Acupuncture for Acne

Acne – Condition Resources

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

Approx. 15 in 1,000 people in UK suffer with acne, but for most, the exact cause is unknown.

Research and Resources on Acne and Acupuncture:

A scholarly search on “acne” + “acupuncture” reveals over 1,800 papers, and narrowing to Randomised Controlled Trials (RCT’s) reveals over 640 results (Google Scholar). This suggests that acupuncture is being used traditionally and currently in this area, and that it has been recognised there is a need to research it a scientific manner.

The British Acupuncture Council have produced an evidence-based factsheet on acne and acupuncture research, including details of the research studies done (link below) and you can also find and read the original research from this resource.

Any research articles referred to on this page (and on the BAcC helpsheets) are listed in full in the References section at the foot of the relevant page.  Within the text, where studies are quoted as sources of the information being given, the first author’s name and the year of the paper is used (as authors usually have numerous publications), with the full title, journal, etc listed in the References section, in alphabetical order by Author surname to enable identifying and finding the original source paper.

About the research:

When reading health research, it is important to know that Systematic Reviews** or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms.  The next best level of evidence is the individual Randomised Controlled Study* (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment).  In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.

The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control).  Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.

The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.

Regarding Your Individual Condition and Symptoms:

Whilst the scientific studies are of great interest to researchers and acupuncturists in terms of comparing protocols, for the patient not versed in research they are less accessible, which is why when we asked “can acupuncture work for my (condition or symptom) we are not able to give a simple yes or no response, we are able to tell you in the decades of experience we personally have at the clinic of the types of outcomes we have seen in similar cases, and give you an idea of our level of experience and knowledge in that area, which is why the research data do not tell the whole story and if you want to find out more specific information in how this could relate to your own individual situation, we recommend booking a free telephone consultation where we can answer any questions you have and give a realistic appraisal of what acupuncture may be able to provide.

Resources: British Acupuncture Council evidence based factsheet about acne including specific research, trials and mechanisms of action for acupuncture in this condition.

Helen
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Is acupuncture just a placebo?

We are always happy to answer any questions that people put to us about acupuncture. One of the ones that used to take me by surprise was “but it’s just a placebo, right?”
Really? What a question. I was surprised to consider it possible that anyone would believe that an entire profession, training colleges, regulatory boards and research bodies would be built on a treatment that was placebo. Where would the ethics and justification come from? Why would acupuncture still exist?
Read More Is acupuncture just a placebo?

Helen
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Shaftesbury Clinic Star of Conditions

Visual Disorders – Condition Resources

Page under construction

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

References:

Helen
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Acupuncture for Tennis and Golfer's Elbow

Tennis & Golfers Elbow – Condition Resources

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

Chronic Pain in General

“Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain”. (Vickers et al, 2018: large chronic pain review of high quality RCTs updating a previous meta-analysis; 39 trials, n=20827; conditions addressed chronic headache, back/neck pain and osteoarthritis)

Another recent overview (Yin et al, 2017) confirms that there is increasing evidence for acupuncture  as an effective, safe, and cost-effective intervention in chronic low back, neck, shoulder, and knee pain, as well as headaches.

The NHS body in charge of which treatments should be used in particular conditions recommends acupuncture for chronic pain:  The NICE Scenario Management guidelines (2021) for chronic pain state: “consider a course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system”

Overall, a large systematic review has found acupuncture a cost effective intervention for several painful conditions (Ambrósio et al, 2012).

Tennis Elbow

The British Acupuncture Council has a Research digest where they examined some recent studies on lateral elbow pain, as well as an evidence based factsheet (tennis elbow – links are below), finding promising evidence in the field.   

Gadau et al, (2014) conducted a systematic review of 19 RCTs of varying quality were examined, and overall the evidence suggested acupuncture was more effective than sham control.  Tang et al (2015) looed at a smaller number of RCT and were more tentative about the outcomes due to concern over trial designs and highlighted a need for further research.

Recent small trials include one comparing acupuncture and manipulation (n=35; Hsu et al, 2016) in which both groups experienced improvement in pain and function.  Another looked at ultrasound imaging of the affected tendon to evaluate acupuncture’s effect, finding reduction of tendon thickness after 10 sessions as well as improvement in pain scores (Ural et al 2017; n-41).  A further trial (Wong  et al, 2017; n=34) compared acupuncture and extracorporeal shockwave therapy (ESWT), finding a trend of improvement in pain scores in both groups.

Mechanisms of Action

Acupuncture stimulates the body to create its own natural painkilling substances, such as Beta Endorphins (β-Endorphin). In studies acupuncture has been shown to stimulate the production of natural painkillers called opioid-like peptides (OLPs), including β-Endorphin: For example, this was shown in an RCT in 90 patients with a range of painful disorders (Petti et al, 1998). The same study showed acupuncture also and enhanced the activity of immune cells (lymphocytes, natural killer cells and monocytes) that help fight infections and diseases (Petti et al, 1998).

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

Resources:

British Acupuncture Council (BAcC) evidence based factsheet about Tennis and Golfers Elbow including specific research, trials and mechanisms of action for acupuncture in this condition.

BAcC Sports Injuries Factsheet

BAcC Research Digest

References:

General Chronic Pain References:

Ambrósio, E.M.M., Bloor, K. and MacPherson, H., 2012. Costs and consequences of acupuncture as a treatment for chronic pain: a systematic review of economic evaluations conducted alongside randomised controlled trials. Complementary therapies in medicine, 20(5), pp.364-374.

Vickers, A.J., Vertosick, E.A., Lewith, G., MacPherson, H., Foster, N.E., Sherman, K.J., Irnich, D., Witt, C.M., Linde, K. and Acupuncture Trialists’ Collaboration, 2018. Acupuncture for chronic pain: update of an individual patient data meta-analysis. The Journal of Pain, 19(5), pp.455-474.

Birch, S., Lee, M.S., Alraek, T. and Kim, T.H., 2018. Overview of treatment guidelines and clinical practical guidelines that recommend the use of acupuncture: a bibliometric analysis. The Journal of Alternative and Complementary Medicine24(8), pp.752-769.

NICE 2021 Chronic pain: Scenario: Management Last revised in April 2021

Petti, F.., Bangrazi, A., Liguori, A., Reale, G. and Ippoliti, F., 1998. Effects of acupuncture on immune response related to opioid-like peptides. Journal of Traditional Chinese Medicine 18(1), pp.55-63.

Yin, C., Buchheit, T.E. and Park, J.J., 2017. Acupuncture for chronic pain: an update and critical overview. Current opinion in anaesthesiology30(5), pp.583-592.

Tennis Elbow References:

Gadau, M., Yeung, W.F., Liu, H., Zaslawski, C., Tan, Y.S., Wang, F.C., Bangrazi, S., Chung, K.F., Bian, Z.X. and Zhang, S.P., 2014. Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials. BMC Complementary and Alternative Medicine14(1), pp.1-19.

Tang, H., Fan, H., Chen, J., Yang, M., Yi, X., Dai, G., Chen, J., Tang, L., Rong, H., Wu, J. and Liang, F., 2015. Acupuncture for lateral epicondylitis: a systematic review. Evidence-based complementary and alternative medicine2015.

Hsu, C.Y., Lee, K.H., Huang, H.C., Chang, Z.Y., Chen, H.Y. and Yang, T.H., 2016. Manipulation therapy relieved pain more rapidly than acupuncture among lateral epicondylalgia (tennis elbow) patients: a randomized controlled trial with 8-week follow-up. Evidence-Based Complementary and Alternative Medicine2016.

Ural, F.G., Öztürk, G.T., Bölük, H. and Akkuş, S., 2017. Ultrasonographic evaluation of acupuncture effect on common extensor tendon thickness in patients with lateral epicondylitis: a randomized controlled study. The Journal of Alternative and Complementary Medicine23(10), pp.819-822.

Wong, C.W.Y., Ng, E.Y.L., Fung, P.W., Mok, K.M., Yung, P.S.H. and Chan, K.M., 2017. Comparison of treatment effects on lateral epicondylitis between acupuncture and extracorporeal shockwave therapy. Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology7, pp.21-26.

Helen
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Shaftesbury Clinic Star of Conditions

Sports injuries, performance & Stamina – Condition Resources

Page under construction

See also Tennis/Golfer’s Elbow, MusculoSkeletal (MSK), Painful Conditions, Joints

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

Mechanisms of Action

Acupuncture stimulates the body to create its own natural painkilling substances, such as Beta Endorphins (β-Endorphin). In studies acupuncture has been shown to stimulate the production of natural painkillers called opioid-like peptides (OLPs), including β-Endorphin: For example, this was shown in an RCT in 90 patients with a range of painful disorders (Petti et al, 1998). The same study showed acupuncture also and enhanced the activity of immune cells (lymphocytes, natural killer cells and monocytes) that help fight infections and diseases (Petti et al, 1998).

References:

Petti, F.., Bangrazi, A., Liguori, A., Reale, G. and Ippoliti, F., 1998. Effects of acupuncture on immune response related to opioid-like peptides. Journal of Traditional Chinese Medicine 18(1), pp.55-63.

Helen
0 comment