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Research: Pain disorders

Facial Muscular Pain (Acupuncture)

Acupuncture in treatment of facial muscular pain

Abstract: Forty-five individuals with long-standing facial pain or headache of muscular origin were randomly allocated into three groups. The first group was treated with acupuncture, the second group received an occlusal splint, and the third group served as controls.

Both acupuncture and occlusal splint therapy significantly reduced subjective symptoms and clinical signs from the stomatognathic system. No differences between these two groups were found with regard to treatment effects. It is concluded that acupuncture is an alternative method to conventional stomatognathic treatment for individuals with craniomandibular disorders of muscular origin.

Johansson A; Wenneberg B; Wagersten C; Haraldson T. Acupuncture in treatment of facial muscular pain. Acta Odontologica Scandinavica, 1991 Jun, 49(3):153-8. (UI: 91353214) Pub type: Clinical Trial; Journal Article; Randomized Controlled Trial. AT: UCLA Biomed W1 AC812 (PE title: Acta odontologica scandinavica)

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Dental Pain (Acupuncture)

Practical application of meridian acupuncture treatment for trigeminal neuralgia

Abstract: This report evaluates the effect of meridian acupuncture treatment on trigeminal neuralgia. Ten patients aged 26 to 67 years (mean 55.4 years) who visited the outpatient Dental Anesthesiology Clinic at Tsurumi University Dental Hospital from 1985 to 1990 were studied. Five of the patients suffered from idiopathic and five from symptomatic trigeminal neuralgia. The patients underwent meridian treatment by acupuncture alone or acupuncture combined with moxibustion. The acupuncture method used was primarily basic treatment employing only needles without electrical stimulation. Meridian acupuncture treatments were repeated from two to four times a month.

Five patients were restored to a pain-free state. The other five patients noted a decrease in pain, but with some level of pain remaining (significant pain in one patient). It is concluded that meridian acupuncture treatment is useful and can be one therapeutic approach in the management of trigeminal neuralgia.

Anesthesia and Pain Control in Dentistry, 1992 Spring, 1(2):103-8. (UI: 93005964) Beppu S; Sato Y; Amemiya Y; Tode I.

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Fibromyalgia (Acupuncture)

Needling increases blood flow in fibromyalgia patients

Acupuncture has become a widely used treatment modality in various musculoskeletal pain conditions. Acupuncture is also shown to enhance blood flow and recovery in surgical flaps due to certain substances released by needle stimulation. In a previous study on healthy subjects, researchers found that stimulation into the anterior tibial muscle increased both skin and muscle blood flow. The aim of this study was to examine the effect of needle stimulation on local blood flow in the anterior tibial muscle and overlying skin in patients suffering from a widespread chronic pain condition.

Fifteen patients with fibromyalgia participated in the study. The authors performed two modes of needling -- deep muscle stimulation and subcutaneous needle insertion -- at the upper anterior aspect of the tibia, and assessed the resulting blood flow.

The results of the present study were partly similar to those earlier found at a corresponding site in healthy female subjects. However, in fibromyalgia patients subcutaneous needle insertion was followed by a significant increase in both skin and muscle blood flow, in contrast to findings in healthy subjects where no significant blood flow increase was found following the subcutaneous needling. The different results of subcutaneous needling between the groups may be related to a greater sensitivity to pain and other somatosensory input in fibromyalgia.

Sandberg M, et al. Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia. European Journal of Pain 8(2):163-71.

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General Research on Acupuncture and Pain (Acupuncture)

Report on 971 cases of acupuncture for pain

The results in 971 outpatients who have been treated with acupuncture for different diseases are reported. The outcome of treatments and number of sessions are discussed in relation to the different diseases. Acupuncture treatment was regarded as successful when
  1. the patients had no pain at all without medication and
  2. there was a significant improvement (no long-term medication, only mild pain under unusual strain, minimal medication under such circumstances).
We obtained positive results in cephalalgias , sinusitis, cervical spine syndrome, shoulder-arm syndrome, ischialgias , back pain, constipation, herpes zoster, allergic rhinitis and disturbances of peripheral blood flow. For the following ailments, in order to reduce the medication, we recommend acupuncture despite a high rate of recurrence: Trigeminal neuralgia, colitis ulcerosa, bronchial asthma and cancer pain.
Results in the treatment of mental disturbances were unsatisfactory, and in cases of tinnitus results were negative. Fischer MV; Behr A; von Reumont J . Acupunct Electrother Res, 9: 1, 1984, 11-29

Cerebral blood flow effects of pain and acupuncture

Seven patients with chronic pain and five healthy controls participated in a study that aimed to measure the cerebral blood flow changes associated with the analgesic effect of acupuncture inpatients with chronic pain. All single-photon emission computed tomography (SPECT) scans were acquired with a uniform protocol.

The patient group was injected with the radioisotope hexamethyl propyleneamine oxime (HMPAO) while experiencing their usual level of pain. A baseline scan was acquired approximately 20 minutes after administration of the HMPAO. Afterwards, the patients were treated with acupuncture with needles placed in points specifically selected to relieve pain. When the pain improved, as determined by a 10-digit score for pain assessment, the patients were re-injected with HMPAO and imaged twenty minutes later for the acupuncture scan. The reference group also had a baseline and acupuncture scan, although the acupuncture itself was performed using a standardized set of needle points.

The reference group participants were found to have significant increases in the thalamic and prefrontal cortex activity on the acupuncture scan compared to the baseline. The baseline scans of the pain patients showed significant asymmetric uptake in the thalami compared to controls. This asymmetry reversed or normalized after the acupuncture therapy. Significant correlations were observed between the change of activity in the prefrontal cortex and ipsilateral sensorimotor area. The results from these cases show that HMPAO-SPECT is capable of detecting changes in cerebral blood flow associated with pain and that acupuncture analgesia is associated with changes in the activity of the frontal lobes, brain stem, and thalami.

Newberg AB, et al. Division of Nuclear Medicine, Hospital of the University of Pennsylvania

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