Single Cupping Thearpy Session Improves Pain, Sleep, and Disability in Patients with Nonspecific Chronic Low Back Pain.

The objective of this study was to evaluate if a single session of real or placebo cupping therapy in patients with chronic low back pain would be enough to temporarily reduce pain intensity and functional disability, enhancing their mechanical threshold and reducing local skin temperature. The outcome measures were Brief Pain Inventory, pressure pain threshold, Roland-Morris disability questionnaire and low back skin temperature. This is an experimental clinical trial; after examination (AV0), patients were submitted to real or placebo cupping therapy (15 minutes, bilaterally at the points BL23 (Shenshu), BL24 (Qihaishu) and BL25 (Dachangshu) and were revaluated immediately after the session (AV1) and after one week (AV2). The patients showed a significant improvement in all pain severity items and sleep in the Brief Pain Inventory (p < 0.05) and a decrease in disability in Roland-Morris disability questionnaire (p < 0.001). No significant differences were found in pressure pain threshold or skin temperature. No significant differences were found in any outcome of the placebo cupping therapy group. Thus, the cupping therapy is effective in reducing low back pain and decreasing disability after one single session but not in changing skin mechanical threshold or temperature.

Analgesic Effects Elicited by Neuroactive Mediators Injected into the ST 36 Acupuncture Point on Inflammatory and Neuropathic Pain in Mice.

The present study evaluates whether the injection of serotonin, acetylcholine, glutamate, bradykinin, histamine, or substance P (SP) into the Zusanli (Stomach 36, ST 36) acupoint can also produce the acupuncture-induced antinociceptive effect on inflammatory or neuropathic pain. In this in vivo experimental study, a total of 450 male Swiss mice were used. Mice were injected with saline or complete Freund's adjuvant (CFA) or subjected to sham or chronic constriction injury (CCI) surgery. After the establishment of the inflammatory (4 hours) or the neuropathic pain (3 days), the animals (n = 6) received manual acupuncture, sham acupuncture, or injection of saline, serotonin, acetylcholine, glutamate, bradykinin, histamine, or SP into the ST 36 and were evaluated for up to 24 hours. Mechanical threshold was evaluated, and the L4-L6 dorsal root ganglion was used for analysis of the transient receptor potential vanilloid type 1 overexpression. The mice from both the CFA and CCI models treated with manual acupuncture had significant increases in the thresholds for more than 24 hours. Sham acupuncture stimulation did not change the thresholds. In the mice injected with each of the mediators, the thresholds were significantly increased for all times in both the CFA and CCI models. Transient receptor potential vanilloid type 1 overexpression in CFA and CCI mice was reduced at all times by injection of serotonin, acetylcholine, or SP but not by injection of glutamate, histamine, or bradykinin. Our data suggest that the neuroactive mediators released by acupuncture-induced tissue injury may contribute to acupuncture-induced analgesia.

Single or Multiple Electroacupuncture Sessions in Nonspecific Low Back Pain: Are We Low-Responders to Electroacupuncture?

The objective of this study was to compare the effects of one or multiple sessions of electroacupuncture (EA) in patients with chronic low back pain. The outcome measures were visual analog score (VAS), pressure pain threshold (PPT), McGill pain questionnaire (MPQ), Roland Morris disability questionnaire (RMDQ), low back skin temperature, surface electromyography of longissimus muscle (contraction/rest) and blood cytokines. After examination (AV0), patients were submitted to EA (2 Hz, 30 minutes, bilaterally at the SP6, BL23, BL31, BL32, BL33, and BL60) and were revaluated after one week (AV1). Patients with VAS <3 (VAS <3 group, n = 20) were directed to return after three weeks (AV2). Patients with VAS >3 (VAS >3 group, n = 20) were submitted to one weekly EA-treatment and revaluated after three weeks (AV2). The VAS <3 group showed a significant reduction in VAS and MPQ and increased PPT in AV1, but not in AV2. No significant differences were found in RMDQ. The VAS >3 group showed reduction in VAS and increased PPT in AV1 and a reduction in MPQ and RMDQ only in AV2. No significant differences were found in electromyography, temperature or cytokines. Thus, despite 2Hz-EA is effective reducing low back pain, some patients only experienced reduced pain intensity and improved functional capacity after full treatment.