https://en.drsaatchi.ir RSS feeds for Dr Kiarash Saatchi 60 https://en.drsaatchi.ir/Articles/ID/69/Effect-of-Progressive-Musclee-Relaxation-on-Anxiety-and-sleep-quality-in-Pre-University-Students-A-randomized-controlled-clinical-trial#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=69 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=69&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/69/Effect-of-Progressive-Musclee-Relaxation-on-Anxiety-and-sleep-quality-in-Pre-University-Students-A-randomized-controlled-clinical-trial Effect of Progressive Musclee Relaxation on Anxiety and sleep quality in Pre- University Students: A randomized controlled clinical trial SuperUser Account Mon, 28 May 2018 11:02:00 GMT f1397696-738c-4295-afcd-943feb885714:69 https://en.drsaatchi.ir/Articles/ID/65/Modern_technologies_of_Health_assessment#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=65 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=65&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/65/Modern_technologies_of_Health_assessment Modern_technologies_of_Health_assessment SuperUser Account Mon, 28 May 2018 10:49:00 GMT f1397696-738c-4295-afcd-943feb885714:65 https://en.drsaatchi.ir/Articles/ID/60/ICCAM-introduction-in-Thieme-Almanac-2007#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=60 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=60&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/60/ICCAM-introduction-in-Thieme-Almanac-2007 ICCAM introduction in Thieme Almanac 2007 SuperUser Account Mon, 28 May 2018 10:31:00 GMT f1397696-738c-4295-afcd-943feb885714:60 https://en.drsaatchi.ir/Articles/ID/58/Esophageal-Cancer-in-Turkamans#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=58 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=58&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/58/Esophageal-Cancer-in-Turkamans Esophageal Cancer in Turkamans SuperUser Account Mon, 28 May 2018 10:30:00 GMT f1397696-738c-4295-afcd-943feb885714:58 https://en.drsaatchi.ir/Articles/ID/55/Effect-of-PMRT-on-PreUniversity-students--2017-DrKSaatchi-10#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=55 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=55&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/55/Effect-of-PMRT-on-PreUniversity-students--2017-DrKSaatchi-10 Effect of PMRT on PreUniversity students - 2017 DrKSaatchi-10 SuperUser Account Mon, 28 May 2018 10:28:00 GMT f1397696-738c-4295-afcd-943feb885714:55 https://en.drsaatchi.ir/Articles/ID/54/Dr-Kiarash-Saatchis-History-with-iHealth#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=54 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=54&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/54/Dr-Kiarash-Saatchis-History-with-iHealth Dr Kiarash Saatchi's History with iHealth SuperUser Account Mon, 28 May 2018 10:27:00 GMT f1397696-738c-4295-afcd-943feb885714:54 https://en.drsaatchi.ir/Articles/ID/48/Dr-K-Saatchi-Auriculotherapy-Research-Article-in-ELSEVIER-publications#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=48 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=48&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/48/Dr-K-Saatchi-Auriculotherapy-Research-Article-in-ELSEVIER-publications Dr. K. Saatchi Auriculotherapy Research Article in ELSEVIER publications SuperUser Account Mon, 28 May 2018 09:59:00 GMT f1397696-738c-4295-afcd-943feb885714:48 https://en.drsaatchi.ir/Articles/ID/46/Acupuncture-in-management-of-moderate-to-severe-depression#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=46 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=46&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/46/Acupuncture-in-management-of-moderate-to-severe-depression Abstract Background Acupuncture, an ancient therapeutic technique, is emerging as an important modality of complementary medicine in the treatment of psychological diseases. If one protocol existed for treatment of depression with acupuncture regardless of their Chinese Medical diagnosis, it would certainly accelerate researches and incorporation of acupuncture into conventional medicine. In this article all the patients were diagnosed by DSM 4 and were in the range of moderate to severe. The treatment of acupuncture had been performed by one protocol for all of them. Objective To describe the outcome of patients with major depressive disorder diagnosis with moderate and severe types that received acupuncture treatment. Design, Setting and Patients Case series of 60 patients that used acupuncture for treatment of Major Depressive Disorder of moderate to severe; that their diagnosis made by using criteria of DSM 4. The treatment and follow up performed from Mar/2006 to Jan/2008. Intervention 10 treatment sessions: every other day for 5 treatments, every week for 3 treatments and every other week for 2 treatments. Treatment consisted of nearly 20 acupuncture points, based on one formula for all of them. Needles placed bilaterally and De Qi was obtained. Main outcome measure Principally improvement of depressive symptoms and underwent Hamilton Depressive Scale in the beginning and in the end of the course. For those that considered being in full remission should have improvement of 7 or more in HDSD and at least two months without symptoms. Results 7 patients did not complete the course and 53 of them completed the treatment (88.3%). 5 of them did not respond and the rest of them were in full remission based on the DSM 4 (80%). Conclusion Acupuncture is an effective modality in the treatment of moderate to severe depression, regardless of duration of disease. Key Words DSM 4, Hamilton Depressive Scale for Depression, Zang-fu organs, and liver yang. Introduction Although, undergoing TCM diagnosis procedure is essential in the treatment of patients when choosing acupuncture treatment for them. But it seems that in-patients with the conventional medicine diagnosis of depression of moderate to severe threshold because the derangement due to consumption of liver yin by hyperactivity of liver yang or liver Qi stagnation, is not merely one organ system involvement, in the treatment all organ system should be targeted unless treatment would not be successful. All the symptoms in the depression with the magnitude of moderate to severe can be explained by TCM as derangement of several Zang-Fu organs. Therefore, treatment approach should be regulation of Qi in every of them. For this reason in the protocol of treatment every of them are targeted and the diagnosis based on TCM can be omitted. Although, the diagnosis process in TCM by using pulse and tongue diagnosis and history taking can make diagnosis of depression without need to use any other means. But in order to accelerate incorporation of acupuncture into main stream medicine and even in acupuncture treated group with the use of one protocol leads to near to similar effect; existence of one treatment protocol for the disease like depression is a necessary objective. Here some data about prevalence of depression today and in future. Research suggests that 1 in 4 people will experience some kind of mental health problem in the course of a year. (Bird, 1999). A 1993 study estimated that depression alone costs 3 billions pounds each year in England when lost productivity and the cost of welfare benefits are taken into account, with direct cost to the National Health Service estimated at 420 million pound per year (Kind and Sorenson, 1993). While conventional treatments like psychotherapy and medication alleviate the blues in a whopping 50% to 70% of patients who complete the regimen, about one-third of those who begin therapy never complete it because they see no improvement or experience debilitating side effects. Even among people who do recover from depression, more than one-third relapses within 18 months. (Psychology Today, Sep, 1999 by C.C.) Several facts exist today; first its' current high incident, another one is expectation of increase of it in future; the last one is unsatisfactory result from existing drug therapy. Another effective approach is highly necessary and when this effective approach does not have any important side effect and has been used for several centuries' looks lucrative. But the researchers and clinicians do not have one protocol that can lead to a similar result in one group of depressed patients. It seems that when the treatment given by one protocol can effectively hinder the existence problem in incorporation of acupuncture in the treatment of depression. The clinician and researcher expect to see similar result in similar intervention. From the 60 aforementioned patients brief history of five of them will be presented. All of the patients that have been treated got inform consent in the beginning of therapy and agreed to be participated in series report without directly mentioning their personnel information. Case number 1: This patient was 41, male, married and had three children at the time for interview. His symptoms were worthlessness, anhedonia, insomnia, severe agitation, fears, total loss of functioning and besides them feeling of guiltiness. He was agitated, responded to the questions with delay and in questioning had libido. And he was very suspicious, lost 5 kg of weight and did not accept that had depression. He had an interview with psychiatrist and was referred him for hospitalization but he did not accept. And after a short period of drug treatment discontinued them because of side effects. His diagnosis based on DSM four was Major Depressive Disorder, Single Episode, and Severe with melancholic features. The date of first interview was 10/6/2007 and in the same day the treatment begun. Hamilton Rating Scale for Depression at the first interview was 32 and two months later after receiving ten sessions of acupuncture was 20. He was in full remission 2 months later and 6 months later. Case number 2 The patient was 50, female, married with a chronic history of major depressive disorder. The date of first interview was 18/ Apr/2007. The past history consisted of near to 21 days of hospitalisation and 6 courses of electroconvulsive therapy twelve years ago, several attempted suicides. And she has been constantly with two or three antidepressant and antianxiety drug therapy. But as she said with full dosage of several of them, only her symptoms subsided mildly. Her conventional medical diagnosis based on DSM four was; Major depressive Disorder, Chronic, severe without psychotic features with Hamilton Depressive Scale of 32 at the first day of interview. She was on the drug therapy by psychiatrist with combination of SSRI and Tricyclic Antidepressant and Antianxiety agent, in the time of first interview. The method of treatment for this patient because of chronically and depletion of kidney yin besides the protocol was consisting of KD 3 too. She was in complete remission two months after beginning of therapy and six months later. ). Her Hamilton Depressive Scale two months later in 17/June was 22 following the therapy with acupuncture. In telephone conversation with her, she was satisfactory and has been without any drug therapy (in the date of 20/Feb/2008). She was complaining about her affect but she said that it did not require therapy and did not interfere with her life (mild remnant depression). Case number 3 The patient was a male of 40 with over 15 years of depression, date of first interview and beginning of therapy was at 14/May/2007. He received several courses of drug therapies. But he lost his job in the beginning of disease and has been in cover of special welfare organization because of inability to work. His conventional medicine diagnosis that performed by several psychiatrists was; major depressive disorder, chronic, severe without psychotic features. He resumed a new job one-month after beginning of therapy and in his follow up was in full remission. His HDSP in the first interview was 30 and dropped by 8 after two months of receiving the therapy. Case number 4 This patient was 36, female, recently discharged from psychiatric hospital. And although, she was on the treatment for over one-month her depressive symptoms were not subsided. Her DSM diagnosis was MDD, Single Episode, and Severe without psychotic features. After five sessions, she decided to discontinue the drug therapy because of side effects and her condition improved. Her first interview and HRSD was 26 and the date was at the 18/June/2007 and two months later it was 18. She remained in full remission six months later. Case number 5 The patient was a female, married, and 32. Her depressive disorder was chronic with near to 10 years of duration. And she hospitalized for several times and the last time was in last year. In which she received 10 sessions of ECT. Until the date of first acupuncture session that was at the time of first interview, was under drug therapy. The date of first interview was at the 5/Jul/2006 and in that time HRSD was 30. She was under drug treatment at the time of first interview. The treatment had been begun at the date of first interview and received 10 sessions of acupuncture treatment and her HRSD two months later decreased by 10 and was 20. In the follow up six months later, one year and last time at the 19/Feb, her condition was stable. Methods In this protocol all affected Zang-Fu organs is deliberately targeted in acupuncture treatment. The most frequently used points were; ST 36, ST 25, SP 6 for harmony of spleen and stomach; GB 34, LR 3 for dispersing the liver; Du 20, Sishenchon for soothing their minds and improve circulation of Qi in the whole body. And other points were CV 12 for strengthen yang meridian of stomach; CV 6 for strengthen of stomach and spleen and tonification of Qi; HT 7 for tonification of heart Qi; and the acupoint LI 4 because in accompany with LR3 improve the circulation of Qi and blood. In the chronic patients with depression because of Qi of kidney is also altered by the long standing disease and their pulses loss their root, therefore, in them KD 3 had been used. Result The male proportion in this series was 16 male (26.6%) and female proportion was 73.4%. Nine patients were in single episode (15%) of patients and 51 of them were chronic (85%). Twenty of them were moderate (33.3%) and the rest of them were severe (66.7%). Two of them were with congruent psychotic features (3.3%) and 16 patients were with atypical features (26.6%). 48 (80%) patients completed the courses and were in full remission (for at least two months without symptoms) and 5 of them were incompletely treated and 2 were not responded and 7 were not complete the courses (20%). Discussion It seems that use of acupuncture in this intractable disease with such lower rate of side effects and high rate of success could be justifiable. Although, for confirmation of it more research in the greater population, randomized and double blinded is necessary. By incorporation of this method of treatment when eligible by the further research could revolutionize the treatment of major depression of moderate to severe in future.  Even though, some randomized research performed especially more prominent one at University of Arizona and in Tucson. But the matter is that the patients with depression had mild to moderate type of depression. Those types more affected by society and by learning helplessness from society (as some psychologist described). Although, results in comparison with drug therapy are encouraging. But future researches should compare acupuncture treatment in those with moderate and severe types with other ways of therapy and using the proposed protocol in this article can be a milestone in this regard. Another research that mainly focused on scientific documentation of effects of acupuncture on central nervous system that performed at Massachusetts general hospital, department of radiology. They stimulated a point that was LI4 and performing fMRI. They quoted "We hypothesize that modulation of subcortical structures may be an important mechanism by which acupuncture exerts its complex multisystem effects". Therefore, acupuncture effects on depression should be exert its' effects via central nervous system. With through scientific researches may be the rate of compliance could be increase. In this series, the main reason for quitting of therapy (in seven patients 20% of cases) was lack of sufficient scientific resources about the affectivity of acupuncture on their disease. Even though, all of them got inform consent about treatment but it seems that they accept the acupuncture treatment as last resort and may be seeing similar treated patients, could be a motivation force for them.  Because of the below fact the research upon effectiveness of acupuncture on depression should be in long duration. Eighty to 90 percent of individuals will remit within 2 years of the first episode (Kapur & Mann, 1992). Thereafter, at least 50 percent of depressions will recur, and after three or more episodes the odds of recurrence within 3 years increases to 70 to 80 percent if the patient has not had preventive treatment (Thase & Sullivan, 1995).  Conclusion In this article only tried to represent a viable, acceptable way of treatment of this disease with acupuncture and for so many questions that remained, hope that further researches can answer them. But when in some cases in this study several hospitalisation and even in some electroconvulsive sessions were not successful and several acupuncture sessions can lead to better outcome, the scientific community in this field of medicine should begin their study and confirmation of it with haste. Another significant matter in treatment group is even though, their depression based on criteria of DSM4 treated but some remnant depressive mood remained. It can be concluded that for treatment of reservoir depression and gaining full recovery working statue, it should be complemented with other treatment options like psychotherapy. Even it may be better to treat mild depression with the mixture of acupuncture and psychotherapy. Even though, the result was encouraging but without further research it can not corollary related.  References: Bird L. (1999) The fundamental Facts .... All the latest facts and figures on mental illness. London: Mental Health Foundation. Office for National Statistics (1995) Surveys for psychiatric morbidity in Great Britain Report 1: The prevalence of psychiatric morbidity among adults living in private households. London: HMS0 Montgomery SA, Kasper s. Side effects, dropouts from treatment and cost consequences. Int Clin Psychopharmacol. 1998; 13 suppl 2; S1-S5. Kind and Sorenson J. (1993) The cost of depression. International Journal of Clinical Psychopharmacology 7: 191-195 Yoshito Mukaino, Jongbae Park, Adrian White, & et al: Acupuncture In Medicine 2005; 23(2): 70-76. Hui KK, Liu J, Makris N, & et al: Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Hum Brain Mapp. 2000; 9(1):13-25. Essentials of Chinese Acupuncture. Beijing, Peoples' Republic of China: Foreign Language press; 1993; 13-16. Zhixian L. Diagnosis of traditional Chinese Medicine. Beijing, People's Republic of China: Academy Press (Xue Yuan); 1998; 259-272. http://www.surgeongeneral.gov/library/mentalhealth/home.html http://webspace.ship.edu/cgbor/genpsy.mooddisorders.html   SuperUser Account Fri, 25 Feb 2011 12:22:00 GMT f1397696-738c-4295-afcd-943feb885714:46 https://en.drsaatchi.ir/Articles/ID/44/Exploring-vision-related-acupuncture-point-specificity-in-Brain#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=44 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=44&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/44/Exploring-vision-related-acupuncture-point-specificity-in-Brain Li L, Qin W, Bai L, Tian J. Life Science Research Center, School of Electronic Engineering, Xidian University, Xi'an 710071, China.   Acupoint specificity is one of the central issues of functional magnetic resonance imaging (fMRI) studies of acupuncture and has been under discussed. However, strong and consistent proof has not been provided for the existence of acupoint specificity, and unsuitable analysis approach applied could be the reason. We observed that previous researches of acupoint specificity were mostly based on model-based methods which were limited to make exploration of acupoint specificity because of the inaccurate specified prior. Here we applied multi-voxel pattern analysis (MVPA) to investigate the specificity of brain activation patterns induced by acupuncture stimulations at a vision-related acupoint (GB37) and a nearby nonacupoint (NAP). Results showed that multiple brain areas could differentiate the central neural response patterns induced by acupuncture stimulation at these two sites with higher accuracy above the chance level. These regions included occipital cortex, limbic-cerebellar areas and somatosensory cortex. Our results support that the characteristic neural response patterns of brain cortex to the acupuncture stimulation at GB37 and a nearby NAP could differ from each other effectively with the application of MVPA approach. Copyright 2010 Elsevier Inc. All rights reserved. PMID: 20071124 [PubMed - in process] SuperUser Account Fri, 25 Feb 2011 12:12:00 GMT f1397696-738c-4295-afcd-943feb885714:44 https://en.drsaatchi.ir/Articles/ID/42/Acupuncture-for-treatment-of-Migranes#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=42 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=42&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/42/Acupuncture-for-treatment-of-Migranes 15 March 2004 - written by BUPA's Health Information Team British doctors have found that acupuncture can reduce the number of days of migraine a person has a year, as well as reducing the amount of medication they need and days off work. The results of their study are published on the website of the British Medical Journal. How did the study work? The study was designed to look at the use of acupuncture as an option for GPs prescribing treatment for migraines and tension-type headaches. GPs randomly offered their patients either standard treatment (medication and GP advice) or standard treatment plus acupuncture. Those who received acupuncture had up to 12 acupuncture sessions over the space of three months. How many people were studied? The doctors identified 401 people with chronic headache, most of them had migraines while the others had tension-type headaches. All the people were aged 18-65 years old and had an average of at least two headaches a month. What were the results? At the end of 12 months, people who had acupuncture in addition to standard treatment had 34 percent less severe headaches than people who only received standard treatment. Before treatment, the acupuncture group had a mean weekly headache score of 24.6 which fell to 16.2 after 12 months. The group that recieved only standard treatment had a weekly headache score of 26.7 before treatment and a score of 22.3 after 12 months. During the 12-month study, people who had acupuncture in addition to standard treatment reported 15.6 days of headache during the four weeks before treatment and only 11.4 days of headache in four weeks at the end of the 12-month period. In contrast, those people who received standard treatment only reported 16.2 days of headache in the four weeks before treatment and 13.6 days of headache in four weeks at the end of the 12-month period. These results mean that the people who recieved acupunture with standard treatment had 1.8 days less of headache every four weeks, when compared with those who did not have acupuncture. This works out as 21.6 days less of headache a year. Over the 12-month period of the study, people who received acupuncture with standard treatment took a mean number of 12.6 days off from work (standard deviation of 18.9 days). In comparison, the standard treatment only group took 13.8 days off from work (standard deviation of 16.2 days). When these results were analysed statistically, the result is that the acupuncture group took 15 percent less days off work. How were these results measured? People filled in a headache diary for four weeks before their treatment started. They then repeated this at three months and one year after starting treatment. They were asked to assess the severity of their headache on a six-point scale four times a day. These scores were added together to give a daily headache score. In addition, people filled in questionnaires that measured their use of headache treatments and days off sick from work.     What does this mean? Most doctors agree that acupuncture can play a useful role in reducing pain from headaches but, up until now, the evidence has not been conclusive. This study provides further evidence for the benefits of acupuncture as a treatment for migraine. This is because the study was controlled, the people studied were randomly assigned to either standard treatment or standard treatment plus acupuncture, and the study involved a sizeable number of people. In addition, the study also shows that acupuncture appears to offer long-lasting benefits. Most of the acupuncture group only received acupuncture for the first three months of treatment, yet their headache severity scores were significantly lower than those for standard-treament only when measured a full nine months after acupuncture treatment had stopped. What do the study's authors believe this study shows? The authors of this study believe that the results show that the use acupuncture in addition to standard treatment leads to persisting, clinically useful benefits for people with chronic headache, particularly migraine. They argue that acupuncture should be used more widely to treat headaches. Further information BUPA resources: ·                           BUPA factsheet: Acupuncture ·                           BUPA factsheet: Headaches ·                           BUPA factsheet: Migraine External website: ·               Vickers AJ, Rees RW, Zollman CE, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. British Medical Journal.doi:10.1136/bmj.38029.421863.EB (published 15 March 2004) ·               Acupuncture Today April, 2001, Vol. 02, Issue 04   ·               Acupuncture Superior to Drug Therapy for Migraines ·               Study Highlights the "Exceptional Usefulness" of Treatment ·               By Editorial Staff ·               According to the National Headache Foundation, as many as 28 million Americans suffer from migraine headaches each year.1 Migraines can be caused by a variety of physical and environmental factors, including diet, stress, allergens, menstruation, and changes in the weather. They can last from a few minutes to several days, which in some cases may completely incapacitate the person suffering an attack.  Migraine headaches are also one of the leading causes of time missed from work. It is estimated that migraine sufferers lose more than 157 million workdays each year, leading to a loss of approximately 50 billion dollars per year due to absenteeism and medical expenses caused by headache. An additional four billion dollars a year is spent on pain relievers for migraines and other headaches, but many of these remedies either do not work as needed, or simply mask an underlying condition.  In one of the largest studies of its kind to date, a team of investigators in Italy examined the effectiveness of acupuncture versus a variety of pharmacological therapies in treating migraines. Their results, published in a recent issue of the Journal of Traditional Chinese Medicine,2 revealed that patients given acupuncture experienced fewer migraine episodes, missed fewer days from work, and suffered no side effects compared to patients on conventional drug therapy. They also found acupuncture to be more cost-efficient, estimating a savings of hundreds of millions of dollars in private and social health expenditures if it were used to treat headaches alone instead of drugs.  A total of 120 subjects with a history of migraine headaches (without aura) were divided into two treatment groups of 60 patients each. The first group was treated with acupuncture (a maximum of three courses of 10 treatments twice a week, with a one-week break between each course). Acupuncture needles were applied to five points -- ST8; GB5; GB20; GV14; and LU7 -- with practitioners using the reducing method.  The second group of patients received drug therapy consisting of two or three treatments using a variety of pharmaceutical products (flunarizine; nimodipine; dihydroergotamine; lisuride; sumatriptam; or amitriptiline). A subgroup of pharmaceutical patients received a drug called longastatine, along with electrical stimulation.  All patients received a 30-minute medical examination at the beginning of the study, with 15-minute examinations at intervals of three, six and 12 months. For the month prior to the start of care, and for 12 months following the first course of treatment, patients were also given a set of monthly time-sheets and asked to track several criteria, including the duration and severity of symptoms; general psychological and physical condition; side-effects; and work absences.  To measure the daily impact of migraines, the researchers assigned values to the frequency, duration and severity of migraine symptoms. One unit of value was noted for each hour a patient had a migraine. If the migraine caused moderate pain, another unit was added; if the pain was intense, two units were added. Another unit was added if the migraine lowered the patient's quality of life during that hour; two units were added if the patient became bedridden because of the condition. At the end of each month, the units were totaled and expressed as a negative number, indicating the extent to which a patient's quality of life had been affected by migraine attacks.  Results  Statistical analysis of the groups found that acupuncture improved the symptoms of migraine without aura "more significantly" than any type of pharmacological therapy. Total symptom scores in the acupuncture group dropped more than 7,800 points from the start of study to six months after the first treatment; in comparison, scores in the drug therapy group dropped less than 4,500. Twelve months after the start of the study, total symptoms scores for patients using drug therapy were still nearly twice those compared to subjects treated with acupuncture   These variations were also seen on an individual patient basis Six months after receiving their first treatment, the average migraine value for a patient in the drug therapy group was 65.45, a reduction of nearly 46% from the start of care. For those in the acupuncture group, however, the results were even more dramatic: the average acupuncture patient's migraine values decreased nearly 80%, from 163.72 at the start of the study to just 33.17 six months later. Acupuncture patients also experienced considerably fewer absences from work in the second six months of treatment compared to drug therapy patients.  The study also indicates that, contrary to those who would like to pigeonhole acupuncture into the realm of pain relief (and little else), it can do much more than just treat a painful condition. If research is conducted professionally and treatment is applied properly, acupuncture's reach can extend beyond the walls of a clinic or pain center to have a positive effect on a nation's social and financial well-being as well.  References  1. NHF Headache Facts. Available from the National Headache Foundation (http://www.headaches.org/).     2. Liguori A, Petti F, Bangrazi A, Camaioni D, Guccione G, Pitari GM, Bianchi A, Nicoletti WE. Comparison of pharmacological treatment versus acupuncture treatment for migraine without aura - analysis of sociomedical parameters. J Tradit Chin Med 2000;20(3):231-40.  Editor's note: If you would like to comment on this article, please contact Acupuncture Today by fax (714-899-4273 SuperUser Account Fri, 25 Feb 2011 11:51:00 GMT f1397696-738c-4295-afcd-943feb885714:42 https://en.drsaatchi.ir/Articles/ID/43/Acupuncture-for-the-Management-of-Chronic-Headache#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=43 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=43&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/43/Acupuncture-for-the-Management-of-Chronic-Headache Acupuncture for the Management of Chronic Headache :  A systematic review 1.  Yanxia Sun, MD and      2.  Tong J. Gan, MB, FRCA 1.  From the Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina. Address correspondence and reprint requests to Tong J. Gan, Duke University Medical Center, Department of Anesthesiology, Box 3094, Durham, NC 27710. Address e-mail to Gan00001@mc.duke.edu.  Abstract OBJECTIVE: The objective of this review was to evaluate the efficacy of acupuncture for treatment of chronic headache. METHODS: We searched the databases of Medline (1966–2007), CINAHL, The Cochrane Central Register of Controlled Trials (2006), and Scopus for randomized controlled trials investigating the use of acupuncture for chronic headache. Studies were included in which adults with chronic headache, including migraine, tension-type headache or both, were randomized to receive needling acupuncture treatment or control consisting of sham acupuncture, medication therapy, and other nonpharmacological treatments. We extracted the data on headache intensity, headache frequency, and response rate assessed at early and late follow-up periods. RESULTS: Thirty-one studies were included in this review. The majority of included trials comparing true acupuncture and sham acupuncture showed a trend in favor of acupuncture. The combined response rate in the acupuncture group was significantly higher compared with sham acupuncture either at the early follow-up period (risk ratio [RR]: 1.19, 95% confidence interval [CI]: 1.08, 1.30) or late follow-up period (RR: 1.22, 95% CI: 1.04, 1.43). Combined data also showed acupuncture was superior to medication therapy for headache intensity (weighted mean difference: −8.54 mm, 95% CI: −15.52, −1.57), headache frequency (standard mean difference: −0.70, 95% CI: −1.38, −0.02), physical function (weighted mean difference: 4.16, 95% CI: 1.33, 6.98), and response rate (RR: 1.49, 95% CI: 1.02, 2.17). CONCLUSION: Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate. IMPLICATIONS: This systematic review demonstrated that traditional needling acupuncture is superior to sham acupuncture and pharmacological therapy for chronic headache treatment by improving headache intensity and frequency and increasing the response rate. Footnotes  Accepted for publication July 22, 2008. SuperUser Account Thu, 30 Dec 2010 12:09:00 GMT f1397696-738c-4295-afcd-943feb885714:43 https://en.drsaatchi.ir/Articles/ID/45/Acupuncture-in-pain-management#Comments 0 https://en.drsaatchi.ir/DesktopModules/DnnForge%20-%20NewsArticles/RssComments.aspx?TabID=132&ModuleID=576&ArticleID=45 https://en.drsaatchi.ir:443/DesktopModules/DnnForge%20-%20NewsArticles/Tracking/Trackback.aspx?ArticleID=45&PortalID=1&TabID=132 https://en.drsaatchi.ir/Articles/ID/45/Acupuncture-in-pain-management Introduction Physical pain is a common occurrence for many Americans; in fact, a national survey found that more than one-quarter of U.S. adults had recently experienced some sort of pain lasting more than a day. In addition to conventional treatments, such as over-the-counter and prescription medications, people may try acupuncture in an effort to relieve pain. This fact sheet provides basic information about pain and acupuncture, summarizes scientific research on acupuncture for specific kinds of pain, and suggests sources for additional information. Key Points People use acupuncture for various types of pain. Back pain is the most commonly reported use, followed by joint pain, neck pain, and headache. Acupuncture is being studied for its efficacy in alleviating many kinds of pain. There are promising findings in some conditions, such as chronic low-back pain and osteoarthritis of the knee; but, for most other conditions, additional research is needed. The National Center for Complementary and Alternative Medicine (NCCAM) sponsors a wide range of acupuncture research. Acupuncture is generally considered safe when performed correctly. In traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi theory, acupuncture regulates the flow of qi In traditional Chinese medicine, the vital energy or life force proposed to regulate a person's spiritual, emotional, mental, and physical health and to be influenced by the opposing forces of yin and yang. (vital energy) through the body. Research to test scientific theories about how acupuncture might work to relieve pain is under way. Tell all your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about complementary and alternative medicine (CAM), see NCCAM's Time to Talk campaign. About Pain Pain is a feeling triggered in the nervous system. It may be sharp or dull, off-and-on or steady, localized (such as back pain) or all over (such as muscle aches from the flu). Sometimes, pain alerts us to injuries and illnesses that need attention. Although pain usually goes away once the underlying problem is addressed, it can last for weeks, months, or even years. Chronic pain may be due to an ongoing condition (such as arthritis) or to abnormal activity in pain-sensing regions of the brain, or the cause may not be known. To relieve their pain, many people take over-the-counter medications—either acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs, including aspirin, naproxen, and ibuprofen). Stronger medications, including NSAIDs in higher dosages and narcotics, are available by prescription only. People may also try non-drug approaches to help relieve their pain. Examples include physical and occupational therapy, cognitive behavioral therapy, self-care techniques, and CAM therapies such as spinal manipulationThe application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. Manipulation may be performed as a part of other therapies or whole medical systems, including chiropractic medicine, massage, and naturopathy. or acupuncture.   Use of Acupuncture for Pain Acupuncture, among the oldest healing practices in the world, is part of traditional Chinese medicine. Acupuncture practitioners stimulate specific points on the body—most often by inserting thin needles through the skin. In traditional Chinese medicine theory, this regulates the flow of qi (vital energy) along pathways known as meridians. According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, 1.4 percent of respondents (an estimated 3.1 million Americans) said they had used acupuncture in the past year. A special analysis of acupuncture data from an earlier NHIS found that pain or musculoskeletal complaints accounted for 7 of the top 10 conditions for which people use acupuncture. Back pain was the most common, followed by joint pain, neck pain, severe headache/migraine, and recurring pain. © Bob Stockfield What the Science Says About Acupuncture for Pain Acupuncture has been studied for a wide range of pain conditions, such as postoperative dental pain, carpal tunnel syndrome, fibromyalgia, headache, low-back pain, menstrual cramps, myofascial pain, osteoarthritis, and tennis elbow. Overall, it can be very difficult to compare acupuncture research results from study to study and to draw conclusions from the cumulative body of evidence. This is because studies may use different acupuncture techniques (e.g., electrical vs. manual), controls (comparison groups), and outcome measures. One particularly complex factor in acupuncture research is choosing the controls for a clinical trial. The choice depends in part on whether the researchers want to study a particular aspect of acupuncture (e.g., effects on the brain) or to determine whether acupuncture is useful compared with other forms of care. Examples of control groups include study participants who receive no acupuncture, simulated acupuncture (procedures that mimic acupuncture, sometimes also referred to as "placebo" or "sham"), or other treatments (in addition to or in place of acupuncture or simulated acupuncture). An emerging theme in acupuncture research is the role of the placebo. For example, a 2009 systematic review of research on the pain-relieving effects of acupuncture compared with placebo (simulated) or no acupuncture was inconclusive. The reviewers found a small difference between acupuncture and placebo and a moderate difference between placebo and no acupuncture; the effect of placebo acupuncture varied considerably, and the effect of acupuncture appeared unrelated to the specific kind of placebo procedure used. All of the study participants received standard care, typically consisting of analgesic drugs and physical therapy. The following sections summarize research on acupuncture for a variety of pain conditions, including those reported by NHIS respondents who had used acupuncture. In general, acupuncture appears to be a promising alternative for some of these pain conditions; however, further research is needed. About Scientific Evidence on CAM Therapies Scientific evidence on CAM therapies includes results from laboratory research as well as clinical trials (studies in people). It encompasses both "positive" findings (evidence that a therapy may work) and "negative" findings (evidence that it probably does not work or that it may be unsafe). Scientific journals publish study results, as well as review articles that evaluate the evidence as it accumulates; fact sheets from NCCAM—like this one—base information about CAM research primarily on the most rigorous review articles, known as systematic reviews and meta-analyses. Carpal tunnel syndrome—Although a 1997 NIH consensus statement on acupuncture concluded that acupuncture was promising for carpal tunnel syndrome, additional research confirming acupuncture's efficacy for this condition is scant. Fibromyalgia—Evidence on acupuncture for fibromyalgia is mixed. Some reviews of the scientific literature have found the evidence promising. However, another review that focused on the few rigorous randomized controlled trials on acupuncture as an adjunct therapy for fibromyalgia did not find a benefit. Additionally, a 2003 assessment by the Agency for Healthcare Research and Quality concluded that the evidence was insufficient and the beneficial effects of acupuncture for fibromyalgia could not be determined. Headache/migraine—Study results on acupuncture for headache are conflicting. Some literature reviews found evidence to support the use of acupuncture for headache, but others noted that most of the studies were of poor quality. A 2008 review of randomized trials on acupuncture highlighted a few well-designed trials whose findings indicate that acupuncture reduces migraine symptoms and is as effective as headache medications. In addition, a 2009 review found that acupuncture may help relieve tension headaches. However, two large trials that looked at acupuncture for migraines found no difference between actual and simulated acupuncture, both of which were equal to conventional care or superior to no treatment. Low-back pain—According to clinical practice guidelines issued by the American Pain Society and the American College of Physicians in 2007, acupuncture is one of several CAM therapies physicians should consider when patients with chronic low-back pain do not respond to conventional treatment. In early, small studies, combining actual acupuncture with conventional treatment was more effective than conventional treatment alone for relieving chronic low-back pain; but actual acupuncture was not more effective than simulated acupuncture or conventional treatment. However, a large, rigorously designed clinical trial reported in May 2009 found that actual acupuncture and simulated acupuncture were equally effective—and both were more effective than conventional treatment—for relieving chronic low-back pain. There is insufficient evidence to draw definite conclusions about the effectiveness of acupuncture for acute low-back pain. Menstrual cramps—Two literature reviews have suggested that acupuncture may help with pain from menstrual cramps, but the research is limited. Myofascial pain—The evidence for acupuncture and myofascial pain (in which pain occurs in sensitive areas, known as trigger points, in the muscles) is mixed. Some literature reviews have found the evidence promising, but another review indicated that "needling therapies" for myofascial trigger point pain were not more effective than placebo. Neck pain—Studies of acupuncture for chronic neck pain have found that acupuncture provided better pain relief than some simulated treatments. However, the studies varied in terms of design and most had small sample sizes. Osteoarthritis/knee pain—Acupuncture appears to be effective for osteoarthritis, particularly in the area of knee pain. Recent literature reviews have found that acupuncture provides pain relief and improves function for people with osteoarthritis of the knee. However, authors of a 2007 systematic literature review suggested that although some large, high-quality trials have shown that acupuncture may be effective for osteoarthritis of the knee, differences in the design, size, and protocol of the studies make it hard to draw any definite conclusions from the body of research. These authors concluded that it is too soon to recommend acupuncture as a routine part of care for patients with osteoarthritis. Postoperative dental pain—Although recent data on acupuncture for postoperative dental pain are scant, literature reviews based on earlier evidence have identified acupuncture as a promising treatment for dental pain—especially pain following tooth extraction. For example, a 1999 study of 39 dental surgery patients found that acupuncture was superior to placebo (simulated acupuncture) in preventing postoperative pain. However, a 2005 study of 200 dental surgery patients found no significant analgesic effect for acupuncture compared to simulated acupuncture, although patients who believed they received acupuncture reported significantly less pain than those who believed they received a placebo. Tennis elbow—Study results on the use of acupuncture for tennis elbow (lateral epicondyle) pain are mixed. An early review of clinical trials reported that data on acupuncture for lateral epicondyle pain were insufficient and of poor quality; however, recent reviews have found the evidence promising, noting strong evidence that acupuncture provides short-term pain relief for lateral epicondyle pain. Acupuncture has also been studied for a variety of other pain conditions, including arm and shoulder pain, pregnancy-related pelvic and back pain, and temporomandibular joint (jaw) dysfunction. Although some studies have produced some positive results, more evidence is needed to determine the efficacy of acupuncture for any of these conditions. There is evidence that people's attitudes about acupuncture can affect outcomes. In a 2007 study, researchers analyzed data from four clinical trials of acupuncture for various types of chronic pain. Participants had been asked whether they expected acupuncture to help their pain. In all four trials, those with positive expectations reported significantly greater pain relief. In addition to studying acupuncture's efficacy, researchers are looking at potential biomechanisms—that is, how acupuncture might work to relieve pain. There are several theories about these biomechanisms (e.g., acupuncture activates opioid systems in the brain that respond to pain); additional research is still needed to test the theories. Researchers are using neuroimaging techniques such as functional magnetic resonance imaging (fMRI) to look at the effects of acupuncture on various regions of the brain. In 2005, NCCAM sponsored the "Neurobiological Correlates of Acupuncture" conference to discuss research challenges and directions in acupuncture neuroimaging research. Side Effects and Risks Acupuncture is generally considered safe when performed by an experienced practitioner using sterile needles. Relatively few complications from acupuncture have been reported. Serious adverse events related to acupuncture are rare, but include infections and punctured organs. Additionally, there are fewer adverse effects associated with acupuncture than with many standard drug treatments (such as anti-inflammatory medication and steroid injections) used to manage painful musculoskeletal conditions like fibromyalgia, myofascial pain, osteoarthritis, and tennis elbow. NCCAM-Funded Research NCCAM funds clinical trials to evaluate acupuncture's efficacy in alleviating various kinds of pain, as well as research aimed at understanding the body's response to acupuncture and how acupuncture might work. The following are examples of recent projects: Several studies of acupuncture for low-back pain (including integration with conventional medical care) and osteoarthritis of the knee (including cost-effectiveness and long-term results) Studies of acupuncture for pain after oral surgery, and for pain associated with chronic headaches, fibromyalgia, repetitive strain injury/carpal tunnel syndrome, and temporomandibular joint disorder Women's health studies, including acupuncture for pelvic pain, menstrual pain (vitamin K injections at acupuncture points), and pain associated with advanced ovarian cancer Several studies using fMRI technology to study brain activity during acupuncture, including in people with pain conditions such as fibromyalgia and osteoarthritis. Top Selected References Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, 2007. CDC National Health Statistics Report #12. 2008. Birch S, Hesselink JK, Jonkman FA, et al. Clinical research on acupuncture. Part 1. What have reviews of the efficacy and safety of acupuncture told us so far? Journal of Alternative and Complementary Medicine. 2004;10(3):468–480. Burke A, Upchurch DM, Dye C, et al. Acupuncture use in the United States: findings from the National Health Interview Survey. Journal of Alternative and Complementary Medicine. 2006;12(7):639–648. Ernst E. Acupuncture—a critical analysis. Journal of Internal Medicine. 2006;259(2):125–137. Lao L, Hamilton GR, Fu J, et al. Is acupuncture safe? A systematic review of case reports. Alternative Therapies in Health and Medicine. 2003;9(1):72–83. Linde K, Witt CM, Streng A, et al. The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain. 2007;128(3):264–271. Madsen MV, Gøtzsche PC, Hróbjartsson A. Acupuncture treatment for pain: systematic review of randomized clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ. 2009;338:a3115. MacPherson H, Nahin R, Paterson C, et al. Developments in acupuncture research: big-picture perspectives from the leading edge. Journal of Alternative and Complementary Medicine. 2008:14(7):883–887. Napadow V, Ahn A, Longhurst J, et al. The status and future of acupuncture clinical research. Journal of Alternative and Complementary Medicine.2008:14(7):861–869. Napadow V, Webb JM, Pearson N, et al. Neurobiological correlates of acupuncture: November 17–18, 2005. Journal of Alternative and Complementary Medicine. 2006;12(9):931–935. National Center for Health Statistics. Health, United States, 2006, With Chartbook on Trends in the Health of Americans. Special feature: pain. Hyattsville, MD: National Center for Health Statistics; 2006:68–87. National Institutes of Health Consensus Panel. Acupuncture: NIH Consensus Development Conference Statement, Nov. 3–5, 1997. 15(5):1–34. Park J, Linde K, Manheimer E, et al. The status and future of acupuncture clinical research. Journal of Alternative and Complementary Medicine.2008;14(7):871–881. Carpal Tunnel Syndrome Muller M, Tsui D, Schnurr R, et al. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review.Journal of Hand Therapy. 2004;17(2):210–228. Fibromyalgia Agency for Healthcare Research and Quality. Technology Assessment: Acupuncture for Fibromyalgia. Rockville, MD: Agency for Healthcare Research and Quality; 2003. Assefi NP, Sherman KJ, Jacobsen C, et al. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Annals of Internal Medicine. 2005;143(1):10–21. Harris RE, Gracely RH, McLean SA, et al. Comparison of clinical and evoked pain measures in fibromyalgia. The Journal of Pain: Official Journal of the American Pain Society. 2006;7(7):521–527. Harris RE, Tian X, Williams DA, et al. Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency. Journal of Alternative and Complementary Medicine. 2005;11(4):663–671. Mayhew E, Ernst E. Acupuncture for fibromyalgia—a systematic review of randomized clinical trials. Rheumatology (Oxford). 2007;46(5):801–804. Headache/Migraine Coeytaux RR, Kaufman JS, Kaptchuk TJ, et al. A randomized, controlled trial of acupuncture for chronic daily headache. Headache. 2005;45(9):1113–1123. Diener HC, Kronfeld K, Boewing G, et al. Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomized controlled clinical trial.Lancet Neurology. 2006;5(4):310–316. Endres HG, Diener HC, Molsberger, et al. Role of acupuncture in the treatment of migraine. Expert Review of Neurotherapeutics. 2007;7(9):1121–1134. Griggs C, Jensen J. Effectiveness of acupuncture for migraine: critical literature review. Journal of Advanced Nursing. 2006 May;54(4):491–501. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for tension-type headache. Cochrane Database of Systematic Reviews. 2009;(1):CD007587. Linde K, Streng A, Jürgens S, et al. Acupuncture for patients with migraine: a randomized controlled trial. Journal of the American Medical Association.2005;293(17):2118–2125. Melchart D, Streng A, Hoppe A, et al. Acupuncture in patients with tension-type headache: randomized controlled trial. BMJ. 2005;331:376–382. Low-Back Pain Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine. 2007;147(7):478–491. Eisenberg DM, Post DE, Davis RB, et al. Addition of choice of complementary therapies to usual care for acute low back pain: a randomized controlled trial. Spine. 2007;32(2):151–158. Furlan AD, van Tulder M, Cherkin D, et al. Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the Cochrane collaboration. Spine. 2005;30(8):944–963. Manheimer E, White A, Berman B, et al. Meta-analysis: acupuncture for low back pain. Annals of Internal Medicine. 2005;142(8):651–663. Menstrual Cramps Proctor ML, Smith CA, Farquhar CM, et al. Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhoea. Cochrane Database of Systematic Reviews. 2002;(1):CD002123. White AR. A review of controlled trials of acupuncture for women's reproductive health care. The Journal of Family Planning and Reproductive Health Care. 2003;29(4):233–236. Witt CM, Reinhold T, Brinkhaus B, et al. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. American Journal of Obstetrics and Gynecology. 2008;198(2):166.e1–166.e8. Myofascial Pain Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Archives of Physical Medicine and Rehabilitation. 2001;82(7):986–992. Neck Pain Trinh KV, Graham N, Gross AR, et al. Cervical Overview Group. Acupuncture for neck disorders. Cochrane Database of Systematic Reviews.2006;3:CD004870. Osteoarthritis/Knee Pain Agency for Healthcare Research and Quality. Technology Assessment: Acupuncture for Osteoarthritis. Rockville, MD: Agency for Healthcare Research and Quality; 2003. Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial.Annals of Internal Medicine. 2004;141(12):901–910. Bjordal JM, Johnson MI, Lopes-Martins RA, et al. Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials. BMC Musculoskeletal Disorders [online journal]. 2007; 8:51. Accessed at http://www.biomedcentral.com/1471–2474/8/51 on July 30, 2008. Foster NE, Thomas E, Barlas P, et al. Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial. BMJ. [online journal]. 2007;335(7617):436. Accessed at http://www.bmj.com/cgi/content/full/335/7617/436 on July 30, 2008. Kwon YD, Pittler MH, Ernst E. Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Rheumatology (Oxford).2006;45(11):1331–1337. Manheimer E, Linde K, Lao L, et al. Meta-analysis: acupuncture for osteoarthritis of the knee. Annals of Internal Medicine. 2007;146(12):868–877. Scharf H-P, Mansmann U, Streitberger K, et al. Acupuncture and knee osteoarthritis: a three-armed randomized trial. Annuals of Internal Medicine.2006;145(1):12–20. White A, Foster NE, Cummings M, et al. Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology (Oxford). 2007;46(3):384–390. Postoperative Dental Pain Bausell RB, Lao L, Bergman S, et al. Is acupuncture analgesia an expectancy effect? Preliminary evidence based on participants' perceived assignments in two placebo-controlled trials. Evaluation and the Health Professions. 2005:28(1):9–26. Lao L, Bergman S, Hamilton GR, et al. Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial. Archives of Otolaryngology—Head & Neck Surgery. 1999;125(5):567–572. Rosted P. The use of acupuncture in dentistry: a review of the scientific validity of published papers. Oral Diseases. 1998;4(2):100–104. Tennis Elbow Bisset L, Paungmali A, Vicenzino B, et al. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia.British Journal of Sports Medicine. 2005;39(7):411–422. Green S, Buchbinder R, Barnsley L, et al. Acupuncture for lateral elbow pain. Cochrane Database of Systematic Reviews. 2002;(1):CD003527. Trinh KV, Phillips SD, Ho E, et al. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology (Oxford).2004;43(9):1085–1090. Trudel D, Duley J, Zastrow I, et al. Rehabilitation for patients with lateral epicondylitis: a systematic review. Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists. 2004;17(2):243–266. Other Pain Conditions Ee CC, Manheimer E, Pirotta MV, et al. Acupuncture for pelvic and back pain in pregnancy: a systematic review. American Journal of Obstetrics and Gynecology. 2008;198(3):254–259. Ernst E, White AR. Acupuncture as a treatment for temporomandibular joint dysfunction: a systematic review of randomized trials. Archives of Otolaryngology—Head & Neck Surgery. 1999;125(3):269–272. Goldman RH, Stason WB, Park SK, et al. Acupuncture for treatment of persistent arm pain due to repetitive use: a randomized controlled clinical trial.The Clinical Journal of Pain. 2008;24(3):211–218. Green S, Buchbinder R, Hetrick S. Acupuncture for shoulder pain. Cochrane Database of Systematic Reviews. 2005;(2):CD005319. Top For More Information NCCAM Clearinghouse The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners. Toll-free in the U.S.:               1-888-644-6226         1-888-644-6226 TTY (for deaf and hard-of-hearing callers):               1-866-464-3615         1-866-464-3615 Web site: nccam.nih.gov E-mail: info@nccam.nih.gov PubMed® A service of the National Library of Medicine (NLM), PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. CAM on PubMed®, developed jointly by NCCAM and NLM, is a subset of the PubMed® system and focuses on the topic of CAM. Web site: www.ncbi.nlm.nih.gov/sites/entrez CAM on PubMed®: nccam.nih.gov/research/camonpubmed/ ClinicalTrials.gov ClinicalTrials.gov is a database of information on federally and privately supported clinical trials (research studies in people) for a wide range of diseases and conditions. It is sponsored by the National Institutes of Health and the U.S. Food and Drug Administration. Web site: www.clinicaltrials.gov Research Portfolio Online Reporting Tool (RePORT) RePORTER is a database of information on federally funded scientific and medical research projects being conducted at research institutions. Web site: projectreporter.nih.gov Acknowledgments NCCAM thanks the following people for their technical expertise and review of this publication: Ted Kaptchuk, O.M.D., Harvard Medical School; Lixing Lao, Ph.D., University of Maryland Center for Integrative Medicine; Vitaly Napadow, Ph.D., Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital; and Partap Khalsa, D.C., Ph.D., and Richard Nahin, Ph.D., M.P.H., NCCAM.   Address  for the article  : http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm SuperUser Account Thu, 18 Nov 2010 12:15:00 GMT f1397696-738c-4295-afcd-943feb885714:45