Hiroshi Kitakoji

Trigger point acupuncture treatment of chronic low back pain in elderly patients – a blinded RCT

Objective There is some evidence for the efficacy of acupuncture in chronic low back pain, but it remains unclear which acupuncture modes are most effective. Our objective was to evaluate the effects of two different modes of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared to standard acupuncture treatment. Methods Thirty five consecutive out-patients (25 women, 10 men; age range: 65–81 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to one of three groups over 12 weeks. Each group received two phases of acupuncture treatment with an interval between them. Nine patients dropped out during the course of the study. The standard acupuncture group (n=9) received treatment at traditional acupuncture points for low back pain, while the other acupuncture groups received superficial (n=9) or deep (n=9) treatments on trigger points. Outcome measures were VAS pain intensity and Roland Morris Questionnaire. Results After treatment, the group that received deep needling to trigger points reported less pain intensity and improved quality of life compared to the standard acupuncture group or the group that received superficial needling to trigger points, but the differences were not statistically significant. There was a significant reduction in pain intensity between the treatment and interval in the group that received deep needling to trigger points (P<0.01), but not in the standard acupuncture group or the group that received superficial needling to trigger points. Conclusion These results suggest that deep needling to trigger points may be more effective in the treatment of low back pain in elderly patients than either standard acupuncture therapy, or superficial needling to trigger points.

Effects of trigger point acupuncture on chronic low back pain in elderly patients – a sham-controlled randomised trial

Introduction There is some evidence for the efficacy of acupuncture, but it remains unclear whether trigger point acupuncture is effective. Our objective was to evaluate the effects of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared with sham acupuncture. Methods Twenty-six consecutive out-patients (17 women, 9 men; age range: 65–91 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to two groups. Each group received one phase of trigger point acupuncture and one of sham acupuncture with a three week washout period between them, over 12 weeks. Group A (n=13) received trigger point acupuncture in the first phase and sham acupuncture in the second. Group B (n=13) received the same interventions in the reverse order. Outcome measures were pain intensity (visual analogue scale, VAS) and Roland Morris Questionnaire. Results Nineteen patients were included in the analysis. At the end of the first treatment phase, group A receiving trigger point acupuncture scored significantly lower VAS (P<0.001) and Roland Morris Questionnaire scores (P<0.01) than the sham control group. There were significant within-group reductions in pain in both groups during the trigger point acupuncture phase but not in the sham treatment phase. However, the beneficial effects were not sustained. Conclusion These results suggest that trigger point acupuncture may have greater short term effects on low back pain in elderly patients than sham acupuncture.

A pilot study on using acupuncture and transcutaneous electrical nerve stimulation (TENS) to treat knee osteoarthritis (OA)

BackgroundThe present study tests whether a combined treatment of acupuncture and transcutaneous electrical nerve stimulation (TENS) is more effective than acupuncture or TENS alone for treating knee osteoarthritis (OA).MethodsThirty-two patients with knee OA were randomly allocated to four groups. The acupuncture group (ACP) received only acupuncture treatment at selected acupoints for knee pain; the TENS group (TENS) received only TENS treatment at pain areas; the acupuncture and TENS group (A&T) received both acupuncture and TENS treatments; the control group (CT) received topical poultice (only when necessary). Each group received specific weekly treatment five times during the study. Outcome measures were pain intensity in a visual analogue scale (VAS) and knee function in terms of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).ResultsThe ACP, TENS and A&T groups reported lower VAS and WOMAC scores than the control group. Significant reduction in pain intensity (P = 0.039) and significant improvement in knee function (P = 0.008) were shown in the A&T group.ConclusionCombined acupuncture and TENS treatment was effective in pain relief and knee function improvement for the sampled patients suffering from knee OA.

Effects of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion: preliminary results.

Abstract  Background:  The present study was designed to reveal the usefulness of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion as evaluated by symptom scores, transrectal ultrasonography (TRUS) and magnetic resonance (MR) venography.

The influence of aging on renal blood flow in human beings.

Object: We studied the relationship between age and renal blood flow parameters to determine the clinical significance of using Doppler color flow imaging (CFI) in their measurement.Subjects and Methods: One hundred forty-four healthy subjects with no renal or circulatory diseases took part in this study. All subjects were placed in the prone position and examined with CFI. The kidney was visualized in a longitudinal view, and blood flow in the interlobar arteries was studied. Peak systolic flow velocity (Vmax), end-diastolic flow velocity (Vmin), and resistive index (RI) were used as blood flow parameters.Results: Age and Vmax were not significantly associated (p=0.03) in the interlobar artery. Vmin decreased significantly (p<0.01) with age, while RI increased significantly (p<0.01) with age. No statistically significant sex-related renal blood flow parameters were found.Discussion: Ishimura et al have reported that RI was significantly correlated with age in diabetic patients. Here the same result was obtained in healthy subjects. The incidence of arteriosclerosis is known to increase with age. In general, RI is influenced by vascular resistance. Increase in RI with age in this study was explained by the effect of arteriosclerosis on age-related vascular resistance. These results suggest that age should be considered in the study of blood flow in the kidney.