Stroke and Acupuncture: The evidence for effectiveness

In the West interest in the possible effect of acupuncture on stroke has been increasing over the last five years with much of the recent research being carried out in the Scandinavian countries and the USA. Traditional Chinese medicine claims that the symptoms of stroke and its sequaelae respond well to acupuncture treatment. Known as "wind-stroke", such treatment involves either the use body points alone, with or without electrical stimulation, or the combination of body points with scalp acupuncture (Chen 1993). In China many studies have compared different techniques and point combinations. Often very large numbers of patients are involved, for instance Ge (1992) treated and assessed 684 patients with sequelae of stroke at the Air Force Hospital in Shengyang.

The Evidence Series of Briefing Papers aims to provide a review of the key papers in the literature, which provide evidence of the effectiveness of acupuncture in the treatment of specific conditions. The sources of evidence will be clearly identified ranging from clinical trials, outcome studies and case studies. In particular this series of briefing papers will seek to present, discuss and critically evaluate the evidence.
Literature Search

For the purposes of this review a search was made of the Centralised Information Service for Complementary Medicine (CISCOM) database together with that of BIDS, and Medline. Additional information was obtained from the ARRCBASE. The key words used were; CVA, stroke, hemiparesis, hemiplegia, sub-arachnoid haemorrhage, neurological damage/change, acupuncture, and scalp acupuncture. More from BAC

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, such as acupuncture. (Source: NCCAM)

About acupuncture

One basic theory of acupuncture is meridians (or some call it “channels”). There are twelve principal meridians, eight extraordinary vessels and many other collaterals. All those meridians, channels and collaterals intertwined with each other in a similar way of a web, only with more logic. Qi, some call it the energy of the life, circulates along the system of meridians. Qi flows smoothly along the meridians as water does in the river. However, when blockage occurs, the flow of Qi is interrupted. What will we do when there is a blockage? We unblock. How? Acupuncture is the answer here. Therefore, we say, whenever there is an obstruction, there is pain; when an obstruction is removed, pain is relieved.

Acupuncture for pain relief

The World Health Organization (WHO) in 2002 released a report entitled “Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials”. This report states that acupuncture “can be regarded as the method of choice for treating many chronically painful conditions.”

According to WHO, acupuncture’s effective rate in the treatment of chronic pain is comparable with that of morphine. Acupuncture has been shown clinically to trigger the central nervous system to release pain-relieving chemicals, such as endorphins. Many neurotransmitters are also affected by acupuncture, and changes in these may affect pain transmission from irritated nerves.

Our acupuncture approach in pain-relieving

We use different acupuncture techniques in pain conditions. Why?

First, we understand everybody is unique. Different person has different response. One technique that is great to one person might only be ok to another. Everyone deserves a great solution.
Second, we prefer giving our clients some non-invasive methods during the interval of acupuncture session so their pain won’t return to its original level.
Third, we understand that there is no such a method that is for everybody. There are always certain people who don’t respond.

Here are the techniques we use in pain-relieving acupuncture:

Balance method acupuncture: This is the part often asked by our clients – why needle my hand while I have pain in my foot? This is balance. We often see pain reduce in minutes after needles are inserted.
Auricular acupuncture: We may use needles on your ear during the session if necessary, Or, we may only put on some ear press platters at the end of the session to prolong the effect during the treatment intervals.
Battlefield acupuncture: An amazing technique offering pain relief within minutes without side effects. It has been used in the US military. See here: Military turns to acupuncture as alternative to prescription painkillers
Korean hand acupuncture: Another micro-system within our body. We can use it during the session or/and during the intervals of treatments.
Moxibustion: While using needles, either normal needles or auricular needles, in distal (non-injured, unaffected) area, we often use moxibustion, either moxa stick or moxa box, in the local (injured, affected) area to reinforce the effect of treatment.
Chinese herbal medicine: We don’t see it as necessary on most painful occasions. However, when pain is only one symptom of a much more complicated condition, such as MS or endometriosis, we will suggest Chinese herbal medicine as a better way to treat the underlying cause of the pain.

Clinical notes

No matter which technique we use and how good the result is in the first session, further sessions are necessary. Acupuncture is not magic, it has accumulative effect. Pain may return after the treatment often at a lower intensity level.
Not everyone experiences quick pain relief. Some have slower response than others. Generally speaking, it depends on a) the length and severity of the patients, b) the age and constitution of the patients.
It is our advice that you should take it easy even when there is a massive reduction in pain as certain movements and motions may aggravate the affected area.

Conditions may benefit from acupuncture:

Joint pain: neck pain, shoulder pain, scapular pain, elbow pain (tennis elbow/golf elbow), wrist pain (carpal tunnel syndrome), hip pain, knee pain, ankle pain
Back pain, lower back pain, sciatica, buttock pain
Sports Injuries, repetitive strain injury
TMJ, dental pain
Arthritis, osteoarthritis
Migraine, headache, trigeminal neuralgia, peripheral neuropathy, intercostal neuralgia (shingles)
Heartburn, stomach pain, abdominal pain
Menstrual cramps/dysmenorrhea, endometriosis

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