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In this Issue

In this Issue Highlights 1,2 doi:10.1136/acupmed-2016-011059 David John Carr Welcome to our first issue of 2016, Collectively, these reports suggest Other original research in this issue includes another pilot study, from which opens with two RCTs. The there is potential for the future inte- Hesse et al, who demonstrate the first, by Arab et al, which is also this gration of acupuncture and related acceptability of indwelling auricular issue’seditor’s choice, examines the techniques into nephrology, although needles as a method of pain relief in efficacy and effectiveness of acupres- further research is needed. new mothers following elective sure at asinglepoint (HT7)onsleep The second RCT, from Solberg and Caesarean section. If proven effective colleagues, is a pilot that demonstrates quality in renal patients on haemodi- after an adequately powered RCT, the the feasibility of recruitment of alysis relative to sham acupressure anticipated ease of implementation and women with stress and urge (mixed) (equivalent technique applied at a cost-effectiveness of this method urinary incontinence to receive trad- location 0.5 cmaway) andnotreat- would, in my opinion, make it particu- itional acupuncture as an alternative to ment, respectively. Scores on the larly appealing to busy postnatal wards. pelvic floor exercises or remaining on Pittsburgh sleep quality index were Finally, we have preclinical studies in rat a waiting list for medical and/or surgi- significantly improved to some models of tendinopathy, inhibited cal treatment. Like many other studies degree in both the acupressure gastric motility, neuropathic pain and with an untreated group, the loss to groups relative to standard care, traumatic brain injury, all of which follow-up in the waiting list group was reflecting the generalised effects of provide novel mechanistic insights. I am high and this needs to be taken into treatment, however there was a particularly grateful to Almeida et al for account in future definitive trials to notably larger size of effect in the providing the inspiration for this issue’s ensure adequate statistical power. The verum group compared to the sham cover image and extending their previ- acupuncture treatment protocol was group, suggesting that targeting HT7 ous work investigating the processes varied but typically involved needling is advantageous. Having noted the underlying the beneficial effects of acu- segmental to the bladder (T11 to L2 closer proximity of the ulnar nerve at puncture on tendon healing. and S2 to S4 based on the sympathetic this location, the authors consider and parasympathetic innervation, the possibility that a greater degree of Twitter Follow David Carr at respectively) ventrally (eg, CV3, CV4), @IntegrativeMFM somatosensory stimulation may result distally (eg, SP6, KI3, LR3) and/or Competing interests None declared. following application of pressure at dorsally (eg, BL23, BL28, BL31–34). Provenance and peer review Not HT7. This study adds to a growing Sacral neuromodulation is widely commissioned; internally peer reviewed. literature in this subspecialist field accepted for the management of lower and compliments previous controlled urinary tract symptoms and typically REFERENCES involves intermittent peripheral forms investigations of acupressure for 1 2 1 Shariati A, Jahani S, Hooshmand M, of stimulation like percutaneous tibial sleep quality, fatigue and uraemic et al. The effect of acupressure on sleep nerve stimulation (ie, EA at or close to pruritis in patients on haemodialy- quality in hemodialysis patients. SP6), with paraspinal sacral nerve sis. Regular readers of Acupuncture Complement Ther Med 2012;20: stimulation using internalised devices in Medicine may also remember case 417–23. being reserved for longer-term neuro- reports describing the use of acu- 2Eğlence R, Karataş N, Taşci S. The modulation. However, in this issue, puncture for problems such as erect- effect of acupressure on the level of Katayama et al confirm using CT that ile dysfunction, gastroparesis and fatigue in hemodialysis patients. Altern a 50 mm needle inserted directly over hypersexuality in such patients. Ther Health Med 2013;19:23–31. the S2 or S3 foramina at a 60° angle 3 Kiliç Akça N, Taşçi S, Karataş N. Effect comes into close contact with the of acupressure on patients in Turkey sacral nerve roots and could be used to Institute for Medical and Biomedical Education, St receiving hemodialysis treatment for George’s University of London, London, UK; Royal apply electrical stimulation through a uremic pruritus. Altern Ther Health London Hospital for Integrated Medicine, University relatively less invasive approach. From Med 2013;19:12–18. College London Hospitals NHS Trust, London, UK a safety perspective, they advise against 4 Yamanishi T, Kaga K, Fuse M, et al. Correspondence to Dr David John Carr, Institute deep needling over the S4 foramina as Neuromodulation for the treatment of of Medical and Biomedical Education, St George’s, needles came into close proximity lower urinary tract symptoms. Low Urin University of London, Cranmer Terrace, London with the rectum (6 mm). Tract Symptoms 2015;7:121–32. SW17 0RE, UK; davidcarr@doctors.org.uk Carr DJ. Acupunct Med 2016;34:1. doi:10.1136/acupmed-2016-011059 1 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acupuncture in Medicine SAGE

In this Issue

Carr, David John
Acupuncture in Medicine , Volume 34 (1): 1 – Feb 1, 2016
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Publisher
SAGE
Copyright
© 2016 British Medical Acupuncutre Society
ISSN
0964-5284
eISSN
1759-9873
DOI
10.1136/acupmed-2016-011059
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Abstract

Highlights 1,2 doi:10.1136/acupmed-2016-011059 David John Carr Welcome to our first issue of 2016, Collectively, these reports suggest Other original research in this issue includes another pilot study, from which opens with two RCTs. The there is potential for the future inte- Hesse et al, who demonstrate the first, by Arab et al, which is also this gration of acupuncture and related acceptability of indwelling auricular issue’seditor’s choice, examines the techniques into nephrology, although needles as a method of pain relief in efficacy and effectiveness of acupres- further research is needed. new mothers following elective sure at asinglepoint (HT7)onsleep The second RCT, from Solberg and Caesarean section. If proven effective colleagues, is a pilot that demonstrates quality in renal patients on haemodi- after an adequately powered RCT, the the feasibility of recruitment of alysis relative to sham acupressure anticipated ease of implementation and women with stress and urge (mixed) (equivalent technique applied at a cost-effectiveness of this method urinary incontinence to receive trad- location 0.5 cmaway) andnotreat- would, in my opinion, make it particu- itional acupuncture as an alternative to ment, respectively. Scores on the larly appealing to busy postnatal wards. pelvic floor exercises or remaining on Pittsburgh sleep quality index were Finally, we have preclinical studies in rat a waiting list for medical and/or surgi- significantly improved to some models of tendinopathy, inhibited cal treatment. Like many other studies degree in both the acupressure gastric motility, neuropathic pain and with an untreated group, the loss to groups relative to standard care, traumatic brain injury, all of which follow-up in the waiting list group was reflecting the generalised effects of provide novel mechanistic insights. I am high and this needs to be taken into treatment, however there was a particularly grateful to Almeida et al for account in future definitive trials to notably larger size of effect in the providing the inspiration for this issue’s ensure adequate statistical power. The verum group compared to the sham cover image and extending their previ- acupuncture treatment protocol was group, suggesting that targeting HT7 ous work investigating the processes varied but typically involved needling is advantageous. Having noted the underlying the beneficial effects of acu- segmental to the bladder (T11 to L2 closer proximity of the ulnar nerve at puncture on tendon healing. and S2 to S4 based on the sympathetic this location, the authors consider and parasympathetic innervation, the possibility that a greater degree of Twitter Follow David Carr at respectively) ventrally (eg, CV3, CV4), @IntegrativeMFM somatosensory stimulation may result distally (eg, SP6, KI3, LR3) and/or Competing interests None declared. following application of pressure at dorsally (eg, BL23, BL28, BL31–34). Provenance and peer review Not HT7. This study adds to a growing Sacral neuromodulation is widely commissioned; internally peer reviewed. literature in this subspecialist field accepted for the management of lower and compliments previous controlled urinary tract symptoms and typically REFERENCES involves intermittent peripheral forms investigations of acupressure for 1 2 1 Shariati A, Jahani S, Hooshmand M, of stimulation like percutaneous tibial sleep quality, fatigue and uraemic et al. The effect of acupressure on sleep nerve stimulation (ie, EA at or close to pruritis in patients on haemodialy- quality in hemodialysis patients. SP6), with paraspinal sacral nerve sis. Regular readers of Acupuncture Complement Ther Med 2012;20: stimulation using internalised devices in Medicine may also remember case 417–23. being reserved for longer-term neuro- reports describing the use of acu- 2Eğlence R, Karataş N, Taşci S. The modulation. However, in this issue, puncture for problems such as erect- effect of acupressure on the level of Katayama et al confirm using CT that ile dysfunction, gastroparesis and fatigue in hemodialysis patients. Altern a 50 mm needle inserted directly over hypersexuality in such patients. Ther Health Med 2013;19:23–31. the S2 or S3 foramina at a 60° angle 3 Kiliç Akça N, Taşçi S, Karataş N. Effect comes into close contact with the of acupressure on patients in Turkey sacral nerve roots and could be used to Institute for Medical and Biomedical Education, St receiving hemodialysis treatment for George’s University of London, London, UK; Royal apply electrical stimulation through a uremic pruritus. Altern Ther Health London Hospital for Integrated Medicine, University relatively less invasive approach. From Med 2013;19:12–18. College London Hospitals NHS Trust, London, UK a safety perspective, they advise against 4 Yamanishi T, Kaga K, Fuse M, et al. Correspondence to Dr David John Carr, Institute deep needling over the S4 foramina as Neuromodulation for the treatment of of Medical and Biomedical Education, St George’s, needles came into close proximity lower urinary tract symptoms. Low Urin University of London, Cranmer Terrace, London with the rectum (6 mm). Tract Symptoms 2015;7:121–32. SW17 0RE, UK; davidcarr@doctors.org.uk Carr DJ. Acupunct Med 2016;34:1. doi:10.1136/acupmed-2016-011059 1

Journal

Acupuncture in Medicine – SAGE

Published: Feb 1, 2016

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