Patient-Centered Acupuncture and Moxibustion / 全日本鍼灸学会雑誌

In recent years, due to the rapid changing social structure, thedemands for medical services are also changing. There is a need to explore the future direction of acupuncture and moxibustion. Therefore, using the keyword "patient"as the focus of medicalservices, we discussed the question, "What is meant by 'patient-centered'Acupuncture and Moxibustion?"<BR>Our results indicate that the numerous clinical treatments, education, and research that occurred throughout the long history of acupuncture and moxibustion in Japan were in fact all done "for the patient."However, we note that there is still room for improvement in verification method and cooperation between each field, and we confirmed that there is a need to build Acupuncture and Moxibustion methods that truly represent "patient-centered medicine."

Review of the effects of acupuncture and moxibustion on lower back pain / 全日本鍼灸学会雑誌

The effects of acupuncture and moxibustion on lower back pain in clinical trials were reviewed. First, the effects of Western medicine on lower back pain, patients with specific and nonspecific lower back pain, were systematically reviewed based on online data, and possible mechanisms were discussed. Secondly, the role and potential of acupuncture and moxibustion on lower back pain were considered based on a review of research literature. Finally, the effectiveness of acupuncture and moxibustion on several kinds of lower back pain was systematically examined based on online data. These results suggest that acupuncture and moxibustion may be more effective on non-specific lower back pain.

Clinical application of acupuncture on temporomandibular disorder in a patient with disc disorders / 全日本鍼灸学会雑誌

[Objective]Acupuncture has been reported to be useful for temporomandibular disorders. There have been many reports on muscle problems in temporomandibular disorders (TMD) but only a few reports on disc problems. We report on the use of acupuncture in a temporomandibular disorder patient with disc disorders.<BR>[Case]A 19-year-old female complained of pain upon opening her mouth and trismus. We applied acupuncture with the aim of resolving the disc problems and providing analgesia by a contributing muscle needling approach.<BR>[Methods]The following were measured:intensity of jaw pain, anxiety and satisfaction (visual analogue scale:VAS), position and form of disc and caput mandibulae (MRI) and presence of jaw deviation.<BR>[Results]The following were improved after acupuncture treatments:intensity of jaw pain, anxiety and satisfaction, limitation of jaw movement and jaw deviation. However, the positions of the discs did not change.<BR>[Conclusion]These results suggest that acupuncture may be effective for temporomandibular disorder patients with disc disorders.

The efficacy of acupuncture treatment on pain and ability with osteoarthritis of the knee-Examination of the curative effect by the depth of an acupuncture needle- / 全日本鍼灸学会雑誌

[Objective]To evaluate the efficacy of the different depth of acupuncture on the motor function and the pain with osteoarthritis of the knee. <BR>[Design]Single blind randomized controlled trial.<BR>[Method]Subjects were randomly allocated to one of two groups. Acupuncture needles were inserted about 3mm in the superficial acupuncture group and 10 to 20 mm in the deep acupuncture group. Subjects in both groups received the treatments for ten minutes on ten tender points. Acupuncture sessions were performed once a week for 8 weeks and without treatment 4 weeks.<BR>[Outcome Measures]Pain intensity (visual analogue scale :VAS) , Objective evaluation of the motor function (Timed Up &Go test, 20m walking time, Time of going up and down stairs) and QOL (Western Ontario and MacMaster Universities osteoarthritis index :WOMAC).<BR>All measurements were recorded at baseline, 4th, 8th and 11thweek.<BR>[Result]Motor function improved significantly only in the superficial acupuncture group(P<0.05). The degree of pain decreased significantly in both groups (P<0.05). <BR>[Conclusion]Superficial acupuncture provided the improvements on pain and motor function and contributed to the QOL improvement. Therefore the superficial acupuncture would be suggested to be one of the most effective method for the acupuncture treatment of OA of the knee.

Effect of trigger point acupuncture treatment in older patients with chronic low back pain: randomized controlled trial / 全日本鍼灸学会雑誌

[Objective]To compare the efficacies of three types of acupuncture modalities on the pain magnitude and disability of chronic low back pain (LBP).<BR>[Design]Single blind randomized controlled trial, three parallel arms.<BR>[Setting]Outpatients of the Meiji University of Integrative Medicine Hospital.<BR>[Subjects]Thirty-nine elderly patients (24 females, 15 males;age 71.2 ± 7.7) who suffered from LBP for at least six months.<BR>[Interventions]Subjects were randomly allocated to one of three groups. Tender point group (TeP, n = 13) received to the tender point. Trigger point acupuncture group (TrP, n = 13) received to the trigger points. Sham acupuncture group (SM, n = 13) mimicked needling without insertion of the needle in the trigger point. Acupuncture sessions were performed once a week for five weeks. <BR>[Main Outcome Measures]Pain intensity (visual analogue scale:VAS) and QOL (Roland-Morris Disability Questionnaire:RDQ). <BR>[Results]At the end of the treatment period, significant improvement was observed on pain intensity and QOL in the TrP group alone (p < 0.01). However, there were significant differences in pain at the three month follow-up.<BR>[Conclusion]These results suggest that trigger point acupuncture has a long-term effect on treatment for low back pain in aged patients.

The Effect of Trigger Point Acupuncture Treatment on Chronic Neck and Shoulder Pain-Questionnaire and Acupuncture Treatment for Unversity Students- / 全日本鍼灸学会雑誌

[Purpose] This study investigated shoulder stiffness in university students and compared three different treatment procedures for shoulder stiffness.<BR>[Method] The questionnaire (7 items) was distributed to 30 university students with a 3-month history of shoulder stiffness treated by three different treatments procedures. There were no abnormal findings on neuro logical examination.<BR>[Result] The questionnaire response rate was 64.6%. The overall prevalence of shoulder stiffness was 61.9%, most patients had asthenopia and headache along with shoulder stiffness. However, immediately after the tender point and sham treatment periods, there were no remarkable clinical effect on shoulder stiffness, whereas after trigger point treatment, there were remarkable clinical effects on shoulder stiffness, as evaluated by the visual analogue scale.<BR>[Conclusion] These results suggest that trigger point acupuncture treatment may be more effective for shoul- der stiffness in university students than other acupuncture treatments

Review of the Effects of Acupuncture and Moxibustion on Chronic Pain / 全日本鍼灸学会雑誌

Effects of acupuncture and moxibustion on chronic pain in human and animals were reviewed. Firstly, the role of sensitization of pheripheral and/or central nervous systems on the mechanisms of chronic pain was introduced based on the basic researches in experimental animals. Secondly, the effects of acupuncture on neuropathic pain and postoperative pain patients were reviewed and its possiblemechanisms were discussed. Finally, effectiveness of acupuncture and moxibustion on several kinds of chronic nociceptive pain (low back pain, neck pain, headache) was systematically reviewed based on the online database

A Controlled Clinical Trial Comparing Trigger Point Acupuncture with Tender Point Acupuncture Treatments for Chronic Low Back Pain-A Pilot Study on 9 Elderly Patients- / 全日本鍼灸学会雑誌

[Objective] Although there is some evidence for the efficacy of trigger point acupuncture and tender point acupuncture treatments for chronic low back pain, differences between the therapeutic effect of trigger point needling and that of tender point needling remain unclear. We compared the therapeutic effects of trigger point acupuncture and tender point acupuncture treatment for chronic low pack pain in elderly patients.<BR>[Design] Single-blind clinical controlled trial, quasi-randomized, 2 parallel arms.<BR>[Methods] Nine patients, aged 65 or over, with chronic low back pain for at least 6 months were alternately allocated to the trigger point needling group (n=4) or tender point needling group (n=5). Patients received treatments once a week for five weeks. Outcome measures were pain intensity (Visual Analog Scale : VAS) and pain disability (Roland-Morris Disability Questionnaire : RDQ).<BR>[Results] After the treatment period, VAS and RDQ values had improved significantly in the trigger point group, but there were no significant improvements in the tender point group.<BR>[Conclusion] Differences in improvement between the trigger point and tender point groups seem to suggest that the trigger point needling was different from tender meridian point needling in respect to the therapeutic effect. Further studies are necessary to fully assess the efficacy of this treatment for chronic low back pain using a blinded or placebo control group.

Effect of Acupuncture Treatment on Chronic Low Back Pain with Leg Pain in Aged Patients-A Controlled Trial about Short-term Effects of Trigger Point Acupuncture- / 全日本鍼灸学会雑誌

[Objective] To compare the efficacies of four types of acupuncture modalities on pain magnitude and disability due to chronic low back pain (LBP) in sciatica patients.<BR>[Design] Single blind randomized controlled trial, 4 parallel arms.<BR>[Setting] Outpatients of the Meiji University of Oriental Medicine Hospital.<BR>[Subjects] Forty-four elderly patients (29 woman, 15 man; age range : 65-81 years) with LBP due to sciatica persisting for at least 6 months.<BR>[Interventions] Subjects were randomly allocated to one of four groups. The standard acupuncture group (SA, n=9) received acupuncture on traditional acupoints used for treatment of LBP. Superficial trigger point acupuncture group (S-TrP, n=9) and deep trigger point acupuncture group (D-TrP, n=10) received superficial (S-TrP) or deep (D-TrP) needling of the trigger points. Sham acupuncture group (SM, n=9) was treated by mimicked needling without insertion of the needle in the trigger point. Acupuncture sessions were performed once a week for 3 weeks.<BR>[Main Outcome Measures] Pain intensity (visual analogue scale : VAS) and QOL (Roland-Morris Disability Questionnaire : RDQ).<BR>[Results] At the end of the treatment period, significant improvement was observed on pain intensity and QOL in the D-TrP group alone (p<0.01). Furthermore, the effects persisted during the 3-week follow-up (p<0.05) [Conclusion] These results suggest that trigger point acupuncture with deep needling provides effective treatment for low back pain in aged patients.

The Effect of Trigger Point Acupuncture Treatment on Sport-induced Chronic Low Back Pain-Questionnaire and Acupuncture Treatment for University Students- / 全日本鍼灸学会雑誌

[Purpose] This study investigated sports injuries in university students and compared two different acupuncture therapy procedures for chronic low back pain (LBP).<BR>[Method] The questionnaire (12 items) was distributed to members of sports clubs at Meiji University of Oriental Medicine. Patients with LBP resulting from sports injuries who had had low back pain for more than a year were treated by two different acupuncture therapy procedures. There were no abnormal findings in their neurological examinations.<BR>[Result] The questionnaire response rate was 68.6%. The overall prevalence rate of sports injuries was 77.6%, and LBP patients were the most common. On the other hand, during and after the preceding therapy, using the traditional acupoints for LBP, there was no remarkable clinical effect on LBP, whereas during and after the succeeding therapy using the trigger point, there were remarkable clinical effects on LBP, as evaluated by the visual analogue scale.<BR>[Conclusion] These results suggest that trigger point acupuncture therapy may be more effective on chronic LBP in sports than therapy which uses traditional acupuncture.

Clinical Observations of Spontaneous Osteonecrosis of the Medial Tibial Plateau / 全日本鍼灸学会雑誌

[Objective] We analyzed the clinical findings in 5 patients with osteonecrosis in the medial condyle of the tibia. We also evaluated the usefulness of a tibial percussion test that we developed for examination of differences between the healthy and affected sides in percussion caused by knocking on the tibial rough surface.<BR>[Methods] The subjects were 5 females, who consulted our hospital with a chief complaint of gonalgia and in whom conditions such as osteonecrosis in the medial condyle of the tibia were confirmed by MRI in 4 limbs. In addition to X-p, MRI findings, medical findings by interview, and findings by physical examination were evaluated as clinical findings. Furthermore, the tibial percussion test was performed.<BR>[Results] The causes of pain in the knee joint were unclear in all patients. Pain was severe in 3 patients and marked in 2 patients. Physical examination showed marked tenderness in the medial articular gap and tenderness in the medial condyle of the tibia. In all patients, a difference in the percussion findings between the healthy and affected sides was confirmed by the tibial percussion test.<BR>[Conclusions] These findings indicated that the tibia percussion test in addition to confirmation of characteristic clinical conditions, such as the initial condition of the disease and the severity of tenderness, is useful for the evaluation of conditions of this disease.

Characteristics of Spontaneous Electrical Activities at the Trigger Point in a Chronic Shoulder Pain Patient-A Case of Trigger Point on Trapezuis Muscle- / 全日本鍼灸学会雑誌

[Purpose] The characteristic of electrical activities recorded at the clinical trigger point was examined.<BR>[Materials] A 26-year-old woman complained of chronic shoulder pain. She had a trigger point near GB 21 (Jianjing, Kensei). The electrical activities were recorded at the trigger point and a non- tender point.<BR>[Results] Electrical activities were detected only when the electrode was located on the trigger point andthere was a subjective dull pain sensation. The amplitudes of electrical activities did not change during psychological stress. [ Conclusion ] These results suggest that the electrical activities were the result of nociceptive reflex.

The Effect of Acupuncture Treatment on Fibromyalgia Syndrome-Four Cases of Electrical Acupuncture Treatment for Chronic Muscle Pain- / 日本東洋医学雑誌

Four fibromyalgia syndrome (FMS) patients with complaints of widespread pain, fatigue and difficulty sleeping received acupuncture therapy. The effects of acupuncture treatment were evaluated using a visual analogue scale (VAS), and a pain disability assessment scale (PDAS). After whole body acupuncture treatments, VAS and PDAS values were almost unchanged. However, VAS and PDAS values improved following a 3-treatment course of FMS-specific acupuncture treatments (electroacupuncture at the characteristic tender points of FMS). These results suggest that FMS-specific acupuncture treatment of fibromyalgia patients may relieve their commonly reported symptoms of pain, and fatigue.

Effect of Acupuncture Treatment on a Fibromyalgia-like Syndrome Patient / 全日本鍼灸学会雑誌

Case Report : Acupuncture therapy for a fibromyalgia-like syndrome (FMS-like) patient. A 44-year-old woman complained of widespread pain, fatigue and poor quality sleep. Effects of acupuncture treatment were evaluated using a visual analogue scale (VAS), pain disability assessment scale (PDAS) and pressure pain thresholds (PPT) at tender sites of FMS. After 13 whole body acupuncture treatments PPT, VAS and PDAS were almost unchanged. However, three FMS-specific acupuncture treatments (eletroacupuncture at characteristic tender sites of FMS) increased PPT and improved VAS and PDAS. These results suggest that FMS-specific acu-puncture treatment may relieve widespread pain and fatigue symptoms in FMS-like patients.

Effect of trigger point acupuncture treatment on chronic low back pain in elderly patients-Three cases of effectiveness with trigger points, instead of the traditional acupoints- / 全日本鍼灸学会雑誌

[Purpose] Elderly patients with chronic low back pain have often been treated by acupuncture andmoxibustion therapy, using the traditional acupoints for low back pain. But there are some patients who do not get a clinical effect. Therefore, we tried to treat three such patients with three sessions of trigger point acupuncture therapy, instead of using the traditional acupoints for low back pain.<BR>[Methods] The patients were aged 74, 71 and 66, and had low back pain for at least 6 months. They hadround backs, but there were no extraordinary findings in their neurological examinations.<BR>[Results] During and after the previous therapy using the traditional acupoints for low back pain, there wereno remarkable clinical effects on low back pain. But during and after the present therapy using trigger points, there were remarkable clinical effects on low back pain, as evaluated by the visual analogue scale (VAS) and the pain disability assessment scale (PDAS).<BR>[Conclusion] These results suggest that the trigger point acupuncture therapy may be more effective on lowback pain in elderly patients than acupuncture therapy which uses the traditional acupoints.

Relationships between Clinical Symptoms and Pressure Pain Thresholds in Patients with Osteoarthritis of the Knee Joints / 全日本鍼灸学会雑誌

Treatment of tender points has widely been used for diagnosis and treatment, but there are few studies elucidating the usefulness of this approach to diagnosing knee pain. This study investigated the diagnostic importance of tender points. The symptoms and the pressure pain threshold (PPT) in osteoarthritis of the knee (pain and motion of knee joint) were measured in 45 patients being treated at the Acupuncture Center of Meiji University of Oriental Medicine. The change in PPT was related to symptoms of knee pain (staircase and flexion pain). It is suggested that changes in PPT around the knee joints are a useful indicator for evaluating knee pain.

Electrical Activities Detected from the Experimentally-induced Trigger Points in Human Subjects / 全日本鍼灸学会雑誌

Electrical activities detected from the experimentally-induced trigger points in human subjects.<BR>Objectives : To examine the pathogenic mechanisms of the trigger points, electrical activities were recorded from the experimentally-induced trigger points.<BR>Methods : Nine healthy volunteers who gave informed consent were used. The adjustable loads were set around the third finger and repetitive eccentric contraction was loaded on the extensor digital muscles. The subjects were asked to keep the position as long as possible. The loadings (about 10s) were continued until his all-out effort and were repeated 3 times with 5 min resting periods. The electrical activities in the skin, fascia and muscle of the trigger point and non-tender region of palpable band and 10mm outside the band were recorded on the second day after the eccentric exercise.<BR>Results : Repetitive eccentric exercise produced a trigger point within the palpable band, which developed on the second day after the exercise. Electrical activities were detected only when the electrode tip was located in or near the fascia of the trigger point and there were subjective dull pain sensations. When the radial nerve was blocked by lidocaine, the needle EMG activity could not be recorded.<BR>Conclusions : These results suggest that the EMG activities are the result of nociceptive reflex, and the sensitized nociceptors in the fascia of the palpable band might be a substrate for the trigger point.

Relationships Between Pressure Pain Thresholds and Clinical Symptoms in Acupuncture and Moxibustion Therapy. A Case of Osteoarthritis of the Knee Joints / 全日本鍼灸学会雑誌

The tender points treatment has been widely used for both treatment and diagnosis, but there have been very few studies that have examined its diagnostic usefulness. Thus, the purpose of this study was to clarify the diagnostic importance of tender points. The subject was a patient who had osteoarthritis of the knee of Meiji University of Oriental Medicine Hospital. The relationship between pressure pain thresholds (PPTs) and symptoms in osteoarthritis of the knee (painful knee motion) were evaluated with the Japanese Orthopaedic Association scale (JOA scale), a knee scale and the subject's knee pain diary (starting pain, flexion pain, walking pain and total pain Wong-Baker faces pain rating scale). After 40 acupuncture treatments, improvement was noted in the symptoms and PPTs. The changes in PPTs were related to the symptoms of the knee (flexion and walking pain). This suggests that changes in PPTs (around the knee) are a useful indicator for evaluating knee pain.

Examination of an Eccentric Contraction-induced Trigger Point Model Using Human Subjects / 全日本鍼灸学会雑誌

The nature of an experimental trigger point model produced by eccentric exercise was examined in seven healthy volunteers who gave their informed consent. Adjustable loads were set around the third finger and the subjects were asked to keep the position as long as possible. The loadings (about 10s) were continued until his all-out effort and were carried out 3 times interspersed with 5 min rest periods. Pressure pain thresholds (PPT) and deep pain thresholds (DPT) before exercise, and on the 2nd and 7th day after the exercise, were measured in the skin, fascia and muscles. On the 2nd day after the exercise, the PPT of the restricted area of the taut band was the minimum. A similar reduction of the DPT was observed only in the fascia of the restricted area. These results suggest that the present experimental model is useful for the further investigation of trigger points.

Suppressive effects on human flexion reflex induced by different pressure intensities and stimulation sites / 全日本鍼灸学会雑誌

Different intensities of pressure were applied to various tender or non-tender points and the suppressive effects on the flexion reflex were examined in 21 healthy humans (18-26 years), who gave informed consent. The sural nerve was stimulated transcutaneously with trains of 5 pulses at intervals of 13 sec (1.05-1.10x T, T : threshold) and evoked EMGs were recorded from the biceps femoralis muscle. Tender points in the contralateral forearm were detected by careful palpation, and conditioning pressure stimulation was applied at variousintensities by a push-pull gauge for 78 sec. Pressure applied to tender points induced slightly greater suppression of evoked EMGs than that to non-tender points (C statistics : time series analysis), although the difference was not significant (group comparison). Pressure intensities of ten and 50 % of pain tolerance pressure seemed to be adequate for suppression of EMGs in both tender and non-tender points. These results suggest that suppression of flexion reflex by pressure application in humans may be mediated by tactile and pain-related afferent fibers and the importance of adequate stimulus intensity for the induction of analgesic effects.