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Efficacy and safety of chiropractic and acupuncture on media and journals
* Click the headings for a link to the original web page
Non-opioid options for managing chronic pain (Harvard Medical Health Publishing)​
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Chiropractic care for pain relief (Harvard Medical Health Publishing)​
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Should you see a chiropractor for low back pain? (Harvard Medical Health Publishing)​
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" A 2018 study published in JAMA Network Open is among the latest to weigh in on the pros and cons of chiropractic care for treating low back pain. Researchers enrolled 750 active-duty military personnel who complained of back pain. Half were randomly assigned to receive usual care (including medications, self-care, and physical therapy) while the other half received usual care plus up to 12 chiropractic treatments.
After six weeks of treatment, those assigned to receive chiropractic care:
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reported less pain intensity
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experienced less disability and more improvement in function
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reported higher satisfaction with their treatment
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needed less pain medicine.
While no serious side effects were reported,...."
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Spinal manipulation and exercise trump drugs for neck pain (Harvard Medical Health Publishing)​
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" There are many ways to treat neck pain, including spinal manipulation (for example, spinal or chiropractic adjustment), medications, exercise, massage, acupuncture, and electrotherapy. Despite considerable study of these treatments, results so far have been inconsistent and difficult to compare, and the quality of research has been uneven. Now, a randomized trial comparing three of these therapies has found that spinal manipulation and simple exercises performed at home are more effective than analgesic medications in relieving neck pain. "
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Here’s something completely different for low back pain (Harvard Medical Health Publishing)​
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" The American College of Physicians has just come out with new guidelines for the treatment of low back pain based on a review of more than 150 studies. The big news? Medications tend to have only temporary and modest benefits, so it makes sense to try something other than a pill. The specifics depend on the type and duration of back pain.
For new low back pain (lasting less than 12 weeks), try:
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heat
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massage
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acupuncture
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spinal manipulation, as with chiropractic care.
If these don’t work, NSAIDs or a muscle relaxant are reasonable options. But given their potential to cause side effects and their modest benefit, they aren’t the first choice.
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For chronic low back pain (lasting 12 weeks or more), try:
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exercise (including stretching, improving balance, and strengthening core muscles)
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physical therapy
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acupuncture
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mindfulness-based programs intended to cope with or reduce stress. "
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Is it time to give acupuncture a try for pain relief? (Harvard Medical Health Publishing)​
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" If you have chronic pain and are wondering how to avoid the potential side effects associated with long-term use of pain medications, you may want to consider an alternative—acupuncture. Since the technique was introduced in the United States in the 1970s, it has moved from alternative to mainstream medicine. Today, Harvard Medical School and other leading institutions offer courses in acupuncture for physicians, several professional societies certify acupuncturists, and two to three million Americans visit an acupuncturist every year. "
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" While earlier studies compared acupuncture to no treatment or a sham procedure, a more recent clinical trial compared it to conventional pain treatment—medication and physical therapy. In that study, published in November 2015 in Annals of Internal Medicine, researchers determined that up to 12 50-minute acupuncture treatments over several months were more effective for relieving chronic neck pain than customary treatment with pain relievers and physical therapy. The patients who underwent acupuncture had an average 33% reduction in reported pain six months after they completed treatment, compared with a 22% reduction for those who had conventional treatment. There were no adverse effects associated with acupuncture. "
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Acupuncture for headache (Harvard Medical Health Publishing)​
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" Individual large-scale clinical studies have consistently demonstrated that acupuncture provided better pain relief compared with usual care. However, most studies also showed little difference between real and sham (fake) acupuncture. In order to address this concern, a 2012 meta-analysis combined data from roughly 18,000 individual patients in 23 high-quality randomized controlled trials of acupuncture for common pain conditions. This analysis conclusively demonstrated that acupuncture is superior to sham for low back pain, headache, and osteoarthritis, and improvements seen were similar to that of other widely used non-opiate pain relievers.
And the safety profile of acupuncture is excellent, with very few adverse events when performed by a trained practitioner. Meanwhile, basic science studies of acupuncture involving animals and humans have shown other potential benefits, from lowering blood pressure to long-lasting improvements in brain function. More broadly, acupuncture research has resulted in a number of insights and advances in biomedicine, with applications beyond the field of acupuncture itself. "
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Traditional Medicine in China, Korea, and Japan: A Brief Introduction and Comparison
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" The TM education system of mainland China mostly consists of a 5-year course culminating in a bachelor's degree, accounting for more than 90% of graduates, and a 7-year course offering a bachelor's degree and a master's degree. Students who complete the 5-year course should complete an additional 1 year of clinical training to obtain a national license, and students enrolled in the 7-year course should write a master's thesis to earn a master's degree .............. The TM education system of the Taiwan region consists of two educational pathways: an 8-year course and a 5-year postbaccalaureate program. After graduation, only students who complete the 8-year course are eligible to obtain two kinds of licenses, Doctor of Chinese Medicine and Doctor of Medicine, after 1 year of clinical training in TCM and another year of training in CM. The TM education system of Korea consists of two educational pathways with a specialization in TKM: a 6-year program offered by 11 private universities is the main type, accounting for 92% of graduates, and a 4-year post-baccalaureate program is offered by 1 national university (8%). Students in the Taiwan region and Korea can enroll in their respective postbaccalaureate programs after finishing a 4-year bachelor's degree in another specialization and should write a master's thesis to earn a master's degree. "
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" Amongst Australian general practitioners (GPs), acupuncture is one of the most accepted forms of complementary medicine. In 1998, a United States National Institute of Health Consensus Conference Panel reviewed the status of acupuncture and concluded that: "There is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value." Similarly, in 2002, the World Health Organisation (WHO) stated that acupuncture is a safe, simple and convenient therapy and that its effectiveness as analgesia has been established in controlled clinical studies. "
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" The German Randomized Acupuncture Trial for chronic shoulder pain (GRASP) comprised 424 outpatients with chronic shoulder pain .......... Descriptive statistics showed greater improvement of shoulder mobility (abduction and arm-above-head test) for the verum group versus the control group immediately after treatment and after 3 months. The trial indicates that acupuncture is an effective alternative to conventional orthopaedic treatment for chronic shoulder pain (CSP). "
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Acupuncture as effective as drugs in treating pain, trial shows (Sydney Morning Herald)
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"An acupuncture trial in four Melbourne emergency departments has found it is just as good as drugs in relieving lower-back pain and that from sprained ankles and migraines. "
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" He said it was particularly good for people who did not want drugs, such as pregnant women, and for those whose pain was not relieved by Western medicine. "
" Dr Ben-Meir, director of Cabrini Hospital's emergency department, said the randomised controlled study of about 550 patients also found that the combination of acupuncture with standard pharmaceutical care delivered equivalent pain relief to acupuncture alone or standard care alone. "
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" In a new study published in JAMA Surgery, researchers examined the most commonly used non-pharmaceutical pain management therapies following knee replacement surgery to see if they did indeed work to reduced pain or opioid use while the patient was in the hospital. They found that acupuncture and electrotherapy could reduce and delay opioid use. "
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" Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain. "
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" Electro acupuncture, through a neurohumoral mechanism, lowers blood pressure in 70% of subjects with mild hypertension when it is applied in a standardized manner at acupuncture points overlying deep somatic nerve pathways.
......... This response is persistent in a group of high responders, which comprise approximately 70% of the patient population, lasting for a month after termination of acupuncture and for at least six months during monthly maintenance therapy. The mechanisms underlying these blood pressure actions of electro acupuncture include reductions in both sympathetic outflow, as reflected by plasma norepinephrine, and renin-aldosterone.
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Neural mechanisms of acupuncture as revealed by fMRI studies (Autonomic Neuroscience Journal)
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Acupuncture could not only affect brain activity but modulate connectivity of the brain.
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Acupuncture at diseases-related acupoints modulates diseases-related brain regions.
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Acupuncture regulates brain network which are overlapped with pain-related areas
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" Here we investigated the effects of manual acupuncture (MA) on modulating macrophage phenotype and interleukin-10 (IL-10) concentrations in animals with muscle inflammation. ........These findings provide new evidence that manual acupuncture produces a phenotypic switch in macrophages and increases IL-10 concentrations in muscle to reduce pain and inflammation. "
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" Reduction in pain in the active group persisted through a 6-month assessment......... No serious adverse events were reported.​ ........... Preliminary estimates indicate that Japanese-style acupuncture may be an effective, safe, and well-tolerated adjunct therapy for endometriosis-related pelvic pain in adolescents. A more definitive trial evaluating Japanese-style acupuncture in this population is both feasible and warranted. "
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" Our results showed that patients received acupuncture had significantly better improvement in clinical symptoms of carpal tunnel syndrome. ........... Acupuncture treatment had superior efficacy when compared to night splinting plus sham acupuncture at least in subjective symptom assessment............ In conclusion, the results of this randomized controlled trial indicated that acupuncture can improve the overall subjective symptoms of carpal tunnel syndrome and could be adopted in comprehensive care programs of these patients. "
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" The short and long term effectiveness of acupuncture and NSAID usage was rather similar. Moreover, acupuncture was better in cervical discopathies in short term, and there was more compliance of the patients in the acupuncture group. ............... In conclusion, acupuncture as a noninvasive treatment with minimal side effects is a promising therapeutic option in the management of acute radiculopathy of discogenic origin. "
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More to come....
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