In this Issue
White, Adrian
2009-12-01 00:00:00
doi:10.1136/aim.2009.002006 Adrian White Our first two papers and their commen- back pain in which they found significant taries address areas of acupuncture prac- effects of acupuncture in rather small tice that are quite contentious in the samples. The latest careful report by scientific community—stroke and myo- Inoue et al (see page 174) does not give fascial trigger point pain. any clues as to what it is about their Could acupuncture make a real differ- acupuncture needling that is so effective, ence to patients, or would resources be but the results will contribute to the better used on other treatments? overall search for evidence on acupuncture Firstly, in acute stroke, Inoue et al (see and so are welcome. page 155) report observations that electro- Acupuncture is thriving in Brazil. Saad et acupuncture can sometimes lead to al (see page 178) describe how acupuncture immediate improvement in the clinical is already being offered as part of the pain status of patients, and then test for possible service for inpatients, and describe how this mechanisms using MRI (figure 1). The peer differs from an outpatient service. Our reviewers questioned these reports, and the Education and practice section continues authors vigorously defended their state- with Straiton’s essay which combines ment with references (in Chinese). We knowledge about acupuncture mechanisms asked Zhang and colleagues, experts on and theories of cortical development in the acupuncture for stroke in China, to com- child to speculate on the important area of ment (see page 146): they say that sudden acupuncture responders and non-respon- improvement in acute stroke with electro- ders: it may all be due to the mother’s acupuncture has been reported, though Figure 1 Cerebral blood flow (CBF) and nurturing skills in the first 18 months of volume (CBV) after spontaneous stroke in rats. rather rarely, and that resources would be life. Cakmak (page 183) provides another better used in exploring acupuncture’s thought-provoking review, this time of the place in preventing long term sequelae. possible role and mechanisms of electro- little specific value in the acute treatment Secondly, we address that ‘Cinderella’ of acupuncture in an increasing the chance of of facial palsy—which fortunately is often conventional musculoskeletal medicine, cell survival in another increasingly recog- a self-limiting condition. It was interesting myofascial trigger point pain. Though the nised pathological event—heat-shock pro- that recruitment to the study was diffi- concept seems valuable clinically, the teins and apoptosis. cult—in China! Optimists will point to the diagnosis is still fraught with inconsisten- The issue continues with letters on trend towards acupuncture, and argue for cies and problems of definition, and auricular electrostimulation, Sydenham’s another, larger study though it may be evidence is still lacking on whether acu- chorea and peripheral neuropathy, then more profitable to test acupuncture for puncture and other physical treatments summarises recent research including residual defects of those patients who do have specific effects or not. But now Ge et some important studies on the psycholo- not fully recover spontaneously. al (see page 150) have taken the under- gical aspects of acupuncture treatment, This journal’s policy is to encourage standing forward by defining some specific and ends with the notices of meetings so reporting of feasibility studies because the electrical properties of myofascial trigger that readers can plan next year’s learning lessons learned are important for others points that were previously unknown— on this fascinating topic of acupuncture. planning studies. Hughes and colleagues though Cummings’ commentary (see page (see page 163) report such a study on 148) explaining more about the back- Correspondence to: Adrian White, email: info-aim@ acupuncture and reflexology for insomnia ground to the study urges us to be cautious bmjgroup.com which has helped them to plan a full scale in interpreting the work. randomised controlled trial. Competing interests: None. A neat clinical trial from China by Tong The group from Meiji University in et al (see page 169) shows that acupuncture Provenance and peer review: Not commissioned; not joins acyclovir and corticosteroids in having Japan have reported several studies of low externally peer reviewed. Acupunct Med December 2009 Vol 27 No 4 145
http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.pngAcupuncture in MedicineSAGEhttp://www.deepdyve.com/lp/sage/in-this-issue-Vj59y0FDkH
doi:10.1136/aim.2009.002006 Adrian White Our first two papers and their commen- back pain in which they found significant taries address areas of acupuncture prac- effects of acupuncture in rather small tice that are quite contentious in the samples. The latest careful report by scientific community—stroke and myo- Inoue et al (see page 174) does not give fascial trigger point pain. any clues as to what it is about their Could acupuncture make a real differ- acupuncture needling that is so effective, ence to patients, or would resources be but the results will contribute to the better used on other treatments? overall search for evidence on acupuncture Firstly, in acute stroke, Inoue et al (see and so are welcome. page 155) report observations that electro- Acupuncture is thriving in Brazil. Saad et acupuncture can sometimes lead to al (see page 178) describe how acupuncture immediate improvement in the clinical is already being offered as part of the pain status of patients, and then test for possible service for inpatients, and describe how this mechanisms using MRI (figure 1). The peer differs from an outpatient service. Our reviewers questioned these reports, and the Education and practice section continues authors vigorously defended their state- with Straiton’s essay which combines ment with references (in Chinese). We knowledge about acupuncture mechanisms asked Zhang and colleagues, experts on and theories of cortical development in the acupuncture for stroke in China, to com- child to speculate on the important area of ment (see page 146): they say that sudden acupuncture responders and non-respon- improvement in acute stroke with electro- ders: it may all be due to the mother’s acupuncture has been reported, though Figure 1 Cerebral blood flow (CBF) and nurturing skills in the first 18 months of volume (CBV) after spontaneous stroke in rats. rather rarely, and that resources would be life. Cakmak (page 183) provides another better used in exploring acupuncture’s thought-provoking review, this time of the place in preventing long term sequelae. possible role and mechanisms of electro- little specific value in the acute treatment Secondly, we address that ‘Cinderella’ of acupuncture in an increasing the chance of of facial palsy—which fortunately is often conventional musculoskeletal medicine, cell survival in another increasingly recog- a self-limiting condition. It was interesting myofascial trigger point pain. Though the nised pathological event—heat-shock pro- that recruitment to the study was diffi- concept seems valuable clinically, the teins and apoptosis. cult—in China! Optimists will point to the diagnosis is still fraught with inconsisten- The issue continues with letters on trend towards acupuncture, and argue for cies and problems of definition, and auricular electrostimulation, Sydenham’s another, larger study though it may be evidence is still lacking on whether acu- chorea and peripheral neuropathy, then more profitable to test acupuncture for puncture and other physical treatments summarises recent research including residual defects of those patients who do have specific effects or not. But now Ge et some important studies on the psycholo- not fully recover spontaneously. al (see page 150) have taken the under- gical aspects of acupuncture treatment, This journal’s policy is to encourage standing forward by defining some specific and ends with the notices of meetings so reporting of feasibility studies because the electrical properties of myofascial trigger that readers can plan next year’s learning lessons learned are important for others points that were previously unknown— on this fascinating topic of acupuncture. planning studies. Hughes and colleagues though Cummings’ commentary (see page (see page 163) report such a study on 148) explaining more about the back- Correspondence to: Adrian White, email: info-aim@ acupuncture and reflexology for insomnia ground to the study urges us to be cautious bmjgroup.com which has helped them to plan a full scale in interpreting the work. randomised controlled trial. Competing interests: None. A neat clinical trial from China by Tong The group from Meiji University in et al (see page 169) shows that acupuncture Provenance and peer review: Not commissioned; not joins acyclovir and corticosteroids in having Japan have reported several studies of low externally peer reviewed. Acupunct Med December 2009 Vol 27 No 4 145
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