Muscular Skeletal

racm woman
More than 6 million Australians (31%) suffer from a chronic muscular skeletal condition (NHS 2004), and the financial burden amounts to more than 4.6 billion each year (AIHW 2004).

The most muscular skeletal common conditions are back pain, osteoarthritis, and rheumatoid arthritis. (NHS 2004), and a recent major report (Arthritis Research 2013), confirmed that acupuncture is the most effective form of complementary therapy for osteoarthritis and lower back pain as well as fibromyalgia.

Chinese medicine theory suggests that certain acupuncture points promote rapid healing of injured sites, including bone fractures, and tears of ligaments, muscles, and tendons. Other acupuncture points are said to reduce joint and soft tissue inflammation and pain, as well as swelling and bruising, and a growing body of research data in sports medicine in the US is explaining these mechanisms (Sfara 2013).

Acupuncture may also be used to relieve deep muscle tension and tightness over the whole body. Multiple areas of the body can usually be addressed in the one session making acupuncture very cost effective (see Acupuncture).

Our team has a great deal of experience treating sporting injuries, and the following muscular skeletal conditions listed in the right-hand menu.

Achilles tendon injuries

Recent research on participants with chronic achilles tendinitis found that participants who received acupuncture demonstrated significantly greater benefit and more rapid recovery compared to participants receiving physiotherapy and exercise therapy alone (Zhang et al., 2013).

Arthritis and Osteoarthritis

A 2013 report from Arthritis Research UK confirmed that acupuncture is the most effective form of complementary therapy for treating osteoarthritis, low back pain, and fibromyalgia (Arthritis Research, 2013).

Our team uses acupuncture and Chinese herbal medicine to relieve the pain of arthritis and reduce risk factors to arthritis continuing to develop. We find overall improvement in quality of life can also be assisted with Chinese medicine diet therapy.

See also Osteoarthritis below.

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Car accident injuries

Anecdotally, our team has found that recovery from car accidents, including healing and pain management, is supported well by acupuncture. There have also been many clinical trials conducted on the use of acupuncture for chronic pain management with promising outcomes (see Chronic Pain). Our team recommends that acupuncture commences as soon as clients are able. However, even in cases where the injury is not recent, response to acupuncture can still be significant.

The most common car accident injury involves the head and this can lead to multiple symptoms that may not respond to medical intervention. Our anecdotal evidence suggests that scalp acupuncture (using very fine superficial needles around the site of trauma on the head) may alleviate head injury symptoms, in a similar wayto scalp acupuncture for post stroke paralysis.

We also find addressing post traumatic stress disorder (PTSD) assists the client to relax deeply and recover more fully, while improving mood, anxiety, insomnia, and a sense of wellbeing and happiness. Other research on PTSD has shown promising results using acupuncture and Chinese herbal medicine, while explaining the mechanism by which these modalities influence mood and anxiety (see also Mental Health).

Carpel Tunnel Syndrome

Early evidence suggests promising results using acupuncture to treat carpel tunnel syndrome. In 2010, one randomised clinical trial concluded that acupuncture reduced pain more effectively than night splinting (Kumnerddee and Kaewtong, 2010).

Our anecdotal evidence suggests that good results are achieved if acupuncture addresses both local hand and wrist pain as well as potential nerve and muscle impingement at the neck (cervical spine), upper back (thoracic), and scapular (shoulder blade).

During pregnancy we progressively monitor risk for carpel tunnel syndrome and address early symptoms to avoid the condition progressing. We have found this approach reduces incidence and severity of carpel tunnel syndrome during pregnancy and post delivery.

Cartilage and meniscus tears (see also Knee Pain)

Our Sydney based team has documented anecdotal evidence over nearly three decades to suggest that acupuncture is a cost effective treatment for meniscus tears, especially when there is no serious ‘fraying’ or ‘shredding’ of the meniscus, indicated by significant ‘locking’ or ‘catching’ of the knee while walking.

Alternatively, we have found that meniscus tears are generally beyond ‘repair’, or normal healing by the time the tearing and ‘shredding’ is significant enough to cause ‘locking’ and ‘catching’. However, if this is not occurring, the prognosis is good, and the cartilage is likely to be able to heal. Improvement after acupuncture is generally obvious after the first session. Our team also recommends appropriate rest and strengthening exercises to support recovery. Certain herbal supplements may also be recommended.

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Fibromyalgia

Currently, there is no effective medical treatment for fibromyalgia, and some of our clients have experienced significant pain for up to 20 years before having acupuncture.

Our anecdotal evidence suggests very promising pain relief and recovery after acupuncture, while early clinical research also looks promising. In 2007, Martin and colleagues conducted a randomised clinical trial showing mixed results but promising outcomes especially when a tailored acupuncture treatment was provided, rather than a 'one size fits all’ standardised treatment.

Earlier, Deluze and colleagues (2004), conducted a study on 20 participants with chronic fibromyalgia who received electroacupuncture and counselling for 12 weeks. The researchers found that seven participants had significant improvement, eleven had moderate improvement,and two participants had only slight improvement after 12 weeks.

Frozen shoulder

A pragmatic, randomised clinical trial in Germany (Molsberger et al., 2010) for chronic shoulder pain showed that acupuncture was more effective for relieving shoulder pain than standard therapy, such as non steroid anti inflammatories (NSAID’s) and physiotherapy.

Our team has much of experience treating shoulder pain and frozen shoulder, and our anecdotal evidence suggests that acupuncture is particularly good at releasing muscle tension under the scapular, compared to other therapies. We find this muscle is often involved in ‘frozen shoulder’ syndromes.

Knee pain (see also Cartilage and Meniscus Tears)

Researchers in Chinese medicine (CM) have conducted many clinical trials on the effectiveness of acupuncture for knee pain, especially associated with osteoarthritis. In several of these randomised clinical trials, acupuncture was found to be more effective than standard care (Corbett et al., 2013.) (Vas and White, 2007) (Berman et al., 2004) (Manheimer, 2007) (White et al., 2007).

Our team offers acupuncture for knee pain related to partial anterior cruciate ligament tear, osteoarthritis, meniscus tear, and patella inflammation.

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Ligaments and tendons (see also Sporting Injuries)

Much of the research conducted on acupuncture for ligament and tendon injuries is conducted in the US because acupuncture is increasingly being used by US sporting professionals and teams (Sfara, 2013).

Our practitioners have experience using acupuncture to support:

  • Recovery after surgery related to ligament and tendon tears,
  • Inflammation and pain related to ligament, tendon and soft tissue injury,
  • Healing and recovery of partial tears to achilles, shoulder rotator cuff, ACL (anterior cruciate ligament), and ‘tennis elbow.’

For example, if a rotator cuff tear is only partially torn rather than fully torn, acupuncture may provide immediate relief while supporting full recovery and healing of the tear. We have found that the benefits are generally apparent after the first treatment.

In Chinese medicine (CM) theory, muscles and ligaments are influenced by the liver qi, blood, and yin. If the liver qi is not flowing smoothly, excessive tightness in the muscles, ligaments, and tendons, as well as higher risk for injury during exercise, is more likely. Consequently, treatment of ligament, tendon, or muscle inflammation, tears, or strains generally involves selecting acupuncture points along the liver channel, as well as on or near the site of injury and pain.

Lower back pain

Lower back pain is the single most significant cause of disability world wide (WHO, 2013). Importantly, a recent systematic review on acute and chronic lower back pain demonstrated that acupuncture provided significantly better relief of lower back pain compared to other therapy, while also being more cost effective. (AACMA 2016)

Our team’s anecdotal evidence suggests that, the earlier acupuncture commences after injury, the more dramatic the relief in lower back pain. TThe The above study also confirms that chronic lower back pain is significantly reduced by acupuncture. Lower back pain may include: herniated discs, sciatica, muscle tightness and spasm, numbness, and nerve impingement.

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Migraines and Headaches (see Gynaecology - Migraines)
Neck Pain

A recent randomised clinical trial, for participants suffering neck pain for six years on average, showed that acupuncture provided a significant reduction in neck pain over a 12 month period compared to conventional standard therapy with NSAIDs (non steroid anti inflammatories) (MacPherson et al., 2013).

There have been a substantial number of clinical trials conducted in Chinese medicine on chronic neck pain, including several systematic reviews and meta-analyses. Most research suggests promising outcomes after acupuncture treatment for both acute and chronic neck pain (Trinh et al., 2006) (Witt et al., 2006) (Fu et al., 2009). Willich and colleagues (2006) also investigated the cost effectiveness of acupuncture and found acupuncture to be a cost effective option for relieving chronic neck pain compared to standard treatment.

Neuropathy and nerve pain (see Fibromyalgia)

Pain involving nerve pathways can be extremely debilitating and distressing. Generally our team provides acupuncture for neuropathy related to shingles, radiation therapy, falls, car accidents, sporting injuries, and surgery. Our anecdotal evidence suggests that after the first acupuncture session, relief from chronic nerve pain can be within 24 hours.

Osteoarthritis

Osteoarthritis is one of the most common conditions studied and treated in Chinese medicine. Below is a list of some of the most robust clinical trials conducted on osteoarthritis, demonstrating promising evidence for the use of acupuncture for this condition:

  1. Corbett and colleagues (2013). Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis.
  2. Vas and White (2007). Evidence from Randomised Clinical Trials on optimal acupuncture treatment for knee osteoarthritis - an exploratory review.
  3. Berman and colleagues (2004). Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Manheimer and colleagues (2007). Meta-analysis: acupuncture of osteoarthritis of the knee.

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Plantar faciitis or heel spurs

Heel spurs, or inflammation of the sole of the foot, is a commonly seen condition in our clinic, first treated more than 20 years ago. Our anecdotal evidence suggests relief often begins after the first acupuncture session. While, to date, there have been few clinical trials measuring the effect of acupuncture on plantar faciitis, a study by Zhang and colleagues (2011) showed some promising evidence of pain relief by acupuncture, and our experience is that for many this may last for well over 20 years after a course of treatment.

Rheumatoid arthritis

Our team enjoys supporting clients suffering from pain and mobility issues because we love helping people and improving quality of life. We use acupuncture to relieve inflammation and pain and recommend an antiinflammatory diet and appropriate exercise to clients suffering rheumatoid arthritis.

There have been many clinical trials conducted on rheumatoid arthritis in Chinese medicine and generally the studies show promising results after a course of acupuncture. Below is a list of systematic reviews that analysed all the studies evaluating acupuncture treatment of rheumatoid arthritis (a meta-analysis) to collect the overall results:

  1. Lee and colleagues (2008). Acupuncture for rheumatoid arthritis: a systematic review.
  2. White and colleagues (2007). Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology (Oxford). 2007; 46(3): 384–390.
  3. Wang and colleagues (2008). Acupuncture for pain relief in patients with rheumatoid arthritis: a systematic review.

Rotator cuff injury (see Ligaments and Tendons)
Shoulder pain (see Frozen Shoulder)
Sporting injuries

Acupuncture is increasingly being used to treat acute and chronic sporting injuries world wide (Meleger and Borg-Stein, 2000), and an exciting development in the treatment of sporting injuries with acupuncture now includes research on the effect of acupuncture on performance, muscle strength, fatigue, and endurance. Further studies measuring the benefits of acupuncture against standard treatment are also showing promising results (Pelham, Holt, and Stalker, 2001).

One study showed that certain acupuncture points increase communication with the central nervous system to reset muscle spindles and restore balance (Sklar, 2009), allowing for quicker recovery from sporting activities while increasing endurance and performance.

Sfara (2013) in her thesis “Acupuncture in Sports Medicine,” lists more than 20 references to studies done predominantly in the US, which is increasingly gaining acceptance by sporting professionals because of the benefits seen on the field and in research. Our team has experience treating professional ballet dancers, world champion kick boxers, league, union and soccer players, swimmers, runners, cyclists, yoga students and teachers, martial arts students, golfers, rowers, kayakers, tennis players, and weight lifters.

Often it is thought that acupuncture works best to relieve pain but, more importantly for athletes, is the emerging evidence of the heightened healing and recovery response that acupuncture initiates that is not matched by other therapies.

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Tennis elbow

A recent systematic review evaluating all robust randomised clinical trials investigating the treatment of lateral elbow pain with acupuncture found that acupuncture and moxibustion showed a significantly higher cure rate than standard procedure, including steroid injections (Gadau et al., 2014).

Tennis elbow is a common complaint that we see especially among local tradesmen and hairdressers because it is most often aggravated by repetitive use. Tennis elbow usually involves inflammation and pain of the lateral epicondyle and the extensor carpi radialis brevis (ECRB). Our team has also found that both neck and thoracic tightness causing nerve impingement is often a compounding factor that needs to be addressed for better outcomes.

References

  1. Arthritis Research (2013) Complementary and alternative therapies report:
    CAT Report [Accessed 12 February 2016].
  2. Deluze C, Bosia L, Zirbs A, et al. Electroacupuncture in fibromyalgia: Results of a controlled trial. BCMJ, Vol. 46, No. 1, January, February 2004, page(s) 21-23 Articles.
  3. Sfara, Melanie, "The Use of Acupuncture in Sports Medicine" (2013). All Graduate Plan B and other Reports. Paper 252.
  4. Yuan, C., Xing, J. & Yan, C. (1989) Observations on clinical therapeutic effect in treating soft tissue injuries. Journal Of Traditional Chinese Medicine, 9 (1), pp. 40–44.
  5. Zhang, B., Zhong, L., Xu, S., Jiang, H. & Shen, J. (2013) Acupuncture for chronic Achilles tendnopathy: a randomized controlled study. Chinese Journal Of Integrative Medicine, 19 (12), pp. 900–904.
  6. Zhang, S.P., Yip, T.-P. & Li, Q.-S. (2011) Acupuncture treatment for plantar fasciitis: a randomized controlled trial with six months follow-up. Evidence-based complementary and alternative medicine: eCAM, 2011, p. 154108.
  7. MacPherson, H., Tilbrook, H.E., Richmond, S.J., Atkin, K., Ballard, K., Bland, M., Eldred, J., Essex, H.N., Hopton, A., Lansdown, H., Muhammad, U., Parrott, S., Torgerson, D., Wenham, A., Woodman, J. & Watt, I. (2013) Alexander Technique Lessons, Acupuncture Sessions or usual care for patients with chronic neck pain (ATLAS): study protocol for a randomised controlled trial. Trials, 14, p. 209.
  8. Molsberger, A.F., Schneider, T., Gotthardt, H. & Drabik, A. (2010) German Randomized Acupuncture Trial for chronic shoulder pain (GRASP) - A pragmatic, controlled, patient-blinded, multi-centre trial in an outpatient care environment. Pain, 151, pp. 146–154.
  9. Gadau, M., Yeung, W.-F., Liu, H., Zaslawski, C., Tan, Y.-S., Wang, F.-C., Bangrazi, S., Chung, K.- F., Bian, Z.-X. & Zhang, S.-P. (2014) Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials. BMC complementary and alternative medicine, 14, p.136.
  10. Hui, K.K.S., Napadow, V., Liu, J., Li, M., Marina, O., Nixon, E.E., Claunch, J.D., LaCount, L., Sporko, T. & Kwong, K.K. (2010) Monitoring acupuncture effects on human brain by FMRI. Journal of visualized experiments : JoVE, (38).
    11. Kumnerddee, W. & Kaewtong, A. (2010) Efficacy of acupuncture versus night splinting for carpal tunnel syndrome: a randomized clinical trial. Journal of the Medical Association of Thailand - Chotmaihet thangphaet, 93 (12), pp.1463–9.
  11. Bizzini, M., Childs, J.D., Piva, S.R. & Delitto, A. (2003) Systematic review of the quality of randomized controlled trials for patellofemoral pain syndrome. The Journal of orthopaedic and sports physical therapy, 33 (1), pp. 4–20.
  12. Callison, M. (2002) Clinical study. Acupuncture and tibial stress syndrome (shin splints). Journal of Chinese Medicine.
  13. Corbett, M.S., Rice, S.J.C., Madurasinghe, V., Slack, R., Faster, D.A., Harden, M., Sutton, A.J., Macpherson, H. & Woolacott, N.F. (2013) Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis and cartilage, OARS, Osteoarthritis Research Society, 21 (9), pp.1290–8.
  14. Australian Bureau of Statistics 2006c, National Health Survey: Summary of Results, Australia, 2004–05, cat. no. 4364.0, ABS, Canberra.
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  19. Sun Y, Gan TJ, Dubose JW, Habib AS. Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. Br J Anaesth. 2008; 101(2): 151–160.
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  23. Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2004; 141(12): 901–910.
  24. Manheimer E, Linde K, Lao L, Bouter LM, Berman BM. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med. 2007; 146(12): 868–877.
  25. White A, Foster NE, Cummings M, Barlas P. Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology (Oxford). 2007; 46(3): 384–390.
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  30. Vas J, Perea-Milla E, Méndez C, et al. Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomised controlled study. Pain. 2006; 126(1–3): 245–255.
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  32. Fu LM, Li JT, Wu WS. Randomized controlled trials of acupuncture for neck pain: systematic review and meta-analysis. J Altern Complement Med. 2009; 15(2): 133–145.
  33. Willich SN, Reinhold T, Selim D, Jena S, Bronchus B, Witt CM. Cost-effectiveness of acupuncture treatment in patients with chronic neck pain. Pain. 2006; 125(1–2): 107–113.
  34. Guerra de Hoyos JA, Andrés Martín Mdel C, Bassas y Baena de Leon E, et al. Randomized trial of long term effect of acupuncture for shoulder pain. Pain. 2004; 112(3): 289–298.
  35. Wong Lit Wan, D 2016, Acupuncture for chronic musculoskeletal pain: the effect of needle placement, pain adaptability and endogenous pain controls, Doctor of Philosophy (PhD), Health and Biomedical Sciences, RMIT University: https://researchbank.rmit.edu.au/view/rmit:161881.
  36. Dina Law Suzanne McDonough, Chris Bleakley, George David Baxter, Steve Tumilty. Laser Acupuncture for Treating Musculoskeletal Pain: A Systematic Review with Meta-analysis. JAMS Journal of Acupuncture and Meridian studies. February 2015 Volume 8, Issue 1, Pages 2–16.

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