Trigger Point Acupuncture and Exercise for Chronic Low Back Pain in Older Adult: a Preliminary Randomized Clinical Trial

Yoichi Minakawa^1,2,*, Shogo Miyazaki^1,2, Hideaki Waki^1,2, Naruto Yoshida^1,2, Kaori Iimura³, Kazunori Itoh⁴

J Acupunct Meridian Stud 2022; 15(2): 143-151 https://doi.org/10.51507/j.jams.2022.15.2.143

Background: Exercise therapy is the first choice non-pharmacotherapeutic approach for musculoskeletal pain; however, it often interferes with the implementation and continuation of exercise due to fear-avoidance behaviors. Trigger point acupuncture (TrPAcp) has been reported to reduce musculoskeletal pain.Objectives: To examine the efficacy of exercise combined with TrPAcp compared to exercise alone for older patients with chronic low back pain (CLBP), the most common subjective symptom reported by old people of both sexes in Japan.Methods: In this single-center randomized controlled trial conducted at Teikyo Heisei University, 15 men and women aged ≥ 65 years with low back pain for at least 3 months who met the eligibility criteria were included. The Ex+TrPAcp group received exercise and trigger point acupuncture, while the Ex group received only exercise for 3 months. The main outcome, pain intensity, was measured using the numerical rating scale (NRS). Improvement was defined as a decrease in NRS of ≥ 2 or less than moderate (NRS < 4).Results: The analysis included 7 of 8 cases in the Ex+TrPAcp group and 7 of 7 cases in the Ex group. NRS improved in 6 of 7 and 1 of 7 patients in the intervention and control groups, respectively, with a significant difference between groups (p = 0.03, φ = 0.71). Regarding adverse events due to acupuncture, one patient (14.3%) complained of heaviness after acupuncture. Nothing specific was reported with exercise.Conclusion: Compared with Ex alone, Ex+TrPAcp may be more effective therapy for older people with CLBP who do not have an exercise habit.

Correlation Between the Sinew Channels with the Myofascial System, Pathology, and Treatment

Pablo Nava Jaimes*, Alejandro Martínez Reyes, Daniel García Lara, Abel Cristian Patiño Coyuca

J Acupunct Meridian Stud 2022; 15(4): 201-213 https://doi.org/10.51507/j.jams.2022.15.4.201

The sinew channels are a tendon and muscle network, and their description is based on the observation presented on the Huangdi Neijing Ling Shu. However, the myofascial system is an uninterrupted series of connective tissue that is comprised of layers that run in different directions. The similarities on these pathways are compared, such as a brief description on the myofascial pain syndrome and its similitude with the Impediment disorder from the Traditional Chinese Medicine (TCM). Furthermore, we discuss the treatment of these conditions from a Traditional Chinese Medicine perspective.

Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial

Marianna de Melo Salemi^1,*, Vanessa Maria da Silva Alves Gomes¹, Laylla Marjorye Rebouças Bezerra¹, Thania Maion de Souza Melo¹, Geisa Guimarães de Alencar¹, Iracema Hermes Pires de Mélo Montenegro², Alessandra Paula de Melo Calado³, Eduardo José Nepomuceno Montenegro¹, Gisela Rocha de Siqueira¹

J Acupunct Meridian Stud 2021; 14(6): 219-230 https://doi.org/10.51507/j.jams.2021.14.6.219

Background: Cupping therapy is used to treat musculoskeletal conditions, including low back pain.Objectives: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. Methods: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen̓s d. Results: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference: –2.36; standard error [SE]: 0.58; p < 0.001; “large” effect size: –0.94) and follow up (mean difference: –1.71; SE: 0.81; p < 0.042; ‘large’ effect size: –0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference: –4.68; SE: 1.85; p: 0.017; ‘large’ effect size: –0.87), although in follow-up, there was no difference between the groups (mean difference: 4.16; SE: 2.97; p: 0.17; “medium” effect size: –0.70). Conclusion: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.

Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial

Marianna de Melo Salemi^1,*, Vanessa Maria da Silva Alves Gomes¹, Laylla Marjorye Rebouças Bezerra¹, Thania Maion de Souza Melo¹, Geisa Guimarães de Alencar¹, Iracema Hermes Pires de Mélo Montenegro², Alessandra Paula de Melo Calado³, Eduardo José Nepomuceno Montenegro¹, Gisela Rocha de Siqueira¹

J Acupunct Meridian Stud 2021; 14(6): 219-230 https://doi.org/10.51507/j.jams.2021.14.6.219

Background: Cupping therapy is used to treat musculoskeletal conditions, including low back pain.Objectives: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. Methods: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen̓s d. Results: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference: –2.36; standard error [SE]: 0.58; p < 0.001; “large” effect size: –0.94) and follow up (mean difference: –1.71; SE: 0.81; p < 0.042; ‘large’ effect size: –0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference: –4.68; SE: 1.85; p: 0.017; ‘large’ effect size: –0.87), although in follow-up, there was no difference between the groups (mean difference: 4.16; SE: 2.97; p: 0.17; “medium” effect size: –0.70). Conclusion: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.

Correlation Between the Sinew Channels with the Myofascial System, Pathology, and Treatment

Pablo Nava Jaimes*, Alejandro Martínez Reyes, Daniel García Lara, Abel Cristian Patiño Coyuca

J Acupunct Meridian Stud 2022; 15(4): 201-213 https://doi.org/10.51507/j.jams.2022.15.4.201

The sinew channels are a tendon and muscle network, and their description is based on the observation presented on the Huangdi Neijing Ling Shu. However, the myofascial system is an uninterrupted series of connective tissue that is comprised of layers that run in different directions. The similarities on these pathways are compared, such as a brief description on the myofascial pain syndrome and its similitude with the Impediment disorder from the Traditional Chinese Medicine (TCM). Furthermore, we discuss the treatment of these conditions from a Traditional Chinese Medicine perspective.

Trigger Point Acupuncture and Exercise for Chronic Low Back Pain in Older Adult: a Preliminary Randomized Clinical Trial

Yoichi Minakawa^1,2,*, Shogo Miyazaki^1,2, Hideaki Waki^1,2, Naruto Yoshida^1,2, Kaori Iimura³, Kazunori Itoh⁴

J Acupunct Meridian Stud 2022; 15(2): 143-151 https://doi.org/10.51507/j.jams.2022.15.2.143

Background: Exercise therapy is the first choice non-pharmacotherapeutic approach for musculoskeletal pain; however, it often interferes with the implementation and continuation of exercise due to fear-avoidance behaviors. Trigger point acupuncture (TrPAcp) has been reported to reduce musculoskeletal pain.Objectives: To examine the efficacy of exercise combined with TrPAcp compared to exercise alone for older patients with chronic low back pain (CLBP), the most common subjective symptom reported by old people of both sexes in Japan.Methods: In this single-center randomized controlled trial conducted at Teikyo Heisei University, 15 men and women aged ≥ 65 years with low back pain for at least 3 months who met the eligibility criteria were included. The Ex+TrPAcp group received exercise and trigger point acupuncture, while the Ex group received only exercise for 3 months. The main outcome, pain intensity, was measured using the numerical rating scale (NRS). Improvement was defined as a decrease in NRS of ≥ 2 or less than moderate (NRS < 4).Results: The analysis included 7 of 8 cases in the Ex+TrPAcp group and 7 of 7 cases in the Ex group. NRS improved in 6 of 7 and 1 of 7 patients in the intervention and control groups, respectively, with a significant difference between groups (p = 0.03, φ = 0.71). Regarding adverse events due to acupuncture, one patient (14.3%) complained of heaviness after acupuncture. Nothing specific was reported with exercise.Conclusion: Compared with Ex alone, Ex+TrPAcp may be more effective therapy for older people with CLBP who do not have an exercise habit.