The effect of brief electrical and manual acupuncture stimulation on mechanical experimental pain. Immediate Effect of Acupuncture on the Sleep Pattern of Patients with Obstructive Sleep Apnoea Treatment of cervical spondylosis. Electroacupuncture versus physiotherapy. Antispastic effect of electroacupuncture and moxibustion in stroke patients. Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment. Clinical observation on cervical spondylopathy vertebroarterial type treated by electro-acupuncture. Electroacupuncture Reduces the Dose of Midazolam Monitored by the Bispectral Index in Critically Ill Patients with Mechanical Ventilation: An Exploratory Study Acupuncture analgesia for temporal summation of experimental pain: a randomised controlled study. Low-frequency electroacupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome. Acupuncture in the treatment of rheumatoid arthritis: a double-blind controlled pilot study Electrical Stimulation of Auricular Acupuncture Points Is More Effective Than Conventional Manual Auricular Acupuncture in Chronic Cervical Pain: A Pilot Study Acupuncture for pain relief during induced labour in nulliparae: a randomised controlled study The Diagnosis and Treatment of Chronic Back Pain by Acupuncturists, Chiropractors, and Massage Therapists Psychophysical outcomes from a randomized pilot study of manual, electro, and sham acupuncture treatment on experimentally induced thermal pain. The Short- and Long-Term Benefit in Chronic Low Back Pain Through Adjuvant Electrical Versus Manual Auricular Acupuncture Comparison of the effectiveness between manual acupuncture and electro-acupuncture on patients with tennis elbow. Comparative study of the analgesic effect of transcutaneous nerve stimulation (TNS); electroacupuncture (EA) and meperidine in the treatment of postoperative pain. The impact of patients with non-organic physical findings on a controlled trial of transcutaneous electrical nerve stimulation and electroacupuncture Acupuncture for low back pain: a survey of clinical practice in the UK. A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods. How traditional Chinese medicine acupuncturists would diagnose and treat chronic low back pain: results of a survey of licensed acupuncturists in Washington State. Acupuncture and transcutaneous electric nerve stimulation in the treatment of pain associated with chronic pancreatitis. A randomized study. Two modes of acupuncture as a treatment for hot flushes in men with prostate cancer--a prospective multicenter study with long-term follow-up.
OBJECTIVE Although manual and electrical stimulation are frequently used in acupuncture analgesia , studies comparing both stimulation modalities are contradictory . This blinded , placebo-controlled cross-over study investigates effects of brief manual and electrical acupuncture stimulation on pressure pain detection thresholds ( PPDT ) compared with nonpenetrating sham acupuncture ( NPSA ) . INTERVENTIONS Forty-five healthy volunteers received electrically and manually stimulated acupuncture and NPSA at large intestine 4 and 11 in r and omized order .  PPDT was assessed using pressure algometry at the second toe before ; during ; and 0 , 2 , and 5 minutes after each intervention . Stimulus intensity during stimulation was rated on a 0 - 10 numeric rating scale ( NRS ) . RESULTS PPDT rose from 316 kPa ( st and ard deviation [ SD ] 149 ) to 398 kPa ( SD 157 ) and 405 kPa ( SD 184 ) immediately after acupuncture with manual and electrical stimulation , respectively , and to 380 kPa ( SD 175 ) and 367 kPa ( SD 168 ) after NPSA with simulated manual and electrical stimulation , respectively . During the intervention , electroacupuncture produced a higher PPDT increase than any other procedure ( P<0.001 ) . Immediately after , both acupuncture procedures were significantly more effective than NPSA ( P<0.001 ) but did not mutually differ ( P=0.082 ) . NRS ratings differed significantly : manual acupuncture 4.1 , electroacupuncture 2.7 , manual NPSA 2.5 , electro-NPSA 1.2 ( P<0.001 except for electroacupuncture vs manual NPSA , P=0.271 ) . CONCLUSION Electroacupuncture produced higher PPDT elevation than manual acupuncture , and acupuncture in general showed significantly greater analgesic effect than NPSA . These effects seem to be short lasting ( < 5 minutes ) in the context of only brief acupuncture . The superiority of acupuncture to NPSA provides further evidence for acupuncture-specific analgesic effects Background Most patients with obstructive sleep apnoea ( OSA ) do not tolerate treatment with nasal continuous positive airway pressure , the ‘ gold st and ard ’ treatment for this condition . It was shown in a pilot study that acupuncture was more effective than placebo treatment ( sham acupuncture ) in producing significant changes in the respiratory events assessed by polysomnography ( PSG ) . Objectives To investigate the immediate effect of manual acupuncture ( MA ) and electroacupuncture ( EA ) on the sleep pattern of patients presenting with moderate OSA . Methods 40 patients with an Apnoea – Hypopnoea Index ( AHI ) of 15–30/h were r and omly allocated to MA treatment ( n=10 ) , EA 10 Hz treatment ( n=10 ) , EA 2 Hz treatment ( n=10 ) and a no-treatment control group ( n=10 ) . The patients received MA or EA ( 2 or 10 Hz ) just before the PSG study at 20:00 . Results The AHI ( p=0.005 ; p=0.005 ) , the Apnoea Index ( p=0.038 ; p=0.009 ) and the respiratory events ( p=0.039 ; p=0.014 ) decreased significantly in the MA and EA 10 Hz groups , respectively ( AHI ( 21.9 , 11.2 ) , Apnoea Index ( 5.15 , 0.7 ) , respiratory events ( 120.5 , 61.0 ) in the MA group before and after . AHI ( 20.6 , 9.9 ) , Apnoea Index ( 8.2 , 0.3 ) , respiratory events ( 117.0 , 56.0 ) in the EA 10 Hz group before and after ) . The micro-arousals decreased only in the MA group ( 146.0 vs 88.5 , p=0.0002 ) . There were no significant changes in the EA 2 Hz group or in the control group . Conclusion A single session of either MA or EA 10 Hz had an acute effect in reducing the AHI as well as the number of nocturnal respiratory events of patients presenting with moderate OSA A prospect i ve , controlled clinical trial was undertaken to assess the relative efficacies of physiotherapy and electroacupuncture in the treatment of cervical spondylosis . The results suggested that , while both methods were effective , electroacupuncture produced an earlier symptomatic improvement with increased neck movement , especially in patients with mild degenerative changes of the cervical spine Spasticity is a frequently observed motor impairment that develops after stroke . The objective of this study was to evaluate the efficacy of electroacupuncture ( EA ) and moxibustion ( Mox ) on  spasticity due to stroke . The subjects consisted of 35 stroke patients with elbow spasticity whose mean duration of stroke was 2.97 months . Fifteen patients were r and omized to the EA group , ten to Mox , and ten to control . Every other day , 30 minutes of electrical stimulation with a frequency of 50 Hz was given through four needles on the Ch'ü-Ch'ih-San-Li ( LI-11-LI-10 ) and Wai-Kuan-Ho-Ku ( TB-5-LI-4 ) points of the paretic side . Direct Mox was applied to Ch'ü-Ch'ih ( LI-11 ) , San-Li ( LI-10 ) , Wai-Kuan ( TB-5 ) and Ho-Ku ( LI-4 ) points three times a day every other day . The control group was given only the routine acupuncture therapy for stroke and range of motion ( ROM ) exercise , which were also applied to the EA and Mox groups . The efficacy of treatment was measured before , immediately , 1 hour , 3 hours , 1 day , 5 days , 10 days and 15 days after the start of treatment using a modified Ashworth scale ( MAS ) . In the EA group , spasticity was significantly reduced immediately , 1 hour and 3 hours after treatment ( p < 0.05 ) . Reductions were significant on the 5th day and thereafter ( p < 0.05 ) . In the Mox group , there was no significant change in the MAS scores after the first treatment . In the Mox and control group , there was no significant change in MAS scores . This study suggests that EA can temporarily reduce spasticity due to stroke , and if applied repeatedly it can maintain reduced spasticity BACKGROUND The aim of this study was to compare the pain-relieving effect and the subjective well-being between auricular electro-acupuncture ( EA ) analgesia , auricular acupuncture ( A ) and conventional analgesia with remifentanil ( CO ) . METHODS A total of 94 women undergoing IVF were r and omized to auricular acupuncture with ( EA , n = 32 ) or without ( A , n = 32 ) continuous 1 Hz auricular stimulation ( using a battery-powered miniaturized stimulator , P-Stim ) or with adhesive tapes instead of needles and no electrical stimulation ( control group , CO , n = 30 ) at the auricular acupuncture points 29 , 55 and 57 . All patients received patient-controlled analgesia ( PCA ) with remifentanil .  Pain intensity and psychological well-being were assessed by means of visual analogue scales ( VAS ) ; tiredness , nausea and vomiting and analgesic drug consumption were documented . RESULTS Pain relief and subjective well-being were significantly greater in group EA during and after the procedure as compared with groups A and CO ( P < 0.001 ) . The patients were significantly more tired in group CO than in groups A and EA ( P < 0.001 ) . Consumption of the opioid remifentanil was significantly lower in group EA , comparable nausea ( P < 0.001 ) . CONCLUSION Auricular EA significantly reduces pain intensity and analgesic consumption of the opioid remifentanil during oocyte aspiration in IVF treatment OBJECTIVE To observe the clinical therapeutic effects of electro-acupuncture in the treatment of cervical spondylopathy of the vertebroarterial type . METHODS According to the consulting order , the patients were r and omly divided into a treatment group ( 29 cases treated with electro-acupuncture ) , and a control group ( 28 cases treated with simple acupuncture ) . 20 treatments were given to patients in both groups . RESULTS The markedly effective rate of the treatment group was 75 % and that of the control group was 61.54 % ( P<0.05 ) . CONCLUSION Electro-acupuncture has a better therapeutic effect than the simple acupuncture in the treatment of cervical spondylopathy of the vertebroarterial type Objective Electroacupuncture , a modern variation on a traditional Chinese treatment , might be useful for sedation and analgesia . This study aims to investigate whether electroacupuncture can modify the dose of midazolam monitored by the bispectral index ( BIS ) in critically ill patients with mechanical ventilation . Methods Orotracheally intubated patients undergoing mechanical ventilation were r and omly assigned into three groups ( groups A , B and C ) . All patients were given an intravenous infusion of midazolam . Patients in group A received no additional treatment . Patients in group B were given acupuncture without electrical stimulation at acupuncture points GV24 and EX – HN3 ( Yintang ) for 6 h simultaneously , and patients in group C were given electroacupuncture to the same points as in group B. Results Maintaining the BIS between 60 and 80 , the hourly mean one dose of midazolam within the first 6 h after sedation in group C was 0.05 ( ±0.02 mg/kg per hour ) , which was significantly lower than both group A ( 0.08±0.03 mg/kg per hour , p<0.001 ) and group B ( 0.07±0.01 mg/kg per hour , p<0.021 ) . The doses in groups A and B showed no significant difference . Between-group comparison analysis of hepatic and renal function and severe adverse reactions all showed no significant difference between the three groups . Conclusions Electroacupuncture appears to reduce markedly the dose of sedative drug required in critically ill patients with mechanical ventilation monitored by BIS , without any obvious severe adverse action , and larger studies to confirm the effect are justified BACKGROUND Temporal summation of pain , a phenomenon of the central nervous system ( CNS ) , represents enhanced painful sensation or reduced pain threshold upon repeated stimulation . This pain model has been used to evaluate the analgesic effect of various medications on the CNS . AIMS The present study aim ed to evaluate the effects and characteristics of analgesia induced by electroacupuncture ( EA ) , manual acupuncture ( MA ) and non-invasive sham-acupuncture ( SA ) in healthy humans on temporal summation of pain . METHODS Thirsty-six pain-free volunteers were r and omised into one of the three groups EA ( 2/100 Hz ) , MA or SA . Acupuncture intervention was on ST36 and ST40 on the dominant leg delivered by an acupuncturist blinded to the outcome assessment . Both subjects and the evaluator were blinded to the treatment allocation . Pain thresholds to a single pulse ( single pain threshold , SPT ) and repeated pulses electrical stimulation ( temporal summation thresholds , TST ) were measured before , 30 min after and 24h after each treatment . RESULTS The baseline values of three groups were comparable . Compared to SA , EA significantly increased both SPT and TST immediately after the treatment on the treatment leg as well as 24h after on both the treatment and non-treatment legs ( ANOVA , p<0.05 ) . MA also increased SPT and TST , but the changes were not significantly different from those induced by SA . CONCLUSION EA induces bilateral , segmentally distributed and prolong analgesia on both SPT and TST , indicating a non- central ly specific effect . This effect needs to be verified with heat or mechanical model and in pain patients We have recently shown that polycystic ovary syndrome ( PCOS ) is associated with high muscle sympathetic nerve activity ( MSNA ) . Animal studies support the concept that low-frequency electroacupuncture ( EA ) and physical exercise , via stimulation of ergoreceptors and somatic afferents in the muscles , may modulate the activity of the sympathetic nervous system . The aim of the present study was to investigate the effect of these interventions on sympathetic nerve activity in women with PCOS . In a r and omized controlled trial , 20 women with PCOS were r and omly allocated to one of three groups : low-frequency EA ( n = 9 ) , physical exercise ( n = 5 ) , or untreated control ( n = 6 ) during 16 wk . Direct recordings of multiunit efferent postganglionic MSNA in a muscle fascicle of the peroneal nerve before and following 16 wk of treatment . Biometric , hemodynamic , endocrine , and metabolic parameters were measured . Low-frequency EA ( P = 0.036 ) and physical exercise ( P = 0.030 ) decreased MSNA burst frequency compared with the untreated control group . The low-frequency EA group reduced sagittal diameter ( P = 0.001 ) , while the physical exercise group reduced body weight ( P = 0.004 ) and body mass index ( P = 0.004 ) compared with the untreated control group . Sagittal diameter was related to MSNA burst frequency ( Rs = 0.58 , P < 0.005 ) in the EA group . No correlation was found for body mass index and MSNA in the exercise group . There were no differences between the groups in hemodynamic , endocrine , and metabolic variables . For the first time we demonstrate that low-frequency EA and physical exercise lowers high sympathetic nerve activity in women with PCOS . Thus , treatment with low-frequency EA or physical exercise with the aim to reduce MSNA may be of importance for women with PCOS Background In planning a r and omized controlled trial of acupuncture , we conducted a pilot study using vali date d outcome measures to assess the feasibility of the protocol , and to obtain preliminary data on efficacy and tolerability of 3 different forms of acupuncture treatment as an adjunct for the treatment of chronic pain in patients with Rheumatoid arthritis ( RA ) . Methods The study employs a r and omized , prospect i ve , double-blind , placebo-controlled trial to evaluate the effect of electroacupuncture ( EA ) , traditional Chinese acupuncture ( TCA ) and sham acupuncture ( Sham ) in patients with RA . All patients received 20 sessions over a period of 10 weeks . Six acupuncture points were chosen . Primary outcome is the changes in the pain score . Secondary outcomes included the changes in the ACR core disease measures , DAS 28 score and the number of patients who achieved ACR 20 at week 10 . Results From 80 eligible patients , 36 patients with mean age of 58 ± 10 years and disease duration of 9.3 ± 6.4 years were recruited . Twelve patients were r and omized to each group . Twelve , 10 and 7 patients from the EA , TCA and Sham group respectively completed the study at 20 weeks ( p < 0.03 ) ; all except one of the premature dropouts were due to lack of efficacy . At week 10 , the pain score remained unchanged in all 3 groups . The number of tender joints was significantly reduced for the EA and TCA groups . Physician 's global score was significantly reduced for the EA group and patient 's global score was significantly reduced for the TCA group . All the outcomes except patient 's global score remained unchanged in the Sham group . Conclusion This pilot study has allowed a number of recommendations to be made to facilitate the design of a large-scale trial , which in turn will help to clarify the existing evidence base on acupuncture for RA.Trial registration Clinical Trials.gov In this prospect i ve , r and omized , double-blinded , controlled study , we tested the hypothesis that auricular electroacupuncture relieves pain more effectively than conventional manual auricular acupuncture . We studied 21 chronic cervical pain patients without radicular symptoms with insufficient pain relief ( visual analogue scale > 5 ) treated with st and ardized analgesic therapy .  All patients received disposable acupuncture needles on the dominant side on the following acupuncture points : cervical spine , shen men , and cushion . In 10 patients , needles were continuously stimulated ( 2-mA constant current , 1 Hz monophasic ) by using the electrical point stimulation device P-STIM ™ . In 11 control patients , no electrical stimulation was administered . All needles were withdrawn 48 h after insertion . Acupuncture was performed once a week for 6 wk . Patients had to complete a question naire assessing pain intensity , psychological well-being , activity , sleep , and dem and for rescue medication ( lornoxicam and tramadol ) . The reduction in pain scores was significant in the electrical acupuncture group . Similarly , psychological well-being , activity , and sleep were significantly improved in patients receiving electrical acupuncture , and consumption of rescue medication was significantly less . These results demonstrate that continuous electrical stimulation of auricular acupuncture points by using the new point stimulation device P-STIM ™ improves the treatment of chronic cervical pain in an outpatient population Please cite this paper as : MacKenzie I , Xu J , Cusick C , Midwinter‐Morten H , Meacher H , Mollison J , Brock M. Acupuncture for pain relief during induced labour in nulliparae : a r and omised controlled study . BJOG 2011;118:440–447 Objectives To describe the diagnostic and therapeutic content of visits for chronic back pain to acupuncturists , chiropractors , and massage therapists .  Methods R and omly selected acupuncturists , chiropractors , and massage therapists in two states were surveyed , and then eligible providers collected data on consecutive patient visits . The authors analyzed information on diagnosis , treatment , and self-care recommendations for chronic back pain patients collected during consecutive patient visits to these complementary and alternative medicine ( CAM ) providers . Results Back pain was the most common reason for visits to each of these providers , with chronic back pain representing about 10 % of visits to acupuncturists , 20 % of visits to chiropractors , and 12 % of visits to massage therapists . Diagnosis by acupuncturists included traditional question ing and inspecting the patient as well as pulse and tongue assessment and palpation of the acupuncture meridians . Treatments usually included acupuncture needling , heat of some sort , and other modalities , such as East Asian massage , herbs , and /or cupping ( application of suction cups to the skin ) . Lifestyle recommendations were common , particularly exercise and dietary counseling . Visits to chiropractors usually included spinal and muscle/soft tissue examinations and spinal manipulation . Soft tissue techniques ( eg , “ active release ” ) , stretch or strength training , and home exercise recommendations were much less common . Massage therapists usually performed a tissue assessment and commonly assessed range of motion . They emphasized Swedish , deep tissue , and trigger point massage techniques and usually made self-care recommendations , particularly increased water intake , hot/cold therapy , exercise , and body awareness . Conclusion Information on the care patients routinely receive from CAM providers will help physicians better underst and these increasingly popular forms of care UNLABELLED In this pilot study comparing the analgesic effects of three acupuncture modes -- manual , electro , and placebo ( with Streitberger placebo needles)--in a cohort of healthy subjects , we found that verum acupuncture treatment , but not placebo , lowered pain ratings in response to calibrated noxious thermal stimuli . This finding was mainly the result of highly significant analgesia in 5 of the 11 subjects who completed the 5-session study . Of the 5 responders , 2 responded only to electroacupuncture and 3 only to manual acupuncture , suggesting that acupuncture 's analgesic effects on experimental pain may be dependent on both subject and mode . We developed a simple quantitative assessment tool , the  Subjective Acupuncture Sensation Scale ( SASS ) , comprised of 9 descriptors and an anxiety measure to study the relationship between the deqi sensation induced by acupuncture and the putative therapeutic effects of acupuncture . The SASS results confirm that the deqi sensation is complex , with all subjects rating multiple descriptors during each mode . We found significant correlations of analgesia with SASS ratings of numbness and soreness , but not with ratings of stabbing , throbbing , tingling , burning , heaviness , fullness , or aching . This suggests that attributes of the deqi sensation may be useful clinical indicators of effective treatment . PERSPECTIVE The results of this study indicate the existence of both individual subject and acupuncture mode variability in the analgesic effects of acupuncture . This suggests that switching acupuncture mode may be a treatment option for unresponsive patients Acupuncture is an established adjuvant analgesic modality for the treatment of chronic pain .  Electrical stimulation of acupuncture points is considered to increase acupuncture analgesia . In this prospect i ve , r and omized , double-blind , controlled study we tested the hypothesis that auricular electroacupuncture ( EA )  relieves pain more effectively than conventional manual auricular acupuncture ( CO ) in chronic low back pain patients with insufficient pain relief ( visual analogue scale [ VAS ] ≥5 ) treated with st and ardized analgesic therapy . Disposable acupuncture needles were inserted in the auricular acupuncture points 29 , 40 , and 55 of the dominant side and connected to a newly developed battery-powered miniaturized stimulator worn behind the ear . Patients were r and omized into group EA ( n = 31 ) with continuous low-frequency auricular EA ( 1 Hz biphasic constant current of 2 mA ) and group CO ( n = 30 ) without electrical stimulation ( sham-electroacupuncture ) . Treatment was performed once weekly for 6 wk , and in each group needles were withdrawn 48 h after insertion . During the study period and a 3-mo follow-up , patients were asked to complete the McGill question naire . Psychological well being , activity level , quality of sleep , and pain intensity were assessed by means of VAS ; moreover , analgesic drug consumption was documented . Pain relief was significantly better in group EA during the study and the follow-up period as compared with group CO . Similarly , psychological well-being , activity , and sleep were significantly improved in group EA versus group CO , the consumption of analgesic rescue medication was less , and more patients returned to full-time employment . Neuropathic pain in particular improved in patients treated with EA . There were no adverse side effects . These results are the first to demonstrate that continuous EA stimulation of auricular acupuncture points improves the treatment of chronic low back pain in an outpatient population This is a single-blinded r and omized controlled trial to compare the relative effectiveness between manual acupuncture ( MA ) and electro-acupuncture ( EA ) on the patients with chronic tennis elbow . Twenty patients recruited in the study were first introduced into control group for 2 weeks waiting period . Then , they were r and omly assigned into either MA or EA group for acupuncture treatment . The acupuncture points of GB34 and ST38 were used in both treatment groups . In the MA group , the needle was retained for 20 minutes after the Deqi sensation obtained . In the EA group , electrical stimulation with 4 pulses/second frequency was applied and treatment lasted for 20 minutes . After 6 treatments within 2 weeks duration , significant differences were observed between groups favoring the electro-acupuncture in relation to pain relief ( Pain visual analogue scale ) and pain free h and grip strength ( PFG ) . This study showed that electro-acupuncture is superior to manual acupuncture in treating patients with tennis elbow Seventy two patients , from 15 to 60 years old , in good physical status and su bmi tted to surgery in the upper or lower abdominal , rectal or lumbar areas were studied . In the immediate postoperative period , they were r and omly divided in three groups and each group was su bmi tted to one of the following treatments : intravenous meperidine , transcutaneous nerve stimulation ( TNS ) or electroacupuncture ( EA ) . Each treatment was divided in two phases with one hour interval between them . Each phase was constituted of 30 minutes of stimulation in case of TNS and EA and fractionated administration of meperidine in all groups . The pain level was evaluated through a visual analogue scale before and after each phase of treatment . The results were compared among groups and , on each group , between the phases of treatment . In all surgery types , the postoperative pain relief presented by TNS and EA groups of patients was greater than that of meperidine treated group . But , the analgesia presented by the EA treated group of patients lasted longer and increased with the repetition of treatment . The differences of behaviour of  TNS and EA analgesia suggest that their neurochemical mechanisms may not be the same Fifty-four patients treated in a three-week in-patient rehabilitation program were r and omly assigned to and accepted treatment with electroacupuncture ( n = 17 ) , TENS ( low-intensity transcutaneous nerve stimulation , n = 18 ) and TENS-dead battery ( placebo , n = 18 ) . Outcome measures included estimates of pain ( on a visual analogue scale ) and disability by both physician and patient as well as physical measures of spine function .  Two groups were constructed based on the absence of nonorganic physical findings ( Valid group , n = 30 ) and the presence of two or more nonorganic physical findings out of a possible four ( Invalid group , n = 10 ) . Multivariate and univariate analyses of covariance were utilized to determine effects of treatment ( acupuncture , TENS , placebo ) and the effects of over-reporting ( presence of excessive nonorganic physical findings ) . Statistically significant findings demonstrated that the acupuncture group enjoyed more relief of peak pain and more relief of pain on an average day at the three-month return assessment . Additionally , the acupuncture group demonstrated greater improvement in extension trunk strength at the discharge assessment . The Invalid group were found to have a contaminating effect on the acupuncture results . Analysis also demonstrated associations between nonorganic physical findings and both personality traits ( " Conversion V " profile on MMPI ) and retention of an attorney . Research ers conducting clinical trials in chronic low-back pain patients should control for contamination by the presence of over-reporters OBJECTIVES Acupuncture is recommended in official UK guidelines for persistent non-specific low back pain and is popular with patients . However , what UK-based acupuncturists actually do in every day clinical practice is poorly documented . We therefore conducted a survey of every-day clinical practice of acupuncture for low back pain in the UK . DESIGN Cross-sectional postal survey . SETTING R and om sample s of 100 acupuncturists from each of the three main UK societies for acupuncturists were sent question naires . MAIN OUTCOME MEASURES A question naire design ed ( and pilot-tested ) for this study asked about : training and professional identity , current work situation , and typical approach to treating a patient with low back pain .  RESULTS Completed question naires were received from 129 respondents ( 53 % male ) , representing each society approximately equally . Work situation ( e.g. weekly hours practicing acupuncture ) differed across societies . Respondents reported needling 2 - 30 acupuncture points in an average treatment ( median=8 ) and leaving needles in for 0 - 40 min ( median=20 min ) . A large number of individual points ( 121 ) were named as ' typical ' . CONCLUSIONS There is huge variation in how acupuncture is used by UK practitioners to treat people with low back pain . This probably constitutes a difficult situation for patients when selecting an acupuncturist . It may also translate into large variation in clinical outcomes for patients receiving care from different acupuncturists as well as difficulty in developing acupuncture protocol s for pragmatic and other trials . Such diversity reflects the ongoing debate within the acupuncture profession about good practice for common conditions OBJECTIVES To characterize the brain activation patterns evoked by manual and electroacupuncture on normal human subjects . DESIGN We used functional magnetic resonance imaging ( fMRI ) to investigate the brain regions involved in electroacupuncture and manual acupuncture needle stimulation . A block design was adopted for the study . Each functional run consists of 5 minutes , starting with 1-minute baseline and two 1-minute stimulation , the interval between the two stimuli was 1 minute . Four functional runs were performed on each subject , two runs for electroacupuncture and two runs for manual acupuncture . The order of the two modalities was r and omized among subjects . During the experiment , acupuncture needle manipulation was performed at Large Intestine 4 ( LI4 , Hegu ) on the left h and . For each subject , before scanning started , the needle was inserted perpendicular to the skin surface to a depth of approximately 1.0 cm . Electroacupuncture stimulation was delivered using a continuous rectangular wave form ( pulse width 30 ms ) at a frequency of 3 Hz . For manual acupuncture , the needle was rotated manually clockwise and counterclockwise at a rate of about 180 times per minute ( 3 Hz ) . SUBJECTS Eleven right-h and ed , normal , healthy volunteer adults , 6 male and 5 female , ages 21 - 64 participated in the experiment . RESULTS Results showed that electroacupuncture mainly produced fMRI signal increases in pre central gyrus , post central gyrus/inferior parietal lobule , and putamen/insula ; in contrast , manual needle manipulation produced prominent decreases of fMRI signals in posterior cingulate , superior temporal gyrus , putamen/insula . CONCLUSION These results indicate that different brain networks are involved during manual and electroacupuncture stimulation . It suggests that different brain mechanisms may be recruited during manual and electroacupuncture OBJECTIVES This survey was undertaken to learn how Traditional Chinese Medicine acupuncturists ' diagnose and treat patients with chronic low back pain in order to develop a st and ardized treatment for a clinical trial of that condition . DESIGN We surveyed a r and omly selected group of 56 acupuncturists in Washington State , USA about styles of  acupuncture they used for treating chronic low back pain , diagnoses made , and key features of treatment for this condition . RESULTS While substantial variability existed among practitioners , there was agreement on several broad features of treatment including : the use of local and distal acupuncture points  ( 86 % of practitioners ) , the use of acupuncture points on the meridians traversing the back ( especially the UB meridian , 90 % ) the use of acupoints determined by palpation ( 82 % ) , the importance of eliciting de qi ( 60 % ) , and of providing up to eight treatments for achieving therapeutic results ( 79 % ) . CONCLUSION The use of practitioner surveys can enhance the systematic development of acupuncture treatment protocol s and should be part of this process in future clinical trials of common conditions In 23 patients with pancreatitis , daily pain for at least 3 months , and no abuse of alcohol , the pain-relieving effect of electroacupuncture ( 13 patients ) or transcutaneous electric nerve stimulation ( TENS ) ( 16 patients ) was studied . In two prospect i ve studies with a cross-over design , active acupuncture was compared with sham acupuncture , and TENS of the segmental points of the pancreas with sham treatment . Neither electroacupuncture nor TENS brought about pain relief that could substitute for or supplement medical treatment BACKGROUND Hot flushes are common and distressing among men with castrational treatment for prostate cancer . Of the few treatments , most have side effects . OBJECTIVE Assess changes in hot flushes of electrostimulated ( EA ) and traditional acupuncture ( TA ) . DESIGN , SETTING , AND PARTICIPANTS Thirty-one men with hot flushes due to prostate cancer treatment were recruited from three urological departments in Sweden , from 2001 to 2004 . INTERVENTION Thirty-one men were r and omized to EA ( 12 needle points , with 4 electrostimulated ) or TA ( 12 needle points ) weekly for 12 wk . MEASUREMENTS PRIMARY OUTCOME number of and distress from hot flushes in 24 h and change in " hot flush score . " Secondary outcome : change in 24-h urine excretion of CGRP ( calcitonin gene-related peptide ) . RESULTS AND LIMITATIONS Twenty-nine men completed the treatment .  Hot flushes per 24 h decreased significantly , from a median of 7.6 ( interquartile range [ IQR ] , 6.0 - 12.3 ) at baseline in the EA group to 4.1 ( IQR , 2.0 - 6.5 ) ( p=0.012 ) after 12 wk , and from 5.7 ( IQR , 5.1 - 9.5 ) in the TA group to 3.4 ( IQR1.8 - 6.3 ) ( p=0.001 ) . Distress by flushes decreased from 8.2 ( IQR , 6.5 - 10.7 ) in the EA group to 3.3 ( IQR , 0.3 - 8.1 ) ( p=0.003 ) , and from 7.6 ( IQR , 4.7 - 8.3 ) to 3.4 ( IQR , 2.0 - 5.6 ) ( p=0.001 ) in the TA group after 12 wk , ( 78 % and 73 % reduction in " hot flush score , " respectively ) . The effect lasted up to 9 mo after treatment ended . CGRP did not change significantly . Few , minor side effects were reported . LIMITATIONS small number of patients ; no placebo control , instead a small group controlled for 6 wk pretreatment . CONCLUSIONS EA and TA lowered number of and distress from hot flushes . The hot flush score decreased 78 % and 73 % , respectively , in line with or better than medical regimens for these symptoms . Acupuncture should be considered an alternative treatment for these symptoms , but further evaluation is needed , preferably with a non- or placebo-treated control group
In the field of acupuncture research there is an implicit yet unexplored assumption that the evidence on manual and electrical stimulation techniques , derived from basic science studies , clinical trials , systematic review s , and meta-analyses , is generally interchangeable .
Such interchangeability would justify a bidirectional approach to acupuncture research , where basic science studies and clinical trials each inform the other .
This article examines the validity of this fundamental assumption by critically review ing the literature and comparing manual to electrical acupuncture in basic science studies , clinical trials , and meta-analyses .
Further , most clinical trials purporting to compare the two types of stimulation have instead tested  electroacupuncture  as an adjunct to manual acupuncture .