Neurobiological Correlates of Acupuncture: November 17–18, 2005

Napadow, Vitaly; Webb, Julia Megan; Pearson, Nancy J.; Hammerschlag, Richard

doi:10.1089/acm.2006.12.931

Cited by 17 publications

(8 citation statements)

References 12 publications

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“…Vascular, chemical, endocrine, neural, and central changes have been demonstrated following needling techniques [68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86]. Interestingly, dry needling also appears to be associated with activation of diffuse noxious inhibitory control reducing pain sensitivity in remote areas to the site of needling.…”

Section: Muscle Activationmentioning

confidence: 99%

myoActivation: A Structured Process for Chronic Pain Resolution

Lauder¹,

West²,

Siren³

2019

From Conventional to Innovative Approaches for Pain Treatment

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Chronic pain is a significant burden in all societies. The myofascial origins of chronic pain are often unrecognized but play a major role in chronic pain generation. Myofascial release has been shown to be effective and can augment the limited number of therapeutic tools available to manage chronic pain. However, there is no standardized approach that allows for comparative analysis of this technique. myoActivation ® is a unique therapeutic system, which targets active myofascial trigger points, fascia in tension, and scars in patients with chronic pain. Targets for intervention are determined through obtaining a history of lifetime trauma and a structured, reproducible posture, and movement assessment. Catenated cycles of movement tests, palpation, and needling are used to achieve the goal of pain resolution through restoration of soft tissue integrity. This chapter describes the distinctive features of myoActivation from the important key elements of the patient's clinical history, through to the aftercare instructions. Relevant evidence for each component will be presented. Case studies will be used to illustrate some important concepts and the effectiveness of myoActivation. This chapter is relevant to all clinicians that manage people living with chronic pain.

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Section: Muscle Activationmentioning

confidence: 99%

myoActivation: A Structured Process for Chronic Pain Resolution

Lauder¹,

West²,

Siren³

2019

From Conventional to Innovative Approaches for Pain Treatment

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“…Network meta-analysis was used to synthesise data reported atINTRODUCTION NIHR Journals Library www.journalslibrary.nihr.ac.uk research findings showing how acupuncture analgesia is mediated in part by endogenous opioids. 87 More recently, acupuncture neuroimaging research on pain has not only led to a better understanding of how acupuncture might work, 88 but also has informed biomedical understanding of neuroplasticity. 89 Second, there has been a remarkable growth in the utilisation of acupuncture for chronic pain after its transmission from East Asia to the West.…”

Section: Fundingmentioning

confidence: 99%

Acupuncture for chronic pain and depression in primary care: a programme of research

MacPherson

Vickers

Bland

et al. 2017

Programme Grants Appl Res

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BackgroundThere has been an increase in the utilisation of acupuncture in recent years, yet the evidence base is insufficiently well established to be certain about its clinical effectiveness and cost-effectiveness. Addressing the questions related to the evidence base will reduce uncertainty and help policy- and decision-makers with regard to whether or not wider access is appropriate and provides value for money.AimOur aim was to establish the most reliable evidence on the clinical effectiveness and cost-effectiveness of acupuncture for chronic pain by drawing on relevant evidence, including recent high-quality trials, and to develop fresh evidence on acupuncture for depression. To extend the evidence base we synthesised the results of published trials using robust systematic review methodology and conducted a randomised controlled trial (RCT) of acupuncture for depression.Methods and resultsWe synthesised the evidence from high-quality trials of acupuncture for chronic pain, consisting of musculoskeletal pain related to the neck and low back, osteoarthritis of the knee, and headache and migraine, involving nearly 18,000 patients. In an individual patient data (IPD) pairwise meta-analysis, acupuncture was significantly better than both sham acupuncture (p < 0.001) and usual care (p < 0.001) for all conditions. Using network meta-analyses, we compared acupuncture with other physical therapies for osteoarthritis of the knee. In both an analysis of all available evidence and an analysis of a subset of better-quality trials, using aggregate-level data, we found acupuncture to be one of the more effective therapies. We developed new Bayesian methods for analysing multiple individual patient-level data sets to evaluate heterogeneous continuous outcomes. An accompanying cost-effectiveness analysis found transcutaneous electrical nerve stimulation (TENS) to be cost-effective for osteoarthritis at a threshold of £20,000 per quality-adjusted life-year when all trials were synthesised. When the analysis was restricted to trials of higher quality with adequate allocation concealment, acupuncture was cost-effective. In a RCT of acupuncture or counselling compared with usual care for depression, in which half the patients were also experiencing comorbid pain, we found acupuncture and counselling to be clinically effective and acupuncture to be cost-effective. For patients in whom acupuncture is inappropriate or unavailable, counselling is cost-effective.ConclusionWe have provided the most robust evidence from high-quality trials on acupuncture for chronic pain. The synthesis of high-quality IPD found that acupuncture was more effective than both usual care and sham acupuncture. Acupuncture is one of the more clinically effective physical therapies for osteoarthritis and is also cost-effective if only high-quality trials are analysed. When all trials are analysed, TENS is cost-effective. Promising clinical and economic evidence on acupuncture for depression needs to be extended to other contexts and settings. For the conditions we have investigated, the drawing together of evidence on acupuncture from this programme of research has substantially reduced levels of uncertainty. We have identified directions for further research. Our research also provides a valuable basis for considering the potential role of acupuncture as a referral option in health care and enabling providers and policy-makers to make decisions based on robust sources of evidence.Trial registrationCurrent Controlled Trials ISRCTN63787732.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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“…11 More recently, biomedical research on pain has seen significant contributions from acupuncture neuroimaging research. 4,12 For example, positron emission tomography detected an increase of mu-opioid receptor-binding potential in multiple brain regions that correlated with acupunctureassociated reduction in fibromyalgia pain. 13 This specific demonstration of altered brain activity in patients with fibromyalgia has been cited as an important precedent in studies on the pathophysiology of other chronic pain conditions.…”

Section: Acupuncture Endorphins and Analgesia Researchmentioning

confidence: 99%

“…This support has led to important research findings regarding acupuncture's effectiveness, 3 as well as advances in the understanding of acupuncture's mechanisms of action. 4 Despite this considerable progress, debate remains regarding the interpretation and acceptance of the evidence base for acupuncture and the value of future research. 5,6 Missing from these reviews and discussions is a consideration of the often unexpected and broad-reaching discoveries that emerge when the traditions of biomedicine and acupuncture meet in the context of objective and systematic scientific exploration.…”

mentioning

confidence: 99%

Unanticipated insights into biomedicine from the study of acupuncture

2016

Br Dent J

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Research into acupuncture has had ripple effects beyond the field of acupuncture. This paper identifies five exemplars to illustrate that there is tangible evidence of the way insights gleaned from acupuncture research have informed biomedical research, practice, or policy. The first exemplar documents how early research into acupuncture analgesia has expanded into neuroimaging research, broadening physiologic understanding and treatment of chronic pain. The second describes how the acupuncture needle has become a tool to enhance biomedical knowledge of connective tissue. The third exemplar, which illustrates use of a modified acupuncture needle as a sham device, focuses on emergent understanding of placebo effects and, in turn, on insights into therapeutic encounters in treatments unrelated to acupuncture. The fourth exemplar documents that two medical devices now in widespread use were inspired by acupuncture: transcutaneous electrical nerve stimulators for pain control and antinausea wrist bands. The final exemplar describes how pragmatic clinical trial designs applied in acupuncture research have informed current general interest in comparative effectiveness research. In conclusion, these exemplars of unanticipated outcomes of acupuncture research comprise an additional rationale for continued support of basic and clinical research evaluating acupuncture and other under-researched therapies. Background W ithin the history of medicine, there are examples of scientific discoveries that emerged from unrelated or marginally related research. Such events often result from cross-fertilization of ideas, as for example when the emergent concept of autoimmunity catalyzed the shift in understanding of type 1 diabetes from a genetically determined endocrine imbalance to an organ-specific autoimmune disorder. 1 New ideas also arise when research efforts to target specific questions reveal unexpected findings, for example, the effectiveness of sildenafil for treating erectile dysfunction

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Neurobiological Correlates of Acupuncture: November 17–18, 2005

Cited by 17 publications

References 12 publications

myoActivation: A Structured Process for Chronic Pain Resolution

myoActivation: A Structured Process for Chronic Pain Resolution

Acupuncture for chronic pain and depression in primary care: a programme of research

Unanticipated insights into biomedicine from the study of acupuncture

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