Pain relief with PAP injections may last 100 times longer than a traditional acupuncture treatment

Image: D Sharon Pruitt via Flickr


Last week I blogged about the newest research showing that acupuncture can improve skeletal muscle atrophy in mice. Well these are exciting times as researchers around the world are looking at the mechanisms of acupuncture (which unfortunately are still unknown) and applying them in a whole new way.


Traditionally acupuncture uses the concepts of qi and blood (which is basically oxygen and nutrients) in the channels (or vessels) and helping direct them to where they are needed most. If you are deficient in either qi or blood, then the acupuncturist will use the tonifying method and point selection. Likewise if there is a blood stasis (think back to the nightmare traffic jam) then the acupuncture method chosen would be of the moving variety, to help remove the blockage, or stagnation, and get the traffic going again.


Recent studies have looked at these concepts from outside the box. Researchers still don’t know how acupuncture works exactly but that hasn’t stopped them from applying them in new and wonderful ways.


Take this new finding from scientists at the University of North Carolina at Chapel Hill who have identified a new way to deliver long-lasting pain relief through acupuncture.


Injecting prostatic acid phosphatise (PAP) into the spine of rodents eased chronic pain for up to three days. Unfortunately the method of delivery, spinal injections, are invasive and must be performed in a clinical setting meaning they are typically reserved for patients with excruciating pain.


Mark J. Zylka, PhD, associate professor in the Department of Cell and Molecular Physiology and the UNC Neuroscience Center, explains:


“When an acupuncture needle is inserted into an acupuncture point and stimulated, nucleotides are released. These nucleotides are then converted into adenosine. Adenosine has antinociceptive properties, meaning adenosine can decrease the body’s sensitivity to pain.”


Zylka and his team injected PAP in the soft tissue behind the knee (the acupuncture point, Weizhong) and found that pain relief lasted 100 times longer than a traditional acupuncture treatment. Also, by avoiding the spine the researchers could increase the dose of PAP. A single injection was also effective at reducing symptoms associated with inflammatory pain and neuropathic pain.


In the eyes of traditional Chinese medicine (TCM) this is still masking the symptom and not treating the root of the illness (in this case, the cause of the severe pain). However possibilities like these mean that more research will be done into acupuncture and the mechanics involved, both molecularly and neurologically. This can only be a good thing.



Reference:

Pain relief with PAP injections may last 100 times longer than a traditional acupuncture treatment.  ScienceDaily.  Retrieved April 24, 2012, from http://www.sciencedaily.com /releases/2012/04/120423103715.htm



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Japanese researchers show that acupuncture can improve skeletal muscle atrophy

Image: Steve-h via Flickr


Japanese researchers have revealed study results that show how acupuncture therapy mitigates skeletal muscle loss and holds promise for those seeking improved mobility through muscle rejuvenation.


Akiko Onda, an acupuncturist and graduate student at the Waseda University School of Sport Sciences presented the findings at the American Society for Biochemistry and Molecular Biology annual meeting, part of Experimental Biology 2012. She said, “It is my hope that this study will demonstrate acupuncture’s feasibility with regard to improving health among the elderly and medical patients. Our findings could identify acupuncture as the primary nonpharmacological treatment to prevent skeletal muscle atrophy in the future.”


Skeletal muscle atrophy is the loss of skeletal muscle, more common amongst the elderly and the sick. The usual recommendations to stave off muscle atrophy are exercise, improved nutrition and mechanical stimulation, but this can be difficult for the frail or those who have severe medical conditions.


Onda insists an alternative nonpharmacological intervention is urgently required, and so she and her collaborators in two labs at Waseda University decided to explore how acupuncture affects skeletal muscle at the molecular level. Her  team found that decreases in muscle mass in mice can be significantly reversed by acupuncture.


“Our results have uncovered one molecular mechanism responsible for the efficacy of acupuncture treatment and clarified its usefulness in preventing skeletal muscle atrophy in mice,” Onda said. “We hope to introduce acupuncture as a new strategy for preventing skeletal muscle atrophy in the future. Further investigations into its molecular mechanisms will help to decrease the medical community’s suspicion of acupuncture and provide us with a better understanding of how acupuncture treatment prevents skeletal muscle atrophy.”


Reference:

Japanese Researchers Show that Acupuncture can Improve Skeletal Muscle Atrophy.  Newswise.  Retrieved April 24, 2012, from http://www.newswise.com/articles/japanese-researchers-show-that-acupuncture-can-improve-skeletal-muscle-atrophy


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New MRI acupuncture research shows mind-body connection

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New MRI acupuncture research shows mind-body connection

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A concept in traditional Chinese medicine (TCM) and acupuncture is that the same symptoms can be caused by different factors and therefore the treatment for the same condition could be different depending on the individual. Imagine if you have a problem with always burning the dinner: you could try turning down the fire, adding more liquid, cooking the food for a shorter amount of time. Different changes but all result in a dinner that’s not charred and dry.

 

It is ironic then (to my eyes at least) that an article in Healthcare Medicine Institute reported that MRI acupuncture research showed a mind-body connection. 

 

Let me explain.

Criticism of acupuncture’s effectiveness has focused on the ability of sham acupuncture to produce clinical results. In clinical trials to show the effects of acupuncture, scientists perform needle stimulation at real acupuncture points, as well as some fake points which have no therapeutic purposes. It was noticed however that pain relief or reduction was noticed in subjects in both groups (individuals didn’t know whether they were receiving real or sham acupuncture). 

 

This provided a problem for the scientists: if the sham acupuncture managed to offer pain relief, then acupuncture as a therapy was most probably a placebo and more based on psychological factors. Critics jumped on that conclusion whilst acupuncturists claimed better trial design was needed. It still didn’t explain why sham acupuncture seemed to have a therapeutic effect.

 

Using MRI imaging, it showed that while sham acupuncture may superficially cause pain reduction, it wasn’t achieved by the same mechanisms as true acupuncture. Real acupuncture showed greater cortical activity and more importantly in different areas of the brain.

 

One result, two different ways.

 

So, it seems that just as there are sometimes different ways to treat the same symptom in TCM, clinical trials to see how acupuncture works is throwing up a similar concept. If it wasn’t for research like this, we would never have known that both true and sham acupuncture turns on different areas of the brains.

 

Photo credit: Vivian Chen via flickr

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Can Botox affect your ability to empathise?

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In our flat when we’ve had a long, hardworking day a favourite pass time is to pop on a movie and look for sensational facial over-acting. This works best when it’s a Nicole Kidman movie and not so well when it’s Pixar’s Cars. TV shows also provide ample scenes; I have recently discovered Franklin & Bash, which has a refreshing amount of wrinkles on show (plus I think the show is brilliant). Flexible face acting I call it, because once the emphasis has been registered, the forehead bounces back to being lovely smooth china with not a ripple in sight.

 

Do wrinkles tell the story of the face’s adventures?

 

I have met quite a few people who have had Botox or would definitely contemplate it, including one lovely person who had it done “just to see what it felt like”. I care about the effects of ageing as much as the next person, but injecting myself with botulinum toxin has never appealed.

 

Last month I wrote about preliminary research that suggested having more wrinkles was associated with a lower bone mineral density in early menopausal women. Now it turns out that having Botox to paralyze facial muscles also make it harder to read other people’s emotions.


I know- you should have heard my surprise as well. I imagined the research would’ve shown it was harder for others to read the emotions of the Botoxed one, but the other way around? It appears that Botox interrupts our “embodied cognition” which is when we mimic someone else’s facial expression to empathize with their emotions.  Neuroscientist Tanya L Chartrand, who published the study with her colleague David T Neal, describes it as: “So if you are wincing in pain I immediately do a micro-wince, and that sends signals to my brain that this person is experiencing pain, and by experiencing it myself I now understand what you are going through”.

 

This interference leads to people who have had Botox finding it harder to relate to others. This goes to show that things we do to our bodies have a ripple effect, good and bad. A person may decide to join the gym and exercise more to lose some weight and find that they have more energy and over time, perhaps a greater sense of self-confidence that helps them ride out the bumps in everyday life. Conversely many people might consider Botox another tool to fight ageing but don’t realize that its effects could appear below the surface.

 

Newton’s third law of motion states that for every action there is an equal and opposite reaction. This doesn’t have to apply only to physics, and the reaction may not be exactly opposite, but like in TCM, we understand that everything has a cause and effect. What do you think- would you have Botox knowing that it can hamper your relationships? Or do you think empathy comes in different ways?

 

You can read the full interview with Tanya L Chartrand here.


Photo credit: C Dekeersmaeker via flickr

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Acupuncture being trialled in Australian emergency departments for acute pain relief

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The other day an article was brought to my attention by Colette Day, an acupuncturist based in Essex, UK (via twitter, embrace the technology!). An old article from 2009, it was about a 3 year clinical trial using acupuncture in emergency departments of Australian hospitals to treat migraine, back pain and ankle pain.

 

What caught my eye (and warmed my heart) while reading the article was that these trials were employing traditional Chinese medicine practitioners to work in the emergency departments. In the NHS there are “pain clinics” where acupuncture treatment (usually five sessions) is offered, but there is definitely no such initiative in A&E. During my time at the Whittington Hospital pain clinic (in Archway, north London) most patients there were being treated for chronic back pain, but it would have been interesting to see patients being treated for acute injuries.

 

Another nice aspect of the Australian clinical trials is the fact they are specifically using traditional acupuncture based on the theories of Chinese medicine, as opposed to medical “dry needling” acupuncture. This takes it one step further than the needles-activating-nerve-endings school of thought and acknowledging that the same syndrome can derive from different patterns. As a traditional acupuncturist, I applaud this recognition.

 

We are now more than halfway through the trials, and it would definitely be interesting to see the results next year. Do you think this will happen soon in the UK?

 

Photo credit: Smabs Sputzer via flickr

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The lines on your face may tell a bigger story

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In London where I am based, telling people that I’m an acupuncturist nowadays is often greeted by stories of how their mother/brother/friend/hairdresser had acupuncture with good results. This is certainly great news that acupuncture and traditional Chinese medicine is becoming more and more mainstream.


When I mention that I also do cosmetic acupuncture though, you can see the surprise in their eyes. For most people improving our skin against the heavy weights of gravity and ageing means exfoliating, having a good moisturiser, sun protection, and having facials. On the other more extreme end of the spectrum is the now infamous Botox (I’m not including cosmetic surgery here because most people wouldn’t even contemplate that).

 

Do you have laugh lines or frown lines?


“What is cosmetic acupuncture?” they ask, “and can that help with lines and wrinkles?” “Yes,” I tell them. “And the way it incorporates body acupoints mean that they also feel really relaxed and positive after the treatment.”


A lot of people seem intrigued by the idea, while some reserve their judgement. There is a small minority of people in our society who seem to think that trying to look good and taking care of your face and skin is a very superficial task and not worthy of our little grey cells. Much better to be exercising and feeling good rather than wasting time thinking about our appearances when really, haven’t we learned not to judge a book by its cover and in the end, people are all beautiful inside?


Well, as it turns out, what we look like might actually show the state of our bones, for women at least. In a preliminary study, researchers showed that for early menopausal women, having more wrinkles was associated with a lower bone mineral density. Now this data is still in its early days yet but it would definitely be interesting to see if women with more wrinkles end up of losing bone density at a faster rate, or whether the effects of smoking affecting the face also affects our bone density. Imagine the clinical applications, when more women can be referred accurately to have a scan. And suppose if it works the other way; does actively trying to diminsh lines and wrinkles naturally, could that help decrease the loss of bone density?

 

Photo credit: Marco Pece aka Udronotto via flickr 

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Belly Fat is More Important than BMI in Determining Health

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Body mass index (BMI) is a number calculated from a person’s height and weight used to determine health. I have long been arguing against using BMI as a measure of health purely because it is inaccurate. The ratio of height to weight does not take into account whether the weight is due to fat or muscle. Much more important is the distribution of fat in the body which can be measured by the Body Fat Pinch Test, or even the Waist-Height Ratio.


Despite the medical establishment acknowledging that BMI has shortcomings, it is still revered. In the NHS, possibly due to staff following policies laid out to them, a BMI number in the acceptable range can mean a tall overweight patient will not be dealt a talk about their weight. If only they could just look up from the tables and charts sometimes and just look at the person in front of them.

 

More and more studies are showing the significant dangers of abdominal fat or belly fat or muffin tops or beer bellies. A meta-analysis of five studies showed that belly fat is associated with a 70% increase in risk of death (for coronary artery disease). Belly fat is worse than thigh fat for instance, because it tends to be a sign of visceral fat, the fat that gathers around the organs in the abdomen. This fat seems to promote insulin resistance and unhealthy cholesterol numbers.


This spotlight on abdominal fat could also explain the obesity paradox, whereby overweight and obese patients with cardiovascular disease and/or heart failure appear to fare better than leaner patients.

 

What baffles me is why the medical world is so unwilling to give up BMI despite the plain evidence that:

“BMI, although widely used, ‘is not a good measure of body fatness and gives no insight into the distribution of fat,’ according to Thais Coutinho, MD, also of the Mayo Clinic, who is the study’s lead author.”

 

A healthy weight is obviously of the utmost importance, and advice should be given on lifestyle changes to help with that, but it’s equally as important to educate people that your body shape is just as significant as your weight.

 

Photo credit: Adrian Clark via flickr

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Fat Around the Middle: Chinese people tend to carry extra weight around midsection, increasing the risk of diabetes, heart disease and high blood pressure.

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If you asked most people, they would comment on how typically skinny Chinese (and other Asian) people are. When discussing weight and shape of the Chinese, it seems to be a relative thing: “Yes, So-and-so is chubbier but that’s because most Chinese are so thin!” And everyone else would invariably agree.


The increase in a sedantary lifestyle and fast food diets is slowly changing this image: obesity in China is on the rise. However for the moment, this image of skinnier Asian people (and therefore healthier Asian people) persists and therein lies the danger. Carrying extra weight around your abdominal area increases your risk of diabetes, heart disease and hypertension. So while Chinese people may weigh less overall than their western counterparts, research has shown that they tend to gain weight around the midsection, thus increasing their chances of illness. Obviously being overweight is the major factor, but I think more awareness should be raised among the population traditionally seen as healthy to ensure that 60kg person with a healthy BMI and pot belly knows the possible risks.

 

There are various reasons besides genetics that lead to weight gain around the torso. The important thing is for both professionals and patients to understand the risks of both weight and body shape. So next time, count your bingo wings as a blessing rather than a curse. 

 

Photo credit: Michelle Meiklejohn

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