cm) without rotation. They concluded that needle sensation and pressure pain threshold increased according to the depth and rotation of acupuncture.…”

Section: Introductionmentioning

confidence: 99%

Investigation into the Effects of Using Two Or Four Acupuncture Needles with Bidirectional Rotation on Experimentally-Induced Contact Heat Pain in Healthy Subjects

Paley

Johnson

2015

Acupunct Med

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Objectives There is growing evidence from experimental studies that the acupuncture dose or technique influences the speed of onset of hypoalgesia. The aim of this study was to investigate the effects of acupuncture using two or four needles on experimental contact thermal pain in healthy volunteers. Methods Forty two participants were randomised into three groups: four-needle group (LI4, LI11, LI10, TE5), two-needle group (verum at LI4, LI11 and mock at LI10, TE5) and mock acupuncture group (LI4, LI11, LI10, TE5). Each participant rated pain intensity (visual analogue scale, VAS) to a series of noxious stimuli administered to the forearm 2°C above the heat pain threshold during needling and immediately after removal of the needles. Results Experimentally-induced heat pain intensity (VAS) during and after the intervention was lower than pre-intervention but there were no statistically significant differences in this change between groups. There were no statistically significant differences between groups in the time taken for pain intensity to decrease by 33% from pre-intervention. However, a 33% decrease in pain intensity within 3 min of needle insertion was observed for 13 participants (92.9%) in the four-needle group compared with 66.7% of participants in the two-needle group and 57.1% in the mock acupuncture group. There was less variance in VAS in the four-needle group, suggesting more consistency in hypoalgesic response when using more needles. Conclusions There is tentative evidence that four needles may be superior to two needles in generating rapid onset hypoalgesia. The findings suggest that further investigation is warranted.

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“…또한 현대 한의학에서 도 득기는 침 치료의 효과에 영향을 미치는 중요한 요소로 침 치료의 기전에 핵심적인 역할을 하는 것으로 여긴다 4,5) . 최근의 연구에서 침 치료 시捻轉을 통해 득기감의 강도 를 증가시킬수록 압력 통각 역치(pressure pain threshold, PPT)가 높아져 진통효과가 증가함이 발표되었다 6) . 이는 득기감과 침 치료의 효과가 관련이 있음을 과학적으로 규 명한 것이다.…”

Section: ⅰ 서 론unclassified

The Clinical Study about Qualitative and Quantitative Characteristics of Acupuncture Sensation According to the Body Parts

Oh¹,

Lee²,

Lee³

et al. 2013

The Acupuncture

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Objectives : This study was designed to find out the differences of the acupuncture sensation by body parts. Methods : Sixty-three subjects got acupuncture at five acupoints which represent five different body parts ; head(GV20), abdomen(ST25), back(BL24), upper extremity(LU9), lower extremity(GB40). All subjests were asked to complete questionnaire rating the intensity of 13 kinds of acupuncture sensation(acupuncture sensation scale, ASS). We compared the subjective acupuncture sensation between the body parts. Results : Intensity of acupuncture sensation of GV20 was significantly lower than LU9(p=0.001) and GB40(p=0.000). Sum of acupuncture sensation of GV20 was also significantly lower than BL24(p=0.011), LU9(p=0.004) and GB40(p=0.033). Among the 13 types of acupuncture sensation scale, tingling and aching were well sensed at GV20 and ST25, aching, tingling and sharp pain were well sensed at LU9, GB40, dull pain, deep pressure and heaviness were well sensed at BL24. Conclusions : Head showed significantly lower intensity of acupuncture sensation than upper extremity and lower extremity. Among the acupuncture sensation scales, tingling and aching were well sensed at head and abdomen, aching, tingling and sharp pain were well sensed at upper extremity and lower extremity, dull pain, deep pressure and heaviness were well sensed at back.

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Does the effect of acupuncture depend on needling sensation and manipulation?

Cited by 59 publications

References 29 publications

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals

Investigation into the Effects of Using Two Or Four Acupuncture Needles with Bidirectional Rotation on Experimentally-Induced Contact Heat Pain in Healthy Subjects

The Clinical Study about Qualitative and Quantitative Characteristics of Acupuncture Sensation According to the Body Parts

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